Bolteus A J, Berens M E, Pilkington G J
Experimental Neuro-oncology Group, Department of Neuropathology, Institute of Psychiatry, King's College, London, De Crespigny Park, Denmark Hill, London SE5 8AF, United Kingdom.
Curr Neurol Neurosci Rep. 2001 May;1(3):225-32. doi: 10.1007/s11910-001-0022-x.
Local invasion of the brain by neoplastic glial cells is a major obstacle to effective treatment of intrinsic brain tumors. Invasion is directly related to histologic malignancy, but occurs to some extent irrespective of tumor grade. Because the brain-to-tumor interface is not well demarcated, total surgical removal is rarely possible; moreover, as invading cells transiently arrest from cell division they are refractory to radiotherapeutic intervention. Invading cells may also be protected from the action of cytotoxic drugs by the presence of an intact blood-brain barrier. The invading cells, having migrated several millimeters or even centimeters from the main focus of the tumor, return to cycle phase under the control of some as yet unknown microenvironmental cue to form a recurrent tumor adjacent to the original site of presentation. Recent cellular and genetic information concerning factors underlying invasion may not only yield suitable targets for adaptation of existing therapies, but may also lead to novel approaches in glioma management.
肿瘤性胶质细胞对脑的局部浸润是有效治疗原发性脑肿瘤的主要障碍。浸润与组织学恶性程度直接相关，但在一定程度上与肿瘤分级无关。由于脑与肿瘤的界面界限不清，很少能够进行完全手术切除；此外，由于浸润细胞会暂时停止细胞分裂，因此对放射治疗干预具有抗性。完整的血脑屏障的存在还可能使浸润细胞免受细胞毒性药物作用的影响。这些浸润细胞从肿瘤主要病灶迁移了数毫米甚至数厘米后，在某些尚不清楚的微环境信号的控制下重新进入细胞周期，从而在原发表现部位附近形成复发性肿瘤。最近有关浸润相关因素的细胞和遗传学信息不仅可能为现有治疗方法的调整提供合适的靶点，还可能带来胶质瘤治疗的新方法。
