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<article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" article-type="review-article" dtd-version="1.1" xml:lang="zh" xsi:noNamespaceSchemaLocation="https://jats.nlm.nih.gov/publishing/1.1/xsd/JATS-journalpublishing1.xsd"><front><journal-meta><!-- 出版商赋予期刊ID--><journal-id journal-id-type="publisher-id">YIKE</journal-id><journal-title-group><!-- 期刊中文全称--><journal-title>安徽医科大学学报</journal-title><!-- 期刊英文全称--><journal-title xml:lang="en">Acta Universitatis Medicinalis Anhui</journal-title><!-- 期刊英文缩写--><abbrev-journal-title abbrev-type="publisher" xml:lang="en">Acta Universitatis Medicinalis Anhui</abbrev-journal-title><!-- 期刊中文缩写--><abbrev-journal-title abbrev-type="publisher">安徽医科大学学报</abbrev-journal-title></journal-title-group><!-- 期刊ISSN号--><issn pub-type="ppub">1000-1492</issn><!-- 期刊CN号--><issn pub-type="cn">34-1065/R</issn><publisher><!--出版商英文名称【预置实体】 待确认 --><publisher-name xml:lang="en">Anhui Lianzhong Printing Limited Company</publisher-name><!--出版商英文地址【预置实体】 --><publisher-loc xml:lang="en">Editorial Board of Acta Universitatis Medi-cinalis Anhui Meishan Road , Hefei 230032</publisher-loc><!-- 出版商中文名称【预置实体】--><publisher-name>《安徽医科大学学报》编辑部</publisher-name><!--出版商中文地址【预置实体】 --><publisher-loc>安徽省合肥市安徽医科大学校内老图书馆三楼</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="publisher-id">1000–1492（2026）06–1151–06</article-id><article-id pub-id-type="doi">10.19405/j.cnki.issn1000–1492.2026.06.022</article-id><article-id pub-id-type="manuscript">V351于辉</article-id><article-categories><subj-group subj-group-type="heading"><subject>◇栏目名称:综述◇</subject></subj-group><subj-group subj-group-type="clc"><subject>R 730.2</subject></subj-group><subj-group subj-group-type="dc"><subject>A</subject></subj-group></article-categories><title-group><article-title>EphA2促进肿瘤发生和进展分子机制的研究进展</article-title><trans-title-group xml:lang="en"><trans-title>Advances in molecular mechanisms underlying the promotion of cancer development and progression by EphA2</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author"><name-alternatives><name name-style="eastern"><surname>于</surname><given-names>辉</given-names></name><name name-style="eastern" xml:lang="en"><surname>Yu</surname><given-names>Hui</given-names></name></name-alternatives><xref ref-type="aff" rid="aff1">1</xref><xref ref-type="author-notes" rid="fna1"/></contrib><contrib contrib-type="author"><name-alternatives><name name-style="eastern"><surname>韩</surname><given-names>琛</given-names></name><name name-style="eastern" xml:lang="en"><surname>Han</surname><given-names>Chen</given-names></name></name-alternatives><xref ref-type="aff" rid="aff2">2</xref></contrib><contrib contrib-type="author"><name-alternatives><name name-style="eastern"><surname>王</surname><given-names>世丽</given-names></name><name