乳酸是体内产生的糖酵解的代谢产物，其产生被认为是癌细胞逃避免疫监视的一种机制。免疫逃避和代谢变化已被确定为癌症的基本标志。尽管乳酸长期以来一直被认为是一种废物，但现在人们普遍认为它是一种多功能小分子化学物质，在肿瘤微环境 (TME) 中发挥着重要作用，乳酸产量的增加与人类恶性肿瘤的发展有关。肝癌中的代谢转向糖酵解，这增强了肿瘤细胞用于产生蛋白质、脂质和核苷酸的代谢化合物的产生，使它们能够维持高增殖率并建立 TME。由于肿瘤细胞中无氧糖酵解速率产生的乳酸具有免疫抑制活性，肝癌中代谢活性的失调可能会损害抗肿瘤反应。本综述主要探讨乳酸与 TME 之间的联系；评估乳酸在肝癌发生、转移、预后和治疗中的作用。此外，它还研究了作为肝癌治疗潜在靶点的相关途径。在 PubMed、Web of Science 和 Google Scholar 中进行了文献检索，最新文章的发表日期为 2024 年 1 月。在消除重复文章和更少文章后通过标题和摘要的相关文章，我们选择了 113 篇文章进行本次综述。我们将参考文献分为两类。一是将内容分为乳酸相关、肝癌相关和肿瘤代谢相关。另一种是对文章类型进行分类，分为综述、研究文章和临床试验。此外，我们还查阅了相关文章的参考文献列表，以确保覆盖范围全面且公正。乳酸与TME之间的联系最近成为人们广泛关注的领域，并且该领域已经发表了许多相关文章。本综述的主要发现是总结乳酸与 TME 之间已证实的联系及其对肝癌 TME 的可能影响。并分析了乳酸在肝癌治疗和预后预测中的潜力。乳酸可能是未来开发肝癌治疗新方法的关键。经典疗法与分子靶向药物相结合的相关研究可能会提供更有选择性地调节免疫细胞活性的创新药物。2024年胃肠肿瘤学杂志。版权所有。

Lactic acid is a metabolite of glycolysis produced in the body, and its production is thought to be a mechanism by which cancer cells evade immune surveillance. Immune evasion and metabolic changes are well established as basic hallmarks of cancer. Although lactate has long been considered a waste product, it is now generally recognized to be a versatile small-molecule chemical that plays an important part in the tumor microenvironment (TME), with increased lactate production linked to the development of human malignancies. Metabolism in liver cancer is redirected toward glycolysis, which enhances the production of metabolic compounds used by tumor cells to produce proteins, lipids, and nucleotides, enabling them to maintain high proliferation rates and to establish the TME. Dysregulation of metabolic activity in liver cancer may impair antitumor responses owing to the immunosuppressive activity of the lactate produced by anaerobic glycolytic rates in tumor cells. This review primarily explores the link connection between lactic acid and the TME; evaluates the role of lactic acid in the occurrence, metastasis, prognosis, and treatment of liver cancer. Additionally, it investigates the associated pathways as potential targets for liver cancer treatment.Literature searches were conducted in PubMed, Web of Science, and Google Scholar, with the publication date of the most recent article included being January 2024. After eliminating duplicate articles and less relevant articles through titles and abstracts, we selected 113 articles for this review. We categorized references into two categories. One is to classify the content into lactate-related, liver cancer-related and tumor metabolism-related. The other is to classify the article types, which are divided into reviews, research articles and clinical trials. Additionally, we consulted the reference lists of the relevant articles to ensure coverage was comprehensive and unbiased.The connection between lactic acid and the TME has recently become an area of intense research interest, and many related articles have been published in this field. The main finding of this review is to summarize the proven link between lactate and the TME and its possible impact on the TME of liver cancer. And analyzed the potential of lactate in liver cancer treatment and prognosis prediction.Lactate may be key to developing novel approaches in the future treatment of liver cancer. Related research on the combination of classic therapies and molecular targeted drugs may provide innovative medicines that more selectively regulate immune cell activity.2024 Journal of Gastrointestinal Oncology. All rights reserved.