Department of Critical Care Medicine, Shengjing Hospital of China Medical University, Shenyang, China.
Department of General Surgery, Shengjing Hospital of China Medical University, Shenyang, China.
Cancer Med. 2022 Jul;11(13):2601-2611. doi: 10.1002/cam4.4637. Epub 2022 Mar 13.
In this study, based on some clinical phenomena and recently published knowledge, we proposed our "conversion-deterioration-double mutation" theory, which provides a possible unifying explanation for the evolutionary process of colorectal cancer cells in the human body. In this theory, we proposed that there is a partial interconversion and a jump conversion relationship among normal colorectal epithelial cells, colorectal cancer cells, stem cells, and cancer stem cells (conversion). This conversion leads to tumor heterogeneity. We also proposed that well-differentiated cancer cells converted from cancer stem cells have a more aggressive pattern than primary cancer cells (deterioration). The deterioration of primary cancer cells leads to differences in treatment responses and prognosis. Finally, we speculate a double mutation theory, indicating that for metastasis to occur, both mutations of cancer cells and mutations of target organs are needed and should match and meet. All these three points constitute the "conversion-deterioration-double mutation" theory.
在这项研究中，基于一些临床现象和最近发表的知识，我们提出了我们的“转化-恶化-双重突变”理论，该理论为人体内结直肠癌细胞的进化过程提供了一个可能的统一解释。在该理论中，我们提出在正常结直肠上皮细胞、结直肠癌细胞、干细胞和癌症干细胞（转化）之间存在部分相互转化和跳跃转化关系。这种转化导致肿瘤异质性。我们还提出，从癌症干细胞转化而来的分化良好的癌细胞比原发性癌细胞具有更具侵袭性的模式（恶化）。原发性癌细胞的恶化导致治疗反应和预后的差异。最后，我们推测了一个双重突变理论，表明为了发生转移，需要癌细胞和靶器官的突变，并且应该匹配和满足。所有这三点构成了“转化-恶化-双重突变”理论。
