title: The microenvironments of multistage carcinogenesis.
abstract: Overt neoplasia is often the result of a chronic disease process encompassing an extended segment of the lifespan of any species. A common pathway in the natural history of the disease is the appearance of focal proliferative lesions that are known to act as precursors for cancer development. It is becoming increasingly apparent that the emergence of such lesions is not a cell-autonomous phenomenon, but is heavily dependent on microenvironmental cues derived from the surrounding tissue. Specific alterations in the tissue microenvironment that can foster the selective growth of focal lesions are discussed herein. Furthermore, we argue that a fundamental property of focal lesions as it relates to their precancerous nature lies in their altered growth pattern as compared to the tissue where they reside. The resulting altered tissue architecture translates into the emergence of a unique tumor microenvironment inside these lesions, associated with altered blood vessels and/or blood supply which in turn can trigger biochemical and metabolic changes fueling tumor progression. A deeper understanding of the role(s) of tissue and tumor microenvironments in the pathogenesis of cancer is essential to design more effective strategies for the management of this disease.
authors.affiliation: Dipartimento di Scienze e Tecnologie Biomediche, Sezione di Patologia Sperimentale, Università di Cagliari, 09125 Cagliari, Italy. elaaconi@unica.it
authors.forename: Ezio
authors.initials: E
authors.lastname: Laconi
authors.forename: Silvia
authors.initials: S
authors.lastname: Doratiotto
authors.forename: Paolo
authors.initials: P
authors.lastname: Vineis
mesh_terms: D002274:Carcinogens, Environmental / Q000378:metabolism; D043171:Chromosomal Instability; D004249:DNA Damage; D020022:Genetic Predisposition to Disease; D006801:Humans; D009154:Mutation; D009367:Neoplasm Staging; D009369:Neoplasms / Q000235:genetics / Q000473:pathology* / Q000503:physiopathology*
chemical_list: D002274:Carcinogens, Environmental