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. 2019 Dec 19;21(1):39. doi: 10.3390/ijms21010039

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© 2019 by the authors.

Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).

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Effects of hypoxia in NB initiation and progression. (A) Neural crest (NC) migrating cells can undergo malignant transformation due to hypoxia exposition or disregulation, driving tumourigenesis. (B) A neuroblastoma (NB) tumour is comprised of phenotypically divergent cells. Hypoxia might favour malignant progression in NB tumours, characterised by the activation of angiogenesis, alteration of cellular differentiation, tumour cell survival and resistance and an increase of metastasis. The extracellular matrix is also affected by hypoxia. NB: neuroblastoma; NCC: neural crest cell; ADR: adrenergic cells, MES: mesenchymal undifferentiated cells; TPC: Undifferentiated tumour-propagating cells. Blue arrow in box denote an increase.