Gruber Reinhard
Laboratory for Oral Cell Biology, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland.
Wien Med Wochenschr. 2012 Sep;162(17-18):370-3. doi: 10.1007/s10354-012-0110-3. Epub 2012 Jul 14.
Bone metastases are a process originally proposed as the "seed and soil theory" in the eighteenth century. Tumor cell disseminating from patients with breast or prostate cancer typically use the bony environment to grow outside the primary tumor location. The severe clinical consequences of bone metastasis such as pain, fractures, and hypercalcemia result from a serious misbalance of bone turnover. Most bone metastases cause catabolic changes of bone turnover. The severity of bone resorption is associated with tumor growth, suggesting the existence of a vicious cycle that needs to be interrupted. Osteoblastic metastasis showing signs of osteosclerotic lesions are observed in prostate cancer. Understanding the pathophysiology of bone metastases and their detrimental consequence provide the scientific basis for therapeutic interventions at various levels including homing of tumors to bone, survival and growth of the tumor cell in the bone niche, and the mechanisms causing bone destruction.
骨转移是一个最初在18世纪被提出的“种子与土壤理论”过程。来自乳腺癌或前列腺癌患者的肿瘤细胞通常利用骨环境在原发肿瘤位置以外生长。骨转移的严重临床后果，如疼痛、骨折和高钙血症，是由骨转换的严重失衡导致的。大多数骨转移会引起骨转换的分解代谢变化。骨吸收的严重程度与肿瘤生长相关，这表明存在一个需要被打断的恶性循环。在前列腺癌中可观察到显示骨硬化性病变迹象的成骨性转移。了解骨转移的病理生理学及其有害后果为包括肿瘤归巢至骨、肿瘤细胞在骨微环境中的存活和生长以及导致骨破坏的机制等各个层面的治疗干预提供了科学依据。
