Pathogenesis of cancer

Thus, a proliferating somatic cell, having genotypic changes in nuclear DNA, finds itself in “super conditions” of chronic inflammation, where it is exposed to long-term and continuous (months) aggressive influence in an oxygen-free environment. As a result, it acquires epigenetic changes — structural damage to the cell membrane and chemical changes in the cytoplasm. It is currently believed that genotypic and epigenetic changes in a proliferating somatic cell are preparatory and, at the same time, trigger for the mechanism of actual transformation into a malignant stem cell. A prerequisite for the implementation of the transformation mechanism is sufficient isolation from the influence of the host organism.

The third stage is progression (the actual transformation mechanism):

— the formation of a malignant “embryo” due to the proliferation of the primary malignant stem cell — in an isolated microcavity, mitosis of a tissue mononuclear cell occurs, which has genotypic and epigenetic changes and its transformation into a primary malignant stem cell. During mitosis, the transformation mechanism is implemented as a continuous process consisting of two parts:

— part one — manifestation of the level of genotypic changes: the return of the Mononuclear cell during mitosis to the embryonic state and the block of differentiation of daughter cells at the pluripotent or unipotent level, corresponding to the level at which genotypic changes in the nuclear DNA of the bone marrow stem cell occurred during hematopoiesis;

— part two — manifestation of the nature of genotypic changes: the spectrum of changes in nuclear DNA at the gene, chromosomal and genomic levels comes into force: amplification (increasing the copy number of genes), deletions, insertions, translocations, micromutations (point substitutions, microdeletions, microinsertions), etc. An unstable active system “emerges” — a primary malignant stem cell, which has retained many of the basic abilities and capabilities of the mother cell — the tissue mononuclear cell, which has not completely escaped from the embryonic state and acquires new abilities of its new life.

Thus, a proliferating somatic cell, which has primary mutations in the nuclear DNA of the genome as a result of initiation, then structural changes in the cell membrane and chemical changes in the cytoplasm as a result of promotion, turns into a primary malignant stem cell with subsequent progression.

The third period is the growth and development of the malignant process.

Stage first — formation of a malignant “embryo”: due to the proliferation of the primary malignant stem cell, the accumulation of similar or homogeneous malignant cells occurs within the shell of an isolated microcavity. Due to exposure growth, the size of the malignant “embryo” can increase significantly.

Stage second — organization of the primary malignant focus: with the release of malignant cells beyond the isolated microcavity into the intercellular space, subsequent proliferation, appositional and invasive growth, the organization and increase in the volume of the primary malignant focus occurs.

Stage third — organization of a secondary malignant focus — metastasis: invasive growth and angioneogenesis contribute to the penetration of malignant cells into the vascular bed and organization of a secondary malignant focus — metastasis.

The malignant process, as an independent system, is capable of self-organization and self-regulation. Throughout its growth and development, it is accompanied by deliberate death of cells and non-cellular structures, redistribution of water, autonomous regulation, malignant progression, increasing superiority, as well as control and subjugation of the host organism. To create the theory of “Mononuclear oncogenesis” as a natural mechanism of the emergence, growth and development of a malignant process, we considered it possible to question the existing theory about the origin of the primary malignant stem cell of solid tumors from cambial cells of the integumentary or glandular epithelium. After all, the question of what cellular and/or tissue substrate the malignant stem cells of solid tumors originate from is still debatable, and the range of cells that could lay claim to the role of the precursor cell of the primary malignant stem cell has not yet been precisely determined. Theoretically, any somatic cell can turn into a malignant cell. However, it is impossible to identify transformation processes in vitro and oncogenicity of cells in vivo, because The transformation of a normal cell into a malignant cell is a process initiated at the molecular level.

Important and undeniable statements:

— malignant cells are more similar to each other than normal cells are to each other;