The hallmarks of cancer conceptualization is a heuristic tool for distilling the vast complexity of cancer phenotypes and genotypes into a provisional set of underlying principles. As knowledge of cancer mechanisms has progressed, other facets of the disease have emerged as potential refinements. Herein, the prospect is raised that phenotypic plasticity and disrupted differentiation is a discrete hallmark capability, and that nonmutational epigenetic reprogramming and polymorphic microbiomes both constitute distinctive enabling characteristics that facilitate the acquisition of hallmark capabilities. Additionally, senescent cells, of varying origins, may be added to the roster of functionally important cell types in the tumor microenvironment. Significance: Cancer is daunting in the breadth and scope of its diversity, spanning genetics, cell and tissue biology, pathology, and response to therapy. Ever more powerful experimental and computational tools and technologies are providing an avalanche of “big data” about the myriad manifestations of the diseases that cancer encompasses. The integrative concept embodied in the hallmarks of cancer is helping to distill this complexity into an increasingly logical science, and the provisional new dimensions presented in this perspective may add value to that endeavor, to more fully understand mechanisms of cancer development and malignant progression, and apply that knowledge to cancer medicine.

中文翻译：

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癌症的标志：新维度

癌症概念化的标志是一种启发式工具，用于将癌症表型和基因型的巨大复杂性提炼成一组临时的基本原则。随着对癌症机制认识的不断进步，该疾病的其他方面也出现了潜在的改进。在此，提出了这样的前景：表型可塑性和破坏的分化是一种离散的标志能力，并且非突变表观遗传重编程和多态性微生物组都构成了促进标志能力获得的独特的使能特征。此外，不同来源的衰老细胞可能会被添加到肿瘤微环境中功能重要的细胞类型名册中。意义：癌症的多样性广度和范围令人畏惧，涵盖遗传、细胞和组织生物学、病理学和治疗反应。越来越强大的实验和计算工具和技术正在提供大量有关癌症所包含疾病的各种表现的“大数据”。癌症标志中体现的综合概念正在帮助将这种复杂性提炼成一门越来越合乎逻辑的科学，从这个角度提出的临时新维度可能会为这一努力增加价值，以更全面地理解癌症发展和恶性进展的机制，并将这些知识应用于癌症医学。