Breaking through to the Other Side: Microenvironment Contributions to DCIS Initiation and Progression.
Breaking through to the Other Side: Microenvironment Contributions to DCIS Initiation and Progression.
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DOI：
10.1007/s10911-018-9409-z
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发表时间：
2018-12
影响因子：
2.5
通讯作者：
Schwertfeger KL
中科院分区：
文献类型：
--
作者：
Nelson AC;Machado HL;Schwertfeger KL
早期检测、手术和放射治疗以及激素受体靶向治疗的改进提高了乳腺癌患者的生存率。然而，可靠地识别哪些非侵入性病变和局部肿瘤具有进展和/或转移能力的能力仍然是该领域中未满足的主要需求。目前的诊断和治疗策略集中在与增殖密切相关的癌细胞内的内在改变。然而，大量积累的证据表明，癌周围的间质组织中的容许变化在乳腺癌肿瘤的发生和发展中起着不可或缺的作用。许多研究表明，导管原位癌（DCIS）病变周围的基质环境积极促进肿瘤细胞的侵袭和免疫逃逸。这篇综述将描述目前的知识状态，通过微环境与DCIS病变相互作用的机制，重点是最近的研究，描述了肌上皮细胞，成纤维细胞和免疫细胞的入侵和随后的进展的贡献。这些机制将在开发生物标志物的背景下考虑，用于识别将进展为浸润性癌的病变和/或开发治疗干预的方法。
Refinements in early detection, surgical and radiation therapy, and hormone receptor-targeted treatments have improved the survival rates for breast cancer patients. However, the ability to reliably identify which non-invasive lesions and localized tumors have the ability to progress and/or metastasize remains a major unmet need in the field. The current diagnostic and therapeutic strategies focus on intrinsic alterations within carcinoma cells that are closely associated with proliferation. However, substantial accumulating evidence has indicated that permissive changes in the stromal tissues surrounding the carcinoma play an integral role in breast cancer tumor initiation and progression. Numerous studies have suggested that the stromal environment surrounding ductal carcinoma in situ (DCIS) lesions actively contributes to enhancing tumor cell invasion and immune escape. This review will describe the current state of knowledge regarding the mechanisms through which the microenvironment interacts with DCIS lesions focusing on recent studies that describe the contributions of myoepithelial cells, fibroblasts and immune cells to invasion and subsequent progression. These mechanisms will be considered in the context of developing biomarkers for identifying lesions that will progress to invasive carcinoma and/or developing approaches for therapeutic intervention.
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