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[脑转移瘤的流行病学与生物学]

[Brain metastases epidemiology and biology].

作者信息

Tabouret Emeline, Bauchet Luc, Carpentier Antoine F

机构信息

AP-HM, hôpital de la Timone, service de neuro-oncologie, 264, rue Saint-Pierre, 13005 Marseille, France.

出版信息

Bull Cancer. 2013 Jan 1;100(1):57-62. doi: 10.1684/bdc.2012.1681.

Abstract

Recent progresses in chemotherapies and targeted therapies have improved survival in cancer patients. In this context of better-controlled systemic disease, brain metastases (BM) are emerging as a new challenge for the oncologist. However, BM epidemiology and biology remain largely unclear. Incidence of BM is increasing. This trend could be explained by improvement in the quality of neuro-imaging (MRI) and increased survival. Primary cancers associated with BM patients are mainly: lung, breast, renal, colorectal cancers and melanoma. Prevalence of BM is estimated at 9% although this figure is probably underestimated. Time from initial to BM diagnoses is increasing and BM is occurring more frequently in individuals with advanced-stage disease. Biology of BM remains poorly known. Interactions between circulated tumoral cells (CTC) and blood-brain-barrier (BBB) cells are required. Some cytokines may act as CTC attractants and promote BM formation. BM development also involves several steps (extravasations through non-fenestrated capillaries, local proliferation, neoangiogenesis…), which represent potential therapeutic targets.

摘要

化疗和靶向治疗的最新进展提高了癌症患者的生存率。在这种全身疾病得到更好控制的背景下,脑转移瘤(BM)正成为肿瘤学家面临的新挑战。然而,BM的流行病学和生物学在很大程度上仍不清楚。BM的发病率正在上升。这种趋势可以通过神经影像学(MRI)质量的提高和生存率的增加来解释。与BM患者相关的原发性癌症主要有:肺癌、乳腺癌、肾癌、结直肠癌和黑色素瘤。BM的患病率估计为9%,不过这个数字可能被低估了。从初次诊断到BM诊断的时间在增加,并且BM在晚期疾病患者中更频繁地发生。BM的生物学仍然知之甚少。循环肿瘤细胞(CTC)与血脑屏障(BBB)细胞之间需要相互作用。一些细胞因子可能作为CTC吸引剂并促进BM形成。BM的发展还涉及几个步骤(通过无窗孔毛细血管外渗、局部增殖、新生血管形成……),这些步骤代表了潜在的治疗靶点。

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