Department of Gynaecology, University of Leipzig, Leipzig, Germany.
Lancet Oncol. 2015 Mar;16(3):e148-51. doi: 10.1016/S1470-2045(14)71028-9.
The ontogenetic theory of locoregional cancer spread regards cancer as a clinical manifestation of the pathological reactivation and maintenance of the sequential developmental programmes that previously controlled the stepwise embryological morphogenesis of the tissue from which the cancer originated. In the state of morphostasis that characterises adult organisms, these programmes are silenced. During malignant progression, these programmes run in retrograde sequence, which leads to cancer infiltration of ever larger tissue areas. However, because the reactivated morphogenetic programmes need topologically defined tissue domains--morphogenetic fields--to provide positional information for their interpretation, local tumour propagation is confined to permissive compartments (topographically defined tissue domains where malignant cells can survive, migrate, and proliferate), which are determined by the state of malignant progression. The tissue at risk of local tumour spread, the cancer field, is the mature tissue derived from the corresponding morphogenetic field in the embryo, which is labelled with the respective positional information. The theory can be tested morphologically and clinically for all tumours. Verification of this theory would offer substantial potential to improve prognostic assessment and surgical treatment. Identification of the complementary positional information for tumour cells in different ontogenetic stages, and their associated cancer fields, could be a molecular research strategy to further test the theory.
局部区域癌症转移的个体发生理论将癌症视为先前控制组织逐步胚胎发生形态发生的病理再激活和维持的临床表现，而该组织是癌症的起源。在成年生物的形态稳定状态下，这些程序被沉默。在恶性进展过程中，这些程序逆行运行，导致癌症浸润越来越大的组织区域。然而，由于重新激活的形态发生程序需要拓扑定义的组织域（形态发生场）来提供解释的位置信息，因此局部肿瘤的传播仅限于允许的隔室（拓扑定义的组织域，其中恶性细胞可以存活、迁移和增殖），这由恶性进展的状态决定。有局部肿瘤扩散风险的组织，即癌症场，是源自胚胎相应形态发生场的成熟组织，该组织标有相应的位置信息。该理论可以对所有肿瘤进行形态学和临床检验。该理论的验证将为改善预后评估和手术治疗提供实质性潜力。鉴定不同个体发生阶段肿瘤细胞的互补位置信息及其相关的癌症场可能是进一步检验该理论的分子研究策略。
