Aili Yirizhati, Maimaitiming Nuersimanguli, Qin Hu, Ji Wenyu, Fan Guofeng, Wang Zengliang, Wang Yongxin
Department of Neurosurgery, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China.
Department of Four Comprehensive Internal Medicine, The First Affiliated Hospital of Xinjiang Medical University, Xinjiang, China.
Front Oncol. 2022 Oct 20;12:983878. doi: 10.3389/fonc.2022.983878. eCollection 2022.
Metastasis is one of the important biological features of malignant tumors and one of the main factors responsible for poor prognosis. Although the widespread application of newer clinical technologies and their continuous development have significantly improved survival in patients with brain metastases, there is no uniform standard of care. More effective therapeutic measures are therefore needed to improve prognosis. Understanding the mechanisms of tumor cell colonization, growth, and invasion in the central nervous system is of particular importance for the prevention and treatment of brain metastases. This process can be plausibly explained by the "seed and soil" hypothesis, which essentially states that tumor cells can interact with various components of the central nervous system microenvironment to produce adaptive changes; it is this interaction that determines the development of brain metastases. As a novel form of intercellular communication, exosomes play a key role in the brain metastasis microenvironment and carry various bioactive molecules that regulate receptor cell activity. In this paper, we review the roles and prospects of brain metastatic tumor cells, the brain metastatic tumor microenvironment, and exosomes in the development and clinical management of brain metastases.
转移是恶性肿瘤的重要生物学特征之一，也是导致预后不良的主要因素之一。尽管更新的临床技术广泛应用及其不断发展显著提高了脑转移患者的生存率，但目前尚无统一的治疗标准。因此，需要更有效的治疗措施来改善预后。了解肿瘤细胞在中枢神经系统中的定植、生长和侵袭机制对于脑转移的预防和治疗尤为重要。这一过程可以用“种子与土壤”假说来合理解释，该假说本质上认为肿瘤细胞可以与中枢神经系统微环境的各种成分相互作用以产生适应性变化；正是这种相互作用决定了脑转移的发展。作为一种新型的细胞间通讯形式，外泌体在脑转移微环境中起关键作用，并携带各种调节受体细胞活性的生物活性分子。在本文中，我们综述了脑转移肿瘤细胞、脑转移肿瘤微环境和外泌体在脑转移发生发展及临床管理中的作用和前景。
