151
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Cabioglu N, Gong Y, Islam R, Broglio KR, Sneige N, Sahin A, Gonzalez-Angulo AM, Morandi P, Bucana C, Hortobagyi GN, Cristofanilli M. Expression of growth factor and chemokine receptors: new insights in the biology of inflammatory breast cancer. Ann Oncol 2007; 18:1021-9. [PMID: 17351259 DOI: 10.1093/annonc/mdm060] [Citation(s) in RCA: 121] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
PURPOSE Recent studies have indicated that expression of chemokine receptors CXCR4 and CCR7 could be an indicator of the metastatic potential of breast cancer. Expression of CXCR4 and CCR7 along with the biomarkers HER2-neu and epidermal growth factor receptor (EGFR) was investigated in inflammatory breast cancer (IBC) to evaluate their prognostic implications. EXPERIMENTAL DESIGN CXCR4, CCR7, and EGFR were evaluated by immunohistochemical staining (IHC) of paraffin-embedded tissue sections. HER2-neu amplification was assessed by FISH and/or IHC. All patients received chemotherapy, surgery, and radiation. RESULTS Forty-four cases diagnosed with IBC from 1994 to 2002 were included in the study. In all, 18 (40.9%) patients had positive CXCR4, 10 (22.7%) had positive CCR7, 21 (47.7%) had positive HER2-neu, and EGFR was positive in 12 of 40 patients (30%). The 5-year overall survival (OS) was 24.8% for CXCR4-positive disease versus 42.3% for CXCR4-negative patients (P = 0.53) and 20.0% for CCR7-positive disease versus 41.9% for CCR7-negative patients (P = 0.24). EGFR-positive disease had significantly worse OS compared with EGFR-negative disease (P = 0.01). CONCLUSIONS These data demonstrate the expression of growth factor and chemokine receptors in IBC. The expression of these receptors is associated with increased risk of recurrence and death, and thus, they may represent potential therapeutic targets in IBC.
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Affiliation(s)
- N Cabioglu
- Department of Pathology, The University of Texas M. D. Anderson Cancer Center, Houston, TX 77230, USA
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152
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Van der Auwera I, Cao Y, Tille JC, Pepper MS, Jackson DG, Fox SB, Harris AL, Dirix LY, Vermeulen PB. First international consensus on the methodology of lymphangiogenesis quantification in solid human tumours. Br J Cancer 2006; 95:1611-25. [PMID: 17117184 PMCID: PMC2360768 DOI: 10.1038/sj.bjc.6603445] [Citation(s) in RCA: 156] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
The lymphatic system is the primary pathway of metastasis for most human cancers. Recent research efforts in studying lymphangiogenesis have suggested the existence of a relationship between lymphatic vessel density and patient survival. However, current methodology of lymphangiogenesis quantification is still characterised by high intra- and interobserver variability. For the amount of lymphatic vessels in a tumour to be a clinically useful parameter, a reliable quantification technique needs to be developed. With this consensus report, we therefore would like to initiate discussion on the standardisation of the immunohistochemical method for lymphangiogenesis assessment.
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Affiliation(s)
- I Van der Auwera
- Translational Cancer Research Group Antwerp, Laboratory of Pathology, University of Antwerp/University Hospital Antwerp, Edegem 2650, Belgium; Oncology Centre, General Hospital Sint-Augustinus, Wilrijk 2610, Belgium
| | - Y Cao
- Laboratory of Angiogenesis Research, Microbiology and Tumor Biology Center, Karolinska Institutet, Stockholm 171 77, Sweden
| | - J C Tille
- Department of Microbiology, Laboratory of Angiogenesis Research, Tumor and Cell Biology, Karolinska Institutet, Stockholm 171 77, Sweden
| | - M S Pepper
- NetCare Molecular Medicine Institute, Unitas Hospital and Department of Immunology, Faculty of Health Sciences, University of Pretoria, Pretoria 0002, South Africa
| | - D G Jackson
- Medical Research Council Human Immunology Unit, Weatherall Institute of Molecular Medicine, John Radcliffe Hospital, Oxford OX3 9DS, UK
| | - S B Fox
- Department of Pathology, Peter MacCallum Cancer Centre, Victoria 8006, Australia
| | - A L Harris
- Cancer Research UK Molecular Oncology Laboratories, Weatherall Institute of Molecular Medicine, University of Oxford, John Radcliffe Hospital, Oxford OX3 9DS, UK
| | - L Y Dirix
- Translational Cancer Research Group Antwerp, Laboratory of Pathology, University of Antwerp/University Hospital Antwerp, Edegem 2650, Belgium; Oncology Centre, General Hospital Sint-Augustinus, Wilrijk 2610, Belgium
| | - P B Vermeulen
