Department of Molecular Oncology, John Wayne Cancer Institute, 2200 Santa Monica Blvd, Santa Monica, CA 90404, USA.
Clin Exp Metastasis. 2012 Oct;29(7):747-56. doi: 10.1007/s10585-012-9491-3. Epub 2012 Jun 9.
Regional nodal status remains one of the most important prognostic factors in several solid tumors including melanoma, breast cancer, and gastrointestinal malignancies. However, despite the accuracy of lymph node (LN) staging, patients who are LN negative are still at risk for development of recurrence and distant metastasis. As such, numerous molecular studies have focused on genetic and transcriptome changes in primary and metastatic tumors to discover molecular determinants that can predict aggressive metastatic disease and/or correlated to clinical outcomes. More recently, epigenetic aberrations have been investigated in solid cancers and are associated with tumorigenesis and disease progression. These epigenetic alterations have demonstrated potential utility as diagnostic and prognostic biomarkers and are being developed into novel targeted treatment strategies, as epigenetic changes can be reversed by appropriate drugs. If patients who are at increased risk of developing metastases or recurrence can be accurately identified, this will help stratify patients into more appropriate treatment and follow-up. This review discusses some of the recent studies on regional LN metastases in melanoma, breast cancer, and colorectal cancer, focusing on the potential clinicopathological utility of epigenetic aberrations in the management of cancer patients.
区域淋巴结状态仍然是黑色素瘤、乳腺癌和胃肠道恶性肿瘤等几种实体瘤中最重要的预后因素之一。然而，尽管淋巴结（LN）分期的准确性很高，但 LN 阴性的患者仍有发展复发和远处转移的风险。因此，许多分子研究集中在原发和转移肿瘤的遗传和转录组变化上，以发现可预测侵袭性转移疾病和/或与临床结果相关的分子决定因素。最近，在实体癌中研究了表观遗传异常，这些异常与肿瘤发生和疾病进展有关。这些表观遗传改变已被证明具有作为诊断和预后生物标志物的潜在用途，并正在开发为新的靶向治疗策略，因为适当的药物可以逆转表观遗传变化。如果能够准确识别出有更高转移或复发风险的患者，这将有助于将患者分层为更合适的治疗和随访。本文综述了黑色素瘤、乳腺癌和结直肠癌中区域 LN 转移的一些最新研究，重点讨论了表观遗传异常在癌症患者管理中的潜在临床病理应用。
