Zhang Yao-Yao, Chen Bin, Ding Yan-Qing
Reproductive Medical Center, Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China.
Asian Pac J Cancer Prev. 2012;13(6):2437-44. doi: 10.7314/apjcp.2012.13.6.2437.
Tumor metastasis remains the principal cause of treatment failure and poor prognosis in patients with colorectal cancer. It is a multistage process which includes proteolysis, motility and migration of cells, proliferation in a new site, and neoangiogenesis. A crucial step in the process of intra- and extra-vasation is the activation of proteolytic enzymes capable of degrading the extracellular matrix (ECM). In this stage, urokinase plasminogen activator receptor (uPAR) and matrix metalloproteinases (MMPs) are necessary. Micrometastases need the presence of growth factor and vascular growth factor so that they can form macrometastasis. In addition, cell adhesion molecules (CAMs) and guanine nucleotide exchange factors (GEFs) play important roles in the progression of colorectal cancer and metastatic migration. Further elucidation of the mechanisms of how these molecules contribute will aid in the identification of diagnostic and prognostic markers as well as therapeutic targets for patients with colorectal metastasis.
肿瘤转移仍然是结直肠癌患者治疗失败和预后不良的主要原因。它是一个多阶段过程，包括细胞的蛋白水解、运动和迁移、在新部位的增殖以及新生血管形成。血管内和血管外渗过程中的一个关键步骤是能够降解细胞外基质（ECM）的蛋白水解酶的激活。在这个阶段，尿激酶型纤溶酶原激活物受体（uPAR）和基质金属蛋白酶（MMPs）是必需的。微转移需要生长因子和血管生长因子的存在，以便它们能够形成大转移。此外，细胞粘附分子（CAMs）和鸟嘌呤核苷酸交换因子（GEFs）在结直肠癌的进展和转移迁移中发挥重要作用。进一步阐明这些分子如何发挥作用的机制将有助于识别结直肠癌转移患者的诊断和预后标志物以及治疗靶点。
