干细胞与胃癌

Stem cells and gastric carcinoma

目的:概述与胃癌发生发展关系密切的干细胞的研究进展。资料来源:检索Pubmed 1998-02/2007-02关于干细胞与胃癌的文章。检索词为“stem cell;cancer stem cell;marrow stem cell;gastric carcinoma”并限定语言种类为英文。资料选择:对资料进行初审,纳入标准:①与肿瘤干细胞相关的研究。②胃干细胞、骨髓干细胞与胃癌相关的研究。排除标准:重复性研究。资料提炼:共收集到123篇文章,排除94篇重复性研究,纳入29篇与纳入标准最为贴近的文章。资料综合:肿瘤干细胞是指肿瘤组织中存在的一小部分具有干细胞性质的细胞群体,具备高度的自我更新能力和增殖能力,也具备多向分化的潜能,是形成不同分化程度肿瘤细胞和肿瘤不断扩大以及复发的源泉。其与干细胞具有许多共同的特性:具有自我更新能力和分裂增殖能力,具有相似的生长调控机制,具有很强的分化能力等。胃组织也存在自己特异的干细胞。据肿瘤干细胞理论,认为胃癌的发生与干细胞的突变有关。生长调控机制失控可解释胃癌与干细胞的关系。由于缺乏特异性标志,不了解调节胃干细胞增殖分化的分子通路,目前还没有理想的技术可以分离纯化出人类胃干细胞。在成体组织中,肿瘤的发生来自骨髓干细胞在再生修复过程中异常分化的结果,而并不是原组织中已分化成熟细胞的突变后产生,肿瘤的不断增大需骨髓干细胞持续的提供“原材料”。结论:胃干细胞在胃黏膜上皮的克隆化、更新增殖及胃癌的形成中起重要作用,但还有许多空白,更多的观点是基于现象的分析和理论的推断,作为肿瘤学研究的一个新领域,还有许多问题需要进一步解决。

OBJECTIVE： To summarize the development of stem cells related with the occurrence and development of gastric carcinoma. DATA SOURCES： Pubmed database was undertaken to identify the articles of stem cells and gastric carcinoma published from February 1998 to February 2007 with the key words of ＂stem cell, cancer stem cell, marrow stem cell, gastric carcinoma＂ in English. STUDY SELECTION： The data were checked primarily. Inclusive criteria were （1）research on cancer stem cells, and （2） research of gastdc stem cells and bone marrow stem cells with gastric carcinoma. Inclusive cntedon was repetitive study. DATA EXTRACTION： Totally 123 articles were collected, and 94 of them were excluded due to repetitive study. The 29 articles met the inclusive criteria were included. DATA SYNTHESIS： Cancer stem cells refer to a small number of cell colonies with stem cell feature in tumor tissues, with high self-renewing and proliferative ability as well as multi-directional differentiation potential. They are the source of forming tumor cells to different degrees as well as enlarging and recurring of tumor. They have many common features as stem cells, such as self-renewing, proliferating ability, growth-regolation ability, strong differentiation ability and so on. Specific stem cells also exist in gastdc tissues. On the basis of cancer stem cells theory, it believed that the occurrence of gastdc carcinoma was associated with the mutation of stem cells. Runaway of growth-regulation mechanism can explain the relationship between gastric carcinoma and stem cells. Because of lack of specific markers and incomprehension of molecular approach that regulates gastric stem cell proliferation and differentiation, no ideal technology can isolate and purify human gastric stem cells at present. In adult tissues, tumor is from dysdifferentiation of bone marrow stem cells in regeneration and reparative process, but not from mutation of mature differentiation cells in onginal tissues. The increasing proliferation of tumor needs ＂native material＂ provided successively by bone marrow stem cells. CONCLUSION： Gastnc stem cells play important roles in cloning, renewal proliferation and gastric carcinoma of epthelium of gastric mucosa. However, many points still focus on phenomenon analysis and theoretical inference. As a new circle in oncology, many relevant problems on gastric stem cells deserve further study.