- Translational Cancer Research Group Antwerp, Laboratory of Pathology, University of Antwerp/University Hospital Antwerp, Edegem 2650, Belgium; Oncology Centre, General Hospital Sint-Augustinus, Wilrijk 2610, Belgium
- Laboratory of Pathology, General Hospital St-Augustinus, Oosterveldlaan 24, 2610 Wilrijk, Belgium. E-mail:
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153
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Mina L, Soule SE, Badve S, Baehner FL, Baker J, Cronin M, Watson D, Liu ML, Sledge GW, Shak S, Miller KD. Predicting response to primary chemotherapy: gene expression profiling of paraffin-embedded core biopsy tissue. Breast Cancer Res Treat 2006; 103:197-208. [PMID: 17039265 DOI: 10.1007/s10549-006-9366-x] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2006] [Accepted: 08/03/2006] [Indexed: 01/30/2023]
Abstract
PURPOSE Primary chemotherapy provides an ideal opportunity to correlate gene expression with response to treatment. We used paraffin-embedded core biopsies from a completed phase II trial to identify genes that correlate with response to primary chemotherapy. PATIENTS AND METHODS Patients with newly diagnosed stage II or III breast cancer were treated with sequential doxorubicin 75 mg/M2 q2 wks x 3 and docetaxel 40 mg/M2 weekly x 6; treatment order was randomly assigned. Pretreatment core biopsy samples were interrogated for genes that might correlate with pathologic complete response (pCR). In addition to the individual genes, the correlation of the Oncotype DX Recurrence Score with pCR was examined. RESULTS Of 70 patients enrolled in the parent trial, core biopsies samples with sufficient RNA for gene analyses were available from 45 patients; 9 (20%) had inflammatory breast cancer (IBC). Six (14%) patients achieved a pCR. Twenty-two of the 274 candidate genes assessed correlated with pCR (p < 0.05). Genes correlating with pCR could be grouped into three large clusters: angiogenesis-related genes, proliferation related genes, and invasion-related genes. Expression of estrogen receptor (ER)-related genes and Recurrence Score did not correlate with pCR. In an exploratory analysis we compared gene expression in IBC to non-inflammatory breast cancer; twenty-four (9%) of the genes were differentially expressed (p < 0.05), 5 were upregulated and 19 were downregulated in IBC. CONCLUSION Gene expression analysis on core biopsy samples is feasible and identifies candidate genes that correlate with pCR to primary chemotherapy. Gene expression in IBC differs significantly from noninflammatory breast cancer.
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Affiliation(s)
- Lida Mina
- Department of Medicine, Indiana University, RT-473, Indianapolis, IN, 46202, USA
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154
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Timoshenko AV, Chakraborty C, Wagner GF, Lala PK. COX-2-mediated stimulation of the lymphangiogenic factor VEGF-C in human breast cancer. Br J Cancer 2006; 94:1154-63. [PMID: 16570043 PMCID: PMC2361247 DOI: 10.1038/sj.bjc.6603067] [Citation(s) in RCA: 122] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Increased expression of COX-2 or VEGF-C has been correlated with progressive disease in certain cancers. Present study utilized several human breast cancer cell lines (MCF-7, T-47D, Hs578T and MDA-MB-231, varying in COX-2 expression) as well as 10 human breast cancer specimens to examine the roles of COX-2 and prostaglandin E (EP) receptors in VEGF-C expression or secretion, and the relationship of COX-2 or VEGF-C expression to lymphangiogenesis. We found a strong correlation between COX-2 mRNA expression and VEGF-C expression or secretion levels in breast cancer cell lines and VEGF-C expression in breast cancer tissues. Expression of LYVE-1, a selective marker for lymphatic endothelium, was also positively correlated with COX-2 or VEGF-C expression in breast cancer tissues. Inhibition of VEGF-C expression and secretion in the presence of COX-1/2 or COX-2 inhibitors or following downregulation of COX-2 with COX-2 siRNA established a stimulatory role COX-2 in VEGF-C synthesis by breast cancer cells. EP1 as well as EP4 receptor antagonists inhibited VEGF-C production indicating the roles of EP1 and EP4 in VEGF-C upregulation by endogenous PGE2. Finally, VEGF-C secretion by MDA-MB-231 cells was inhibited in the presence of kinase inhibitors for Her-2/neu, Src and p38 MAPK, indicating a requirement of these kinases for VEGF-C synthesis. These results, for the first time, demonstrate a regulatory role of COX-2 in VEGF-C synthesis (and thereby lymphangiogenesis) in human breast cancer, which is mediated at least in part by EP1/EP4 receptors.
