What might a stromal response mean to prostate cancer progression?

Abstract

Many similarities exist between the stroma at sites of wound repair and reactive stroma in cancer. Common features include an elevated stromal cell proliferation, altered expression of matrix components, elevated expression of TGF beta-1, neovascularization, and expression of several common stromal markers. In addition, proliferative stromal cells at these sites generally express myodifferentiation markers. A comparison between the many common features and the biologically active molecules observed in reactive stroma in carcinoma and reactive stroma in wound repair is discussed in this review. An extended analysis of the literature suggests a functional link between mechanisms in wound repair response and the stromal reaction in many cancers including prostate cancer. We propose in this review, that the fundamental mechanisms of stroma in providing a rapid response to altered homeostasis in wounding, also provides for a tumor-regulating stromal microenvironment in cancer. The functional consequences of this stromal response to carcinoma progression and how the stromal response might be used in extended diagnosis and in therapeutic approaches are discussed.