M. D. Anderson Cancer Center | Dept of Molecular Pathology
 
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Cancer is the uncontrolled division of cells that leads to the formation of an abnormal mass of cells (a tumor). Cancer can occur in any organ in the human body; however more than 80% of the cancers originates in epithelial organs (See figure below). This type of cancer is known as carcinoma.
Epithelial cells are one of the two main types of cells found in the body; the other main type being mesenchymal cells. Epithelial cells exist in sheets of cells that are tightly joined together by adhesion molecules; therefore, these epithelial cells are immobile, while the mesenchymal cells exist as independent cells and are highly motile. Many organs, including breast and lungs, are mostly made up of epithelial cells. When these epithelial cells become cancerous, they are initially confined to the organ in which it originated due to the continued expression of the adhesion molecules. However, eventually these adhesions may break thereby allowing the epithelial cancer cells to become detached and more motile, which facilitates the spread of the cancer cells to other regions of the body. We and others have found that the breaking of the cell-cell adhesion within carcinomas is facilitated by a process known as epithelial-mesenchymal transition (EMT), as a result these carcinoma cells appear similar to mesenchymal cells in shape and behavior. Therefore, this acquisition of mesenchymal traits through EMT seems to facilitate the spread of cancer to other organs. The EMT process is a reminiscent of embryo development. It is this deadly spread of cancer, (metastasis) mediated by EMT, that causes the majority of cancer-related mortalities.

Stem cells are the cells found in the body, which are capable of generating many different cell types.  Recently, stem-like cells have been found to exist in human epithelial tumors, and these cells, which are named cancer stem cells, are responsible for initiating the formation of tumors.  One of the key determinants for metastasis to occur is the ability to self-renew and generate a new tumor at the distant site. These abilities are similar to the abilities of stem cells to generate new organ. EMT promotes metastasis and we found that EMT process generates cells with many properties associated with stem cells.  Therefore, it seems that EMT generates epithelial cancer stem-like cells with all the traits necessary to spread to a new organ.  We are in the process of better understanding how the EMT generates cancer stem-like cells and what the mechanism they use to reach the distant site to form cancer metastasis.

 
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