Table_1_Targeting Myeloid-Derived Suppressor Cells Derived From Surgical Stress: The Key to Prevent Post-surgical Metastasis.DOCX

Myeloid-derived suppressor cells (MDSCs) are known to play an essential part in tumor progression under chronic stress settings through their manipulation of adaptive and innate immune systems. Previous researches mainly focus on MDSC's role in the chronic tumor immune environment. In addition, surgery can also serve as a form of acute stress within the patient's internal environment. Nevertheless, the part that MDSCs play in post-surgical tumor development has not gained enough attention yet. Although surgery is known to be an effective definite treatment for most localized solid tumors, there are still plenty of cancer patients who experience recurrence or metastasis after radical resection of the primary tumor. It is believed that surgery has the paradoxical capability to enhance tumor growth. Many possible mechanisms exist for explaining post-surgical metastasis. We hypothesize that surgical resection of the primary tumor can also facilitate the expansion of MDSCs and their pro-tumor role since these surgery-induced MDSCs can prepare the pre-metastatic niche (the “soil”) and at the same time interact with circulating tumor cells (the “seeds”). This vicious, reciprocal mechanism is a crucial point in the emergence of post-surgical metastasis. According to our hypothesis, MDSCs can be the precise target to prevent cancer patients from post-surgical recurrence and metastasis during the perioperative phase to break the wretched cycle and provide better long-term survival for these patients. Future studies are needed to validate this hypothesis.

髓源性抑制细胞（MDSCs）在慢性应激条件下通过调节适应性及先天免疫系统，在肿瘤进展中扮演着至关重要的角色。先前的研究主要聚焦于MDSCs在慢性肿瘤免疫环境中的功能。此外，手术在患者内部环境中也可作为一种急性应激的形式。然而，MDSCs在术后肿瘤发展中的作用尚未得到足够的关注。尽管手术已知是大多数局限性实体瘤的有效根治性治疗手段，但仍有大量癌症病人在接受原发肿瘤根治性切除术后出现复发或转移。人们普遍认为手术具有一种看似矛盾的潜能，即促进肿瘤生长。术后转移的可能机制众多。我们提出假设，原发肿瘤的手术切除可能促进MDSCs的扩增及其促肿瘤作用，因为这些由手术诱导的MDSCs能够准备前转移性微环境（即“土壤”），同时与循环肿瘤细胞（即“种子”）相互作用。这一恶性、相互作用的机制是术后转移出现的关键。根据我们的假设，MDSCs可以作为精确的治疗靶点，在围手术期防止癌症患者术后复发和转移，打破这一痛苦的循环，并为这些患者提供更长的生存期。未来研究需要验证这一假设。