Department of Pathology, Indiana University School of Medicine, 350 West 11th Street, Room 4010, Indianapolis, IN 4620, USA.
Expert Rev Anticancer Ther. 2011 Jul;11(7):1131-43. doi: 10.1586/era.11.82.
Cancer stem cells (CSCs) have provided new insights into the tumorigenesis and metastatic potential of cancer. The discovery of CSCs has provided many new insights into the complexities of cancer therapy: tumor initiation, treatment resistance, metastasis, recurrence, assessment of prognosis and prediction of clinical course. Recent rapid advances in molecular analysis have contributed to the better understanding of the molecular attributes and pathways that give CSCs their unique attributes. Use of these molecular techniques has facilitated elucidation of specific surface markers and pathways that favor propagation of CSCs - allowing for targeted therapy. Furthermore, it has been discovered that a specific microenvironment, or niche, is essential for the genesis of tumors from CSCs. Therapeutic strategies that alter these microenvironments compromise CSC proliferation and constitute another method of targeted cancer therapy. We review the clinical and therapeutic implications of CSCs, with a focus on treatment resistance and metastasis, and the emerging approaches to target CSCs and their microenvironments in order to attain improved outcomes in cancer. It is noteworthy that CSCs are the only cells capable of sustaining tumorigenesis; however, the cell of origin of cancer, in which tumorigenesis is initiated, may be distinct from CSCs that propagate the tumor.
癌症干细胞 (CSCs) 为肿瘤发生和癌症转移潜能提供了新的见解。CSCs 的发现为癌症治疗的复杂性提供了许多新的见解：肿瘤起始、治疗抵抗、转移、复发、预后评估和临床过程预测。最近分子分析的快速进展有助于更好地理解赋予 CSCs 独特特性的分子特征和途径。这些分子技术的使用促进了有利于 CSCs 增殖的特定表面标志物和途径的阐明 - 从而实现靶向治疗。此外，已经发现特定的微环境或生态位对于 CSCs 生成肿瘤是必不可少的。改变这些微环境的治疗策略会损害 CSC 的增殖，构成另一种靶向癌症治疗方法。我们综述了 CSCs 的临床和治疗意义，重点关注治疗抵抗和转移，以及针对 CSCs 及其微环境的新兴方法，以在癌症治疗中获得更好的结果。值得注意的是，CSCs 是唯一能够维持肿瘤发生的细胞；然而，肿瘤发生起始的癌症起源细胞可能与传播肿瘤的 CSCs 不同。