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MESH Headings
- Breast Neoplasms/metabolism
- Cell Line, Tumor
- Cyclooxygenase 2/biosynthesis
- Cyclooxygenase 2/drug effects
- Cyclooxygenase 2/physiology
- Cyclooxygenase Inhibitors/pharmacology
- Down-Regulation
- Enzyme Activation/drug effects
- Enzyme Activation/physiology
- Female
- Glycoproteins/biosynthesis
- Humans
- Imidazoles/pharmacology
- Lymphangiogenesis/physiology
- Molecular Sequence Data
- Pyrazoles/pharmacology
- Pyridines/pharmacology
- Pyrimidines/pharmacology
- Quinazolines/pharmacology
- RNA, Messenger/biosynthesis
- RNA, Messenger/metabolism
- RNA, Small Interfering/pharmacology
- Receptors, Prostaglandin E/metabolism
- Receptors, Prostaglandin E/physiology
- Receptors, Prostaglandin E, EP1 Subtype
- Receptors, Prostaglandin E, EP4 Subtype
- Structure-Activity Relationship
- Vascular Endothelial Growth Factor C/antagonists & inhibitors
- Vascular Endothelial Growth Factor C/biosynthesis
- Vascular Endothelial Growth Factor C/metabolism
- Vesicular Transport Proteins
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Affiliation(s)
- A V Timoshenko
- Department of Anatomy and Cell Biology, The University of Western Ontario, London, Ontario, Canada N6A5C1
- Department of Biology, The University of Western Ontario, London, Ontario, Canada N6A5B7
| | - C Chakraborty
- Department of Pathology, The University of Western Ontario, London, Ontario, Canada N6A5C1
| | - G F Wagner
- Department of Physiology and Pharmacology, The University of Western Ontario, London, Ontario, Canada N6A5C1
| | - P K Lala
- Department of Anatomy and Cell Biology, The University of Western Ontario, London, Ontario, Canada N6A5C1
- Department of Anatomy and Cell Biology, The University of Western Ontario, London, Ontario, Canada N6A5C1. E-mail:
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155
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Whitehurst B, Eversgerd C, Flister M, Bivens CM, Pickett B, Zawieja DC, Ran S. Molecular Profile and Proliferative Responses of Rat Lymphatic Endothelial Cells in Culture. Lymphat Res Biol 2006; 4:119-42. [PMID: 17034293 DOI: 10.1089/lrb.2006.4.119] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Lymphangiogenesis plays an important role in metastasis of many solid tumors. To study lymphangiogenesis under controlled conditions, an in vitro model is needed. The goal of this work was to establish such an in vitro model by determining a molecular profile of rat mesenteric lymphatic endothelial cells (RMLEC) and characterizing their proliferative responses to angiogenic and lymphangiogenic factors, such as vascular endothelial growth factor A and C (VEGF-A and VEGF-C). METHODS AND RESULTS RMLEC strongly expressed most lymphatic-specific markers, including Prox-1, LYVE-1, and VEGFR-3. Proliferation of RMLEC was serum and heparin dependent. In the presence of low (2%) serum concentration, exogenously added VEGF-A and VEGFC stimulated RMLEC in a linear and dose-dependent manner. This effect was abrogated by anti-VEGF-A and VEGF-C antibodies, as well as by soluble Tie-2 and Flt-4 fusion proteins. Abrogation was reversed by VEGF-A, suggesting that this factor as an important regulator of lymphangiogenesis. CONCLUSIONS Cultured RMLEC preserved a molecular profile consistent with the phenotype of lymphatic endothelium in vivo and respond to either VEGF-A or VEGF-C factors. VEGFA was able to rescue RMLEC proliferation inhibited by a neutralizing VEGF-C antibody or soluble Tie-2 fusion protein. These results support the existence of cross-talk among angiogenic and lymphangiogenic factors. This work established experimental conditions that allow in vitro modeling of lymphatic endothelial responses to lymphangiogenic regulators. Preliminary results using this model suggest that VEGF-A, VEGF-C, and angiopoietins work in concert to promote lymphangiogenesis in vivo.
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Affiliation(s)
- Brandt Whitehurst
- Department of Medical Microbiology, Immunology, and Cell Biology, Southern Illinois University School of Medicine, Springfield, Illinois 62702-9678, USA
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156
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Sundar SS, Zhang H, Brown P, Manek S, Han C, Kaur K, Charnock MFL, Jackson D, Ganesan TS. Role of lymphangiogenesis in epithelial ovarian cancer. Br J Cancer 2006; 94:1650-7. [PMID: 16685274 PMCID: PMC2361318 DOI: 10.1038/sj.bjc.6603144] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
We investigated the significance of lymphatic count, vascular count and angiogenic growth factors using immunohistochemistry in 108 tumour specimens of epithelial ovarian cancer with antibodies to lymphatic vessel endothelial hyaluronan receptor (LYVE-1), platelet endothelial cell adhesion molecule CD31, vascular endothelial growth factor (VEGF) and thymidine phosphorylase (TP) in epithelial ovarian cancer to understand the pathogenesis of metastasis in ovarian cancer. The effect of prognostic variables on progression-free and overall survival was assessed. On multivariate analysis, bulky residual disease after surgery was the best prognostic indicator (P<0.001) for progression-free and overall survival (P<0.001). Lymphatic count was statistically significant as a prognostic factor for progression-free (P=0.05) and overall survival (P=0.04). However, lymphatic count did not impact on survival curves. No correlation was found between lymphatic count and age, histological subtype, FIGO stage or residual disease. Vascular count, VEGF or TP expressions were not significant in either analysis. Lymphatic spread may be significant in aiding metastases in ovarian cancer but requires other biological factors to act in conjunction, as it does not have clearcut prognostic significance. Dissemination of ovarian cancer does not occur primarily through vascular or lymphatic routes but may occur through direct intraperitoneal spread of disease.
