文章：

解剖转移级联

Dissecting the metastatic cascade

原文发布日期：2004-06-01

DOI: 10.1038/nrc1370

类型: Review Article

开放获取: 否

要点：

1. In some solid tumours, such as those of the head and neck, the presence of lymph-node metastases is closely linked to the development of distant metastases. In others, such as breast cancer, this association is less pronounced.
2. Gene-expression profiling studies of breast cancer cells indicate that specific molecular pathways are associated with haematogenous dissemination of primary tumour cells, whereas these pathways were not involved with lymphatic dissemination.
3. Disseminated tumour cells found in the bone marrow of patients with various types of solid tumours (for example, breast, colon and lung tumours) can be detected by sensitive immunocytochemical and molecular assays.
4. The presence of disseminated tumour cells in bone marrow predicts the development of overt metastases — both in the bone and other organs.
5. The genetic characterization of single disseminated tumour cells isolated from the bone marrow, along with gene-expression profiling studies of primary tumour cells, indicate that haematogenous dissemination is often a very early event in tumour progression. The cells seem to first disseminate from the early primary lesions and then acquire additional genetic defects.
6. Single disseminated tumour cells in the blood and bone marrow are targets for adjuvant therapy. These cells often show different properties to cells of the primary tumour, so further molecular analysis will provide additional information and will help to develop antimetastatic therapies.

要点翻译：

1. 在某些实体瘤（如头颈部肿瘤）中，淋巴结转移的存在与远处转移的发生密切相关。而在其他肿瘤（如乳腺癌）中，这种关联性则不太明显。
2. 乳腺癌细胞的基因表达谱研究表明，特定分子通路与原发性肿瘤细胞的血行播散相关，而这些通路并未参与淋巴道转移。
3. 通过灵敏的免疫细胞化学和分子检测方法，可在多种实体瘤（如乳腺癌、结肠癌和肺癌）患者的骨髓中发现播散性肿瘤细胞。
4. 骨髓中播散性肿瘤细胞的存在预示著显性转移（包括骨骼和其他器官）的发生。
5. 从骨髓中分离的单个播散肿瘤细胞的遗传特征分析，连同原发性肿瘤细胞的基因表达谱研究，均表明血行播散通常是肿瘤进展过程中的早期事件。这些细胞似乎首先从早期原发病灶播散，随后获得额外的遗传缺陷。
6. 血液和骨髓中的单个播散肿瘤细胞是辅助治疗的靶点。这些细胞通常表现出与原发肿瘤细胞不同的特性，因此进一步的分子分析将提供更多信息，有助于开发抗转移疗法。

英文摘要：

Despite recent progress in gene-expression profiling studies, the biology underlying the various patterns of metastasis that are observed in different tumour types remains unclear. The detection and characterization of disseminated tumour cells in patients with cancer has provided important new information about the cascade of metastatic events. This information has important implications for cancer prognosis and for therapy.

摘要翻译： 

尽管基因表达谱研究近期取得了进展，但不同肿瘤类型所表现出的多种转移模式背后的生物学机制仍不清楚。对癌症患者体内播散性肿瘤细胞的检测与鉴定，为揭示转移事件的发生过程提供了重要新信息。这些信息对癌症预后评估及治疗具有重大意义。

原文链接：

Dissecting the metastatic cascade