Head and Neck Oncology Program, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA,
Adv Exp Med Biol. 2014;816:107-27. doi: 10.1007/978-3-0348-0837-8_5.
Cancer-related inflammation is considered the "seventh hallmark of cancer"; numerous studies demonstrate that tumors develop and progress within inflammatory diseases. Central to the development of cancer are genetic changes that endow these cancer cells with many of the hallmarks of cancer, such as self-sufficient growth and resistance to anti-growth and pro-death signals. However, while the genetic changes that occur within cancer cells themselves, such as activated oncogenes or dysfunctional tumor suppressors, are responsible for many aspects of cancer development, they are not sufficient. Tumor promotion and progression are dependent on ancillary processes involving cells of the tumor environment that are not necessarily cancerous themselves. Infiltration of immune cells facilitates tumor development through the production of factors that promote carcinogenesis and by enabling tumors to evade the host immune response. Small molecules including cytokines, chemokines, and growth factors play key roles in both inflammation and cancer by promoting proliferation, angiogenesis, and carcinogenesis and by recruiting immune cells. The extracellular matrix is altered in inflammation and provides structural support to developing tumors. Hypoxia is a common state in cancers and inflamed tissues which causes DNA damage and induces tumorigenic factors. Finally, tissue vasculature is a vital part of its microenvironment, supplying oxygen, nutrients, and growth factors to rapidly dividing cells and providing a mechanism for metastatic spread. This review will discuss the reflexive relationship between cancer and inflammation with particular focus on how by considering the role of inflammation in physiologic processes such as the maintenance of tissue homeostasis and repair may provide a logical framework for understanding the connection between the inflammatory response and cancer. The cells and molecules outlined here represent potential targets for the treatment of head and neck cancer.
癌症相关炎症被认为是“癌症的第七大特征”;许多研究表明,肿瘤是在炎症疾病中发展和进展的。癌症的核心是赋予这些癌细胞许多癌症特征的遗传变化,例如自给自足的生长和对抗生长和促死亡信号的抵抗。然而,虽然发生在癌细胞内部的遗传变化,如激活的癌基因或功能失调的肿瘤抑制基因,负责癌症发展的许多方面,但它们并不足以促成肿瘤的发生和发展。肿瘤的促进和进展取决于涉及肿瘤环境细胞的辅助过程,而这些细胞本身不一定是恶性的。免疫细胞的浸润通过产生促进致癌作用的因子和使肿瘤逃避宿主免疫反应来促进肿瘤的发展。包括细胞因子、趋化因子和生长因子在内的小分子通过促进增殖、血管生成和致癌作用以及招募免疫细胞在炎症和癌症中发挥关键作用。细胞外基质在炎症和提供结构支持发展中的肿瘤中发生改变。缺氧是癌症和炎症组织中的常见状态,会导致 DNA 损伤并诱导致癌因子。最后,组织脉管系统是其微环境的重要组成部分,为快速分裂的细胞提供氧气、营养物质和生长因子,并提供转移扩散的机制。这篇综述将讨论癌症与炎症之间的相互关系,特别关注如何通过考虑炎症在维持组织稳态和修复等生理过程中的作用,为理解炎症反应与癌症之间的联系提供一个合乎逻辑的框架。这里概述的细胞和分子代表了头颈部癌症治疗的潜在靶点。
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