中国肺癌杂志2026，Vol.29Issue(4)：278-285,8.DOI:10.3779/j.issn.1009-3419.2026.102.07
肺腺癌糖酵解重编程:分子机制、代谢标志物及靶向治疗策略
Glycolytic Reprogramming in Lung Adenocarcinoma:Molecular Mechanisms,Metabolic Biomarkers and Targeted Therapeutic Strategies
摘要
Abstract
Lung adenocarcinoma(LUAD)is the most common and highly aggressive subtype of non-small cell lung cancer,characterized by metabolic reprogramming with enhanced glycolysis.Upregulation of key glycolytic enzymes[hexokinase 2(HK2),pyruvate kinase M2(PKM2),lactate dehydrogenase A(LDHA)]and lactate accumulation not only support tumor energy production and biosynthesis but also promote tumor progression and immune evasion through lactate-mediated immunosuppression and epigenetic regulation such as histone lactylation.Oncogenic signaling pathways,includ-ing phosphatidylinositol 3-kinase/protein kinase B/mammalian target of rapamycin(PI3K/Akt/mTOR),hypoxia-inducible factor-1α(HIF-1α),and MYC proto-oncogene(c-Myc),synergistically drive glycolytic activation,thereby reshaping the tumor immune microenvironment and influencing therapeutic responses.In recent years,glycolysis-related metabolic enzymes and imaging parameters have shown promising potential in the early diagnosis,prognostic evaluation,and treatment monitoring of LUAD,with multi-omics integration further facilitating their clinical translation.Collectively,glycolytic reprogramming is not only a hallmark metabolic feature of LUAD but also a critical nexus linking immunosuppression,therapeutic resistance,and precision medicine.This review summarizes the molecular mechanisms,associated biomarkers,and targeted strategies of gly-colytic reprogramming,aiming to provide insights for early screening,risk stratification,and metabolism-targeted therapies in LUAD.关键词
肺肿瘤/糖酵解/乳酸化/代谢标志物/代谢重编程/肿瘤微环境/精准诊疗Key words
Lung neoplasms/Glycolysis/Lactylation/Metabolic biomarker/Metabolic reprogramming/Tumor microenvironment/Precision medicine引用本文复制引用
张彩妮,付裕,冯慧琴,潘玉卿,李娅,何成禄..肺腺癌糖酵解重编程:分子机制、代谢标志物及靶向治疗策略[J].中国肺癌杂志,2026,29(4):278-285,8.基金项目
本文受国家自然科学基金项目(No.82560414)和云南省科技人才与平台计划-临床研究中心专项(No.202505AJ310006)资助 This paper was supported by the grants from National Natural Science Foundation of China(No.82560414,to Chenglu HE)and Yunnan Provincial Program for Science and Technology Talents and Platform-Clinical Medical Re-search Center Special Project(No.202505AJ310006,to Ya LI). （No.82560414）
