Experimental Medicine and Therapy Research, University of Regensburg, Regensburg, Germany.
Nature. 2013 Sep 19;501(7467):365-72. doi: 10.1038/nature12628.
Cancer is often regarded as a process of asexual evolution driven by genomic and genetic instability. Mutation, selection and adaptation are by convention thought to occur primarily within, and to a lesser degree outside, the primary tumour. However, disseminated cancer cells that remain after 'curative' surgery exhibit extreme genomic heterogeneity before the manifestation of metastasis. This heterogeneity is later reduced by selected clonal expansion, suggesting that the disseminated cells had yet to acquire key traits of fully malignant cells. Abrogation of the cells' progression outside the primary tumour implies new challenges and opportunities for diagnosis and adjuvant therapies.
癌症通常被认为是一种由基因组和遗传不稳定性驱动的无性进化过程。传统上认为，突变、选择和适应主要发生在原发性肿瘤内部，程度较轻的情况下也发生在原发性肿瘤外部。然而，在“根治性”手术后仍然存在的播散性癌细胞在转移前表现出极端的基因组异质性。这种异质性随后通过选择的克隆扩张而减少，这表明播散性细胞尚未获得完全恶性细胞的关键特征。原发性肿瘤以外的细胞进展的消除意味着诊断和辅助治疗面临新的挑战和机遇。
