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Deutsche Zeitschrift für Onkologie 2012; 44(1): 11-16
DOI: 10.1055/s-0031-1298684
Forschung
© Karl F. Haug Verlag MVS Medizinverlage Stuttgart GmbH & Co. KG

Die Bedeutung der im Blut zirkulierenden Tumorzellen in der Metastasierungskaskade

Katharina Pachmann
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Publication History

Publication Date:
28 March 2012 (online)

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Zusammenfassung

Obgleich für die meisten Patienten die Diagnose eines bösartigen Tumors der größte Schock ist, ist der Primärtumor selten lebensbedrohlich, vielmehr sind Metastasen in lebenswichtige Organe wie Leber und Lunge die bedrohlichsten Folgen. Solche Absiedelungen können nur durch Zellen entstehen, die den Primärtumor verlassen haben und die Fähigkeit haben, an anderen Stellen wieder anzuwachsen. Die vorliegende Übersicht fasst ältere und neuere Daten darüber zusammen, welche Faktoren dazu beitragen, dass Zellen den Primärtumor verlassen können, geht der Frage nach, wie diese freigesetzten Zellen es bewerkstelligen, im Kreislauf zu überleben, dass der Nachweis solcher zirkulierender Tumorzellen zwar eine wichtige Momentaufnahme im Ablauf der Metastasierung darstellt, aber auch, dass zu einer erfolgreiche Absiedelung weitere, noch wenig verstandene Schritte gehören, die nur ein Bruchteil der freigesetzten Zellen vollbringen. Es wird die Hypothese diskutiert, dass weniger die komplette Elimination dieser Zellen als vielmehr Strategien, die es verhindern, dass diese Zellen sich absiedeln können, in Zukunft am erfolgreichsten im Kampf gegen die Metastasenbildung sein könnten.

Summary

It is rarely the primary malignant tumor but rather cells released from the primary tumor, settling in distant organs and growing into metastases, that determine the fate of the patient. In the present review older and more recent data on cell release from the primary tumor are discussed, revealing that probably many more cells than previously thought can be released into the circulation not only due to natural development but also due to diagnostic and therapeutic manipulations. Such cells circulating in peripheral blood must be the origin of metastases but circulating tumor cells by definition are not micro metastases themselves and only a minor fraction of these cells seems to be capable of settling and growing in distant loci. For this purpose cells must have strategies to survive in the circulation and although a wealth of research has been devoted to clarify the ways by which cells can resettle and re-grow in distant organs these steps have not been well understood until now. Since, however, approaches to eliminate these cells in order to prevent metastasis formation have been only partly successful, strategies to prevent them from settling such as hormone blocking therapies empirically known to be effective or metronomic therapies should in the future more closely be investigated.

Schlüsselwörter

Periphere Tumorstammzellen - Disseminierung - Metastasierung

Keywords

Circulating epithelial tumor cells - dissemination - metastasis formation
 

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