Biologie und Bedeutung von Tumorstammzellen in der HNO: Neueste Erkenntnisse und Zusammenfassung der aktuellen Literatur

Zusammenfassung

Entstehung, Wachstum, Rezidive sowie Metastasen von Plattenepithelkarzinomen im Kopf- Hals-Bereich (KH-PEKA) und anderer Krebserkrankungen wurden vor Kurzem in Zusammenhang mit Tumorstammzellen gebracht. Tumorstammzellen haben einige Eigenschaften mit den gesunden Gewebestammzellen gemeinsam wie die Fähigkeit zur Selbsterneuerung und die Expression von Stammzellfaktoren. Tumorstammzellen (TSZ) sind durch spezifische Marker charakterisiert, die nach Tumortyp oder Tumorlokalisation variieren – die Entdeckung eines universellen Markers steht noch aus. Verglichen mit dem Haupttumor, reagieren die TSZ weniger sensibel auf Chemo- und Strahlentherapie und haben eine geringere Immunogenität. Ein weiteres Konzept, das die Metastasierung der PEKA erklärt, ist die epitheliale-mesenchymale Transition, welche von TSZ ausgeht. Gezielte, auf die TSZ gerichtete Therapieansätze könnten die Prognose von KH-PEKA zukünftig verbessern. Der aktuelle Wissensstand über die Rolle von TSZ in KH-PEKA, bekannte TSZ-Marker und mögliche therapeutische Ziele wird in diesem Artikel zusammengefasst.·

Abstract

The initiation, growth, recurrence and metastasis of head and neck squamous cell carcinomas (HNSCC) and other cancers have recently been related to the presence of cancer stem cells (CSC). Cancer stem cells have some characteristics in common with tissue stem cells like unlimited self renewal and the expression of stem cell factors. CSC express specific markers that vary considerably depending on tumor type or tissue of origin – the discovery of an universal marker has not yet been made. Compared to the bulk tumor mass, CSC are less sensitive to chemo- and radiotherapy and also have a lower immunogenicity. Another concept that explains the seeding of metastases is the epithelial-mesenchymal transition of CSC.

CSC-targeted therapies may change the prognosis of patients with HNSCC in the future. Recent knowledge on the role of CSC in HNSCC is reviewed, and known CSC markers as well as possible therapeutic targets are described.

Schlüsselwörter

Tumorstammzellen - Gewebestammzellen - symmetrische, asymmetrische Zellteilung - Plattenepithelkarzinome - humane Papillomaviren - Immunresistenz - Chemoresistenz - Strahlenresistenz - Metastasierung - epitheliale-mesenchymale Transition - ALDH1 - gezielte Tumorstammzellen-Therapie

Key words

metastasis - cancer stem cells - stem cells - symmetric and asymmetric cell division - head and neck squamous cell ­carcinoma - stemness related genes - ALDH1 - human Papillomavirus - immunotherapy - chemoresistance - radioresistance - epithelial mesenchymal transition - therapeutic targetting of CSC

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