Bockhorn Maximilian, Jain Rakesh K, Munn Lance L
Department of General, Visceral and Transplantation Surgery, University Hospital Essen, Germany.
Lancet Oncol. 2007 May;8(5):444-8. doi: 10.1016/S1470-2045(07)70140-7.
Although millions of cells are shed from a tumour every day, haematogenous metastasis is believed to be very inefficient. This inefficiency is widely assumed to be a result of the destruction of cells in the bloodstream by shear stress and the immune system and a slow rate of extravasation and proliferation in the stroma at a secondary site. Here, we propose that, whereas active intravasation of cells into the circulation is important in some tumours, others might shed cells passively into the blood or lymphatic vessels without the involvement of active cell migration. We discuss the evidence for and against this passive-shedding hypothesis and the implications for future treatments.
尽管肿瘤每天会脱落数百万个细胞，但血行转移被认为效率非常低。人们普遍认为这种低效率是由于血流中的剪切应力和免疫系统对细胞的破坏，以及细胞在二级部位的基质中渗出和增殖速度缓慢所致。在此，我们提出，虽然细胞主动侵入循环系统在某些肿瘤中很重要，但其他肿瘤可能会将细胞被动地脱落到血液或淋巴管中，而无需细胞的主动迁移。我们讨论了支持和反对这种被动脱落假说的证据以及对未来治疗的影响。
