Bidard François-Clément, Poupon Marie-France
Département D'oncologie Médicale, Institut Curie, 26 rue d'Ulm, 75005 Paris, France.
Med Sci (Paris). 2012 Jan;28(1):89-95. doi: 10.1051/medsci/2012281022. Epub 2012 Jan 27.
The onset of metastasis is a critical event in the natural history of cancer, and is generally associated with a poor clinical outcome. Mechanistically, the metastatic process is made of several steps that are biologically distinct and now rather well characterized. Several explanatory models have been proposed: selective models (clonal selection), adaptive models (initial oncogenesis), involvement of tumor "stem" cells, epithelial-mesenchymal transition… The next progresses are expected to come from the characterization of circulating and disseminated tumor cells, which are two recently opened windows on the metastatic process in patients.
转移的发生是癌症自然史中的一个关键事件，通常与不良的临床结局相关。从机制上讲，转移过程由几个生物学上不同且目前已得到较好表征的步骤组成。已经提出了几种解释模型：选择性模型（克隆选择）、适应性模型（初始肿瘤发生）、肿瘤“干细胞”的参与、上皮-间质转化……预计未来的进展将来自对循环肿瘤细胞和播散肿瘤细胞的表征，这是最近在患者转移过程中打开的两扇新窗口。
