Background:Gastric and esophageal cancers are among the most lethal malignancies worldwide, necessitating improved biomarkers and therapeutic targets to improve patient outcomes. Visfatin, also known as nicotinamide phosphoribosyltransferase (NAMPT), is a metabolic enzyme and adipokine with emerging significance in cancer progression. It has been implicated in tumor cell proliferation, angiogenesis, immune modulation, and chemotherapy resistance, yet its clinical relevance in upper gastrointestinal (GI) cancers remains unclear. This review aims to explore visfatin’s biochemical properties, its role in the pathogenesis of upper GI cancers, and its implications for potential therapeutic interventions.Methods: A comprehensive review of the literature was conducted to evaluate the role of visfatin in gastric and esophageal cancer. We analyzed studies investigating visfatin expression in tumor tissues, blood, and adipose tissue, its prognostic significance, and its potential as a therapeutic target. Preclinical and clinical studies evaluating visfatin inhibitors were also reviewed.Results: Visfatin promotes tumor progression through the activation of key oncogenic pathways leading to increased angiogenesis, epithelial–mesenchymal transition (EMT), and immune suppression. Elevated visfatin levels are associated with advanced tumor stage, reduced response to chemotherapy, and poor prognosis in both gastric and esophageal cancers. Therapeutic agents targeting visfatin, such as the inhibitor FK866, have shown promising results in reducing tumor proliferation by >50%, improving chemoresistance, and restoring antitumor immunity in preclinical studies. However, clinical translation remains limited due to toxicity concerns and the need for more targeted therapies.Conclusions: Visfatin is a promising biomarker and potential therapeutic target in gastric and esophageal cancer. However, its precise role and mechanisms require further investigation. The standardization of measurement techniques and large-scale clinical studies is needed to validate its prognostic and predictive value. Future research should focus on optimizing visfatin-targeted therapies, particularly in the context of obesity-associated malignancies and chemoresistant tumors.
背景：胃癌和食管癌是全球范围内致死率最高的恶性肿瘤之一，亟需改进生物标志物和治疗靶点以改善患者预后。内脂素，亦称烟酰胺磷酸核糖转移酶（NAMPT），是一种代谢酶和脂肪因子，在癌症进展中的重要性日益凸显。该分子与肿瘤细胞增殖、血管生成、免疫调节及化疗耐药性密切相关，但其在上消化道癌症中的临床意义尚未明确。本综述旨在探讨内脂素的生化特性、其在上消化道癌症发病机制中的作用及其对潜在治疗干预的启示。 方法：通过系统性文献回顾评估内脂素在胃癌和食管癌中的作用。我们分析了探究内脂素在肿瘤组织、血液及脂肪组织中表达的研究，评估其预后意义及作为治疗靶点的潜力，并对评估内脂素抑制剂的临床前及临床研究进行了综述。 结果：内脂素通过激活关键致癌通路促进肿瘤进展，导致血管生成增加、上皮-间质转化（EMT）及免疫抑制。在胃癌和食管癌中，内脂素水平升高与肿瘤晚期分期、化疗反应降低及不良预后相关。靶向内脂素的治疗药物（如抑制剂FK866）在临床前研究中显示出良好效果，可降低超过50%的肿瘤增殖率、改善化疗耐药性并恢复抗肿瘤免疫力。然而，由于毒性问题及对更具靶向性疗法的需求，其临床转化仍受限。 结论：内脂素是胃癌和食管癌领域具有前景的生物标志物和潜在治疗靶点。但其确切作用机制仍需深入研究。需要建立标准化的检测技术并开展大规模临床研究以验证其预后及预测价值。未来研究应聚焦于优化靶向内脂素的治疗策略，特别是在肥胖相关恶性肿瘤及化疗耐药肿瘤中的应用。
The Role of Visfatin in Gastric and Esophageal Cancer: From Biomarker to Therapeutic Target
肿瘤(癌症)患者之家