Witte Marlys H, Jones Kimberly, Wilting Jörg, Dictor Michael, Selg Manuel, McHale Noel, Gershenwald Jeffrey E, Jackson David G
Department of Surgery, University of Arizona, Tucson, AZ, USA.
Cancer Metastasis Rev. 2006 Jun;25(2):159-84. doi: 10.1007/s10555-006-8496-2.
The lymphatic system, composed of lymphatic vessels, lymph, lymph nodes, and lymphocytes, is a distinctive vasculature (discontinuous basement membrane, open endothelial junctions, anchoring filaments, valves, and intrinsic contractility), different yet similar to the blood vasculature; an integral component of the plasma-tissue fluid-lymph circulation (the "blood-lymph loop"); and the center of the immunoregulatory network. Lymphatics are involved in diverse developmental, growth, repair, and pathologic processes both analogous to and distinct from those affecting the blood vasculature. Interference with the blood-lymph loop produces swelling [an imbalance between lymph formation (regulated by Starling's law of transcapillary fluid exchange) and lymph absorption], scarring, nutritional and immunodysregulatory disorders, as well as disturbances in lymph(hem)angiogenesis (lymphedema-angiodysplasia syndromes). The lymphatic system is also the stage on which key events during cancer development and progression are played out, and historically, also forms the basis for current evaluation, prognostication, and/or both operative and non-operative treatment of most cancers. Recent advances in molecular lymphology (e.g., discovery of lymphatic growth factors, endothelial receptors, transcription factors, genes, and highly specific immunohistochemical markers) and growing interest in lymphangiogenesis, combined with fresh insights and refined tools in clinical lymphology, including non-invasive lymphatic imaging, are opening up a window for translation to the clinical arena. Therefore, in cancer biology, attention to the multifaceted structure-function relationships within this vast, relatively unexplored system is long overdue.
淋巴系统由淋巴管、淋巴、淋巴结和淋巴细胞组成，是一种独特的脉管系统（具有不连续的基底膜、开放的内皮连接、锚定丝、瓣膜和内在收缩性），与血液循环系统不同但又相似；它是血浆 - 组织液 - 淋巴循环（“血 - 淋巴循环”）的一个组成部分，也是免疫调节网络的中心。淋巴管参与多种发育、生长、修复和病理过程，这些过程既与影响血液循环系统的过程相似，又有所不同。干扰血 - 淋巴循环会导致肿胀（淋巴形成——由毛细血管液体交换的斯塔林定律调节——与淋巴吸收之间的失衡）、瘢痕形成、营养和免疫调节紊乱，以及淋巴（血）管生成障碍（淋巴水肿 - 血管发育异常综合征）。淋巴系统也是癌症发生和发展过程中关键事件的发生场所，并且从历史上看，它也是目前大多数癌症评估、预后以及手术和非手术治疗的基础。分子淋巴学的最新进展（例如，发现淋巴生长因子、内皮受体、转录因子、基因和高度特异性免疫组化标志物）以及对淋巴管生成的兴趣日益增加，再加上临床淋巴学方面的新见解和改进工具，包括无创淋巴成像，正在为向临床领域的转化打开一扇窗。因此，在癌症生物学中，关注这个庞大且相对未被探索的系统内多方面的结构 - 功能关系早就应该进行了。