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Affiliation(s)
- S S Sundar
- Ovarian Cancer Group, Cancer Research UK Molecular Oncology Laboratories, Weatherall Institute of Molecular Medicine, John Radcliffe Hospital, Oxford OX3 9DS, UK
| | - H Zhang
- Ovarian Cancer Group, Cancer Research UK Molecular Oncology Laboratories, Weatherall Institute of Molecular Medicine, John Radcliffe Hospital, Oxford OX3 9DS, UK
| | - P Brown
- Department of Cellular Pathology, John Radcliffe Hospital, Oxford OX3 9DS, UK
| | - S Manek
- Department of Cellular Pathology, John Radcliffe Hospital, Oxford OX3 9DS, UK
| | - C Han
- Cancer Research UK, Churchill Hospital, Headington, Oxford OX3 7LF, UK
| | - K Kaur
- Cancer Research UK, Churchill Hospital, Headington, Oxford OX3 7LF, UK
| | - M F L Charnock
- Department of Obstetrics and Gynaecology, John Radcliffe Hospital, Headington, Oxford OX3 9DS, UK
| | - D Jackson
- MRC Human Immunology Unit, Weatherall Institute of Molecular Medicine, John Radcliffe Hospital, Headington, Oxford OX3 9DS, UK
| | - T S Ganesan
- Ovarian Cancer Group, Cancer Research UK Molecular Oncology Laboratories, Weatherall Institute of Molecular Medicine, John Radcliffe Hospital, Oxford OX3 9DS, UK
- E-mail:
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157
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Van der Auwera I, Colpaert C, Van Marck E, Vermeulen P, Dirix L. Lymphangiogenesis in Breast Cancer. Am J Surg Pathol 2006; 30:1055-6; author reply 1056-7. [PMID: 16861982 DOI: 10.1097/00000478-200608000-00021] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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158
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Dréau D, Karaa A, Culberson C, Wyan H, McKillop IH, Clemens MG. Bosentan® inhibits tumor vascularization and bone metastasis in an immunocompetent skin-fold chamber model of breast carcinoma cell metastasis. Clin Exp Metastasis 2006; 23:41-53. [PMID: 16826430 DOI: 10.1007/s10585-006-9016-z] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2005] [Accepted: 04/27/2006] [Indexed: 11/26/2022]
Abstract
Angiogenic factors including endothelin-1 (ET-1) play a key role in the progression of breast metastases to bone. We investigated the impact of ET-1 on the development of bone metastases in an immunocompetent murine skin-fold chamber model. Murine mammary carcinoma 4T1 was injected in a skin-fold chamber implanted on CB6 mice along with bone explants. Furthermore, mice were treated with or without a dual selective antagonist of both ET-1 receptors. The progression of the vascularization within the chamber was monitored over time by intravital microscopy (IVM). The tumor growth and the development of bone metastases were assessed by cytokeratin-19 gene expression and histological studies. Results indicate that this new model associated with IVM allows for the continuous monitoring of the change in vascularization associated with the development of bone metastases. Additionally, treatment with an antagonist of both ET-1 receptors was associated with the presence of significantly less vessels near the tumor mass compared to control mice. These changes were correlated with smaller tumor masses and reduced bone invasion (P < 0.05). Thus, in an immunocompetent murine model of breast carcinoma metastases to bone, our data support the hypothesis that vascularization plays a role in tumor development and progression and that ET-1 specifically modulates the angiogenesis associated with breast metastases to the bone.
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Affiliation(s)
- Didier Dréau
- Department of Biology, University of North Carolina at Charlotte, Science & Technology Bldg, Rm. 490B, 9201 University City Blvd, Charlotte, NC 28223, USA.
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159
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Abstract
Prox1 is a divergent homeodomain protein important for the development of the lens, retina, liver, pancreas, and lymphatic vasculature. Prox1 expression is highly upregulated in transformed hepatocytes and has been used as a marker to distinguish lymphatic from blood vasculature. We produced recombinant human Prox1 (amino acids 547-737) fused to glutathione S-transferase (GST) and used it to create two hybridomas, 5G10 and 4G10. Both of these hybridomas produced monoclonal antibodies able to detect Prox1 by immunofluorescence in lenses from diverse terrestrial vertebrates, including humans, rats, chickens, and lizards, although 5G10 was generally more sensitive in this application. Further, 4G10 was able to robustly detect endogenous and recombinant Prox1 in both cell and tissue extracts by Western blotting, while 5G10 was notably less sensitive for this purpose. These monoclonal antibodies will be useful for diverse studies on the role of Prox1 in both normal development and disease processes in terrestrial vertebrates.
