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Int J Clin Exp Pathol 2012;5(7):614-623

Review Article
Molecular mechanisms of lymphatic metastasis in solid tumors of the gastrointestinal
tract

Melanie C Langheinrich, Vera Schellerer, Aristotelis Perrakis, Clemens Lohmüller, Claus Schildberg, Elisabeth Naschberger, Michael Stürzl,
Werner Hohenberger, Roland S Croner

Department of Surgery, University Hospital Erlangen; Department of Surgery, University Hospital Erlangen,Division of Molecular and
Experimental Surgery, Germany

Received June 22, 2012; Accepted July 22, 2012; Epub September 5, 2012; Published September 15, 2012

Abstract: Tumor cell dissemination from the primary tumor site to distant organs is one of the characteristic properties of malignant tumors
and represents a crucial step in the progression of disease. Although the pattern of spread may vary in different types of carcinomas,
dissemination via the lymphatic system represents a common event in metastasis. The extent of lymph node metastasis is one of the major
determinants for the prognosis of patients with gastrointestinal carcinomas and guides the therapeutically management. During the last
decades, significant attention has been given to the molecular mechanisms that control lymphatic metastasis. The process of
lymphangiogenesis has come into the focus. Lymphangiogenesis, the formation of newly lymphatics, comprises a series of complex cellular
events and is controlled by a balance between pro- and anti-lymphangiogenic signals. This article will briefly describe the lymphatic system
and then provide an overview of the molecular players involved in tumor lymphangiogenesis.

Keywords: Lymphangiogenesis, lymphatic metastasis, molecular mechanisms, gastrointestinal tumors, lymphangiogenic factors

Address all correspondence to:
Dr. Ronald S Croner
Department of Surgery
University Hospital Erlangen
Krankenhausstrasse 12, 91054 Erlangen, Germany.
Phone: +49 (0) 9131-8533296
E-mail: roland.croner@uk-erlangen.de.