Gautam Deepa, Clarke Emily M, Roweth Harvey G, Smith Margaret R, Battinelli Elisabeth M
Division of Hematology, Department of Medicine; Brigham and Women's Hospital.
Harvard Medical School, Boston, Massachusetts, USA.
Curr Opin Hematol. 2025 Jan 1;32(1):52-60. doi: 10.1097/MOH.0000000000000852. Epub 2024 Nov 21.
Despite being discovered decades ago, metastasis remains a formidable challenge in cancer treatment. During the intermediate phase of metastasis, tumor cells detach from primary tumor or metastatic sites and travel through the bloodstream and lymphatic system to distant tissues. These tumor cells in the circulation are known as circulating tumor cells (CTCs), and a higher number of CTCs has been linked to poor prognoses in various cancers. The blood is an inhospitable environment for any foreign cells, including CTCs, as they face numerous challenges, such as the shear stress within blood vessels and their interactions with blood and immune cells. However, the exact mechanisms by which CTCs survive the hostile conditions of the bloodstream remain enigmatic. Platelets have been studied for their interactions with tumor cells, promoting their survival, growth, and metastasis. This review explores the latest clinical methods for enumerating CTCs, recent findings on platelet-CTC crosstalk, and current research on antiplatelet therapy as a potential strategy to inhibit metastasis, offering new therapeutic insights.
Laboratory and clinical data have provided insights into the role of platelets in promoting CTC survival, while clinical advancements in CTC enumeration offer improved prognostic tools.
CTCs play a critical role in metastasis, and their interactions with platelets aid their survival in the hostile environment of the bloodstream. Understanding this crosstalk offers insights into potential therapeutic strategies, including antiplatelet therapy, to inhibit metastasis and improve cancer treatment outcomes.
尽管转移现象在数十年前就已被发现，但它仍是癌症治疗中一项艰巨的挑战。在转移的中间阶段，肿瘤细胞从原发肿瘤或转移部位脱离，通过血液循环和淋巴系统转移至远处组织。循环中的这些肿瘤细胞被称为循环肿瘤细胞（CTC），在多种癌症中，较高数量的CTC与不良预后相关。血液对于包括CTC在内的任何外来细胞而言都是不利环境，因为它们面临诸多挑战，如血管内的剪切应力以及它们与血液和免疫细胞的相互作用。然而，CTC在血流的恶劣条件下存活的确切机制仍不清楚。血小板因其与肿瘤细胞的相互作用、促进肿瘤细胞存活、生长和转移而受到研究。本综述探讨了枚举CTC的最新临床方法、血小板与CTC相互作用的最新发现，以及作为抑制转移的潜在策略的抗血小板治疗的当前研究，提供了新的治疗见解。
实验室和临床数据揭示了血小板在促进CTC存活中的作用，而CTC枚举的临床进展提供了更好的预后工具。
CTC在转移中起关键作用，它们与血小板的相互作用有助于它们在血流的恶劣环境中存活。了解这种相互作用为包括抗血小板治疗在内的潜在治疗策略提供了见解，以抑制转移并改善癌症治疗结果。
