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Almobarak B, Amlani V, Inge L, Hofving T, Muth A, Nilsson O, Johansson M, Arvidsson Y, Elias E. Exposure to nonanoic acid alters small intestinal neuroendocrine tumor phenotype. BMC Cancer 2023; 23:267. [PMID: 36959559 PMCID: PMC10035137 DOI: 10.1186/s12885-023-10722-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 03/09/2023] [Indexed: 03/25/2023] Open
Abstract
Background Small intestinal neuroendocrine tumors (SI-NET) are highly differentiated and genetically stable malignant tumors, yet they often present with advanced metastatic spread at the time of diagnosis. In contrast to many other types of malignant tumors, primary SI-NET are often asymptomatic and typically smaller in size compared to adjacent lymph node metastases. This study explores the hypothesis that stimulating the chemosensing olfactory receptor 51E1 (OR51E1) decreases SI-NET proliferation suggesting a mechanism that explains a difference in proliferative rate based on tumor location. Methods Clinical data was used to address difference in tumor size depending on location. A SI-NET tissue microarray was used to evaluate expression of OR51E1 and olfactory marker protein (OMP). Primary cultured tumor cells from 5 patients were utilized to determine the effect of OR51E1 agonist nonanoic acid on metabolic activity. The SI-NET cell line GOT1 was used to determine effects of nonanoic acid on the transcriptome as well as long-term effects of nonanoic acid exposure with regards to cell proliferation, serotonin secretion, alterations of the cell-cycle and morphology. Results Tumor size differed significantly based on location. OR51E1 and OMP were generally expressed in SI-NET. Primary SI-NET cells responded to nonanoic acid with a dose dependent altered metabolic activity and this was replicated in the GOT1 cell line but not in the MCF10A control cell line. Nonanoic acid treatment in GOT1 cells upregulated transcripts related to neuroendocrine differentiation and hormone secretion. Long-term nonanoic acid treatment of GOT1 cells decreased proliferation, induced senescence, and altered cell morphology. Conclusion Our results raise the possibility that exposure of intraluminal metabolites could represent a mechanism determining aspects of the SI-NET tumor phenotype. However, we could not causally link the observed effects of nonanoic acid exposure to the OR51E1 receptor. Supplementary Information The online version contains supplementary material available at 10.1186/s12885-023-10722-8.
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Affiliation(s)
- Bilal Almobarak
- grid.8761.80000 0000 9919 9582Sahlgrenska Center for Cancer Research, Department of Laboratory Medicine, Institute of Biomedicine, Sahlgrenska Academy at University of Gothenburg, Box 425, Gothenburg, 405 30 Sweden
| | - Vishal Amlani
- grid.1649.a000000009445082XDepartment of Vascular Surgery, Sahlgrenska University Hospital, Gothenburg, 413 45 Sweden
- grid.8761.80000 0000 9919 9582Institute of Medicine, Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, 405 30 Sweden
| | - Linda Inge
- grid.8761.80000 0000 9919 9582Sahlgrenska Center for Cancer Research, Department of Laboratory Medicine, Institute of Biomedicine, Sahlgrenska Academy at University of Gothenburg, Box 425, Gothenburg, 405 30 Sweden
| | - Tobias Hofving
- grid.8761.80000 0000 9919 9582Sahlgrenska Center for Cancer Research, Department of Laboratory Medicine, Institute of Biomedicine, Sahlgrenska Academy at University of Gothenburg, Box 425, Gothenburg, 405 30 Sweden
| | - Andreas Muth
- grid.8761.80000 0000 9919 9582Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Gothenburg, 405 30 Sweden
- grid.1649.a000000009445082XSection for Endocrine and Sarcoma surgery, Department of Surgery, Sahlgrenska University Hospital, Gothenburg, 413 45 Sweden
| | - Ola Nilsson
- grid.8761.80000 0000 9919 9582Sahlgrenska Center for Cancer Research, Department of Laboratory Medicine, Institute of Biomedicine, Sahlgrenska Academy at University of Gothenburg, Box 425, Gothenburg, 405 30 Sweden
- grid.1649.a000000009445082XDepartment of Pathology, Sahlgrenska University Hospital, Gothenburg, 413 45 Sweden
- grid.8761.80000 0000 9919 9582Department of Pathology and Genetics, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, 405 30 Sweden
| | - Martin Johansson
- grid.8761.80000 0000 9919 9582Sahlgrenska Center for Cancer Research, Department of Laboratory Medicine, Institute of Biomedicine, Sahlgrenska Academy at University of Gothenburg, Box 425, Gothenburg, 405 30 Sweden
- grid.1649.a000000009445082XDepartment of Pathology, Sahlgrenska University Hospital, Gothenburg, 413 45 Sweden
- grid.8761.80000 0000 9919 9582Department of Pathology and Genetics, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, 405 30 Sweden
