Insights into cancer metastasis from a clinicopathologic perspective: Epithelial-Mesenchymal Transition is not a necessary step.

摘要: Epithelial-mesenchymal transition (EMT) has been implicated as the critical event initiating cancer invasion and metastasis. After disseminating through circulation, malignant cells have proposed to undergo subsequent mesenchymal-epithelial (MET) form secondary tumors. However, strong evidence from human tumor specimens for this paradigm is lacking. In carcinomas, cancers derived epithelial tissues, morphology gene expression are always retained some degree. While mesenchymal transdifferentiation may be involved in pathogenesis of carcinosarcomas, even these neoplasms, well germ cell tumors capable multilineage differentiation, phenotype does not facilitate metastatic progression. Indeed, most invade travel lymphatic blood vessels via cohesive migration, rather than going EMT-MET sequence. EMT also consistently associated with high histologic grade while transcription factors, Snail, Slug Twist traditionally thought inducers EMT, under certain conditions, they mediate dedifferentiation maintenance stem state. various malignancies, including basal-like breast colorectal cancer, genetically unstable, undifferentiated predicts early spread poor prognosis. This article discusses controversies surrounding differentiation metastasis a clinicopathologic perspective presents that maintained throughout process