are metastases from metastases clinical relevant computer modelling of cancer spread in a case of hepatocellular carcinoma转移转移临床癌症扩散到有关计算机模拟的肝细胞癌.pdf

Are Metastases from Metastases Clinical Relevant? Computer Modelling of Cancer Spread in a Case of Hepatocellular Carcinoma 1 2 3 1 Anja Bethge , Udo Schumacher , Andreas Wree , Gero Wedemann * 1 Competence Center Bioinformatics, Institute for Applied Computer Science, University of Applied Sciences Stralsund, Stralsund, Germany, 2 Institute for Anatomy and Experimental Morphology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany, 3 Institute of Anatomy, University of Rostock, Rostock, Germany Abstract Background: Metastasis formation remains an enigmatic process and one of the main questions recently asked is whether metastases are able to generate further metastases. Different models have been proposed to answer this question; however, their clinical significance remains unclear. Therefore a computer model was developed that permits comparison of the different models quantitatively with clinical data and that additionally predicts the outcome of treatment interventions. Methods: The computer model is based on discrete events simulation approach. On the basis of a case from an untreated patient with hepatocellular carcinoma and its multiple metastases in the liver, it was evaluated whether metastases are able to metastasise and in particular if late disseminated tumour cells are still capable to form metastases. Additionally, the resection of the primary tumour was simulated. The simulation results were compared with clinical data. Results: The simulation results reveal that the number of metastases varies significantly between scenarios where metastases metastasise and scenarios where they do not. In contrast, the total tumour mass is nearly unaffected by the two different modes of metasta