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Affiliation(s)
- Xiaoren Chen
- Department of Biological Sciences, University of Delaware, Newark, DE 19716, USA
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160
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Van der Auwera I, Van den Eynden GG, Colpaert CG, Van Laere SJ, van Dam P, Van Marck EA, Dirix LY, Vermeulen PB. Tumor lymphangiogenesis in inflammatory breast carcinoma: a histomorphometric study. Clin Cancer Res 2006; 11:7637-42. [PMID: 16278382 DOI: 10.1158/1078-0432.ccr-05-1142] [Citation(s) in RCA: 131] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE At the time of diagnosis, metastatic dissemination of tumor cells via the lymphatic system has occurred in nearly all patients with inflammatory breast cancer (IBC). The objective of this study was twofold: (a) to determine which is the most suitable marker of lymph vessels in primary breast tumors and (b) to compare histomorphometric lymph vessel variables in IBC and non-IBC. EXPERIMENTAL DESIGN Serial sections of 10 IBCs and 10 non-IBCs were immunostained for D2-40, LYVE-1, podoplanin, and PROX-1. Relative lymph vessel area, lymph vessel perimeters, and counts and lymphatic endothelial cell proliferation (LECP) were then measured in D2-40/Ki-67 double-immunostained sections of 10 normal breast tissues, 29 IBCs, and 56 non-IBCs. RESULTS D2-40 was the most suitable antibody for staining peritumoral and intratumoral lymph vessels. D2-40-stained intratumoral lymph vessels were present in 80% of non-IBCs and 82.8% of IBCs (P = 0.76). In non-IBC, lymph vessels located in the tumor parenchyma were smaller and less numerous than those at the tumor periphery (P < 0.0001) whereas in IBC, intratumoral and peritumoral variables were not significantly different. The mean relative tumor area occupied by lymph vessels was larger in IBC than in non-IBC (P = 0.01). LECP at the tumor periphery was higher in IBC than in non-IBC: median LECP was 5.74% in IBC versus 1.83% in non-IBC (P = 0.005). CONCLUSIONS The high LECP in IBC suggests that lymphangiogenesis contributes to the extensive lymphatic spread of IBC.
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Affiliation(s)
- Ilse Van der Auwera
- Translational Cancer Research Group Antwerp, Laboratory of Pathology, University of Antwerp/University Hospital Antwerp, Edegem, Belgium
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161
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Rockson SG. Literature watch. Lymphat Res Biol 2006; 4:57-61. [PMID: 16569210 DOI: 10.1089/lrb.2006.4.57] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Stanley G Rockson
- Stanford Center for Lymphatic and Venous Disorders, Stanford University School of Medicine, CA, USA
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162
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Van Laere SJ, Van den Eynden GG, Van der Auwera I, Vandenberghe M, van Dam P, Van Marck EA, van Golen KL, Vermeulen PB, Dirix LY. Identification of cell-of-origin breast tumor subtypes in inflammatory breast cancer by gene expression profiling. Breast Cancer Res Treat 2005; 95:243-55. [PMID: 16261404 DOI: 10.1007/s10549-005-9015-9] [Citation(s) in RCA: 71] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/21/2005] [Indexed: 01/21/2023]
Abstract
Inflammatory breast cancer (IBC) is an aggressive form of locally advanced breast cancer with high metastatic potential. Most patients have lymph node involvement at the time of diagnosis and 1/3 of the patients have distant metastases. In a previous study, we demonstrated that IBC is a distinct form of breast cancer in comparison with non-IBC. The aim of this study was to investigate the presence of the different molecular subtypes in our data set of 16 IBC and 18 non-IBC specimen. Therefore, we selected an 'intrinsic gene set' of 144 genes, present on our cDNA chips and common to the 'intrinsic gene set' described by Sorlie et al. [PNAS, 2003]. This set of genes was tested for performance in the Norway/Stanford data set by unsupervised hierarchical clustering. Expression centroids were then calculated for the core members of each of the five subclasses in the Norway/Stanford data set and used to classify our own specimens by calculating Spearman correlations between each sample and each centroid. We identified the same cell-of-origin subtypes in IBC as those already described in non-IBC. The classification was in good agreement with immunohistochemical data for estrogen receptor protein expression and cytokeratin 5/6 protein expression. Confirmation was done by an alternative unsupervised hierarchical clustering method. The robustness of this classification was assessed by an unsupervised hierarchical clustering with an alternative gene set of 141 genes related to the cell-of-origin subtypes, selected using a discriminating score and iterative random permutation testing. The contribution of the different cell-of-origin subtypes to the IBC phenotype was investigated by principal component analysis. Generally, the combined ErbB2-overexpressing and basal-like cluster was more expressed in IBC compared to non-IBC, whereas the combined luminal A, luminal B and normal-like cluster was more pronounced in non-IBC compared to IBC. The presence of the same molecular cell-of-origin subtypes in IBC as in non-IBC does not exclude the specific molecular nature of IBC, since gene lists that characterize IBC and non-IBC are entirely different from gene lists that define the different cell-of-origin subtypes, as evidenced by principal component analysis.
