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ABSTRACTIt is commonly held belief that prostate tumor invasion is triggered by the overproduction of proteolytic enzymes mainly by tumor cells, which cause degradation of the basement membrane. This theory is consistent with data from cell cultures and animal models, but results from recent worldwide clinical trials with enzyme inhibitors have been very disappointing, casting doubt on the validity of the enzyme theory. Based on our own studies, we have proposed that prostate tumor invasion is triggered by localized degeneration of aged or injured basal cells and the resultant auto-immunoreactions, which selectively favor aberrant proliferation and subsequent invasion of tumor stem or progenitor cells overlying focal basal cell layer disruptions. Our hypothesis differs from the traditional proteolytic enzyme theory in multiple aspects, including the stage of invasion, the precursor of invasive lesions, the roles of stromal and immunoreactive cells, and the potential approaches for prevention of invasion. Our hypothesis has been published in multiple peer-reviewed journals.
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