Gan Jiaqi, Zhang Xinjun, Guo Jie
Health Science Center, Ningbo University, Ningbo, 315211, China.
Department of Gastroenterology, The First Affiliated Hospital of Ningbo University, Ningbo, 315020, China.
Cancer Cell Int. 2025 Jul 11;25(1):258. doi: 10.1186/s12935-025-03877-w.
Only circulating tumor cells (CTCs) that successfully evade immune surveillance upon entering the bloodstream can lead to clonal expansion and metastasis. Cancer progression is accompanied by pathophysiological processes such as platelet activation and thrombosis. Platelets secrete a variety of growth factors to stimulate cancer cell proliferation, regulate tumor angiogenesis, and subsequently mediate surface changes in cancer cells to promote invasion and progression. As part of a dangerous alliance, CTCs and platelets induce mutual activation. Activated platelets aggregate and encapsulate tumor cells, forming microtumor thrombi containing fibrin clots that act as protective barriers. These platelets interact with immune cells, including NK cells, macrophages, neutrophils, and T cells, to facilitate cancer metastasis and progression through various mechanisms. The formation of a favorable tumor microenvironment (TME) and pre-metastatic niche aids cancer cells in evading immune surveillance. Multiple signaling pathways and immune checkpoints are also involved in this process. Given the significant role of platelets in tumor immune evasion, anti-cancer strategies targeting platelets and their potential use as "bionic drug delivery systems" for anti-tumor drugs hold broad prospects in emerging tumor therapies.
只有那些进入血液循环后成功逃避免疫监视的循环肿瘤细胞（CTC）才能导致克隆性扩增和转移。癌症进展伴随着血小板活化和血栓形成等病理生理过程。血小板分泌多种生长因子来刺激癌细胞增殖、调节肿瘤血管生成，并随后介导癌细胞表面变化以促进侵袭和进展。作为危险联盟的一部分，CTC和血小板相互激活。活化的血小板聚集并包裹肿瘤细胞，形成含有纤维蛋白凝块的微肿瘤血栓，这些凝块起到保护屏障的作用。这些血小板与包括自然杀伤细胞、巨噬细胞、中性粒细胞和T细胞在内的免疫细胞相互作用，通过各种机制促进癌症转移和进展。形成有利的肿瘤微环境（TME）和前转移生态位有助于癌细胞逃避免疫监视。多个信号通路和免疫检查点也参与了这一过程。鉴于血小板在肿瘤免疫逃逸中的重要作用，针对血小板的抗癌策略及其作为抗肿瘤药物“仿生药物递送系统”的潜在用途在新兴肿瘤治疗中具有广阔前景。
