Zhang M, Olsson Y
Laboratory of Neuropathology, University Hospital, Uppsala, Sweden.
J Neurooncol. 1997 Oct;35(1):81-9. doi: 10.1023/a:1005799805335.
The brain is an important site of hematogenous metastases from malignant tumors in other organs. The effects on the brain is a combination of tissue destruction induced by invading tumor cells and reactive alterations occurring around the metastases. This review focuses on neuropathological changes around hematogenous metastases of the human brain. The peritumoral brain parenchyma shows structural and functional changes of the intracerebral microvessels and edema. The endothelial cells of peritumoral microvessels express glucose transporter protein (GLUT 1) in the same way as the normal brain. Reduction in immunostaining to GLUT 1 may occur in the microvessels located within the metastases. This would indicate abnormalities of the blood-brain barrier in tumor vessels but normal barrier function in the peritumoral region. Reactive astrocytes and activated microglial cells are both involved in the process of peritumoral gliosis. Activated glial cells produce numerous biological active compounds including endothelin-1 which after release from such cells can influence the structure and function of the peritumoral brain tissue. Lesions of oligodendrocytes and edema may be implicated in myelin degeneration. Finally, metastases will induce axonal and neuronal injuries as indicated by a recent study on expression of beta-amyloid precursor protein (beta APP) in reactive axonal swellings.
脑是其他器官恶性肿瘤血行转移的重要部位。肿瘤细胞侵袭所致的组织破坏以及转移灶周围发生的反应性改变共同构成了对脑的影响。本综述聚焦于人类脑血行转移灶周围的神经病理学变化。肿瘤周围脑实质呈现出脑内微血管的结构和功能改变以及水肿。肿瘤周围微血管的内皮细胞与正常脑一样表达葡萄糖转运蛋白（GLUT 1）。转移灶内微血管对GLUT 1的免疫染色可能会减少。这表明肿瘤血管的血脑屏障存在异常，但肿瘤周围区域的屏障功能正常。反应性星形胶质细胞和活化的小胶质细胞均参与肿瘤周围胶质增生过程。活化的胶质细胞产生多种生物活性化合物，包括内皮素-1，该物质从这些细胞释放后可影响肿瘤周围脑组织的结构和功能。少突胶质细胞损伤和水肿可能与髓鞘变性有关。最后，正如最近一项关于反应性轴突肿胀中β-淀粉样前体蛋白（β APP）表达的研究所表明的，转移灶会导致轴突和神经元损伤。