name-style="eastern" xml:lang="en"><surname>Wang</surname><given-names>Shili</given-names></name></name-alternatives><xref ref-type="aff" rid="aff1">1</xref></contrib><contrib contrib-type="author"><name-alternatives><name name-style="eastern"><surname>杨</surname><given-names>海虹</given-names></name><name name-style="eastern" xml:lang="en"><surname>Yang</surname><given-names>Haihong</given-names></name></name-alternatives><role>综述</role><xref ref-type="aff" rid="aff1">1</xref></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern"><surname>鹿</surname><given-names>培源</given-names></name><name name-style="eastern" xml:lang="en"><surname>Lu</surname><given-names>Peiyuan</given-names></name></name-alternatives><xref ref-type="aff" rid="aff1">1</xref><xref ref-type="aff" rid="aff2">2</xref><xref ref-type="corresp" rid="cor1"/><xref ref-type="author-notes" rid="fna2"/></contrib><aff-alternatives id="aff1"><aff><label>1</label><institution>山东协和学院医学院</institution>，<city>济南</city>  <postal-code>250109</postal-code></aff><aff xml:lang="en"><label>1</label><institution>School of Medicine， Shandong Xiehe University</institution>， <city>Jinan</city>  <postal-code>250109</postal-code></aff></aff-alternatives><aff-alternatives id="aff2"><aff><label>2</label><institution>山东第一医科大学临床与基础医学院</institution>，<city>济南</city>  <postal-code>250117</postal-code></aff><aff xml:lang="en"><label>2</label><institution>School of Clinical and Basic Medical Sciences， Shandong First Medical University</institution>， <city>Jinan</city>  <postal-code>250117</postal-code></aff></aff-alternatives></contrib-group><author-notes><corresp xml:lang="en" id="cor1"><named-content content-type="corresp-name">Lu Peiyuan</named-content>， E-mail： <email>peiyuanlu69@hotmail.com</email></corresp><fn fn-type="other" specific-use="about-author" id="fna1"><p><named-content content-type="corresp-name">于  辉</named-content>，女，硕士，讲师</p></fn><fn fn-type="other" specific-use="about-author" id="fna2"><p><named-content content-type="corresp-name">鹿培源</named-content>，男，博士，教授，博士生导师，通信作者，E-mail： <email>peiyuanlu69@hotmail.com</email></p></fn></author-notes><pub-date pub-type="epub" iso-8601-date="2026-04-13T11：50：55"><day>13</day><month>04</month><year>2026</year></pub-date><pub-date pub-type="ppub"><day>23</day><month>06</month><year>2026</year></pub-date><volume>61</volume><issue>6</issue><issue-id>17</issue-id><fpage>1151</fpage><lpage>1156</lpage><page-range>1151-1156</page-range>      <history>   <date date-type="accepted"><day>06</day><month>03</month><year>2026</year></date></history>    <self-uri/><abstract abstract-type="key-points"><p>A型肝配蛋白受体-2（EphA2）是肝配蛋白（Eph）受体酪氨酸激酶亚家族的一个成员。作为肿瘤发生和进展的重要调节因子，EphA2可以通过激活或者增强促肿瘤的信号通路促进肿瘤的发生、生长、侵袭、转移、干细胞特性和血管生成。EphA2在肿瘤组织中的高表达与不良预后密切相关，是一个非常有前景的肿瘤治疗潜在靶点。