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Affiliation(s)
- Steven J Van Laere
- Translational Cancer Research Group, Lab Pathology University of Antwerp and Oncology Center, General Hospital Sint-Augustinus, Wilrijk, Belgium
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163
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Van den Eynden GG, Van Laere SJ, Van der Auwera I, Merajver SD, Van Marck EA, van Dam P, Vermeulen PB, Dirix LY, van Golen KL. Overexpression of caveolin-1 and -2 in cell lines and in human samples of inflammatory breast cancer. Breast Cancer Res Treat 2005; 95:219-28. [PMID: 16244790 DOI: 10.1007/s10549-005-9002-1] [Citation(s) in RCA: 76] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2005] [Indexed: 12/23/2022]
Abstract
PURPOSE Inflammatory breast cancer (IBC) is the most aggressive form of locally advanced breast cancer (LABC). The IBC phenotype is characterized by an infiltrative growth pattern, increased (lymph)angiogenesis and the propensity to invade dermal lymphatics. In pancreatic cancer, interactions between caveolin-1 and RhoC GTPase, a key molecule in causing the IBC phenotype, regulate tumour cell motility and invasion. In this study we sought to investigate the role of caveolin-1 and -2 in IBC cell lines and in human IBC samples. EXPERIMENTAL DESIGN Differential methylation techniques identified the methylation status of the caveolin-1 and -2 promoters in human mammary epithelial cells (HMECs) and the SUM149 cell line. In cell line experiments, caveolin-1 and -2 mRNA and protein expression were compared in HMECs, MCF10A, the SUM102 non-IBC cell lines and 2 IBC cell lines (SUM149 and SUM190). Furthermore, caveolin-1 and -2 mRNA and protein expression were compared in human IBC and non-IBC samples using cDNA microarray, real-time qRT-PCR and immunohistochemistry. Results were correlated with RhoC protein expression data. RESULTS In the SUM149 cell line, the caveolin-1 and -2 promoter sites were hypomethylated. A significantly increased expression of caveolin-1 and -2, both at the mRNA and protein level was found in IBC cell lines and in human samples of IBC: caveolin-1 and -2 mRNA were respectively 1.7 (p = 0.02) and 2.2 (p = 0.03) fold more expressed in IBC compared to non IBC and at the protein level, 41.4% of IBC specimens expressed either caveolin-1 or -2, compared to 15.6% of non-IBC specimens (p = 0.03). Furthermore a correlation was found between RhoC protein expression and caveolin-1 (p = 0.1) or caveolin-2 (p = 0.09) or either caveolin-1 or -2 protein expression (p = 0.04). CONCLUSIONS Although considered a tumour suppressor in breast cancer, we demonstrated overexpression of caveolin-1 and -2 in IBC cell lines and in human samples of IBC, most likely due to hypomethylation of their respective promoters. These results confirm the distinct molecular signature of IBC. Our data further suggest interaction between RhoC GTPase and the caveolins in IBC.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Biomarkers, Tumor/genetics
- Biomarkers, Tumor/metabolism
- Breast Neoplasms/genetics
- Breast Neoplasms/metabolism
- Breast Neoplasms/pathology
- Carcinoma, Ductal, Breast/genetics
- Carcinoma, Ductal, Breast/metabolism
- Carcinoma, Ductal, Breast/pathology
- Carcinoma, Lobular/genetics
- Carcinoma, Lobular/metabolism
- Carcinoma, Lobular/pathology
- Caveolin 1/genetics
- Caveolin 1/metabolism
- Caveolin 2/genetics
- Caveolin 2/metabolism
- Cell Line, Tumor
- DNA Methylation
- Female
- Gene Expression Profiling
- Gene Expression Regulation, Neoplastic
- Humans
- Immunoenzyme Techniques
- Middle Aged
- Neoplasm Staging
- Oligonucleotide Array Sequence Analysis
- RNA, Messenger/metabolism
- Reverse Transcriptase Polymerase Chain Reaction
- Up-Regulation
- rho GTP-Binding Proteins/genetics
- rho GTP-Binding Proteins/metabolism
- rhoC GTP-Binding Protein
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Affiliation(s)
- Gert G Van den Eynden
- Translational Cancer Research Group Antwerp, Lab Pathology, University of Antwerp/University Hospital Antwerp, Edegem, Belgium
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164
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Van Laere S, Van der Auwera I, Van den Eynden GG, Fox SB, Bianchi F, Harris AL, van Dam P, Van Marck EA, Vermeulen PB, Dirix LY. Distinct Molecular Signature of Inflammatory Breast Cancer by cDNA Microarray Analysis. Breast Cancer Res Treat 2005; 93:237-46. [PMID: 16172796 DOI: 10.1007/s10549-005-5157-z] [Citation(s) in RCA: 67] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Inflammatory breast cancer (IBC) is a clinically distinct and aggressive form of locally advanced breast cancer with largely unknown genetic determinants. Overexpression of the RhoC GTPase and of HER2, and decreased ER-expression are involved in IBC. Multimodality treatment has increased survival but prognosis is still poor. Novel molecular targets for improved neoadjuvant treatment are necessary. Using cDNA microarrays, we performed genome-wide expression profiling of pre-treatment tumour samples of 16 patients with IBC and 18 patients with non-stage-matched non-IBC. Rigid clinical diagnostic criteria according to the TNM classification of the American Joint Committee on Cancer were adopted. Unsupervised hierarchical clustering accurately distinguished IBC and non-IBC samples. A set of 50 discriminator genes was identified in a learning group of tumour samples and was successful in diagnosing IBC in a validation group of samples (accuracy of 88%). Exclusion of ER-related or HER2-related genes did not alter this discriminatory accuracy, indicating that the expression of other genes in addition to ER and HER2 characterize the IBC phenotype. The molecular signature of IBC revealed the overexpression of a large number of NF-kappaB target genes, explaining at least part of the aggressive nature of IBC. Successful validation of some of the overexpressed genes by immunohistochemistry or real-time quantitative PCR demonstrated the robustness of the cDNA microarray experiments. The results of our study provide potential targets for the treatment of patients with IBC.
