Arbeit J M
Department of Surgery, University of California, San Francisco.
Ann Surg. 1990 Jul;212(1):3-13. doi: 10.1097/00000658-199007000-00002.
Interactions between molecules control intra- and intercellular physiology. Cancer is emerging as a disease in which individual molecules are either overproduced, mutated, expressed at inappropriate stages of development, or lost due to inheritance or aberrant mitotic division. The major players in this contest of cellular control are growth factors, growth factor receptors (GFRs), signal transducers, and dominant or suppressor/recessive oncogenes. The tumors most frequently removed by surgeons have been reported to have changes in one or another of these types of molecules. The concept of multistage carcinogenesis, whereby malignancy arises after a sequence of changes that are cumulative, and passed from progenitor to daughter cells, is also being defined as a sequence of molecular, genetic, and chromosomal alterations. Molecular antineoplastic therapy is in early stages of development at the laboratory bench. The future may see patients screened for cancer susceptibility, evaluated for adjuvant therapy, and chosen for particular treatment based on molecular analysis. The types of cancer operations and the scope of surgical resection may change as molecular techniques enhance oncologic treatment.
分子间的相互作用控制着细胞内和细胞间的生理过程。癌症正逐渐成为一种疾病，在这种疾病中，单个分子要么过度产生、发生突变、在不适当的发育阶段表达，要么由于遗传或异常有丝分裂而丢失。这场细胞控制竞赛中的主要参与者是生长因子、生长因子受体（GFRs）、信号转导分子以及显性或抑制/隐性癌基因。据报道，外科医生最常切除的肿瘤在这些类型的分子中有一种或另一种发生了变化。多阶段致癌的概念，即恶性肿瘤是在一系列累积的变化之后出现，并从祖细胞传递给子细胞，也被定义为一系列分子、基因和染色体改变。分子抗肿瘤治疗正处于实验室研究的早期阶段。未来，患者可能会接受癌症易感性筛查、辅助治疗评估，并根据分子分析选择特定的治疗方法。随着分子技术改善肿瘤治疗，癌症手术的类型和手术切除范围可能会发生变化。
