Summary:
The tumor stroma gains increasing attention in recent years. Angiogenesis (AG) is defined as
formation of new vessels from the endothelium of the preexisting vasculature. The vascular bed
does not only provide supply of nutrition factors and oxygen as well as elimination of metabolic
waste, but the neo-formed vessels represent also a gate for lymphogenous and hematogenous
metastatic spread of the tumor. For tumor growth beyond the size of several mm, AG must be
started to form vascular supply of tumor cells. After the switch to angiogenic phenotype, the
tumor starts to exhibit rapid, almost exponential growth.
AG is a complex process, involving degradation of the basement membrane of preexisting vessel,
proliferation of endothelial buds or solid strands towards the angiogenic stimulus, maturation of
endothelial cells with formation of a luminized capillary, connection of such capillaries with
creation of vascular loops, and finally formation of a functional vessel, surrounded by basement
membrane and pericytes. The most intensive AG is observed at the periphery of the tumor.
AG is regulated by numerous angiogenic and anti-angiogenic factors, which can be synthesized
and released by tumor cells themselves, stromal elements, as well as inflammatory cells, namely
macrophages.
The issues of regulation of AG and importance of AG for tumor growth, progression and metasta-
sis are discussed.
Key words:
malignant neoplasms - tumor angiogenesis - VEGF/VPF - tumor stroma - metastasis -
prognosis
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