本文对EphA2促进肿瘤发生和进展的分子机制进行综述，旨在为靶向EphA2的肿瘤治疗提供思路和理论依据。</p></abstract><trans-abstract abstract-type="key-points" xml:lang="en"><p>Erythropoietin-producing hepatoma receptor A2 （EphA2） is a member of the erythropoietin-producing hepatoma （Eph） subfamily of receptor tyrosine kinases. As a critical regulator of cancer development and progression， EphA2 can promote tumor initiation， growth， invasion， metastasis， stemness， and angiogenesis by activating or enhancing the oncogenic signaling pathways. High expression of EphA2 in tumor tissues is closely associated with poor prognosis， thus it is a very promising potential target for cancer treatment. This article reviews the molecular mechanisms by which EphA2 promotes cancer development and progression， aiming to provide clues and theoretical basis for EphA2-targeted cancer treatment.</p></trans-abstract><kwd-group kwd-group-type="author"><kwd>EphA2</kwd><kwd>肿瘤发生</kwd><kwd>肿瘤进展</kwd><kwd>酪氨酸磷酸化</kwd><kwd>受体酪氨酸激酶</kwd><kwd>信号通路</kwd></kwd-group><kwd-group xml:lang="en" kwd-group-type="author"><kwd>EphA2</kwd><kwd>cancer development</kwd><kwd>cancer progression</kwd><kwd>tyrosine phosphorylation</kwd><kwd>receptor tyrosine kinases</kwd><kwd>signaling pathways</kwd></kwd-group><funding-group><award-group><funding-source>国家自然科学基金项目</funding-source><award-id>82104455</award-id></award-group><award-group><funding-source>山东协和学院高层次人才科研启动项目</funding-source><award-id>SDXHQD2025039</award-id></award-group><funding-statement>国家自然科学基金项目（编号： 82104455）；山东协和学院高层次人才科研启动项目（编号： SDXHQD2025039）</funding-statement></funding-group><funding-group xml:lang="en"><award-group><funding-source>National Natural Science Foundation of China</funding-source><award-id>82104455</award-id></award-group><award-group><funding-source>Scientific Research Start-up Grant for High-level Talent of Shandong Xiehe University</funding-source><award-id>SDXHQD2025039</award-id></award-group><funding-statement>National Natural Science Foundation of China （No. 82104455）； Scientific Research Start-up Grant for High-level Talent of Shandong Xiehe University （No. SDXHQD2025039）</funding-statement></funding-group><counts><fig-count count="1"/><table-count count="0"/><equation-count count="0"/><ref-count count="40"/><page-count count="6"/><word-count count="18304"/></counts><custom-meta-group><custom-meta><meta-name>version</meta-name><meta-value>1.0.0.25091</meta-value></custom-meta><custom-meta><meta-name>structure-time</meta-name><meta-value>2026-07-29T16:03:10</meta-value></custom-meta><custom-meta><meta-name>word-source</meta-name><meta-value>FX</meta-value></custom-meta></custom-meta-group></article-meta></front><body><p>受体酪氨酸激酶（receptor tyrosine kinase， RTK）是一类单跨膜的细胞表面受体，它们的胞内区具有蛋白酪氨酸激酶活性。RTK可以介导细胞的信号转导，对细胞的分化、增殖、存活、代谢及迁移具有重要调节作用<sup>［<xref ref-type="bibr" rid="R1">1</xref>］</sup>。