The physiological stress response to surgery promotes wound healing and functional recovery and includes the activation of neural, inflammatory and proangiogenic signaling pathways. Paradoxically, the same pathways also promote metastatic spread and growth of residual cancer. Human and animal studies show that cancer surgery can increase survival, migration and proliferation of residual tumor cells. To secure the survival and growth of disseminated tumor cells, the formation of premetastatic niches in target organs involves a complex interplay between microenvironment, immune system, circulating tumor cells, as well as chemical mediators and exosomes secreted by the primary tumor. This review describes the current understanding of the early mechanisms of dissemination, as well as how surgery may facilitate disease progression.

中文翻译：

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转移前的壁ni，外泌体和循环中的肿瘤细胞：肿瘤扩散的早期机制及其与手术的关系。

对手术的生理应激反应促进伤口愈合和功能恢复，并包括神经，炎症和促血管生成信号通路的激活。矛盾的是，相同的途径也促进转移性扩散和残留癌的生长。人类和动物研究表明，癌症手术可以增加残留肿瘤细胞的存活，迁移和增殖。为了确保扩散的肿瘤细胞的存活和生长，在靶器官中转移前发育的壁ni的形成涉及微环境，免疫系统，循环肿瘤细胞以及原发性肿瘤分泌的化学介质和外泌体之间的复杂相互作用。这篇综述描述了对早期传播机制的当前了解，以及外科手术如何促进疾病进展。