文章：

烟草致癌物及其生物标志物与烟草诱发的癌症

Tobacco carcinogens, their biomarkers and tobacco-induced cancer

原文发布日期：2003-12-01

DOI: 10.1038/nrc1190

类型: Review Article

开放获取: 否

要点：

1. Tobacco products cause a variety of cancers, including those of the lung, oral cavity, nasal cavity, larynx, oropharynx, hypopharynx, oesophagus, stomach, liver, pancreas, bladder, ureter, kidney and cervix, and myeloid leukaemia. The carcinogens contained in tobacco products are responsible for these cancers.
2. There are more than 60 carcinogens in cigarette smoke and at least 16 in unburned tobacco. Among these, tobacco-specific nitrosamines (such as 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK) and N′-nitrosonornicotine (NNN)), polycyclic aromatic hydrocarbons (such as benzo[a]pyrene) and aromatic amines (such as 4-aminobiphenyl) seem to have an important role as causes of cancer.
3. Carcinogen biomarkers — DNA adducts, protein adducts and urinary metabolites — provide objective measures of carcinogen uptake and metabolic activation and detoxification in people who use, or are otherwise exposed to, tobacco products.
4. DNA adducts are central to the carcinogenic process as induced by tobacco products.
5. Among carcinogen biomarkers, DNA adducts potentially provide the most direct link to cancer, but there are still significant measurement problems. Protein adducts are useful alternatives to DNA adducts, and in some cases have provided significant mechanistic insights. Urinary metabolites are probably the most practical biomarkers and provide important information about carcinogen dose and metabolism.
6. Carcinogen biomarkers are important in establishing carcinogen dose in people who are exposed to tobacco products and in understanding mechanisms of carcinogenesis, and might ultimately be useful in predicting cancer risk.

要点翻译：

1. 烟草制品可引发多种癌症，包括肺癌、口腔癌、鼻腔癌、喉癌、口咽癌、下咽癌、食管癌、胃癌、肝癌、胰腺癌、膀胱癌、输尿管癌、肾癌及宫颈癌，以及髓系白血病。烟草制品中含有的致癌物是导致这些癌症的元凶。
2. 卷烟烟雾中含有60多种致癌物，未燃烧烟草中至少存在16种。其中，烟草特有亚硝胺（如4-（甲基亚硝胺基）-1-（3-吡啶基）-1-丁酮（NNK）和N'-亚硝基降烟碱（NNN））、多环芳烃（如苯并[a]芘）和芳香胺（如4-氨基联苯）在致癌过程中似乎起着重要作用。
3. 致癌物生物标志物——DNA加合物、蛋白质加合物和尿液代谢物——为烟草制品使用者或其他接触者提供了客观衡量致癌物吸收、代谢活化和解毒的指标。
4. DNA加合物是烟草制品诱发致癌过程的核心环节。
5. 在致癌物生物标志物中，DNA加合物可能与癌症存在最直接关联，但其测量仍存在重大挑战。蛋白质加合物是DNA加合物的有效替代指标，在某些情况下能提供重要的机制性见解。尿液代谢物可能是最实用的生物标志物，可提供关于致癌物剂量和代谢的关键信息。
6. 致癌物生物标志物对于确定烟草制品接触者的致癌物暴露剂量、理解致癌机制具有重要意义，并最终可能有助于预测癌症风险。

英文摘要：

The devastating link between tobacco products and human cancers results from a powerful alliance of two factors — nicotine and carcinogens. Without either one of these, tobacco would be just another commodity, instead of being the single greatest cause of death due to preventable cancer. Nicotine is addictive and toxic, but it is not carcinogenic. This addiction, however, causes people to use tobacco products continually, and these products contain many carcinogens. What are the mechanisms by which this deadly combination leads to 30% of cancer-related deaths in developed countries, and how can carcinogen biomarkers help to reveal these mechanisms?

摘要翻译： 

烟草制品与人类癌症之间的致命关联源于两个因素的强大结合——尼古丁和致癌物。缺少其中任何一个，烟草都只会是一种普通商品，而不会成为可预防癌症导致死亡的首要原因。尼古丁具有成瘾性和毒性，但并不致癌；然而，正是这种成瘾促使人们持续使用烟草制品，而这些产品中含有大量致癌物。在发达国家，这一致命组合导致了30%的癌症相关死亡，其机制是什么？致癌物生物标志物又如何帮助揭示这些机制？

原文链接：

Tobacco carcinogens, their biomarkers and tobacco-induced cancer