在人类中共有58个RTK，根据它们胞外区的序列相似性可以分为20个亚家族<sup>［<xref ref-type="bibr" rid="R1">1</xref>］</sup>。其中，肝配蛋白（erythropoietin-producing hepatoma， Eph）受体亚家族是最大的RTK亚家族<sup>［<xref ref-type="bibr" rid="R2">2</xref>］</sup>，在人类中共有14个成员<sup>［<xref ref-type="bibr" rid="R2">2</xref>–<xref ref-type="bibr" rid="R3">3</xref>］</sup>。A型肝配蛋白受体-2 （erythropoietin-producing hepatoma receptor A2， EphA2）是Eph受体亚家族中研究得最多的成员之一，它不但具有重要的生物学功能，而且在包括肿瘤在内的多种人类疾病中具有关键调节作用<sup>［<xref ref-type="bibr" rid="R4">4</xref>–<xref ref-type="bibr" rid="R5">5</xref>］</sup>。本文首先概述EphA2的分子结构及其信号转导特征，随后深入探讨其促进肿瘤发生和进展的分子机制。</p><sec id="s1"><label>1</label><title>Eph受体亚家族</title><p>Eph受体亚家族由一组结构相似的RTK组成<sup>［<xref ref-type="bibr" rid="R2">2</xref>–<xref ref-type="bibr" rid="R3">3</xref>］</sup>。Eph受体由与配体结合的N-末端胞外区、跨膜区和具有蛋白激酶活性的C-末端胞内区组成。胞外区由一个配体结合结构域、一个Sushi结构域、一个表皮生长因子（epidermal growth factor， EGF）样结构域以及两个重复的纤连蛋白Ⅲ型结构域组成。胞内区由一个近膜区、一个激酶结构域、一个不育α模体（sterile alpha motif， SAM）结构域以及一个突触后密度蛋白95/果蝇discs large肿瘤抑制蛋白/闭锁小带蛋白-1（postsynaptic density protein 95/discs large/zonula occludens-1， PDZ）结构域结合模体组成，并含有可以被磷酸化的酪氨酸、丝氨酸和苏氨酸残基<sup>［<xref ref-type="bibr" rid="R2">2</xref>- <xref ref-type="bibr" rid="R3">3</xref>］</sup>（<xref ref-type="fig" rid="F1">图1</xref>）。Eph受体的配体是被称为ephrin的细胞表面蛋白<sup>［<xref ref-type="bibr" rid="R2">2</xref>–<xref ref-type="bibr" rid="R3">3</xref>］</sup>。根据其胞外区的序列相似性以及结合的ephrin配体的差异，Eph受体可以分为A型Eph受体和B型Eph受体，它们在人类中分别有9个（EphA1-A8 和EphA10）和5个（EphB1-B4 和EphB6）成员<sup>［<xref ref-type="bibr" rid="R2">2</xref>–<xref ref-type="bibr" rid="R3">3</xref>］</sup>。A型Eph受体通常结合A类ephrin配体，这类配体是被一个糖基磷脂酰肌醇（glycosylphosphatidylinositol， GPI）链锚定在细胞膜上的蛋白分子（<xref ref-type="fig" rid="F1">图1</xref>），在人类中共有5种（ephrin A1-A5）。B型Eph受体通常结合B类ephrin配体，这类配体是一个跨膜蛋白，其胞内区含有一个PDZ结构域结合模体以及可以被磷酸化的酪氨酸和丝氨酸残基（<xref ref-type="fig" rid="F1">图1</xref>），在人类中共有3种（ephrin B1-B3）<sup>［<xref ref-type="bibr" rid="R2">2</xref>–<xref ref-type="bibr" rid="R3">3</xref>］</sup>。这两类ephrin配体都含有一个保守的位于N-末端的受体结合结构域<sup>［<xref ref-type="bibr" rid="R2">2</xref>–<xref ref-type="bibr" rid="R3">3</xref>］</sup>（<xref ref-type="fig" rid="F1">图1</xref>）。</p><fig position="float" id="F1"><object-id pub-id-type="doi">10.19405/j.cnki.issn1000–1492.2026.06.022.F001</object-id><label>图1</label><caption><title>Eph受体和Ephrin配体的结构示意图</title></caption><abstract abstract-type="caption" xml:lang="en"><label>Fig.1</label><title>Schematic diagram of the structure of Eph receptors and their ephrin ligands</title></abstract><alternatives><graphic specific-use="print" xlink:href="media/D8A6759D-DE19-4ad0-9265-DA8593458045-F001.eps" id="Graphic1"><?fx-imagestate width="80.08055115" height="98.77777863"?></graphic><graphic specific-use="big" xlink:href="alternativeImage/D8A6759D-DE19-4ad0-9265-DA8593458045-F001.jpg"><?fx-imagestate width="80.08055115" height="98.77777863"?