Robb Tamsin Joy, Tse Rexson, Blenkiron Cherie
Department of Molecular Medicine and Pathology, Faculty of Medical and Health Sciences, University of Auckland, Auckland 1051, New Zealand.
Department of Forensic Pathology, LabPLUS, Auckland City Hospital, Auckland 1051, New Zealand.
Cancers (Basel). 2021 Jan 22;13(3):409. doi: 10.3390/cancers13030409.
Outstanding questions plaguing oncologists, centred around tumour evolution and heterogeneity, include the development of treatment resistance, immune evasion, and optimal drug targeting strategies. Such questions are difficult to study in limited cancer tissues collected during a patient's routine clinical care, and may be better investigated in the breadth of cancer tissues that may be permissible to collect during autopsies. We are starting to better understand key tumour evolution challenges based on advances facilitated by autopsy studies completed to date. This review article explores the great progress in understanding that cancer tissues collected at autopsy have already enabled, including the shared origin of metastatic cells, the importance of early whole-genome doubling events for amplifying genes needed for tumour survival, and the creation of a wealth of tissue resources powered to answer future questions, including patient-derived xenografts, cell lines, and a wide range of banked tissues. We also highlight the future role of these programmes in advancing our understanding of cancer evolution. The research autopsy provides a special opportunity for cancer patients to give the ultimate gift-to selflessly donate their tissues towards better cancer care.
困扰肿瘤学家的突出问题，围绕肿瘤进化和异质性，包括治疗耐药性的发展、免疫逃逸以及最佳药物靶向策略。这类问题在患者常规临床护理期间收集的有限癌症组织中难以研究，而在尸检时可能允许收集的更广泛癌症组织中或许能得到更好的研究。基于迄今完成的尸检研究取得的进展，我们开始更好地理解肿瘤进化面临的关键挑战。这篇综述文章探讨了在理解方面已经取得的巨大进展，即尸检时收集的癌症组织所带来的进展，包括转移细胞的共同起源、早期全基因组加倍事件对扩增肿瘤生存所需基因的重要性，以及创建了大量有能力回答未来问题的组织资源，包括患者来源的异种移植、细胞系和各种保存的组织。我们还强调了这些项目在推进我们对癌症进化理解方面的未来作用。研究性尸检为癌症患者提供了一个特殊机会，让他们能给予终极礼物——无私捐献自己的组织以促进更好的癌症治疗。