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Affiliation(s)
- Steven Van Laere
- Translational Cancer Research Group, Lab Pathology, University of Antwerp/University Hospital Antwerp, Edegem and General Hospital, Sint-Augustinus, Wilrijk, Belgium
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165
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Abstract
Angiopoietin (Ang)-1 and -2, and mouse Ang-3/human Ang-4 are ligands of the receptor tyrosine kinase with immunoglobulin and epidermal growth factor homology domains (Tie)-2. It is well established that the Ang–Tie-2 pathway is involved in tumor angiogenesis. However, the exact effects of angiopoietins on tumor angiogenesis are under debate. Experimental and clinical studies have demonstrated that increased expression of Ang-1 and -2 promotes or inhibits tumor angiogenesis, and correlates with a reduced or extended survival time of patients, and with a declined or improved clinical outcome. In general, these studies suggest that Ang-1 is a proangiogenic factor that promotes endothelial cell survival and tumor angiogenesis, especially in the presence of vascular endothelial growth factor; whereas Ang-2 destabilizes vasculature that leads to the initiation of angiogenesis or apoptosis of endothelial cells/vessel regression in the presence or absence of vascular endothelial growth factor, respectively, and that the cell-surface tethered Ang-3 displays antiangiogenic activity. Together, these results suggest that the Ang–Tie-2 functional axis is an attractive target for antiangiogenesis-based cancer therapy.
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Affiliation(s)
- Qin Yu
- University of Pennsylvania, Department of Pathobiology, School of Veterinary Medicine, Philadelphia, PA 19104, USA.
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166
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Norton L. Conceptual and Practical Implications of Breast Tissue Geometry: Toward a More Effective, Less Toxic Therapy. Oncologist 2005; 10:370-81. [PMID: 15967831 DOI: 10.1634/theoncologist.10-6-370] [Citation(s) in RCA: 98] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Mathematics provides greater understanding of the complex process of tumorigenesis. Based on the Gompertzian phenomenon and the Norton-Simon hypothesis, enhanced cell kill can be obtained through a greater chemotherapy dose rate. Results from the 1995 Bonadonna et al. study and the CALGB/Intergroup C9741 study demonstrated that patients in the dose-dense arms had significantly longer disease-free survival and overall survival. Because of the demonstrated applicability of Gompertzian kinetics, attention has been turned to the etiology of the Gompertzian curve. Breast tumor dimensions, as with all tissue dimensions in biology, can be calculated by fractals. A less cell-dense tissue usually has a lower fractal dimension than a tissue with more cells (i.e., a higher cell density is usually due to a higher fractal dimension). Density is the number of cells divided by the tissue volume. When allowed to grow, the density of a tissue with a lower fractal dimension drops quickly. However, a tumor, since it has a higher fractal mass dimension, maintains a high density as it grows bigger, resulting in a more rapid growth rate and a larger final size. Fractal dimensions of infiltrating ductal adenocarcinomas of the breast are high (i.e., 2.98), which results in a very dense tissue compared with normal breast tissue (with a fractal dimension of about 2.25). As expected, the higher fractal dimension results in a high rate of growth. The reason for this high fractal dimension is that breast cancer can be considered as a conglomerate of many small Gompertzian tumors, each of which has a high cell density and hence ratio of mitosis to apoptosis. In mathematical terms, each component of the conglomerate can be considered a small metastasis in itself. Thus, the primary tumor is composed of multiple self-metastases that form around a seed from the tumor to itself. Conventional thinking is that cancers metastasize because they are large, but in fact it may be that they are large because they are self-metastatic. Many genes are associated with the biology of metastasis; these include: A) obligatory cancer genes (most of which regulate mitosis and mitotic rate); B) genes relating to self-metastasis and growth of tumors at local sites, conferring the ability to invade and grow with high cell density; and C) genes that relate to the ability of the cancer to metastasize to distant areas. Additionally, fibroblasts may send out abnormal growth signals causing abnormal breast tissue growth. Consequently, we are not only dealing with abnormal cancer cells, but also with the tissue that surrounds them, or the microenvironment, that is, the "Smith-Bissell" model. These new insights may lead us to change the thrust of our attack from genes involved in mitosis to those involved in metastasis, including metastasis to self, and to use and further improve dose-dense regimens.
