Weber M H, Goltzman D, Kostenuik P, Rabbani S, Singh G, Duivenvoorden W C, Orr F W
Department of Pathology, University of Manitoba, Winnipeg, Canada.
Crit Rev Eukaryot Gene Expr. 2000;10(3-4):281-302. doi: 10.1615/critreveukargeneexpr.v10.i3-4.60.
Bone metastases occur in approximately 80% of patients with advanced cancer. They are characterized by cancer cell growth and bone destruction that cause pain, fractures, anemia, and hypercalcemia. At diagnosis, bone metastases are usually incurable owing to their advanced development. However, the early stages in their formation are asymptomatic and begin as single micrometastatic cells from the blood stream. These cells can be detected by molecular analysis of bone marrow in approximately 30% of patients at the time of cancer diagnosis, but not all single micrometastatic cells develop into clinically significant bone metastases. A synergistic relationship exists between the micometastasis and the bone environment creating favorable conditions for the development and growth of disseminated tumor cells. Such bone metastases induce osteolysis or new bone formation, releasing growth factors and cytokines, which in turn amplify this pathological mechanism. The underling hypothesis, first proposed by Paget in 1889, is that the growth of disseminated tumor cells in bone is dependent on the fertility of the soil or bone itself. This article explores the most current opinions in this area of study and presents a comprehensive summary of the major factors involved.
约80%的晚期癌症患者会发生骨转移。其特征是癌细胞生长和骨质破坏，可导致疼痛、骨折、贫血和高钙血症。在诊断时，由于骨转移已处于晚期，通常无法治愈。然而，其形成的早期阶段是无症状的，始于血流中的单个微转移细胞。在癌症诊断时，约30%的患者可通过骨髓分子分析检测到这些细胞，但并非所有单个微转移细胞都会发展为具有临床意义的骨转移。微转移与骨环境之间存在协同关系，为播散性肿瘤细胞的发展和生长创造了有利条件。此类骨转移会诱发骨溶解或新骨形成，释放生长因子和细胞因子，进而放大这一病理机制。该潜在假说是由佩吉特于1889年首次提出的，即播散性肿瘤细胞在骨中的生长取决于土壤或骨本身的肥沃程度。本文探讨了该研究领域的最新观点，并对所涉及的主要因素进行了全面总结。
