● Long-term existence causes genetic damage, and once it is out of control, it breeds a variety of diseases.
The front page of the 1712th issue of Life Times
Interviewed expert: Chen Jinfei, chief physician of oncology department of the First Affiliated Hospital of Wenzhou Medical University.
Pan zhigang, director of general medicine department of Zhongshan hospital affiliated to Fudan university
Our reporter Yu Ye
In the 1960s, a German pathologist Rudolf Wilshaw observed a large number of white blood cells in cancerous tissues. White blood cells are part of the body’s inflammatory response, which are activated to fight "invaders" such as pathogens and heal damaged tissues. Wei Erxiao speculated that the origin of some tumors may be related to inflammation. His basic ideas have stood the test of time. According to the epidemiological survey results of new cancers in various countries in recent years, the International Center for Research on Cancer shows that 1/6 of all cancers in the world are caused by bacterial and viral infections, which are commonly known as "inflammation".
Six kinds of inflammation are confirmed to be related to cancer
Inflammation is one of the most powerful weapons of our body’s immune system, which can occur in various tissues and organs at any time. Pan Zhigang, director of the General Medicine Department of Zhongshan Hospital affiliated to Fudan University, said that when the body encounters the invasion of harmful organisms from outside, it will produce an immune response to eliminate these inflammatory factors. Some immune reactions are to remove foreign "invaders" and promote the rapid repair of damaged tissues, which will cause inflammatory reactions; Others are that after immune cells are activated, they not only attack foreign "invaders", but also attack their own normal tissues, causing inflammation of their own tissues. When people encounter virus infection, external trauma, pollen allergy, etc. every day, they will cause inflammation, such as rhinitis, gastritis, pneumonia, hepatitis and nephritis. These inflammations will have some common manifestations, such as wound pain, redness and swelling, rising temperature, and possibly general fever.
Pan Zhigang said that normal inflammatory reaction can reduce the damage of the body, but sometimes inflammation may become an accomplice to the growth and spread of cancer cells throughout the body. In particular, chronic inflammation persists for a long time, and the relevant parts are in a state of "tinkering all the time but unable to be completely repaired", and cells are constantly dividing, proliferating and aging … In the long run, it is possible to break through the limitation of cell aging because of occasional mistakes in DNA replication during cell division, that is, cancer cells appear. Individual cancer cells appear, which are easily recognized and cleared by the immune system. However, if the front line is stretched too long, the more cancer cells appear, the higher the risk of immune escape.
"Inflammation and cancer are actually in cahoots." Chen Jinfei, chief physician of the Department of Oncology, the First Affiliated Hospital of Wenzhou Medical University, said that some cancer patients’ immunity will decline, which makes them more prone to inflammation, and cancer chemotherapy may further weaken their immune function. Taking gastric cancer as an example, patients often have pneumonia, pharyngitis and even enteritis during treatment. Of course, not all chronic inflammation is related to cancer. For example, arthritis is not related to cancer, but the following six types of evidence have clearly shown that it can progress to cancer:
Chronic hepatitis. Both hepatitis virus and fatty liver can cause liver cancer. After hepatitis B virus infection, it is easy to integrate virus gene fragments into normal cell fragments in the process of repeated cell repair, thus causing cell mutation and forming tumors. Studies have shown that part of liver cancer is caused by aseptic inflammation caused by the accumulation of fat in liver cells, and cells mutate under long-term infiltration of inflammation, which eventually leads to liver cancer.
Chronic atrophic gastritis. At present, it is believed that mild atrophic gastritis can generally be reversed by treatment; Moderate and severe timely intervention, most of them will not progress to gastric cancer; A few severe atrophic gastritis will become cancerous. It should be noted that the progression of chronic atrophic gastritis to gastric cancer is highly related to the combination of Helicobacter pylori infection.
Chronic ulcerative colitis. Colitis can be divided into Crohn’s disease and chronic ulcerative colitis, both of which are intestinal inflammatory diseases in principle. Epidemiological investigation shows that chronic ulcerative colitis is more likely to turn into cancer. The probability of canceration of chronic colitis is less than 1% after 8 years, and the probability of cancer will increase by 0.5%~1% every year, and the probability of canceration will reach 5%~10% after 20 years.
Cervicitis. Inflammatory changes in the cervix will cause clinical manifestations such as increased vaginal discharge and contact bleeding. If cervicitis combined with human papillomavirus infection, cervicitis may develop into cervical cancer.
Pancreatitis Generally speaking, there are only three steps from pancreatitis to pancreatic cancer: the first step is the occurrence of acute pancreatitis; Step 2 If acute pancreatitis is not completely cured and recurs, it may lead to chronic pancreatitis (which is rare) and cannot be completely cured; The third step, pancreatic pseudocyst, mostly secondary to acute and chronic pancreatitis and pancreatic injury, is likely to lead to pancreatic cancer if it is not found or treated in time.
Periodontitis. At present, many epidemiological surveys have shown that periodontitis is one of the high-risk factors of oral cancer, and it is also related to the increased risk of intestinal cancer, pancreatic cancer and breast cancer.
