Michieli Paolo
Institute for Cancer Research and Treatment (IRCC), Department of Oncological Sciences, University of Turin Medical School, Candiolo, Turin, Italy.
Cell Cycle. 2009 Oct 15;8(20):3291-6. doi: 10.4161/cc.8.20.9741. Epub 2009 Oct 5.
As an expanding tumor conquers space within the host, it calls out for an increased oxygen supply. This demand is rarely matched by tumor blood vessels because neo-angiogenesis generates a structurally aberrant and functionally impaired vasculature. As a result of this unbalance, tumor progression is invariably associated with cancer cell hypoxia. Insufficient oxygenation appears to have opposing effects on cancer biology: on one hand, it limits tumor cell division; on the other, it selects for more malignant cells and it induces a series of cellular adaptations that sustain and foster tumor invasion. When designing a therapeutic strategy, how should we resolve this dichotomy? Should we cut oxygen supply, thereby halting neoplastic expansion, or should we let the tumor breathe, in order to prevent its malignant conversion?
随着不断增大的肿瘤在宿主体内占据空间，它对氧气供应的需求也在增加。肿瘤血管很少能满足这一需求，因为新生血管生成的是结构异常且功能受损的脉管系统。这种失衡导致肿瘤进展总是与癌细胞缺氧相关。氧合不足似乎对癌症生物学有相反的影响：一方面，它限制肿瘤细胞分裂；另一方面，它会筛选出更具恶性的细胞，并诱导一系列维持和促进肿瘤侵袭的细胞适应性变化。在设计治疗策略时，我们应如何解决这种二分法？是切断氧气供应，从而阻止肿瘤扩张，还是让肿瘤呼吸，以防止其发生恶性转化？