></graphic><graphic specific-use="small" xlink:href="alternativeImage/D8A6759D-DE19-4ad0-9265-DA8593458045-F001c.jpg"><?fx-imagestate width="80.08055115" height="98.77777863"?></graphic></alternatives></fig></sec><sec id="s2"><label>2</label><title>EphA2及其信号转导</title><sec id="s2a"><label>2.1</label><title>EphA2的结构特征</title><p specific-use="noneIndent">EphA2是1990年在用与蛋白酪氨酸激酶（protein tyrosine kinase， PTK）高度保守区域杂交的简并探针筛选Hela细胞cDNA文库时发现的<sup>［<xref ref-type="bibr" rid="R6">6</xref>］</sup>。因为它在上皮细胞中高表达，所以最初被称为上皮细胞激酶（epithelial cell kinase， ECK）<sup>［<xref ref-type="bibr" rid="R6">6</xref>］</sup>。EphA2是一个由976个氨基酸残基组成的RTK，分子量为130 kD<sup>［<xref ref-type="bibr" rid="R6">6</xref>］</sup>。其C-末端胞内区含有一些可以被磷酸化的氨基酸残基，其中近膜区含有两个可以发生自身磷酸化的酪氨酸残基（Y588和Y594）<sup>［<xref ref-type="bibr" rid="R7">7</xref>］</sup>，激酶结构域含有两个可以被磷酸化的酪氨酸残基（Y735和Y772）<sup>［<xref ref-type="bibr" rid="R7">7</xref>–<xref ref-type="bibr" rid="R8">8</xref>］</sup>，激酶结构域和SAM结构域的连接区含有五个可以被磷酸化的丝氨酸/苏氨酸残基（S892、T898、S897、S899和S901）<sup>［<xref ref-type="bibr" rid="R9">9</xref>］</sup>，SAM结构域含有一个可以被磷酸化的酪氨酸残基（Y930）<sup>［<xref ref-type="bibr" rid="R7">7</xref>］</sup>。这些氨基酸残基的磷酸化都可以改变EphA2的活性，对EphA2的生物学功能具有重要的调节作用。EphA2可以与A类ephrin配体中的任何一种相互作用，其中与ephrin A1亲和力最强<sup>［<xref ref-type="bibr" rid="R5">5</xref>］</sup>。ephrin A1是一个由205个氨基酸残基组成的分子量为22 kD的GPI锚定蛋白<sup>［<xref ref-type="bibr" rid="R5">5</xref>］</sup>。</p></sec><sec id="s2b"><label>2.2</label><title>EphA2的信号转导</title><p specific-use="noneIndent">EphA2与邻近细胞的ephrin A1相互作用可以诱导一系列信号转导。因为EphA2和ephrin A1都是细胞表面蛋白，配体依赖的激活作用可以引发一种独特的双向信号转导。正向信号转导发生于表达EphA2的细胞，反向信号转导发生于表达ephrin A1的细胞<sup>［<xref ref-type="bibr" rid="R4">4</xref>–<xref ref-type="bibr" rid="R5">5</xref>］</sup>。正向信号转导诱导EphA2的寡聚化和近膜区保守酪氨酸残基的自身磷酸化，从而激活其激酶活性，引起一系列的磷酸化级联反应和信号转导<sup>［<xref ref-type="bibr" rid="R4">4</xref>–<xref ref-type="bibr" rid="R5">5</xref>］</sup>。由于ephrin A1不具有激酶活性，反向信号转导通常是激酶非依赖的，其传递的具体信号尚不清楚<sup>［<xref ref-type="bibr" rid="R5">5</xref>］</sup>。这种配体依赖的双向信号转导称为经典的EphA2信号通路<sup>［<xref ref-type="bibr" rid="R4">4</xref>］</sup>。在没有配体结合的情况下，EphA2则可以通过与其他细胞表面受体以及细胞内蛋白激酶的相互作用传递多种信号，称为非经典的EphA2信号通路<sup>［<xref ref-type="bibr" rid="R4">4</xref>］</sup>。例如，EphA2能够以配体非依赖的方式与表皮生长因子受体（epidermal growth factor receptor， EGFR）以及人表皮生长因子受体2（human epidermal growth factor receptor 2， HER2）相互作用并引起一系列的信号转导<sup>［<xref ref-type="bibr" rid="R10">10</xref>–<xref ref-type="bibr" rid="R13">13</xref>］</sup>。此外，EphA2还可以通过其S897被蛋白激酶B（protein kinase B）、核糖体S6激酶（ribosomal S6 kinase， RSK），以及蛋白激酶A（protein kinase A， PKA）磷酸化而发生激活并传递多种信号<sup>［<xref ref-type="bibr" rid="R10">10</xref>， <xref ref-type="bibr" rid="R14">14</xref>–<xref ref-type="bibr" rid="R17">17</xref>］</sup>。</p></sec></sec><sec id="s3"><label>3</label><title>EphA2促进肿瘤发生和进展的分子机制</title><p>EphA2的正常生物学功能包括胚胎的晶状体和肾脏发育、乳腺上皮分支形态发生以及骨稳态<sup>［<xref ref-type="bibr" rid="R4">4</xref>］</sup>。