| Sažetak (engleski) | The process of melanoma metastasis can be divided into
two stages of metastatic cell dissemination and proliferation. The whole
process should be observed and distinguished through the variable or
prism of time. The fact that melanoma metastases are detected in visceral
organs at the stage when they are macroscopically visible does
not imply that their onset has occurred much earlier. Additionally, it is
quite obvious that the entire process is not driven by melanoma but
rather only the initial stage of metastatic cell dissemination, whereas
the later stage of metastatic cell proliferation is driven by other factors,
firstly by mutated genes in the presence of melanoma or without it. Dissemination
of metastatic cells occurs at approximately the same time in
all melanomas, at MIS transition to MM, but is not immediately followed
by metastatic cell proliferation; instead, some time has to elapse for a
particular gene mutation to occur, and this timing varies among melanomas.
Following dissemination of metastatic cells to visceral organs,
they remain inactive, and in this period the presence of melanoma is not
necessary anymore for metastatic cell proliferation, as they are waiting
for a signal to start multiplying. This is clearly discernible from the fact
that melanoma is today detected and removed frequently and early, but
visible metastases then develop in the absence of melanoma, which
may also regress spontaneously. Accordingly, MM is no longer necessary
for metastasis later on. Finally, let me rephrase the title: melanoma
is only responsible for initial dissemination of metastatic cells, whereas
subsequent proliferation of metastatic cells is driven by other factors,
most probably mutated genes. |
