Patel Shyam A, Dave Meneka A, Murthy Raghav G, Helmy Karim Y, Rameshwar Pranela
Division of Hematology/Oncology, Department of Medicine, New Jersey Medical School, University of Medicine and Dentistry of New Jersey, MSB, Room E-579, 185 South Orange Avenue, Newark, NJ 07103, USA. Graduate School of Biomedical Sciences, University of Medicine and Dentistry of New Jersey, Newark, NJ, USA.
Oncol Rev. 2011 Jun 1;5(2):93-102. doi: 10.1007/s12156-010-0071-y.
Among all cancers, malignancies of the breast are the second leading cause of cancer death in the United States after carcinoma of the lung. One of the major factors considered when assessing the prognosis of breast cancer patients is whether the tumor has metastasized to distant organs. Although the exact phenotype of the malignant cells responsible for metastasis and dormancy is still unknown, growing evidence has revealed that they may have stem cell-like properties that may account for resistance to chemotherapy and radiation. One process that has been attributed to primary tumor metastasis is the epithelial-to-mesenchymal transition. In this review, we specifically discuss breast cancer dissemination to the bone marrow and factors that ultimately serve to shelter and promote tumor growth, including the complex relationship between mesenchymal stem cells (MSCs) and various aspects of the immune system, carcinoma-associated fibroblasts, and the diverse components of the tumor microenvironment. A better understanding of the journey from the primary tumor site to the bone marrow and subsequently the oncoprotective role of MSCs and other factors within that microenvironment can potentially lead to development of novel therapeutic targets.
在所有癌症中，乳腺癌是美国仅次于肺癌的第二大致癌死亡原因。评估乳腺癌患者预后时考虑的主要因素之一是肿瘤是否已转移至远处器官。尽管负责转移和休眠的恶性细胞的确切表型仍不清楚，但越来越多的证据表明，它们可能具有类似干细胞的特性，这可能是对化疗和放疗产生抗性的原因。一种被认为与原发性肿瘤转移有关的过程是上皮-间质转化。在本综述中，我们特别讨论了乳腺癌向骨髓的扩散以及最终有助于保护和促进肿瘤生长的因素，包括间充质干细胞（MSC）与免疫系统各方面、癌相关成纤维细胞以及肿瘤微环境的不同组成部分之间的复杂关系。更好地了解从原发性肿瘤部位到骨髓的过程，以及随后MSC和该微环境中其他因素的肿瘤保护作用，可能会促成新型治疗靶点的开发。
