Molecular Basis of Metastasis  

Oleh:

Chiang, Anne C. ; Massague, Joan

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: The New England Journal of Medicine (keterangan: ada di Proquest) vol. 359 no. 26 (Dec. 2008), page 2814-2823.
Topik: Cancer; metastasis

Ketersediaan

Perpustakaan FK Nomor Panggil: N08.K.2008.06 Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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Isi artikel

Metastasis is the end product of an evolutionary process in which diverse interactions between cancer cells and their microenvironment yield alterations that allow these cells to transcend their programmed behavior. Tumor cells thus populate and flourish in new tissue habitats and, ultimately, cause organ dysfunction and death. Understanding the many molecular players and processes involved in metastasis could lead to effective, targeted approaches to prevent and treat cancer metastasis. The tumor–node–metastasis (TNM) staging system used for most solid tumors considers the tumor size and degree of local invasion (T), the number, size, and location of lymph nodes (N), and the presence or absence of distant metastases (M).1 Metastases of tumors originating in different sites, such as the breast or lung, are treated differently because they are thought to behave like the tissue of origin, with characteristic patterns and kinetics of spread, and distinct profiles of chemosensitivity. Lymph nodes are of paramount importance in current staging practices, but it is hard to interpret the clinical significance of the distance of metastases from the primary site (e.g., a supraclavicular N3 vs. a mediastinal N2 lymph node in lung cancer). Indeed, the distance from the primary tumor to the organ of metastasis does not affect staging. For this reason, the real value of staging is to serve as an indicator of the primary cancer's composite capability to metastasize, rather than to ensure that the tumor lies within the prescribed limits of a local intervention. Recent advances bring hope for characterizing the metastatic behavior of cancer cells beyond the simplistic TNM stage. In the future, staging could include identification of subpopulations of tumor cells that have different metastatic behavior. A deeper understanding of the molecular and genetic concepts and processes involved in metastasis may pave the way toward new prognostic models and ways of planning treatment.

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