低氧条件下胶质瘤细胞生长更加旺盛

低氧环境帮助胶质瘤细胞抵御治疗

Curr Cancer Drug Targets. 2009 May;9(3):381-90.

Hypoxia helps glioma to fight therapy.

Amberger-Murphy V. National Institute for Cellular Biotechnology, Dublin City University, Dublin, Ireland. [e-mail]上海东方医院神经外科魏社鹏

Despite major improvements in the surgical management the prognosis for patients bearing malignant gliomas is still dismal. Malignant gliomas are notoriously resistant to treatment and the survival time of patients is between 3-8 years for low-grade and anaplastic gliomas and 6 - 12 month for glioblastoma. Increasing malignancy of gliomas correlates with an increase in cellularity and a poorly organized tumor vasculature leading to insufficient blood supply, hypoxic areas and ultimately to the formation of necrosis, a characteristic of glioblastoma. Hypoxic/necrotic tumors are more resistant to chemotherapy and radiation. Hypoxia induces either directly or indirectly (through the activation of transcription factors) changes in the biology of a tumor and its microenvironment leading to increased aggressiveness and tumor resistance to chemotherapy and radiation. This review is focused on hypoxia-induced molecular changes affecting glioma biology and therapy.

低氧环境帮助胶质瘤细胞抵御治疗

尽管外科技术有了很大的进步，但是恶性胶质瘤的预后仍然非常恶劣。恶性胶质瘤是臭名昭著的对治疗有抵抗的脑瘤。低度恶性胶质瘤和间变胶质瘤的中位生存期一般为3-8年，胶质母细胞瘤的中位生存期则为6-12个月。胶质瘤恶性度增高主要变现为细胞数目的增加，以及肿瘤血管结构的贫乏，从而使得肿瘤细胞的氧供急剧减少。低氧环境最终导致了肿瘤细胞的坏死，后者则是胶质母细胞瘤的典型特点。低氧或者坏死的肿瘤对放疗和化疗表现出明显的抵制。低氧诱导了肿瘤生物学改变，以及肿瘤细胞微环境的变化，最终导致了肿瘤细胞的侵袭力增强，使得肿瘤对不管是放疗和化疗都表现出了明显的抵制。因此低氧环境本质上帮助了胶质瘤细胞抵御了现代肿瘤的主要治疗手段。