此外，EphA2还是肿瘤发生和进展的一个重要调节因子<sup>［<xref ref-type="bibr" rid="R4">4</xref>–<xref ref-type="bibr" rid="R5">5</xref>］</sup>。EphA2对肿瘤的调节作用是双重的，它既可以是肿瘤抑制因子，也可以是肿瘤促进因子<sup>［<xref ref-type="bibr" rid="R2">2</xref>］</sup>。当EphA2与其配体结合时，它通常可以抑制促肿瘤的整联蛋白、大鼠肉瘤病毒癌基因同源物/丝裂原活化蛋白激酶（rat sarcoma viral oncogene homolog/mitogen-activated protein kinase， RAS/MAPK）以及磷脂酰肌醇3-AKT（phosphatidylinositol 3‑kinase/AKT， PI3K/AKT）等信号通路，此时EphA2作为肿瘤抑制因子起作用<sup>［<xref ref-type="bibr" rid="R2">2</xref>］</sup>。相反地，当没有配体结合时，EphA2通常可以与其他细胞表面受体以及细胞内蛋白激酶相互作用，导致促肿瘤的RAS/MAPK、PI3K/AKT以及Ras同源家族成员A（Ras homolog family member A， RhoA）等信号通路的激活或者增强，此时EphA2作为肿瘤促进因子起作用<sup>［<xref ref-type="bibr" rid="R2">2</xref>］</sup>。也就是说，EphA2通过其经典的正向信号转导传递信号时，它通常是肿瘤抑制因子；而通过非经典的信号通路传递信号时，它通常是肿瘤促进因子。当然，也存在一些例外的情况。在某些条件下，经典的EphA2信号通路的正向信号转导也可以起到促进肿瘤发生和进展的作用<sup>［<xref ref-type="bibr" rid="R2">2</xref>–<xref ref-type="bibr" rid="R3">3</xref>］</sup>。由此可见，EphA2可以通过多种机制调节肿瘤的发生和进展。</p><sec id="s3a"><label>3.1</label><title>促进肿瘤发生</title><p specific-use="noneIndent">EphA2对肿瘤发生具有很强的促进作用。在正常的乳腺表皮细胞MCF-10A中过表达<italic>EphA2</italic>即可以诱导细胞发生恶性转化并获得形成肿瘤的能力<sup>［<xref ref-type="bibr" rid="R18">18</xref>］</sup>。EphA2通过增强HER2信号通路促进乳腺癌的发生<sup>［<xref ref-type="bibr" rid="R13">13</xref>］</sup>。在人和小鼠的乳腺细胞中，EphA2与HER2相互作用可以增强HER2对下游的RAS/MAPK和RhoA信号通路的激活作用，从而导致乳腺癌的发生<sup>［<xref ref-type="bibr" rid="R13">13</xref>］</sup>。EphA2还可以通过与EGFR相互作用促进肺癌和结直肠癌的发生<sup>［<xref ref-type="bibr" rid="R10">10</xref>］</sup>。EphA2与EGFR的相互作用是由Eph相互作用交换蛋白Ephexin1介导的，形成的EGFR-Ephexin1-EphA2复合物可以激活RAS，RAS又可以激活AKT，激活的AKT又可以使EphA2的S897发生磷酸化，进而增强EphA2与EGFR的相互作用<sup>［<xref ref-type="bibr" rid="R10">10</xref>］</sup>。此外，EphA2还可以通过激活AKT和贾努斯激酶1/信号转导及转录激活因子3（janus kinase 1/aignal transducer and activator of transcription 3， JAK1/STAT3）信号通路促进肝细胞癌的发生<sup>［<xref ref-type="bibr" rid="R19">19</xref>］</sup>。总之，EphA2可以通过激活或者增强RAS/MAPK、RhoA、AKT以及JAK1/STAT3等促肿瘤信号通路促进肿瘤的发生。</p></sec><sec id="s3b"><label>3.2</label><title>促进肿瘤细胞增殖和肿瘤生长</title><p specific-use="noneIndent">EphA2可以通过激活或者增强促细胞增殖的信号通路促进肿瘤细胞增殖及肿瘤生长。EphA2对促细胞增殖信号通路的激活或增强作用依赖于它的激酶活性<sup>［<xref ref-type="bibr" rid="R20">20</xref>］</sup>，所以通常它自身需要先被其他激酶激活。在胆管癌中，EphA2通过激活哺乳动物雷帕霉素靶蛋白复合物1（mechanistic target of rapamycin complex 1， mTORC1）和细胞外信号调节激酶（extracellular signal-regulated kinases， ERK）信号通路促进肿瘤的生长<sup>［<xref ref-type="bibr" rid="R21">21</xref>］</sup>。EphA2可以磷酸化AKT的T308从而激活AKT，AKT再磷酸化mTORC1使之激活<sup>［<xref ref-type="bibr" rid="R21">21</xref>］</sup>。而ERK是EphA2通过两个独立的信号通路激活的。EphA2可以磷酸化富含脯氨酸的酪氨酸激酶2（proline-rich tyrosine kinase 2， Pyk2）的Y402激活Pyk2，Pyk2激活细胞Src（cellular Src， c-Src），然后c-Src再激活ERK。EphA2还可以磷酸化快速活化纤维肉瘤激酶（rapidly accelerated fibrosarcoma kinase， Raf）而使之激活，由Raf激活丝裂原活化蛋白激酶激酶（mitogen-activated protein kinase kinase， MEK），再由MEK激活ERK<sup>［<xref ref-type="bibr" rid="R21">21</xref>］</sup>。