Department of Gynecology and Obstetrics, Asklepios Klinik Barmbek, Hamburg, Germany.
Department of Obstetrics and Gynecology, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany.
Adv Exp Med Biol. 2020;1220:35-43. doi: 10.1007/978-3-030-35805-1_3.
Hematogenous dissemination of single cancer cells is a common phenomenon in patients with solid tumors. These cells may experience different fates: most will die during the process; some will grow into metastasis and some will persist in secondary homing sites for many years in a state referred to as dormancy. The mechanisms of this state are still not clear; single cancer cells can survive either by completely withdrawing from the cell cycle or by continuing to proliferate at a slow rate that is counterbalanced by cell death. Another hypothesis assumes that at least some of dormant tumor cells feature stem cell-like characteristics that may contribute to their extremely long half-lives and enhance chemotherapy resistance. Breast cancer is particularly known for prolonged periods of clinical freedom of disease (sometimes up to 20-30 years), followed by a distant relapse. In this chapter, we explore the relationship between the clinical phenomenon of tumor dormancy and the disseminated tumor cells and discuss the potential implications for treatment.
血行播散的单个癌细胞是实体瘤患者中常见的现象。这些细胞可能会经历不同的命运：大多数会在这个过程中死亡；一些会生长成转移灶，还有一些会在继发性归巢部位持续多年休眠状态。这种状态的机制尚不清楚；单个癌细胞可以通过完全退出细胞周期或通过继续以缓慢的速度增殖来存活，而细胞死亡会与之平衡。另一种假设认为，至少一些休眠的肿瘤细胞具有类似干细胞的特征，这可能有助于它们极其长的半衰期，并增强化疗耐药性。乳腺癌尤其以疾病临床无进展期长（有时长达 20-30 年）为特征，随后出现远处复发。在本章中，我们探讨了肿瘤休眠的临床现象与播散性肿瘤细胞之间的关系，并讨论了其对治疗的潜在影响。