| | - Yvonne Arvidsson
- grid.8761.80000 0000 9919 9582Sahlgrenska Center for Cancer Research, Department of Laboratory Medicine, Institute of Biomedicine, Sahlgrenska Academy at University of Gothenburg, Box 425, Gothenburg, 405 30 Sweden
- grid.1649.a000000009445082XDepartment of Pathology, Sahlgrenska University Hospital, Gothenburg, 413 45 Sweden
- grid.8761.80000 0000 9919 9582Department of Pathology and Genetics, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, 405 30 Sweden
| | - Erik Elias
- grid.8761.80000 0000 9919 9582Sahlgrenska Center for Cancer Research, Department of Laboratory Medicine, Institute of Biomedicine, Sahlgrenska Academy at University of Gothenburg, Box 425, Gothenburg, 405 30 Sweden
- grid.8761.80000 0000 9919 9582Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Gothenburg, 405 30 Sweden
- grid.1649.a000000009445082XSection for Endocrine and Sarcoma surgery, Department of Surgery, Sahlgrenska University Hospital, Gothenburg, 413 45 Sweden
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Van Den Heede K, Chidambaram S, Van Slycke S, Brusselaers N, Warfvinge CF, Ohlsson H, Nordenström E, Almquist M. Effect of primary tumour resection without curative intent in patients with metastatic neuroendocrine tumours of the small intestine and right colon: meta-analysis. Br J Surg 2021; 109:191-199. [DOI: 10.1093/bjs/znab413] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 10/31/2021] [Indexed: 12/13/2022]
Abstract
Abstract
Background
Patients with small intestinal neuroendocrine tumours (siNETs) usually present with advanced disease. Primary tumour resection without curative intent is controversial in patients with metastatic siNETs. The aim of this meta-analysis was to investigate survival after primary tumour resection without curative intent compared with no resection in patients with metastatic siNETs.
Methods
A systematic literature search was performed, using MEDLINE® (PubMed), Embase®, Web of Science, and the Cochrane Library up to 25 February 2021. Studies were included if survival after primary tumour resection versus no resection in patients with metastatic siNETs was reported. Results were pooled in a random-effects meta-analysis, and are reported as hazard ratios (HRs) with 95 per cent confidence intervals. Sensitivity analyses were undertaken to enable comment on the impact of important confounders.
Results
After screening 3659 abstracts, 16 studies, published between 1992 and 2021, met the inclusion criteria, with a total of 9428 patients. Thirteen studies reported HRs adjusted for important confounders and were included in the meta-analysis. Median overall survival was 112 (i.q.r. 82–134) months in the primary tumour resection group compared with 60 (74–88) months in the group without resection. Five-year overall survival rates were 74 (i.q.r. 67–77) and 44 (34–45) per cent respectively. Primary tumour resection was associated with improved survival compared with no resection (HR 0.55, 95 per cent c.i. 0.47 to 0.66). This effect remained in sensitivity analyses.
Conclusion
Primary tumour resection is associated with increased survival in patients with advanced, metastatic siNETs, even after adjusting for important confounders.
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Affiliation(s)
- Klaas Van Den Heede
- Department of Surgery, Skåne University Hospital, Lund, Sweden
- Department of Clinical Sciences, Lund University, Lund, Sweden
- Department of General and Endocrine Surgery, OLV Clinic Aalst, Aalst, Belgium
| | - Swathikan Chidambaram
- Department of Surgery and Cancer, Imperial College London, London, UK
- Department of Endocrine Surgery, Hammersmith Hospital, London, UK
| | - Sam Van Slycke
- Department of General and Endocrine Surgery, OLV Clinic Aalst, Aalst, Belgium
- Department of Head and Skin, University Hospital Ghent, Ghent, Belgium
- Department of General Surgery, AZ Damiaan, Ostend, Belgium
| | - Nele Brusselaers
- Centre for Translational Microbiome Research Department of Microbiology, Tumour and Cell Biology, Karolinska Institute, Stockholm, Sweden
- Department of Family Medicine and Population Health, Global Health Institute, University of Antwerp, Wilrijk, Belgium
| | - Carl Fredrik Warfvinge
- Department of Clinical Sciences, Lund University, Lund, Sweden
- Department of Oncology and Pathology, Lund University, Lund, Sweden
| | - Håkan Ohlsson
- Department of Clinical Sciences, Lund University, Lund, Sweden
- Department of Surgery, Ystad Hospital, Ystad, Sweden
| | - Erik Nordenström
- Department of Surgery, Skåne University Hospital, Lund, Sweden
- Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Martin Almquist
- Department of Surgery, Skåne University Hospital, Lund, Sweden
- Department of Clinical Sciences, Lund University, Lund, Sweden
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