Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY 10065, USA.
Angiogenesis. 2010 Mar;13(1):43-58. doi: 10.1007/s10456-010-9163-3. Epub 2010 Mar 14.
Tumor neovascularization is a complex process that plays a crucial role in the development of many different types of cancer. Vascular endothelial growth factor (VEGF) is a potent mitogen that is involved with mitogenesis, angiogenesis, endothelial survival, and the induction of hematopoiesis. By increasing vascular permeability in endothelial cells, it helps tumors recruit wound-healing proteins fibrin and fibrinogen from the plasma, suggesting that tumor formation is a process of abnormal wound healing dependent on the ability to generate a blood supply. The human female reproductive tract is highly dependent on VEGF for normal functions such as endometrial proliferation and development of the corpus luteum. The unique influence of female sex steroid hormones on the expression and activity of VEGF deems angiogenesis an important facet of the development of breast and ovarian cancer. Additionally, the up-regulation of VEGF by the E6 oncoprotein of the human papillomavirus suggests that VEGF plays an important role in the development of cervical cancer. Clinical trials have investigated the humanized monoclonal antibody bevacizumab as potential treatment for all three forms of cancer; the data show that in breast cancer, the use of bevacizumab may lengthen the disease-free survival for women with advanced breast cancer, but does not appear to change their overall survival. It may have a role as salvage chemotherapy for ovarian and cervical cancer, though further research is needed to establish it as a definitive form of treatment.
肿瘤血管生成是一个复杂的过程，在许多不同类型的癌症的发展中起着至关重要的作用。血管内皮生长因子（VEGF）是一种有效的有丝分裂原，参与有丝分裂、血管生成、内皮细胞存活和造血诱导。通过增加内皮细胞的血管通透性，它有助于肿瘤从血浆中招募创伤愈合蛋白纤维蛋白和纤维蛋白原，这表明肿瘤的形成是一个依赖于产生血液供应的异常创伤愈合过程。人类女性生殖道的正常功能高度依赖 VEGF，如子宫内膜增殖和黄体发育。女性性激素对 VEGF 的表达和活性的独特影响使得血管生成成为乳腺癌和卵巢癌发展的一个重要方面。此外，人乳头瘤病毒的 E6 致癌蛋白上调 VEGF 表明 VEGF 在宫颈癌的发展中起重要作用。临床试验已经研究了人源化单克隆抗体贝伐珠单抗作为治疗这三种癌症的潜在药物；数据表明，在乳腺癌中，贝伐珠单抗的使用可能延长晚期乳腺癌女性的无病生存期，但似乎不会改变她们的总生存期。它可能在卵巢癌和宫颈癌的挽救化疗中发挥作用，但需要进一步的研究来确立它作为一种明确的治疗方法。