Common soil for many diseases.
Mitchell Lazar, an academician of the American Academy of Sciences, once published an article on the "Yin and Yang" function of inflammation in the authoritative journal Nature, in which he mentioned that the inflammatory reaction can resist foreign invasion on the one hand and cause damage on the other. When the rise and fall of inflammatory factors are not controlled, cancer, heart disease, diabetes and even diseases such as COVID-19 will develop. Excessive inflammation can lead to septic shock, and uncontrolled "cytokine storm" can lead to multiple organ failure, which has also been widely reported in COVID-19 epidemic.
Pan Zhigang said that if the inflammatory reaction goes beyond a certain range of action, it may become a common soil for many diseases.
Cardiovascular diseases Excessive or long-term activation of inflammatory response will lead to the release of a large number of proinflammatory factors by the immune system, which can lead to arterial wall damage and plaque formation, and is an important factor contributing to the development of vascular inflammation and atherosclerosis. In addition, proinflammatory factors can cause platelet aggregation, which can form thrombus and block blood vessels in severe cases, leading to myocardial infarction or stroke.
Obese or overweight. Studies have shown that fat cells can produce chemicals that cause inflammation. In addition, adipose tissue is not only composed of fat cells, but also includes important cells of the immune system, such as macrophages. Too much fat accumulation and macrophage infiltration in adipose tissue can further aggravate the low-grade inflammatory state.
Diabetes. In the development of diabetes mellitus, inflammatory reaction will damage endothelial cells in blood vessels and tissues through oxidative stress mechanism, affect the transport and absorption of insulin in tissues, and thus induce insulin resistance. Inflammatory stimulation will cause abnormal metabolism of adipocytes, and the secretion of too many inflammatory factors will continue to damage islet cells, accelerate the occurrence and development of diabetes, and enter a vicious circle.
Nervous system diseases. If the inflammatory reaction is not controlled, it will directly poison the nerve and damage the neuron cells. Taking dementia as an example, some cells in the patient’s brain can release inflammatory factors when they have an inflammatory reaction, which can accelerate the speed of neuronal degeneration.
Depression. In the acute episode of depression, both inflammatory reaction and inflammatory insulin factor release are extremely active. Some research evidence shows that persistent chronic inflammation can increase the risk of depression.
Take daily anti-inflammatory measures.
Many factors in life can cause inflammation. Biological pathogens such as bacteria, viruses, fungi and parasites are the most common causes, and physical factors such as high temperature, low temperature, ultraviolet rays and mechanical damage can also induce inflammation. Pan Zhigang said that inflammation will accompany a person’s life, and it is not necessary to excessively "talk about inflammation and discoloration". In fact, the current tumor immunotherapy is also improved by activating inflammatory response. However, when there is no tumor, everyone should learn to reduce the possibility of inflammation endangering health and try to avoid chronic inflammation and inflammation out of control.
Adjust "dynamic" anti-inflammatory factors. During exercise, muscle contraction will secrete some cytokines and actin with small molecular weight, which can reduce inflammatory reaction when entering the blood circulation. It is suggested to carry out moderate-intensity aerobic exercise for more than 30 minutes three to four times a week, with strength training to increase muscle strength.
Eat some anti-inflammatory food. Foods high in fat, sugar and salt can disturb the environment of intestinal flora and induce chronic inflammation; Foods and barbecues containing trans fatty acids can also aggravate the inflammatory reaction. It is recommended to have a light diet and eat more fresh fruits and vegetables, eggs, garlic, ginger and other foods that can help anti-inflammation.
Stay away from polluting the environment. Avoid contact with harmful substances, pay attention to indoor hygiene and cleanliness, avoid using hair dyes and pesticides as much as possible, and stay away from chemical factors such as strong acid, strong alkali and formaldehyde.
Reduce "stress inflammation". Carrying great pressure will reduce the body’s ability to regulate inflammation. Staying up late will disturb the biological clock and induce a variety of inflammatory diseases. Therefore, it is suggested to be optimistic, actively adjust bad emotions and work and rest regularly.
Chen Jinfei said that patients with chronic inflammation must be monitored and treated according to the doctor’s advice, and it is best to have a general physical examination every year. Taking chronic atrophic gastritis as an example, patients should not only do gastroscopy regularly, but also pay attention to screening Helicobacter pylori and timely treatment. Pan Zhigang said that sometimes the combination of traditional Chinese and western medicine is an effective way to regulate chronic inflammation. For example, there is no specific medicine for the treatment of chronic ulcerative colitis at present. Western medicine adopts intestinal flora planting (transplanting some flora into the intestine again), but sometimes the new flora can’t adapt to the intestinal environment and can’t succeed, and Chinese medicine can use enema to repair it.
Two experts stressed that non-bacterial inflammation, do not use antibiotics indiscriminately. Chronic inflammation is often not caused by bacteria, either aseptic inflammation or viral infection. Even if the virus infection is combined with bacterial infection, you must go to the hospital and use antibiotics according to the doctor’s advice. ▲