在非小细胞肺癌中，EphA2可以通过激活c-Jun氨基末端激酶/原癌基因Jun蛋白（c-Jun N-terminal kinase/jun proto-oncogene protein， JNK/c-JUN）信号通路促进肿瘤细胞的增殖，但是EphA2激活JNK/c-JUN信号通路的具体机制尚不清楚<sup>［<xref ref-type="bibr" rid="R22">22</xref>］</sup>。在非小细胞肺癌中，EphA2还可以通过激活促肿瘤的磷脂酶Cγ1（phospholipase C gamma 1， PLCγ1）信号通路来促进肿瘤的生长<sup>［<xref ref-type="bibr" rid="R23">23</xref>］</sup>。EphA2与PLCγ1结合并磷酸化其Y783，从而激活PLCγ1<sup>［<xref ref-type="bibr" rid="R23">23</xref>］</sup>。此外，在鼻咽癌中，EphA2可以通过激活含Src同源结构域的蛋白酪氨酸磷酸酶2/细胞外信号调节激酶1/2（SHP2/ERK1/2）信号通路来促进肿瘤的生长<sup>［<xref ref-type="bibr" rid="R24">24</xref>］</sup>。</p><p>EphA2还可以通过增强促细胞增殖的信号通路促进肿瘤细胞增殖以及肿瘤生长。在胃癌中，EphA2可以与Hippo信号通路的转录辅激活因子Yes相关蛋白（Yes-associated protein， YAP）相互作用并磷酸化其Y357。Y357磷酸化可以提高YAP的稳定性和核转移能力，从而增强胃癌中的Hippo信号通路，促进胃癌细胞的增殖及肿瘤生长<sup>［<xref ref-type="bibr" rid="R25">25</xref>］</sup>。</p></sec><sec id="s3c"><label>3.3</label><title>促进肿瘤侵袭和转移</title><p specific-use="noneIndent">侵袭和转移是肿瘤的重要生物学特征，是导致肿瘤不良预后的重要因素<sup>［<xref ref-type="bibr" rid="R26">26</xref>］</sup>。其中转移是引起肿瘤患者死亡的最主要原因，90%以上的肿瘤患者最终死于肿瘤转移<sup>［<xref ref-type="bibr" rid="R27">27</xref>］</sup>。大量研究表明，EphA2 可以通过激活或增强促侵袭和转移的信号通路促进肿瘤的侵袭和转移。如前所述，EphA2可以激活或者增强Ras-MAPK和RhoA信号通路（乳腺癌）<sup>［<xref ref-type="bibr" rid="R13">13</xref>］</sup>、mTORC1和ERK信号通路（胆管癌）<sup>［<xref ref-type="bibr" rid="R21">21</xref>］</sup>、JNK/c-JUN信号通路（非小细胞肺癌）<sup>［<xref ref-type="bibr" rid="R22">22</xref>］</sup>以及Hippo信号通路（胃癌）<sup>［<xref ref-type="bibr" rid="R25">25</xref>］</sup>。这些信号通路不仅可以促进肿瘤的生长，还可以促进肿瘤的侵袭和转移。</p><p>在乳腺癌中，细胞外基质（extracellular matrix， ECM）硬度升高可以引起上皮间质转化（epithelial-mesenchymal transition， EMT）和促进肿瘤的侵袭和转移<sup>［<xref ref-type="bibr" rid="R28">28</xref>］</sup>。ECM硬度升高的这些作用是由EphA2通过激活LYN/TWIST1信号通路实现的<sup>［<xref ref-type="bibr" rid="R29">29</xref>］</sup>。ECM硬度升高可以激活ERK，ERK激活RSK1，激活的RSK1可以磷酸化EphA2的S897，S897磷酸化的EphA2可以使Src激酶家族成员之一LYN在Y397发生磷酸化，从而激活LYN。激活的LYN可以磷酸化EMT转录因子TWIST1的Y103，使之在胞质内与其锚定蛋白Ras GTP酶激活蛋白SH3结构域结合蛋白2（Ras-GTPase activating protein SH3 domain-binding protein 2， G3BP2）分离。然后TWIST1进入细胞核激活EMT相关基因的表达，从而促进肿瘤的侵袭和转移<sup>［<xref ref-type="bibr" rid="R29">29</xref>］</sup>。</p><p>在胃癌中，除了增强Hippo信号通路，EphA2还可以通过激活YES1信号通路促进肿瘤的侵袭和转移<sup>［<xref ref-type="bibr" rid="R30">30</xref>］</sup>。EphA2与Src激酶家族成员之一YES1相互作用并磷酸化其Y426，从而激活YES1。YES1通过磷酸化膜联蛋白A2的Y23激活膜联蛋白A2，膜联蛋白A2进入细胞核与促肿瘤的Myc、STAT3和 STAT6等转录因子形成复合物以增强它们的转录活性，促进胃癌侵袭和转移相关基因的表达，从而促进肿瘤的侵袭和转移<sup>［<xref ref-type="bibr" rid="R30">30</xref>］</sup>。此外，EphA2还可以通过增强Wnt/β‑catenin信号通路促进乙型肝炎病毒相关的肝细胞癌的侵袭和转移<sup>［<xref ref-type="bibr" rid="R31">31</xref>］</sup>。</p></sec><sec id="s3d"><label>3.4</label><title>维持肿瘤干细胞特性</title><p specific-use="noneIndent">肿瘤干细胞（cancer stem cell， CSC）是肿瘤中具有自我更新能力并能够分化成多种肿瘤细胞的细胞亚群，对肿瘤的发生、生长、异质性、转移及复发具有重要作用<sup>［<xref ref-type="bibr" rid="R32">32</xref>］</sup>。EphA2对于CSC特性的维持至关重要。例如，在成胶质细胞瘤和神经胶质瘤中，EphA2对于CSC的自我更新和成瘤性都是必需的<sup>［<xref ref-type="bibr" rid="R33">33</xref>］</sup>。