Brodland D G, Zitelli J A
Department of Dermatology, Mayo Clinic, Rochester, MN 55905.
J Am Acad Dermatol. 1992 Jul;27(1):1-8. doi: 10.1016/0190-9622(92)70146-7.
The role of dermatologists in the diagnosis and treatment of skin cancer continues to increase. Consequently, they will more frequently be involved in the diagnosis, treatment, and management of patients with metastatic or potentially metastatic tumors. Squamous cell carcinomas and malignant melanomas are frequently seen in dermatologic practices and have the capability to metastasize. Metastases are the result of a complex process that is characterized by a sequence of steps, each of which requires acquisition by the malignant cell of key biologic properties. The metastatic sequence can be conceptualized as detachment from the primary tumor followed by invasion, intravasation into a vessel, circulation, stasis within a vessel, extravasation, invasion of the recipient tissue bed, and ultimately proliferation. The basic steps of the metastatic sequence are described as well as how these steps and other tumor cell adaptations can affect the clinical patterns of metastasis. Finally, practical applications of the understanding of these principles of metastasis are discussed.
皮肤科医生在皮肤癌诊断和治疗中的作用持续增强。因此，他们将更频繁地参与转移性或潜在转移性肿瘤患者的诊断、治疗及管理。鳞状细胞癌和恶性黑色素瘤在皮肤科临床实践中较为常见，且具有转移能力。转移是一个复杂的过程，其特征是一系列步骤，每个步骤都要求恶性细胞获得关键生物学特性。转移过程可概念化为从原发肿瘤脱离，随后是侵袭、进入血管、循环、在血管内停滞、外渗、侵袭受体组织床，最终增殖。本文描述了转移过程的基本步骤，以及这些步骤和其他肿瘤细胞适应性如何影响转移的临床模式。最后，讨论了对这些转移原理理解的实际应用。
