摘要：

The development and spread of tumours to give rise to metastatic deposits can be described as a series of definable stages beginning with tumour inception. These stages were recognised and described several decades ago by several prominent pathologists such as Foulds (1969) in his classical book Neoplastic Development and Willis (1973) in his classical work The Spread of Tumours in the Human Body. Recent reviews by Fidler et al. (1978), Nicolson (1982) and Sherbet (1982) have summarised the mechanisms of tumour spread, to which I would like to refer the reader. However, in the following pages, I shall describe as succinctly as possible both the stages and the mechanisms operating at the various stages of the dissemination process, in order that subsequent discussion of the metastatic incapacity of gliomas can be placed in proper perspective. The natural history of tumour development and spread can be divided into various stages according to the conventional plan proposed by Foulds (1969) as follows: (a) development of the primary tumour, (b) vascularisation of the tumour, (c) detachment of tumour cells and invasion of lymphatics and blood vessels, (d) transport of malignant cells, (e) attachment of the cells to vascular endothelium, (f) extravasation or penetration of the endothelium by the tumour cells and (g) host organ-cancer cell interaction and growth of the secondary tumour (Figure 3).

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