Gray Joe W
Life Sciences Division, Lawrence Berkeley National Laboratory, Berkeley, CA 94720, USA.
Cancer Cell. 2003 Jul;4(1):4-6. doi: 10.1016/s1535-6108(03)00167-3.
Tumor progression to metastasis usually is assumed to occur through clonal genomic and epigenetic evolution. However, present evidence that challenges this paradigm. They show that genomic aberrations in tumor cells disseminated in the bone marrows of patients with no clinical evidence of metastasis generally do not resemble the aberrations in the primary tumors from which they arose. They interpret this to mean that tumor cells disseminate very early and evolve to metastatic disease independent from the primary tumor. Their model suggests that adjuvant therapies should be targeted to lesions in the disseminated cells rather than lesions found in primary tumors.
肿瘤进展至转移通常被认为是通过克隆性基因组和表观遗传进化发生的。然而，目前有证据对这一范式提出了挑战。他们发现，在无转移临床证据的患者骨髓中播散的肿瘤细胞中的基因组畸变通常与产生这些细胞的原发肿瘤中的畸变不同。他们将此解释为肿瘤细胞很早就发生播散，并独立于原发肿瘤演变为转移性疾病。他们的模型表明，辅助治疗应针对播散细胞中的病变，而非原发肿瘤中发现的病变。
