Department of Oncology/ Surgery, Carol Davila University, St. Pantelimon Hospital, Dionisie Lupu Street, No. 37, Bucharest, 020021, Romania.
Semin Cancer Biol. 2022 Nov;86(Pt 3):600-615. doi: 10.1016/j.semcancer.2021.10.003. Epub 2021 Oct 23.
Cancer research has been largely focused on the cellular and molecular levels of investigation. Recent data show that not only the cell but also the extracellular matrix plays a major role in the progression of malignancy. In this way, the cells and the extracellular matrix create a specific local microenvironment that supports malignant development. At the same time, cancer implies a systemic evolution which is closely related to developmental processes and adaptation. Consequently, there is currently a real gap between the local investigation of cancer at the microenvironmental level, and the pathophysiological approach to cancer as a systemic disease. In fact, the cells and the matrix are not only complementary structures but also interdependent components that act synergistically. Such relationships lead to cell-matrix integration, a supracellular form of biological organization that supports tissue development. The emergence of this supracellular level of organization, as a structure, leads to the emergence of the supracellular control of proliferation, as a supracellular function. In humans, proliferation is generally involved in developmental processes and adaptation. These processes suppose a specific configuration at the systemic level, which generates high-order guidance for local supracellular control of proliferation. In conclusion, the supracellular control of proliferation act as an interface between the downstream level of cell division and differentiation, and upstream level of developmental processes and adaptation. Understanding these processes and their disorders is useful not only to complete the big picture of malignancy as a systemic disease, but also to open new treatment perspectives in the form of etiopathogenic (supracellular or informational) therapies.
癌症研究主要集中在细胞和分子水平的研究。最近的数据表明,不仅细胞,而且细胞外基质在恶性肿瘤的进展中起着主要作用。通过这种方式,细胞和细胞外基质创造了一个特定的局部微环境,支持恶性发展。同时,癌症意味着一种与发育过程和适应密切相关的系统性进化。因此,目前在癌症的局部微环境研究和癌症作为系统性疾病的病理生理学方法之间存在真正的差距。事实上,细胞和基质不仅是互补的结构,而且是相互依存的组成部分,它们协同作用。这种关系导致细胞-基质整合,这是一种支持组织发育的超细胞形式的生物组织。这种超细胞水平的组织的出现导致了增殖的超细胞控制的出现,作为一种超细胞功能。在人类中,增殖通常涉及发育过程和适应。这些过程在系统水平上假设了一种特定的配置,为局部超细胞增殖控制生成了高级别的指导。总之,增殖的超细胞控制作为细胞分裂和分化的下游水平与发育过程和适应的上游水平之间的接口。理解这些过程及其障碍不仅有助于完成作为系统性疾病的恶性肿瘤的全貌,而且有助于以病因学(超细胞或信息学)治疗的形式开辟新的治疗视角。