EphA2通过激活或者增强特定信号通路来诱导CSC相关基因的表达，从而维持CSC的特性。</p><p>在鼻咽癌中，EphA2可以通过激活PI3K/AKT/STAT3信号通路维持CSC的自我更新和成瘤性<sup>［<xref ref-type="bibr" rid="R34">34</xref>］</sup>。EphA2通过磷酸化p85的Y458激活PI3K，PI3K再激活AKT，AKT通过磷酸化STAT3的S727激活STAT3。STAT3进入细胞核，激活对于维持CSC特性具有重要作用的两个转录因子基因<italic>Sox2</italic>和<italic>c</italic>-<italic>Myc</italic>的表达，从而维持鼻咽癌CSC的自我更新和成瘤性<sup>［<xref ref-type="bibr" rid="R34">34</xref>］</sup>。</p><p>在口腔鳞状细胞癌中，EphA2可以通过增强Hippo信号通路促进CSC的干性<sup>［<xref ref-type="bibr" rid="R35">35</xref>］</sup>。EphA2首先激活ERK，激活的ERK可以增强<italic>YAP</italic>的表达并促进YAP的核转移。YAP进入细胞核后与Hippo信号通路的转录因子TEAD3结合，激活CSC关键转录因子基因<italic>KLF4</italic>的表达，从而增强口腔鳞状细胞癌CSC的干性<sup>［<xref ref-type="bibr" rid="R35">35</xref>］</sup>。此外，EphA2还可以通过激活JNK/c-JUN信号通路维持非小细胞肺癌CSC的成瘤性<sup>［<xref ref-type="bibr" rid="R22">22</xref>］</sup>。</p></sec><sec id="s3e"><label>3.5</label><title>促进肿瘤血管生成</title><p specific-use="noneIndent">血管生成是从已有的血管形成新血管的过程，对于肿瘤的生长和转移具有十分重要的作用。研究<sup>［<xref ref-type="bibr" rid="R2">2</xref>］</sup>表明，EphA2可以促进肿瘤血管生成。然而与前述各个肿瘤发生和进展的过程不同，EphA2对于肿瘤血管生成的促进作用主要是通过其经典的正向信号转导实现的<sup>［<xref ref-type="bibr" rid="R2">2</xref>］</sup>。血管内皮生长因子（vascular endothelial growth Factor， VEGF）信号通路在肿瘤血管生成过程中具有重要作用<sup>［<xref ref-type="bibr" rid="R36">36</xref>］</sup>。EphA2的正向信号转导可以通过作用于VEGF信号通路促进肿瘤血管生成。ephrin A1对EphA2的激活作用对于VEGF诱导的肿瘤血管生成是必需的<sup>［<xref ref-type="bibr" rid="R37">37</xref>］</sup>，可能是因为EphA2的正向信号转导在VEGF引导内皮细胞向肿瘤细胞迁移的过程中起重要作用<sup>［<xref ref-type="bibr" rid="R37">37</xref>–<xref ref-type="bibr" rid="R38">38</xref>］</sup>。此外，ephrin A1还可以增强<italic>VEGF</italic>在肿瘤细胞中的表达<sup>［<xref ref-type="bibr" rid="R38">38</xref>］</sup> ，从而增强肿瘤中的VEGF信号传递。</p><p>最近的研究<sup>［<xref ref-type="bibr" rid="R39">39</xref>］</sup>表明，来源于高转移乳腺癌的外泌体EphA2还可以通过激活腺苷一磷酸-激活蛋白激酶（adenosine monophosphate -activated protein kinase， AMPK）信号通路促进肿瘤血管生成。高转移乳腺癌细胞来源的外泌体可将EphA2递送至内皮细胞，并在受体细胞中介导正向信号转导。ephrin A1激活的EphA2可以激活钙离子/钙调蛋白依赖的蛋白激酶激酶β（Ca/calmodulin-dependent protein kinase kinase β， CaMKKβ），而后CaMKKβ激活AMPK。激活的AMPK可以增强低氧诱导因子-1α（hypoxia inducible factor-1α， HIF-1α）的蛋白水平并促进其核转移<sup>［<xref ref-type="bibr" rid="R39">39</xref>］</sup>。HIF-1α则可以通过激活<italic>VEGF</italic>的表达促进肿瘤血管生成<sup>［<xref ref-type="bibr" rid="R40">40</xref>］</sup>。</p></sec></sec><sec id="s4"><label>4</label><title>总结与展望</title><p>EphA2是肿瘤发生和进展的一个重要促进因子，它可以通过激活或者增强促肿瘤的信号通路促进肿瘤的发生、生长、侵袭和转移、血管生成及维持肿瘤干细胞特性。EphA2在多种人类肿瘤组织中高表达，并且其在肿瘤组织中的高表达与肿瘤的不良预后、转移增加和患者生存期缩短密切相关。因此，EphA2是一个非常有前景的肿瘤治疗潜在靶点。迄今为止已经开展了众多靶向EphA2治疗肿瘤的研究工作，并且一些研究工作已经进入临床试验阶段。EphA2促进肿瘤发生和进展机制的研究对于靶向EphA2的肿瘤治疗具有重要的指导意义。</p></sec></body><back><ref-list><title>参考文献</title><ref id="R1"><label>1</label><mixed-citation publication-type="journal" publication-format="print" xml:lang="en"><person-group><name name-style="eastern"><surname>Tomuleasa</surname><given-names>C</given-names></name>， <name 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