Seoul National University College of Medicine, Seoul, Republic of Korea.
SillaJen, Inc., Seoul, Republic of Korea.
Adv Exp Med Biol. 2021;1187:245-266. doi: 10.1007/978-981-32-9620-6_12.
Cancer stem cells are a subpopulation of cancer cells responsible for the most demanding and aggressive cancer cell phenotypes: therapy resistance, a self-protective feature of stem cells; distant metastasis, requiring anchorage independence for survival in the circulation; and recurrence, which is related to the dormant-active cycling of stem cells. Normal tissues are composed of parenchymal cells, supportive connective components, and cellular disposal systems for removing the products of physiological wear and tear. Cancer stem cells develop from normal counterparts and progressively interact with their microenvironments, modifying and conditioning the cancer microenvironment. Cancer-associated myeloid cells constitute a major element of the cancer microenvironment. During the process of carcinogenesis, cancer stem cells and their intimately associated myeloid cells mutually interact and evolve, such that the cancer cells potentiate the activity of the myeloid cells and, in return, the myeloid cells increase cancer stem cell characteristics. Normal myeloid cells function as key accessory cells to maintain homeostasis in normal tissues and organs; in cancers, these cells co-evolve with the malignant parenchymal cells and are involved in every aspect of cancer cell biology, including proliferation, invasion, distant metastasis, and the development of resistance to therapy. In this way, cancer-associated myeloid cells provide two of the key hallmarks of cancer: evasion of immune destruction and cancer-promoting inflammation.
耐药性是干细胞的自我保护特性；远处转移需要在循环中具有锚定独立性以存活；复发与干细胞的休眠-激活循环有关。正常组织由实质细胞、支持性结缔组织成分和细胞处理系统组成，用于清除生理磨损的产物。癌症干细胞源自正常细胞，并逐渐与其微环境相互作用，改变和调节肿瘤微环境。与癌症相关的髓系细胞构成了肿瘤微环境的主要成分。在癌变过程中，癌症干细胞及其密切相关的髓系细胞相互作用并共同进化，使得癌细胞增强了髓系细胞的活性，而髓系细胞则增加了癌症干细胞的特征。正常的髓系细胞作为维持正常组织和器官内稳态的关键辅助细胞发挥作用；在癌症中，这些细胞与恶性实质细胞共同进化，并参与癌细胞生物学的各个方面，包括增殖、侵袭、远处转移以及对治疗的耐药性发展。通过这种方式，与癌症相关的髓系细胞提供了癌症的两个关键特征：逃避免疫破坏和促进癌症炎症。
