Nasopharyngeal Carcinoma Ecology Theory: Cancer as Multidimensional Spatiotemporal “Unity of Ecology and Evolution” Pathological Ecosystem

Abstract

Nasopharyngeal carcinoma (NPC) is a particular entity of head neck cancer that is generally regarded as a genetic disease with diverse extent of intertumor and intratumor heterogeneity. Here we propose that, NPC is not only a genetic disease; it could be conceptualized as a multidimensional spatiotemporal “unity of ecology and evolution” pathological ecosystem. Subsequently, we discuss NPC cells as invasive species and its metastasis as a multidirectional ecological dispersal. We then interpreter the foundational ecological principles to understand NPC progression. The model of “mulberry-fish-ponds” can well illustrate the dynamic reciprocity of cancer ecosystem. We propose that tumor-host interface is the ecological transition zone in cancers, and tumor buddings should be recognized as ecological islands separated from the mainland. It should be noted that the invasive edge has a significantly molecular and functional edge effect because of its curvature and irregularity. Selection driving factors and ecological therapy including hyperthermia for NPC patients, and future perspectives of “ecological pathology”, “multidimensional spatiotemporal tumoriecology” are also pointed out. Medical ecology tree of human diseases is unprecedentedly constructed. We advance that “nothing in cancer evolution or ecology makes sense except in the light of the other”. The establishment of “NPC ecology” might open up a new horizon, and provide a comprehensive framework for our understanding of the complex progression of this disease and development of potential preventive and therapeutic strategies for patients.