Nia, Rakesh K Jain et al of Harvard Medical School and Massachusetts General Hospital, published "physical traits of cancer" in Science on October 30, 2020. The research was named by MedSci as the Top 10 Important Medical Studies and Discoveries of 2020.
Nia ,Rakesh K Jain et al. reviewed the physical features that are common to tumors and that limit successful treatment:（i）solid stresses, (ii)interstitial fluid pressure, (iii)stiffness (rigidity), and (iv)architecture and organization of tumor constituents. The review provide a conceptual framework and discuss the origins of these distinct physical traits of cancer and how they enable and synergize with aberrant cancer biology to fuel cancer initiation, progression, immune evasion, and treatment resistance. And it is well known that the biological and physical properties of tumors contribute to their growth and to treatment outcome.
The discovery of cancer physical traits suggests that two of "stiffness (rigidity)" and " architecture and organization of tumor constituents." in the four physical traits of cancer are objective indicators that have been used by clinical palpation diagnosis for thousands of years, and in recent years, these physical traits have been found to play an important role in determining the prognosis of cancer. The lesion’s "stiffness" ,output from Bionic Breast Examination System, are the concrete manifestations of the classical clinical breast examination (CBE) by the two physical traits of "increased tissue solid stress" and "increased stiffness & architecture and organization of tumor constituents ".
At present, among a variety of breast examination technology, bionic breast examination is the only one that can output "hardness" and "motility" data which CBE diagnosis required. BBES will have a broader application value, for example, assisting physician to judge the effectiveness of neoadjuvant chemotherapy, assessing the condition of solid tumor, monitoring the breast duct blockage and implementing mastitis prevention. At the same time, based on the basic principles of physical examination, BBES is non-invasive and harmless, and it is not affected by age, menstrual cycle, race, breast density itself, which leads to a greater application space for BBES.
BACKGROUND: Science is published by the American Association for the Advancement of Science. As one of the world's most authoritative academic journals, the IF of Science in 2020 is 41.845. Science publish papers from all over the world and covers all disciplines, and what the Science magazine focused is on publishing important original scientific research and reviews.
Authors of the review（H. T. Nia et al., Science 370, eaaz0868 (2020). DOI: 10.1126/science.aaz0868） firstly outlooked that the tumor microenvironment is characterized by both biological and physical abnormalities. The growing appreciation of the role of tumor-stromal interactions in cancer has led to seminal discoveries that have resulted in previously unexplored targets and strategies for treatment. Many of the concepts involved are nonintuitive and require deep and broad understanding of both the physical and biological aspects of cancer. Therefore, a rigorous but accessible description of physical cancer traits will assist research into the physical sciences of cancer—a highly multidisciplinary area—and help it remain an active and progressive subfield of cancer research.
Authors of the review secondly described the four physical traits of cancer:
1.Solid stresses are created as proliferating and migrating cells push and stretch solid components of the surrounding tissue. Being distinct from fluid pressure and close to zero in most normal tissues, solid stresses are large enough to compress blood and lymphatic vessels in and around tumors, impairing blood flow and the delivery of oxygen, drugs, and immune cells. Acting at organ, tissue, and cellular levels, solid stresses activate signaling pathways that promote tumorigenesis and invasiveness and induce treatment resistance.
2.Elevated interstitial fluid pressure is caused by leakage of plasma from abnormally permeable tumor blood vessels and insufficient lymphatic drainage. As a result, the interstitial fluid leaks out of the tumor into the peritumor tissue, causing edema and elution of drugs and growth factors and facilitating invasion and metastasis through flow-induced shear stresses.
3.Increased stiffness is caused by matrix deposition and remodeling. Traditionally used as a diagnostic marker, and more recently as a prognostic factor, increased stiffness activates signaling pathways that promote proliferation, invasiveness, and metastasis of cancer cells.
4.Microarchitecture is altered when normal tissue architecture is disrupted by cancer growth and invasion. Stromal and cancer cells and extracellular matrix adopt new organization. This changes the interactions between an individual cell and its surrounding matrix and cells, which affects signaling pathways associated with invasion and metastasis.
Authors of the review thirdly described the link between physical traits and biological signaling pathway in cancer biology: Sustaining proliferative signaling, Deregulating cellular energetics, Evading growth suppressors, Resisting cell death.
Genome instability and mutation, Inducing angiogenesis, Activating invasion and metastasis, Tumor promoting inflammation, Enabling replicative immortality, Avoiding immune destruction.