Fundamental pathological mechanisms underlying gastro-intestinal cancer peritoneal metastasis.
10.3760/cma.j.cn.441530-20201101-00583
- Author:
Ru MA
1
;
Zhong He JI
1
;
Ying ZHANG
2
;
Yan LI
3
Author Information
1. Department of Peritoneal Cancer Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China.
2. Department of Pathology, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China.
3. Department of Peritoneal Cancer Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China Department of Pathology, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China.
- Publication Type:Journal Article
- Keywords:
Gastrointestinal neoplasms;
Mesothelial cells;
Milky spots;
Pathological mechanisms;
Peritoneal metastasis;
Permissive immune microenvironment
- MeSH:
Humans;
Intestinal Neoplasms;
Peritoneal Cavity;
Peritoneal Neoplasms;
Peritoneum;
Tumor Microenvironment
- From:
Chinese Journal of Gastrointestinal Surgery
2021;24(3):198-203
- CountryChina
- Language:Chinese
-
Abstract:
Gastrointestinal cancer peritoneal metastasis(GICPM) is one of the biggest challenges of clinical treatment. The ultimate solution to the problem requires the clinicians to accurately understand cytologic and molecular pathological mechanisms behind GICPM, and apply such knowledge in the clinical decision-making process for diagnosis and treatment of individual patient, so as to realize "prevention" and "treatment" proactively. The core cytopathological mechanisms behind GICPM, which are closely related to clinical treatment decisions, are as follows: (1) free cancer cells or clusters in peritoneal cavity colonize the peritoneum, resulting in irreversible pathological damage to peritoneal mesothelial cells; (2) the colonized cancer cells further invade the specific structure of the peritoneal milky spots and initiate an accelerated invasive growth process; (3) the process of peritoneal interstitial fibrosis aggravates the structural destruction of the peritoneum; (4) the interaction between cancer cells and immune cells in the milk spots forms a permissive immune microenvironment that promotes the growth of peritoneal metastatic cancer. These four core cytopathological mechanisms are mutually causal and promote each other, forming a vicious circle of GICPM development. As long as clinicians accurately understand these four points, it is possible to grasp the opportunity of clinical diagnosis and treatment, change reactive and passive treatment into preventive and proactive treatment, and improve the clinical diagnosis and treatment landscape of GICPM.
