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Sawayama et al. J Cancer Metastasis Treat 2018;4:10 Journal of Cancer
DOI: 10.20517/2394-4722.2017.79 Metastasis and Treatment

Review Open Access

Microenvironment in the pathogenesis of gastric
cancer metastasis

Hiroshi Sawayama, Takatsugu Ishimoto, Hideo Baba

Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto 860-8556,
Japan.
Correspondence to: Prof. Hideo Baba, Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto
University, 1-1-1 Honjo, Kumamoto 860-8556, Japan. E-mail: hdobaba@kumamoto-u.ac.jp
How to cite this article: Sawayama H, Ishimoto T, Baba H. Microenvironment in the pathogenesis of gastric cancer metastasis. J Cancer
Metastasis Treat 2018;4:10. http://dx.doi.org/10.20517/2394-4722.2017.79
Received: 21 Nov 2017 First Decision: 25 Dec 2017 Revised: 18 Jan 2018 Accepted: 3 Feb 2018 Published: 28 Feb 2018

Science Editor: Masayuki Watanabe Copy Editor: Jun-Yao Li Production Editor: Huan-Liang Wu

Abstract
Tumor tissues contain cancer cells, other cellular and non-cellular components. Tumor microenvironments consist of
cancer cells and various types of stromal cells, cancer associated fibroblasts, bone marrow-derived cells, endothelial cells,
and hematopoietic cells, mainly tumor-associated macrophages and tumor-infiltrating lymphocytes. Increasing recent
evidence has demonstrated that alteration of tumor microenvironments is deeply implicated in tumor progression and
metastasis in gastric cancer (GC) patients. Recent investigations have provided insights into the molecular mechanisms
of the interaction between tumor cells and tumor microenvironments. Interactions between cancer cells and their
microenvironment with cytokines and microRNA in extracellular vesicles, such as the exosome, can have a substantial
impact on tumor characteristics. Alterations in the tumor microenvironment may play a crucial role in facilitating the
progression of tumor cells and metastasis, as well as the activation of cell signaling pathways, which are associated with
GC cell proliferation and invasion by genetic or epigenetic alterations. In this review, significant molecular insights into the
tumor microenvironment, which consist of cancer associated fibroblasts, bone marrow-derived cells, tumor-associated
macrophages and tumor-infiltrating lymphocytes; the interactions between cancer cells and their microenvironment; and
the clinical impacts of alterations of GC microenvironments will be discussed.

Keywords: Tumor microenvironments, cancer associated fibroblasts, bone marrow-derived cells, tumor-associated
macrophages, tumor-infiltrating lymphocytes

INTRODUCTION
[1]
Gastric cancer (GC) is the fourth most commonly diagnosed cancer worldwide . Surgical resection with
lymph node dissection is the most effective treatment for resectable GC; the standard surgical procedure for

© The Author(s) 2018. Open Access This article is licensed under a Creative Commons Attribution 4.0
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