Recent Advances in the Mechanisms and Prevention Strategies of Esophageal Cancer Metastasis
LI Yue#, SHI Dongni#, CHEN Boyu, PAN Yibing, WANG Rui, WEN Yanling, DENG Pinwei, LIN Chen, ZHAO Xiaohan, CHEN Xuwei, SONG Libing*
Esophageal cancer is a highly invasive malignant tumor of the digestive tract. The five-year survival rate for patients with metastatic disease is less than 20%, which represents a significant challenge for the prevention and control of this disease. The absence of a serosal layer in the esophagus provides a conduit for tumor cells to readily disseminate within the esophageal wall and invade adjacent organs. Furthermore, the esophageal mucosa’s rich vascular and lymphatic networks facilitate the dissemination of cancer cells to distant sites. The metastatic mechanisms of esophageal cancer are complex and varied, rendering the current preventive and therapeutic options largely ineffective. This review examines the primary metastatic pathways of esophageal cancer, including direct invasion, hematogenous spread, and lymphatic dissemination. Additionally, the review explores the molecular mechanisms that facilitate metastasis, with a particular emphasis on the roles of epigenetic regulation and posttranslational modifications in activating cancer signaling pathways and metabolic reprogramming. Moreover, the review offers a detailed examination of the TME (tumor microenvironment) in esophageal cancer metastasis, elucidating the contributions of immune cells, fibroblasts, blood vessels, and the extracellular matrix in facilitating metastasis through complex interactions. A comprehensive understanding of these metastatic mechanisms is essential for the development of novel therapeutic strategies and the improvement of patient outcomes in esophageal cancer.
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