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2016 ; 35
(1
): 75-91
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Progression and metastasis of lung cancer
#MMPMID27018053
Popper HH
Cancer Metastasis Rev
2016[Mar]; 35
(1
): 75-91
PMID27018053
show ga
Metastasis in lung cancer is a multifaceted process. In this review, we will
dissect the process in several isolated steps such as angiogenesis, hypoxia,
circulation, and establishment of a metastatic focus. In reality, several of
these processes overlap and occur even simultaneously, but such a presentation
would be unreadable. Metastasis requires cell migration toward higher oxygen
tension, which is based on changing the structure of the cell
(epithelial-mesenchymal transition), orientation within the stroma and stroma
interaction, and communication with the immune system to avoid attack. Once in
the blood stream, cells have to survive trapping by the coagulation system, to
survive shear stress in small blood vessels, and to find the right location for
extravasation. Once outside in the metastatic locus, tumor cells have to learn
the communication with the "foreign" stroma cells to establish vascular supply
and again express molecules, which induce immune tolerance.