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Dissemination of malignant tumors (metastasis) is a cascade process consisting of growth of primary tumors, detachment of cells from the primary tumor and local invasion of surrounding extracellular-matrix (ECM), intravasation, dissemination in the circulatory system, adhesion to the endothelial cells and vessel wall, extravasation and growth again in the secondary organs.

Tumor cell – ECM interaction has a pivotal role during these steps, which are mediated by adhesion receptors (integrins, non-integrin receptors and proteoglycans), motility factors and their receptors and enzymes responsible for digestion.


Steps of the metastatic process.

  • Tumor growth, tumor cell detachment, tissue invasion
  • Angiogenesis
  • Intravasation
  • Interaction with blood elements
  • Arrest in the capillary system of the target organ
  • Extravasation
  • Establishment of metastatic foci