Pierce G B, Speers W C
Department of Pathology, University of Colorado Health Sciences Center, Denver 80262.
Cancer Res. 1988 Apr 15;48(8):1996-2004.
A concept of neoplasms, based upon developmental and oncological principles, states that carcinomas are caricatures of tissue renewal, in that they are composed of a mixture of malignant stem cells, which have a marked capacity for proliferation and a limited capacity for differentiation under normal homeostatic conditions, and of the differentiated, possibly benign, progeny of these malignant cells. The concept brings order to the facts about carcinoma, has predictive value for embryogenesis, and indicates possibilities for differentiation therapy. One such possibility assumes on the basis of experimentation in vitro that malignant stem cells can be induced to differentiate into postmitotic cells by application of chemicals. Another suggests study of naturally occurring substances which regulate cell proliferation and differentiation in adult tissues. The other possibility, based upon experiments in vivo and in vitro, indicates that embryonic fields are capable of converting their closely corresponding malignant lineages into apparently normal lineages responsive to homeostatic control. Induced differentiation of embryonal carcinoma has been achieved in vivo with improvement in longevity of the host and in some cases with apparent cure. However, ultimate success of treatment based upon turning malignant cells into benign cells will depend upon the nature of the benign cells. Will they remain benign?
一种基于发育学和肿瘤学原理的肿瘤概念认为，癌是组织更新的异常表现，因为它们由恶性干细胞和这些恶性细胞分化后的子代细胞（可能是良性的）混合组成。恶性干细胞在正常稳态条件下具有显著的增殖能力和有限的分化能力。这一概念使有关癌的事实变得有条理，对胚胎发生具有预测价值，并指出了分化治疗的可能性。一种可能性是基于体外实验，即通过应用化学物质可诱导恶性干细胞分化为有丝分裂后细胞。另一种可能性是研究调节成体组织中细胞增殖和分化的天然物质。基于体内和体外实验的另一种可能性表明，胚胎区域能够将其紧密对应的恶性谱系转化为对稳态控制有反应的明显正常谱系。在体内已实现胚胎癌的诱导分化，宿主寿命延长，在某些情况下明显治愈。然而，基于将恶性细胞转化为良性细胞的治疗最终成功与否将取决于良性细胞的性质。它们会保持良性吗？
