Wesseling P, Ruiter D J, Burger P C
Department of Pathology, University Hospital Nijmegen, The Netherlands.
J Neurooncol. 1997 May;32(3):253-65. doi: 10.1023/a:1005746320099.
Angiogenesis is the outgrowth of new blood vessels from the preexistent vasculature. In 1971, Folkman hypothesized that solid tumors are dependent on angiogenesis for sustained growth and that anti-angiogenic treatment is a potential antineoplastic therapy. Because glioblastoma multiforma (GBM) frequently shows florid microvascular proliferation (MVP), this tumor has been considered since then as a suitable candidate for such treatment that attempts to eradicate or control a neoplasm by interfering with its blood supply. Indeed, in animal models the growth of glioma xenografts can be inhibited by targeting the angiogenic process. However, unlike many glioma xenografts, human infiltrating gliomas such as GBMs have a diffuse infiltrative growth pattern, and preexistent vessels may suffice to provide many tumor cells with much of their blood supply, particularly in the critical peripheral infiltrative margins. Thus, while attractive in concept, anti-angiogenic therapy of GBM must address the anatomic vascular realities of this neoplasm. Even if anti-angiogenic therapy ultimately has a role in infiltrative neoplasms, there are a host of other intracranial neoplasms whose discrete architecture might make them attractive candidates for anti-angiogenic therapy. This review summarizes the angiogenic process in GBM and suggests other types of tumors for which the efficacy of anti-angiogenic therapy might be studied.
血管生成是指从已有的脉管系统中长出新的血管。1971年，福克曼提出假说，实体瘤的持续生长依赖于血管生成，抗血管生成治疗是一种潜在的抗肿瘤疗法。由于多形性胶质母细胞瘤（GBM）常表现为显著的微血管增殖（MVP），从那时起，这种肿瘤就被认为是通过干扰肿瘤血液供应来根除或控制肿瘤的这种治疗方法的合适候选对象。事实上，在动物模型中，靶向血管生成过程可抑制胶质瘤异种移植物的生长。然而，与许多胶质瘤异种移植物不同，人类浸润性胶质瘤如GBM具有弥漫性浸润生长模式，已有的血管可能足以向许多肿瘤细胞提供大部分血液供应，特别是在关键的外周浸润边缘。因此，虽然抗血管生成治疗在概念上很有吸引力，但GBM的抗血管生成治疗必须考虑这种肿瘤的解剖学血管实际情况。即使抗血管生成治疗最终在浸润性肿瘤中发挥作用，还有许多其他颅内肿瘤，其离散的结构可能使其成为抗血管生成治疗的有吸引力的候选对象。本文综述了GBM中的血管生成过程，并提出了其他可能研究抗血管生成治疗疗效的肿瘤类型。
