Grundmann E
Klin Wochenschr. 1981 Sep 1;59(17):931-41. doi: 10.1007/BF02310968.
Analysis of invasive malignancy focuses on the particularly high growth rate of tumor cells, and on the aggressive mechanisms of histolysis favoring the infiltration of the malignant cells into the surrounding tissue. Specific significance is attributed to a certain enzyme directed against type IV collagen, and to the auto-locomotion of tumor cells, properties that may also explain the highly selective process of metastazation in at least three consecutive steps: Tumor cells invade a blood or lymph vessel, they are transported along blood or lymphatic pathways, and they eventually infiltrate foreign tissue after penetration and destruction of blood of lymph vessel walls. Among the factors involved in the process of metastazation, special interest is due to blood coagulation and to the coexistence of different tumor cell subpopulations within a primary. These features of malignant growth are based on the loss of functional differentiation as manifested e.g. in the loss of tissue-specific nuclear chromatin structures. Tumor development is triggered by the so-called primary factors which always affect the DNA, i.e. the cell genome. Chemical carcinogens, viruses, and shortwave or ionizing irradiation induce DNA defects which, however, will be reversed and mended by special repair mechanisms in most cases. Thus, the actual development and spread of malignancy is ultimately due to deficient reparation. Co-factors favorizing and promoting carcinogenesis may shorten the latency period, among other several specific chemicals and hormones. Based on current knowledge of tumor dormancy a new concept is proposed for the chronological and morphological sequence of carcinogenesis: Following the development of a primary tumor certain as yet undefined growth factors and especially immunological factors may be responsible for the development of a progressive tumor disease.
侵袭性恶性肿瘤的分析聚焦于肿瘤细胞特别高的生长速率,以及有利于恶性细胞浸润周围组织的组织溶解侵袭机制。一种针对IV型胶原的特定酶以及肿瘤细胞的自动移动具有特殊意义,这些特性也可以解释转移过程中至少三个连续步骤的高度选择性过程:肿瘤细胞侵入血管或淋巴管,它们沿血液或淋巴途径运输,最终在穿透和破坏血管或淋巴管壁后浸润到其他组织。在转移过程涉及的因素中,血液凝固以及原发肿瘤内不同肿瘤细胞亚群的共存特别受关注。恶性生长的这些特征基于功能分化的丧失,例如表现为组织特异性核染色质结构的丧失。肿瘤发展由所谓的主要因素触发,这些因素总是影响DNA,即细胞基因组。化学致癌物、病毒以及短波或电离辐射会诱发DNA缺陷,然而在大多数情况下,这些缺陷会通过特殊的修复机制被逆转和修复。因此,恶性肿瘤的实际发展和扩散最终归因于修复不足。促进致癌作用的辅助因素可能会缩短潜伏期,其他还有几种特定的化学物质和激素。基于目前对肿瘤休眠的认识,提出了一个关于致癌作用的时间和形态序列的新概念:在原发性肿瘤发展之后,某些尚未明确的生长因子,尤其是免疫因子,可能是导致进行性肿瘤疾病发展的原因。