Kenda Suster N, Virant-Klun I, Frkovic Grazio S, Smrkolj S
Eur J Gynaecol Oncol. 2016;37(5):604-612.
Ovarian cancer is among the most common gynecologic cancers and unfortunately the most common cause of death from gynecologic malignancies. Due to few early symptoms and insufficient screening programs, an early diagnosis of ovarian cancer is very difficult and new biomarkers related to early ovarian carcinogenesis are needed. In the last years a growing scientific knowledge about cancer stem cells and their markers opened a new perspective on screening and early diagnosis of ovarian cancer. The transcription factor NANOG is not only a pluripotency and cancer stem cell-related marker, but also promotes cancer stem cell-like characteristics of tumor, tumor growth, dissemination, immune evasion, and resistance to conventional therapy. The recent data showed that small stem cells resembling very small embryonic-like stem cells are present in the ovarian surface epithelium of adult human ovaries. These cells expressed several genes related to primordial germ cells, germinal lineage, and pluripotency, including NANOG, therefore their involvement in the manifestation of ovarian cancer are not excluded. As majority of cancer cells within a tumor are non tumorigenic, the therapies targeting these cells cause tumor regression, but the survived cancer stem cells regenerate the tumor, so tumor relapse or reoccur. The eradication of cancer actually requires the elimination of cancer stem cells, therefore new strategies in treatment that specifically target cancer stem cells are urgently needed. Although the therapeutic efficacy of targeting NANOG as a cancer treatment method is still in experimental phase, the gene therapy with small interfering RNA or short hairpin RNA have already shown some promising therapeutic potential. The authors can conclude that NANOG represents a promising diagnostic marker and agent for target therapy of ovarian cancer.
卵巢癌是最常见的妇科癌症之一，不幸的是，它也是妇科恶性肿瘤最常见的死因。由于早期症状较少且筛查项目不足，卵巢癌的早期诊断非常困难，因此需要与卵巢癌早期发生相关的新生物标志物。近年来，关于癌症干细胞及其标志物的科学知识不断增加，为卵巢癌的筛查和早期诊断开辟了新的视角。转录因子NANOG不仅是一种多能性和癌症干细胞相关标志物，还能促进肿瘤的癌症干细胞样特征、肿瘤生长、扩散、免疫逃逸以及对传统疗法的抗性。最近的数据表明，成人卵巢的卵巢表面上皮中存在类似非常小的胚胎样干细胞的小干细胞。这些细胞表达了几种与原始生殖细胞、生殖谱系和多能性相关的基因，包括NANOG，因此不排除它们参与卵巢癌的发生。由于肿瘤内的大多数癌细胞不具有致瘤性，针对这些细胞的疗法会导致肿瘤消退，但存活的癌症干细胞会使肿瘤再生，从而导致肿瘤复发或再次出现。根除癌症实际上需要消除癌症干细胞，因此迫切需要专门针对癌症干细胞的新治疗策略。尽管将NANOG作为癌症治疗方法的治疗效果仍处于实验阶段，但用小干扰RNA或短发夹RNA进行的基因治疗已经显示出一些有前景的治疗潜力。作者可以得出结论，NANOG是一种有前景的卵巢癌诊断标志物和靶向治疗药物。
