"Advanced Surgical Technologies", Department of Surgical Sciences, Sapienza University of Rome, Rome, Italy.
Department of Surgical Sciences, Sapienza University of Rome, Rome, Italy.
Cancer Biomark. 2017 Sep 7;20(3):231-234. doi: 10.3233/CBM-151176.
According to the American Association of Cancer Research (AACR), a Cancer Stem Cell is a cell within a tumor that possesses the capacity to self-renew and to cause the heterogeneous lineages of cancer cells that constitutes the tumor [1]. Cancer Stem Cells (CSCs) are involved in the metastatic process, in the resistance to therapeutic treatments of many types of human cancers and consequently in the onset of recurrences. Numerous translational studies have been conducted to understand CSC characteristics and evaluate association between CSC-related biomarkers and clinical outcomes. The CSC theory can explain also a tumor relapse after that a tumor has been completely surgically removed (R0 macroscopical zero residual resection) or after an apparently complete response to chemotherapy. CSCs, in fact, showed a marked ability to reduce intracellular accumulation of chemotherapic agents by active drug extrusion, increased chemoresistance and survival, as well as elevated membrane transporter activity. In addition, it is possible that these cancer stem cells may nest in the "secured" (niche) sites of our body, where they may remain undisturbed for a long time, even years, until a stimulus arrives to awaken them, causing the disease to resume. CSCs, in fact, are able to use a variety of cellular pathways to survive to anticancer treatments. More recently CSCs have been described in several solid tumors, expressing specific biomarkers. Another field of research should be focused on the realization of diagnostic instruments to follow up patients after R0 surgical resection or after a complete response for an early detection and management of relapse and metastasis.
根据美国癌症研究协会 (AACR) 的说法，癌症干细胞是肿瘤内具有自我更新能力并能引起构成肿瘤的癌症细胞异质性谱系的细胞[1]。癌症干细胞 (CSC) 参与转移过程，对许多类型的人类癌症的治疗有抵抗力，因此会导致复发。已经进行了许多转化研究来了解 CSC 的特征，并评估与 CSC 相关的生物标志物与临床结果之间的关联。CSC 理论还可以解释肿瘤在完全手术切除（R0 宏观零残留切除）后或在对化疗有明显完全反应后复发。事实上，CSC 具有通过主动药物外排显著减少化疗药物细胞内积累、增加化疗耐药性和存活能力以及提高膜转运体活性的能力。此外，这些癌症干细胞可能栖息在我们身体的“安全”（生态位）部位，在那里它们可能长时间保持不受干扰，甚至数年，直到有刺激物唤醒它们，导致疾病再次发作。CSC 实际上能够利用多种细胞途径来抵抗抗癌治疗。最近，在几种实体肿瘤中描述了 CSC，它们表达特定的生物标志物。另一个研究领域应侧重于开发诊断仪器，以便在 R0 手术后或完全缓解后对患者进行随访，以便早期发现和管理复发和转移。