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Affiliation(s)
- Larry Norton
- Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, New York 10021-6007, USA.
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167
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Abstract
Therapeutic angiogenesis/vasculogenesis holds promise for the cure of ischaemic disease. The approach postulates the manipulation of spontaneous healing response by supplementation of growth factors or transplantation of vascular progenitor cells. These supplements are intended to foster the formation of arterial collaterals and promote the regeneration of damaged tissues. Angiogenic factors are generally delivered in the form of recombinant proteins or by gene transfer using viral vectors. In addition, new non-viral methods are gaining importance for their safer profile. The association of growth factors with different biological activity might offer distinct advantages in terms of efficacy, yet combined approaches require further optimization. Alternatively, substances with pleiotropic activity might be considered, by virtue of their ability to target multiple mechanisms. For instance, some angiogenic factors not only stimulate the growth of arterioles and capillaries, but also inhibit vascular destabilization triggered by metabolic and oxidative stress. Transplantation of endothelial progenitor cells was recently proposed for the treatment of peripheral and myocardial ischaemia. Progenitor cells can be transplanted either without any preliminary conditioning or after ex vivo genetic manipulation. Delivery of genetically modified progenitor cells eliminates the drawback of immune response against viral vectors and makes feasible repeating the therapeutic procedure in case of injury recurrence. It is envisioned that these new approaches of regenerative medicine will open unprecedented opportunities for the care of life-threatening diseases.
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Affiliation(s)
- Paolo Madeddu
- Experimental Medicine and Gene Therapy, National Institute of Biostructures and Biosystems, Osilo and Porto Conte Technological Park, Osilo (Sassari), Italy.
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168
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Abstract
The worldwide epidemic of ischemic disease urgently requires innovative treatments. Recently, therapeutic angiogenesis has emerged as a noninvasive supply-side approach, aimed at promoting neovascularization in underperfused tissues through the local delivery of angiogenic growth factors. Successful preclinical studies paved the way for the first clinical trials, with single growth factors given as recombinant proteins or genes. However, clinical results have not matched the initial promises. Our opinion is that the logic of therapeutic angiogenesis needs profound revision. Here, we introduce the concept that pleiotropic agents can stimulate the healing of all the components of ischemic tissue. We also propose prophylactic interventions to delay vascular senescence. The optimization of therapeutic angiogenesis will open unprecedented opportunities for the care of life-threatening ischemic disease.
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Affiliation(s)
- Costanza Emanueli
- Molecular and Cellular Medicine, Porto Conte Ricerche Technological Park and Experimental Medicine, and Gene Therapy, INBB Inter-University Consortium, Via S. Antonio s.n.c., 07033 Osilo (SS), Italy
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169
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Van der Auwera I, Vermeulen P, Van Marck E, Dirix L. Lack of lymphangiogenesis during breast carcinogenesis. J Clin Pathol 2004; 57:1342-3. [PMID: 15563685 PMCID: PMC1770494 DOI: 10.1136/jcp.2004.021626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- I Van der Auwera
- Translational Cancer Research Group (University of Antwerp and General Hospital Sint-Augustinus), Oosterveldlaan 24 Wilrijk, Antwerp 2610, Belgium;
| | - P Vermeulen
- Translational Cancer Research Group (University of Antwerp and General Hospital Sint-Augustinus), Oosterveldlaan 24 Wilrijk, Antwerp 2610, Belgium;
| | - E Van Marck
- Translational Cancer Research Group (University of Antwerp and General Hospital Sint-Augustinus), Oosterveldlaan 24 Wilrijk, Antwerp 2610, Belgium;
| | - L Dirix
- Translational Cancer Research Group (University of Antwerp and General Hospital Sint-Augustinus), Oosterveldlaan 24 Wilrijk, Antwerp 2610, Belgium;
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