[How to understand mechanisms of metastases]

The dissemination of malignant cells is the result of successive and complex biological steps. In most cases, physiopathological observations can explain the different cases of metastatic spread observed in clinical oncology. Our knowledge of the biological mechanisms involved in tumoral dissemination is poor. However, recent data have disclosed cellular modifications associated with malignant spread: these observations concern physiopathological aspects of the cytoplasmic membrane of malignant cells, their interconnexion with the stroma of tumors, the characterisation of new genes involved in tumoral progression and viral oncogenic mechanisms involved in cervical neoplasia. These data will yield biological parameters of potential value in assessing the metastatic risk of malignant tumors at the time of diagnosis. In the near future, it should be possible to more accurately select patients for antitumoral therapy and to achieve a better understanding of the cellular mechanisms involved in tumoral progression.