Piérard Gérald E, Piérard-Franchimont Claudine, Reginster Marie-Annick, Quatresooz Pascale
Department of Dermatopathology, University Hospital of Liège, 4000 Liège, Belgium.
Dermatol Res Pract. 2012;2012:461278. doi: 10.1155/2012/461278. Epub 2011 Nov 2.
The fund of knowledge regarding the versatility of presentation of MM metastases is still quite incomplete. The recent literature pertaining to the current understanding of the mechanisms underlying two special features of MM metastasis is reviewed. On the one hand, a long disease-free interval (MM dormancy) may occur before the surge of overt metastases. On the other hand, the so-called MM smouldering phenomenon refers to the condition where regional metastases wax and wane for long periods of time on restricted skin regions. It is important to emphasize that local micrometastases often predict sentinel lymph node involvement but may not reflect progression of the primary MM to full-blown visceral metastatic competence. It is likely that a combination of factors impacts the versatile MM metastasic progression. Among the main factors, one has to mention the phenotypic heterogeneity and variability in the phenotype of MM cells, the presence of MM stem cells and MM cells engaged in an amplification proliferation pool, as well as the host immune response, and possibly the induction of a particular stromal structure and vascularity.
关于多发性骨髓瘤（MM）转移表现多样性的知识储备仍相当不完整。本文综述了近期有关MM转移两个特殊特征潜在机制的当前理解的文献。一方面，在明显转移激增之前可能会出现较长的无病间期（MM休眠）。另一方面，所谓的MM隐匿现象是指区域转移在受限皮肤区域长期波动的情况。需要强调的是，局部微转移往往预示着前哨淋巴结受累，但可能无法反映原发性MM发展为完全成熟的内脏转移能力。多种因素可能共同影响MM转移的多样化进程。在主要因素中，必须提到MM细胞表型的异质性和变异性、MM干细胞的存在以及参与扩增增殖池的MM细胞，以及宿主免疫反应，可能还有特定基质结构和血管生成的诱导。
