Moore S W
Department of Paediatric Surgery, Faculty of Medicine and Health Sciences, University of Stellenbosch, P.O. Box 19063, Tygerberg, 7505, South Africa,
Pediatr Surg Int. 2013 Dec;29(12):1217-29. doi: 10.1007/s00383-013-3424-3. Epub 2013 Oct 31.
Neonatal or perinatal tumours frequently relate to prenatal or developmental events and have a short exposure window which provides an opportunity to study tumours in a selective sensitive period of development. As a result, they display a number of host-specific features which include occasional spontaneous maturational changes with cells still responding to developmental influences. Neonatal tumours (NNT) are studied for a number of important reasons. Firstly, many of the benign tumours arising from soft tissue appear to result from disturbances in growth and development and some are associated with other congenital anomalies. Study of these aspects may open the door for investigation of genetic and epigenetic changes in genes controlling foetal development as well as environmental and drug effects during pregnancy. Secondly, the clinical behaviour of NNT differs from that of similar tumours occurring later in childhood. In addition, certain apparently malignant NNT can 'change course' in infancy leading to the maturation of apparently highly malignant tumours. Thirdly, NNT underline the genetic associations of most tumours but appear to differ in the effects of proto-oncogenes and other oncogenic factors. In this context, there are also connections between the foetal and neonatal period and some "adult" cancers. Fourthly, they appear to arise in a period in which minimal environmental interference has occurred, thus providing a unique potential window of opportunity to study the pathogenesis of tumour behaviour. This study will seek to review what is currently known in each of these areas of study as they apply to NNT. Further study of the provocative differences in tumour behaviour in neonates provides insights into the natural history of cancer in humans and promotes novel cancer therapies.
新生儿或围产期肿瘤通常与产前或发育事件相关,且暴露窗口较短,这为在发育的选择性敏感期研究肿瘤提供了机会。因此,它们表现出许多宿主特异性特征,包括偶尔出现的自发成熟变化,细胞仍对发育影响作出反应。研究新生儿肿瘤(NNT)有多个重要原因。首先,许多起源于软组织的良性肿瘤似乎是由生长和发育紊乱导致的,有些还与其他先天性异常有关。对这些方面的研究可能为调查控制胎儿发育的基因中的遗传和表观遗传变化以及孕期的环境和药物影响打开大门。其次,NNT的临床行为与儿童后期出现的类似肿瘤不同。此外,某些看似恶性的NNT在婴儿期可能“改变进程”,导致看似高度恶性的肿瘤成熟。第三,NNT突显了大多数肿瘤的遗传关联,但原癌基因和其他致癌因素的影响似乎有所不同。在这种情况下,胎儿期和新生儿期与一些“成人”癌症之间也存在联系。第四,它们似乎出现在环境干扰最小的时期,从而提供了一个独特的潜在机会窗口来研究肿瘤行为的发病机制。本研究将试图回顾目前在这些适用于NNT的研究领域中每个领域的已知情况。对新生儿肿瘤行为中引人注目的差异进行进一步研究,有助于深入了解人类癌症的自然史,并推动新型癌症治疗方法的发展。