Smolle J
Department of Dermatology, University of Graz, Austria.
Am J Dermatopathol. 1995 Jun;17(3):281-6. doi: 10.1097/00000372-199506000-00011.
Maximum vertical tumor thickness is a highly significant prognostic criterion in cutaneous melanoma. To date, little is known about the problem, why thick lesions are more capable of metastatic spread than thin ones. To evaluate theoretical possibilities of the biological impact of thick lesions, computer simulation of tumor growth was performed. In a set of 35,000 simulated tumors, the thickness of the resulting tumor was measured and the functional simulation settings contributing to tumor thickness were identified by statistical methods. It turned out that in this theoretical model of tumor growth, besides time, which is the most important factor, other factors contribute to tumor thickness. These are tumor cell motility, particularly when stimulated by stromal elements, a decreased rate of tumor cell loss, and pronounced proliferation associated with high numbers of cell cycle generations in the tumor cells. These findings are in agreement with experimental data indicating that metastatic capacity may depend on increased motility, stroma-induced motility stimulation, evasion from the host immune system, and genetic instability manifesting during cell cycling. Thus the observations may help to clarify the relationship of vertical tumor thickness and poor clinical outcome in cutaneous melanomas.
最大垂直肿瘤厚度是皮肤黑色素瘤中一个极具重要性的预后标准。迄今为止，对于厚病变比薄病变更易发生转移扩散这一问题，人们了解甚少。为评估厚病变生物学影响的理论可能性，进行了肿瘤生长的计算机模拟。在一组35000个模拟肿瘤中，测量所得肿瘤的厚度，并通过统计方法确定导致肿瘤厚度的功能模拟设置。结果表明，在这个肿瘤生长的理论模型中，除了时间（这是最重要的因素）之外，其他因素也会影响肿瘤厚度。这些因素包括肿瘤细胞的运动性，尤其是在受到基质成分刺激时，肿瘤细胞损失率降低，以及与肿瘤细胞中大量细胞周期世代相关的显著增殖。这些发现与实验数据一致，实验数据表明转移能力可能取决于运动性增加、基质诱导的运动性刺激、逃避宿主免疫系统以及细胞周期中表现出的基因不稳定性。因此，这些观察结果可能有助于阐明皮肤黑色素瘤中垂直肿瘤厚度与不良临床结果之间的关系。
