Yuspa S H, Poirier M C
Division of Cancer Etiology, National Cancer Institute, Bethesda, Maryland 20892.
Adv Cancer Res. 1988;50:25-70. doi: 10.1016/s0065-230x(08)60434-0.
During the last decade, progress in chemical carcinogenesis research has been substantial, and understanding the cellular changes and molecular causes of initiation, promotion, and malignant conversion appears to be within reach. Cancer begins as a carcinogen-induced genetic change in a single cell. The interaction of a particular carcinogen with specific genetic sites results, in part, from selectivity of metabolically activated carcinogens for particular nucleosides or gene sequences. In turn, modification of the molecular structure at specific genetic loci will have tissue-specific and species-specific consequences dependent on the expression of a particular gene, its sequence, and the function of the gene product in the target cell. It is likely that inactivation of regulatory regions, genomic rearrangements, and point mutations in coding sequences all can result in an altered cell phenotype. The rasH gene (and perhaps other members of the ras gene family) appears to be a common target for coding sequence mutations in the initiation of carcinogenesis in several organ sites and species by specific carcinogens. Whatever genetic mechanisms are involved, an initiated cell phenotype common to many epithelial cell types is observed. Initiated cells have an altered program of terminal differentiation, are resistant to cytotoxic substances or show altered requirements for specific growth factors or nutrients. These cells would have a selective growth advantage in cytostatic or cytotoxic situations or under conditions favoring terminal differentiation. Tumor promoters, some acting through specific cellular receptors, produce a tissue environment conductive to the selective clonal outgrowth of the initiated cell population resulting in a clinically evident premalignant lesion. The tissue specificity for most promoters depends on the ability of a particular agent to produce the selective conditions required for the initiated phenotype of that organ. At the molecular level, phorbol ester tumor promoters bind to and activate protein kinase C and transduce signals through this second-messenger pathway. Heterogeneity in the species of protein kinase C molecule expressed by normal and initiated epidermal cells could account for the differential response pattern observed in these cell types during skin tumor promotion. Malignant conversion of benign tumors requires further genetic changes in the tumor cell. Such changes could result from inherent instability in the genome of initiated cells, from spontaneous mutations more likely to occur in the expanding population of proliferating benign tumor cells, or by additional exposure to exogenous genotoxic agents.(ABSTRACT TRUNCATED AT 400 WORDS)
在过去十年中,化学致癌作用研究取得了重大进展,似乎有望了解引发、促进和恶性转化的细胞变化及分子原因。癌症始于单个细胞中致癌物诱导的基因变化。特定致癌物与特定基因位点的相互作用,部分源于代谢活化致癌物对特定核苷或基因序列的选择性。反过来,特定基因位点分子结构的改变将产生组织特异性和物种特异性后果,这取决于特定基因的表达、其序列以及基因产物在靶细胞中的功能。调控区域的失活、基因组重排以及编码序列中的点突变都可能导致细胞表型改变。rasH基因(或许还有ras基因家族的其他成员)似乎是特定致癌物在多个器官部位和物种引发致癌作用时编码序列突变的常见靶点。无论涉及何种遗传机制,都能观察到许多上皮细胞类型共有的起始细胞表型。起始细胞具有改变的终末分化程序,对细胞毒性物质有抗性,或对特定生长因子或营养物质的需求发生改变。这些细胞在细胞抑制或细胞毒性情况下,或在有利于终末分化的条件下,将具有选择性生长优势。肿瘤促进剂,有些通过特定细胞受体起作用,产生有利于起始细胞群体选择性克隆扩增的组织环境,从而导致临床上明显的癌前病变。大多数促进剂的组织特异性取决于特定试剂产生该器官起始表型所需选择性条件的能力。在分子水平上,佛波酯肿瘤促进剂与蛋白激酶C结合并激活它,并通过这条第二信使途径转导信号。正常和起始表皮细胞表达的蛋白激酶C分子种类的异质性,可能解释了在皮肤肿瘤促进过程中这些细胞类型观察到的不同反应模式。良性肿瘤的恶性转化需要肿瘤细胞进一步的基因变化。这种变化可能源于起始细胞基因组固有的不稳定性,源于在不断扩大的增殖性良性肿瘤细胞群体中更可能发生的自发突变,或源于额外接触外源性基因毒性剂。(摘要截选至400词)