肺癌干细胞与肺癌的发生

Lung cancer stem cells and lung cancer

背景:肺癌具有高度异质性,能够抵抗化疗药物治疗,5年生存率小于15%,目前难以确定肺癌的异质性和耐药性的发病基础。肿瘤干细胞模型近年来吸引了相当多的关注,通过这种模型可以解释各种肿瘤的异质性、耐药性、休眠、复发和转移的机制。目的:通过综述各类肺癌的组织学类型和肿瘤生长部位的特征,概括肺癌干细胞与各种肺癌发生的关系,从而为消灭肺癌干细胞攻克肺癌提供理论依据。方法:以英文检索词为"lung cancer,cancer stem cell,lung cancer stem cell,lung cancer occur,tumor heterogeneity,drug resistance,gene mutation,signal pathways"由第一作者检索1990至2014年Sciencedirect/PubMed数据库,查阅近年肺癌干细胞对肺癌发生的影响的相关文献,最终保留48篇文献。结果与结论:肿瘤干细胞模型近年来吸引了相当多的关注,通过这种模型可以解释各种肿瘤的异质性、耐药性、休眠、复发和转移。肺癌干细胞被认为是一类异质的细胞群,多种信号通路可以有针对性的有效的消除他们,从而有助于增强治疗效果。目前多学科通力合作,正在进行肺癌干细胞表征和靶定,这将给肺癌治疗领域带来显著的治疗受益。

BACKGROUND：Lung cancers are highly heterogeneous and resistant to available therapeutic agents, with a five year survival rate of less than 15%. It has been difficult to determine the basis of lung cancer heterogeneity and drug resistance. Cancer stem cellmodel has attracted a significant amount of attention in recent years as a viable explanation for the heterogeneity, drug resistance, dormancy and recurrence and metastasis of various tumors. OBJECTIVE：To summarize the current understanding of lung cancer stem cells, including their histological types and tumor growth areas, and to discusses the prognosis of lung cancer and its relationship with lung cancer stem cells, in an effort to eradicate these cells to combat lung cancer. METHODS：In order to search relevant articles about the lung cancer stem celland its relationship with lung cancer from PubMed and Sciencedirect databases （from 1990 to 2014）, a computer-based search was performed, using the key words of“lung cancer, cancer stem cell, lung cancer stem cell, lung cancer occur, tumor heterogeneity, drug resistance, gene mutation, signal pathways”in English. After eliminating literatures which were irrelevant to research purpose or containing a similar content, 48 articles were chosen for further analysis. RESULTS AND CONCLUSION：The cancer stem cellmodel has gained considerable support recently in context of lung cancers and stem-like cells that are associated with aggressive cancer behavior, metastatic progression, resistance to therapy and relapse. Since lung cancer stem cells are thought to consist of a heterogeneous population depending on the histology and site of tumors, and multiple signaling pathways might have to be targeted to effectively eliminate lung cancer stem cells for therapeutic benefit. It can be imagined that the multidisciplinary efforts currently under way to characterize and target stem-like cells in lung cancer wil reap significant therapeutic benefits in the future.