Eccles Suzanne, Paon Lenaic, Sleeman Jonathan
Cancer Research UK Centre for Cancer Therapeutics, McElwain Laboratories, The Institute of Cancer Research, Cotswold Road, Sutton, Surrey, SM2 5NG, UK.
Clin Exp Metastasis. 2007;24(8):619-36. doi: 10.1007/s10585-007-9123-5. Epub 2007 Nov 6.
Lymph node metastasis is the main prognosis factor in a number of malignancies, including breast carcinomas. The means by which lymph node metastases arise is not fully understood, and many questions remain about their importance in the further spread of breast cancer. Nevertheless, a number of key cellular and molecular mechanisms of lymphatic metastasis have been identified. These include induction of intra- or peri-tumoral lymphangiogenesis or co-option of existing lymphatic vessels to allow tumour cells to enter the lymphatics, although it remains to be established whether this is primarily an active or passive process. Gene expression microarrays and functional studies in vitro and in vivo, together with detailed clinical observations have identified a number of molecules that can play a role in the genesis of lymph node metastases. These include the well-recognised lymphangiogenic cytokines VEGF-C and VEGF-D as well as chemokine-receptor interactions, integrins and downstream signalling pathways. This paper briefly reviews current clinical and experimental evidence for the underlying mechanisms and significance of lymphatic metastasis in breast cancer and highlights questions that still need to be addressed.
淋巴结转移是包括乳腺癌在内的多种恶性肿瘤的主要预后因素。淋巴结转移产生的机制尚未完全明确，关于其在乳腺癌进一步扩散中的重要性仍存在许多问题。然而，已经确定了一些淋巴转移的关键细胞和分子机制。这些机制包括肿瘤内或肿瘤周围淋巴管生成的诱导，或利用现有的淋巴管以使肿瘤细胞进入淋巴管，尽管这主要是一个主动还是被动过程仍有待确定。基因表达微阵列以及体外和体内的功能研究，连同详细的临床观察，已经确定了一些可能在淋巴结转移发生过程中起作用的分子。这些分子包括广为人知的淋巴管生成细胞因子VEGF-C和VEGF-D，以及趋化因子-受体相互作用、整合素和下游信号通路。本文简要回顾了目前关于乳腺癌淋巴转移潜在机制和意义的临床和实验证据，并强调了仍需解决的问题。
