Tumour Biology: tumour-associated inflammation versus antitumor immunity.

The latest research results suggest that tumour-infiltrating leukocytes and the intra-tumoural cytokine environment play a central role in both the genesis and development of cancer. Over a hundred years ago, Virchow pointed out that numerous immune cells occur in the vicinity of practically all malignant tumours and that the structure of tumour tissue closely resembles the inflamed region of a non-healing wound. With the aid of the latest molecular and cell-biological methods, we are not only able today to closely characterise tumour cells and their immediate vicinity but also the other cell types present in tumour tissue, such as infiltrating immune cells, endothelial cells, connective tissue cells and others, both in terms of phenotype and function. In addition, there is growing understanding of the significance of the composition and functioning of endogenous messenger substances such as cytokines, chemokines and prostaglandins in healthy and malignantly altered tissues. From the immunological point of view, the main characteristics are dysregulated inflammatory conditions caused by the tumour cells themselves or by external factors, depending on the type of tumour event. It is evident that prolonged dysregulated inflammatory conditions favour not only carcinogenesis but also the local infiltration and metastasis of malignantly modified cells and counteract the development of efficient antitumor immunity. On the other hand, there are indications that through the polarisation of immunological reactions, the ability of immunological regulator and effector cells to induce efficient antitumor immunity can be modulated. Within the framework of this summary, the essential immunological aspects of tumour formation and tumour development known at present are presented and possible new therapeutic strategies are discussed.