title: Progression and metastasis of lung cancer.
abstract: Metastasis in lung cancer is a multifaceted process. In this review, we will dissect the process in several isolated steps such as angiogenesis, hypoxia, circulation, and establishment of a metastatic focus. In reality, several of these processes overlap and occur even simultaneously, but such a presentation would be unreadable. Metastasis requires cell migration toward higher oxygen tension, which is based on changing the structure of the cell (epithelial-mesenchymal transition), orientation within the stroma and stroma interaction, and communication with the immune system to avoid attack. Once in the blood stream, cells have to survive trapping by the coagulation system, to survive shear stress in small blood vessels, and to find the right location for extravasation. Once outside in the metastatic locus, tumor cells have to learn the communication with the "foreign" stroma cells to establish vascular supply and again express molecules, which induce immune tolerance.
authors.affiliation: Research Unit Molecular Lung and Pleura Pathology, Institute of Pathology, Medical University of Graz, Auenbruggerplatz 25, Graz, 8036, Austria. helmut.popper@medunigraz.at.
authors.forename: Helmut H
authors.initials: HH
authors.lastname: Popper
mesh_terms: D002465:Cell Movement / Q000235:genetics; D018450:Disease Progression; D058750:Epithelial-Mesenchymal Transition / Q000235:genetics*; D006801:Humans; D008175:Lung Neoplasms / Q000235:genetics* / Q000473:pathology; D009362:Neoplasm Metastasis; D009389:Neovascularization, Pathologic / Q000235:genetics*; D010100:Oxygen / Q000378:metabolism; D015398:Signal Transduction
chemical_list: D010100:Oxygen
keywords: Angiogenesis; Bone; Brain; Circulation; Epithelial-mesenchymal transition; Hypoxia; Lung cancer; Metastasis; Migration