前列腺癌治疗新视点.pdf

前列腺癌治疗新视点 Advances in prostate cancer treatment 山东大学齐鲁医院泌尿外科 刘照旭 肿瘤的浸润、转移研究进展 • 肿瘤微环境(tumor microenvironment) • 肿瘤异质性(tumor heterogeneity) • 肿瘤靶向治疗的个性化(personalized cancer therapy ) Traits of Metastasis 肿瘤转移的特点 Metastasis Steps and Bottlenecks The sequence of metastasis steps starts with the dissemination of cancer cells from the primary tumor and ends in the formation of clinically detectable macrometastases. Whereas dissemination is not severely rate limiting, only a small fraction of disseminated cells form micrometastases, and only a small minority of micrometastases become macrometastases. A cancer cell may reach distant organ capillaries within seconds of departing from a primary tumor and extravasate into the parenchyma within hours, but it may remain latent for decades. Progression of metastasis through each of these bottlenecks requires several specialized functions including cancer cellautonomous functions and the cooption of various components of the target tissue stroma. Vanharanta S. Cancer cell 2013,24:410 Inefficiency of the Invasion-Metastasis Cascade 肿瘤转移学说 Tumour-driven pathophysiological processes underlying cancer progression. 肿瘤进展转移的过程 McAllister SS. 2014, Nat Cell Biol. 2014 Aug 1;16(8):717-27 肿瘤原发灶与全身系 统的关系 Excess Perioperative Catecholamines （儿茶酚胺） and Prostaglandins （前列腺素） Are the Key Factors in Promoting Tumor Metastasis by Directly Impacting the Malignant Tissue and by Suppressing Antimetastatic CMI Clin Cancer Res; 18(18); 4895–902. 2012 前列腺癌的临床进展过程 无PCa证据 局部浸润 局部浸润