Brabletz Thomas, Jung Andreas, Kirchner Thomas
Institute of Pathology, University of Erlangen-Nürnberg, Krankenhausstrasse 8-10, 91054 Erlangen, Germany.
Virchows Arch. 2002 Jul;441(1):1-11. doi: 10.1007/s00428-002-0642-9. Epub 2002 Apr 27.
Tumor growth and progression are morphogenetic processes that are characterized by ongoing changes in tumor structure and differentiation. These processes show similarities to morphogenesis in embryonic development, as supported by the fact that the main pathways regulating morphogenesis in early embryogenesis and organogenesis are directly or indirectly altered in most neoplasms. In colorectal adenocarcinomas, different morphogenetic areas can be clearly defined. The focus of this review is on combining morphology-based aspects and recent molecular and genetic data on the progression of colorectal carcinomas. The decisive genetic alteration in most colorectal cancers is the loss of function mutation in the adenomatous polyposis coli tumor suppressor gene, leading to an accumulation of the oncoprotein beta-catenin, the main effector of the embryonic Wnt/wingless pathway. The possibility is discussed that, on the basis of this genetic alteration, the tumor microenvironment is an additional driving force of tumor progression.
肿瘤生长和进展是形态发生过程,其特征是肿瘤结构和分化不断变化。这些过程与胚胎发育中的形态发生相似,这一事实得到了支持,即在大多数肿瘤中,早期胚胎发生和器官发生中调节形态发生的主要途径直接或间接发生改变。在结直肠癌中,可以清楚地定义不同的形态发生区域。本综述的重点是结合基于形态学的方面以及结直肠癌进展的最新分子和遗传数据。大多数结直肠癌中决定性的基因改变是腺瘤性息肉病 coli 肿瘤抑制基因的功能丧失突变,导致癌蛋白 β-连环蛋白的积累,β-连环蛋白是胚胎 Wnt/无翅通路的主要效应器。基于这种基因改变,肿瘤微环境是肿瘤进展的额外驱动力这一可能性也被讨论。