Significance of Tumor Microenvironment on the Genesis of: Interstitial Fluid, Angiogenesis, Haemostatic/Haemorheologic Abnormalities. Pathogenesis and Therapeutic Aspects

摘要: In order for tumors to grow more than a few millimetres in size, new vasculature must be established. However, the vascular support is generally inefficient, poorly organized and cannot keep up with pace of tumor proliferation. This creates undernourished hypoxic regions environment, neo-vasculature having perturbed structure function. Two abnormalities are peculiarly important. The first an excessive leakiness endothelium due malfunction Starling’s law that regulates liquid distribution across endothelium, resulting increased accumulation interstitium. second enhanced procoagulant activity as shown by numerous clinical experimental findings on interaction between coagulation fibrinolytic systems. Through these interactions, growth dissemination while can generate matrix supporting neoangiogenesis. unique microenvironment, both endothelial cells express wide variety factors, including procoagulants, cell adhesion molecules, vasomotor substances survival signals. up-regulation microenvironment MET oncogenes other hemostatic further contribute alterations balance. Platelets (PLTs), leukocytes (LKs), red blood (RBCs) behave differently capillary lumen, normally such being hemoconcentrated. These create conditions anomalous hemorheology leukocyte interaction. PLTs, LKs, RBCs may bind fibrin envelopes form cocoon-like protect them from colliding immune surveillance, thus not eliminated body’s defensive system. feature contributes partially progression metastasization. We believe have important therapeutic implications. this overview, attempt will made describe how abrogate normal physiologic mechanisms suit environment their own purposes review common pathways coagulation, angiogenesis patho-physiology.