Laboratory of Molecular Gastroenterology, Humanitas Clinical and Research Center, 20089 Milan, Italy.
World J Gastroenterol. 2013 Jan 14;19(2):174-84. doi: 10.3748/wjg.v19.i2.174.
Colorectal cancer (CRC) remains one of the major public health problems throughout the world. Originally depicted as a multi-step dynamical disease, CRC develops slowly over several years and progresses through cytologically distinct benign and malignant states, from single crypt lesions through adenoma, to malignant carcinoma with the potential for invasion and metastasis. Moving from histological observations since a long time, it has been recognized that inflammation and immunity actively participate in the pathogenesis, surveillance and progression of CRC. The advent of immunohistochemical techniques and of animal models has improved our understanding of the immune dynamical system in CRC. It is well known that immune cells have variable behavior controlled by complex interactions in the tumor microenvironment. Advances in immunology and molecular biology have shown that CRC is immunogenic and that host immune responses influence survival. Several lines of evidence support the concept that tumor stromal cells, are not merely a scaffold, but rather they influence growth, survival, and invasiveness of cancer cells, dynamically contributing to the tumor microenvironment, together with immune cells. Different types of immune cells infiltrate CRC, comprising cells of both the innate and adaptive immune system. A relevant issue is to unravel the discrepancy between the inhibitory effects on cancer growth exerted by the local immune response and the promoting effects on cancer proliferation, invasion, and dissemination induced by some types of inflammatory cells. Here, we sought to discuss the role played by innate and adaptive immune system in the local progression and metastasis of CRC, and the prognostic information that we can currently understand and exploit.
结直肠癌（CRC）仍然是全世界主要的公共卫生问题之一。最初被描述为一个多步骤的动态疾病，CRC 在几年内缓慢发展，并通过细胞学上不同的良性和恶性状态进展，从单个隐窝病变发展为腺瘤，再发展为具有侵袭和转移潜力的恶性癌。从很久以前的组织学观察中可以认识到，炎症和免疫积极参与 CRC 的发病机制、监测和进展。免疫组织化学技术和动物模型的出现提高了我们对 CRC 中免疫动态系统的理解。众所周知，免疫细胞的行为具有可变性，受肿瘤微环境中复杂相互作用的控制。免疫学和分子生物学的进展表明 CRC 具有免疫原性，宿主免疫反应影响生存。有几条证据支持这样的概念，即肿瘤基质细胞不仅是支架，而且它们动态地影响癌细胞的生长、存活和侵袭性，与免疫细胞一起共同影响肿瘤微环境。不同类型的免疫细胞浸润 CRC，包括固有免疫和适应性免疫系统的细胞。一个相关的问题是揭示局部免疫反应对癌症生长的抑制作用与某些类型的炎症细胞对癌症增殖、侵袭和扩散的促进作用之间的差异。在这里，我们试图讨论先天和适应性免疫系统在 CRC 的局部进展和转移中所起的作用，以及我们目前可以理解和利用的预后信息。
