Division of Hematology and Oncology, Department of Medicine, University of Vermont, Burlington, VT 05401, USA.
J Thromb Haemost. 2011 Feb;9(2):237-49. doi: 10.1111/j.1538-7836.2010.04131.x.
Traditionally viewed as major cellular components in hemostasis and thrombosis, the contribution of platelets to the progression of cancer is an emerging area of research interest. Complex interactions between tumor cells and circulating platelets play an important role in cancer growth and dissemination, and a growing body of evidence supports a role for physiologic platelet receptors and platelet agonists in cancer metastases and angiogenesis. Platelets provide a procoagulant surface facilitating amplification of cancer-related coagulation, and can be recruited to shroud tumor cells, thereby shielding them from immune responses, and facilitate cancer growth and dissemination. Experimental blockade of key platelet receptors, such as GP1b/IX/V, GPIIbIIIa and GPVI, has been shown to attenuate metastases. Platelets are also recognized as dynamic reservoirs of proangiogenic and anti-angiogenic proteins that can be manipulated pharmacologically. A bidirectional relationship between platelets and tumors is also seen, with evidence of 'tumor conditioning' of platelets. The platelet as a reporter of malignancy and a targeted delivery system for anticancer therapy has also been proposed. The development of platelet inhibitors that influence malignancy progression and clinical testing of currently available antiplatelet drugs represents a promising area of targeted cancer therapy.
传统上被认为是止血和血栓形成的主要细胞成分，血小板在癌症进展中的作用是一个新兴的研究领域。肿瘤细胞与循环血小板之间的复杂相互作用在癌症的生长和扩散中起着重要作用，越来越多的证据支持生理血小板受体和血小板激动剂在癌症转移和血管生成中的作用。血小板提供促凝表面，促进与癌症相关的凝血放大，并且可以被募集来包裹肿瘤细胞，从而使它们免受免疫反应的影响，并促进癌症的生长和扩散。实验性阻断关键血小板受体，如 GP1b/IX/V、GPIIbIIIa 和 GPVI，已被证明可以减弱转移。血小板也被认为是具有促血管生成和抗血管生成蛋白的动态储存库，可以通过药理学手段进行操纵。血小板与肿瘤之间也存在双向关系，有证据表明血小板存在“肿瘤调节”。血小板作为恶性肿瘤的报告者和抗癌治疗的靶向递药系统也已被提出。开发影响恶性肿瘤进展的血小板抑制剂和临床试验目前可用的抗血小板药物代表了靶向癌症治疗的一个有前途的领域。
