文章：

癌痛的分子机制

Molecular mechanisms of cancer pain

原文发布日期：2002-03-01

DOI: 10.1038/nrc747

类型: Review Article

开放获取: 否

要点：

1. As advances in cancer detection and therapy are extending the life expectancy of cancer patients, there is increasing focus on improving the quality of life of patients. New approaches are desperately needed to control cancer-associated pain.
2. Sensory information from peripheral tissues is transmitted to the spinal cord and brain by primary afferent sensory neurons. Specialized sensory neurons — known as nociceptors — detect and convert environmental stimuli that are perceived as harmful into electrochemical signals that are transmitted to the central nervous system.
3. Tumours secrete a variety of factors that sensitize or directly excite primary afferent neurons, causing the sensation of pain. Receptors for many of these factors are expressed by primary afferent neurons.
4. Both the intracellular and extracellular pH of solid tumours are lower than that of surrounding normal tissues, which can also activate sensory neurons and cause pain in cancer patients.
5. Tumour growth entraps and injures nerves, causing neuropathic pain.
6. The spinal cord and forebrain undergo neurochemical and structural changes as a state of chronic pain develops.
7. Cancer pain frequently becomes more severe as the disease progresses, and might require different types of analgesic at different time points.
8. For the first time, animal models of cancer pain are now available. These will offer insight into one of the main conundrums of cancer pain — why the severity of this pain is so variable from patient to patient, tumour to tumour, and even from site to site.

要点翻译：

1. 随着癌症检测和治疗的进步延长了癌症患者的预期寿命，人们越来越关注如何提高患者的生活质量。迫切需要新的方法来控制癌症相关疼痛。
2. 来自外周组织的感官信息通过初级传入感觉神经元传递到脊髓和大脑。特化的感觉神经元——即伤害性感受器——能检测并转换那些被感知为有害的环境刺激，将其转化为传递至中枢神经系统的电化学信号。
3. 肿瘤分泌多种因子使初级传入神经元致敏或直接兴奋，从而引发疼痛感。初级传入神经元表达许多这些因子的受体。
4. 实体瘤的细胞内和细胞外pH值均低于周围正常组织，这也会激活感觉神经元并导致癌症患者疼痛。
5. 肿瘤生长会包埋和损伤神经，引起神经性疼痛。
6. 随着慢性疼痛状态的发展，脊髓和前脑会发生神经化学和结构变化。
7. 癌症疼痛通常随着疾病进展而加剧，可能需要在不同时间点使用不同类型的镇痛药。
8. 癌症疼痛动物模型首次问世，这将有助于解开癌症疼痛的主要难题——为何这种疼痛的严重程度会因患者而异、因肿瘤而异，甚至因部位而异。

英文摘要：

Pain is the most disruptive influence on the quality of life of cancer patients. Although significant advances are being made in cancer treatment and diagnosis, the basic neurobiology of cancer pain is poorly understood. New insights into these mechanisms are now arising from animal models, and have the potential to fundamentally change the way that cancer pain is controlled.

摘要翻译： 

疼痛是对癌症患者生活质量最具破坏性的影响。尽管在癌症治疗和诊断方面正在取得重大进展，但对癌症疼痛基础神经生物学的理解仍然不足。目前，动物模型正在揭示这些机制的新见解，并有可能从根本上改变癌症疼痛控制的方式。

原文链接：

Molecular mechanisms of cancer pain