Kenda Suster Natasa, Virant-Klun Irma
Department of Gynecology, Division of Obstetrics and Gynecology, University Medical Centre Ljubljana, Ljubljana 1000, Slovenia.
Department of Human Reproduction, Division of Obstetrics and Gynecology, University Medical Centre Ljubljana, Ljubljana 1000, Slovenia.
World J Stem Cells. 2019 Jul 26;11(7):383-397. doi: 10.4252/wjsc.v11.i7.383.
Ovarian cancer is the deadliest gynecological malignancy. It is typically diagnosed at advanced stages of the disease, with metastatic sites disseminated widely within the abdominal cavity. Ovarian cancer treatment is challenging due to high disease recurrence and further complicated pursuant to acquired chemoresistance. Cancer stem cell (CSC) theory proposes that both tumor development and progression are driven by undifferentiated stem cells capable of self-renewal and tumor-initiation. The most recent evidence revealed that CSCs in terms of ovarian cancer are not only responsible for primary tumor growth, metastasis and relapse of disease, but also for the development of chemoresistance. As the elimination of this cell population is critical for increasing treatment success, a deeper understanding of ovarian CSCs pathobiology, including epithelial-mesenchymal transition, signaling pathways and tumor microenvironment, is needed. Finally, before introducing new therapeutic agents for ovarian cancer, targeting CSCs, accurate identification of different ovarian stem cell subpopulations, including the very small embryonic-like stem cells suggested as progenitors, is necessary. To these ends, reliable markers of ovarian CSCs should be identified. In this review, we present the current knowledge and a critical discussion concerning ovarian CSCs and their clinical role.
卵巢癌是最致命的妇科恶性肿瘤。它通常在疾病晚期被诊断出来，转移部位广泛散布于腹腔内。由于疾病复发率高，且因获得性化疗耐药而使情况进一步复杂化，卵巢癌的治疗颇具挑战性。癌症干细胞（CSC）理论提出，肿瘤的发生和发展是由能够自我更新和启动肿瘤形成的未分化干细胞驱动的。最新证据表明，就卵巢癌而言，癌症干细胞不仅负责原发性肿瘤的生长、转移和疾病复发，还与化疗耐药的产生有关。由于清除这一细胞群体对于提高治疗成功率至关重要，因此需要更深入地了解卵巢癌干细胞的病理生物学，包括上皮-间质转化、信号通路和肿瘤微环境。最后，在引入针对卵巢癌干细胞的新治疗药物之前，准确识别不同的卵巢干细胞亚群，包括被认为是祖细胞的极小胚胎样干细胞，是很有必要的。为此，应确定卵巢癌干细胞的可靠标志物。在这篇综述中，我们介绍了有关卵巢癌干细胞及其临床作用的当前知识并进行了批判性讨论。
