Voravud N, Charuruk N
Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
J Med Assoc Thai. 1999 Apr;82(4):394-404.
Tumor angiogenesis is the growth of new blood vessels which is required for tumor growth and progression. Vascularization of the tumor occurs through a series of sequential steps before or during the multistep progression to neoplasia. Several events occur during the formation of new vessels including production of protease enzymes, unregulation of positive regulators of angiogenesis, and down regulation of negative regulators. In addition, tumor associated macrophage also influence angiogenesis by secreting enzymes, enzymes inhibitors and cytokines. Recent knowledge in tumor angiogenesis may have clinical implications in diagnosis and treatment. Quantification of microvessel density in tumor specimen correlates either metastasis or recurrence in many malignancies such as breast cancer and lung cancer. Therefore, assessment of tumor angiogenesis may serve as prognostic factors. Therapeutic applications include the development of new agents with antiangiogenic properties, vascular targeting drugs, antibody-based therapy, and gene therapy. Combination of antiangiogenic therapy with cytotoxic drugs may enhance antitumor activity. Moreover, the role of antiangiogenic therapy in adjuvant setting may provide and alternative approach to better cancer treatment in the near future.
肿瘤血管生成是肿瘤生长和进展所必需的新血管的生长。在肿瘤形成多步骤进展之前或期间，肿瘤的血管化通过一系列连续步骤发生。在新血管形成过程中会发生若干事件，包括蛋白酶的产生、血管生成正调节因子的失调以及负调节因子的下调。此外，肿瘤相关巨噬细胞也通过分泌酶、酶抑制剂和细胞因子来影响血管生成。肿瘤血管生成的最新知识可能在诊断和治疗方面具有临床意义。肿瘤标本中微血管密度的量化与许多恶性肿瘤（如乳腺癌和肺癌）的转移或复发相关。因此，评估肿瘤血管生成可作为预后因素。治疗应用包括开发具有抗血管生成特性的新药、血管靶向药物、基于抗体的疗法和基因疗法。抗血管生成疗法与细胞毒性药物联合使用可能会增强抗肿瘤活性。此外，抗血管生成疗法在辅助治疗中的作用可能在不久的将来为更好的癌症治疗提供一种替代方法。
