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Qi LW, Xie YF, Wang WN, Liu J, Yang KG, Chen K, Luo CH, Fei J, Hu JM. High microvessel and lymphatic vessel density predict poor prognosis in patients with esophageal squamous cell carcinoma. PeerJ 2024; 12:e18080. [PMID: 39351370 PMCID: PMC11441385 DOI: 10.7717/peerj.18080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2024] [Accepted: 08/20/2024] [Indexed: 10/04/2024] Open
Abstract
Background Microangiogenesis and lymphangiogenesis are essential for tumor growth in the tumor microenvironment, contributing to tumor invasion and metastasis. Limited literature exists on these processes in esophageal squamous cell carcinoma (ESCC). Therefore, the purpose of this study is to explore the impacts of microangiogenesis and lymphangiogenesis on the occurrence, progression, and prognosis assessment of ESCC. Methods Surgical specimens and paraffin-embedded human tissues were procured from ESCC patients, encompassing 100 ESCC tissues and 100 cancer-adjacent normal (CAN) tissues. CD34 and D2-40 were utilized as markers for microvessel endothelial cells and lymphatic vessel endothelial cells, respectively. Microvascular density (MVD) and lymphatic vessel density (LVD) were evaluated through immunohistochemical quantification. Results We found that tumor tissues in ESCC patients had significantly higher MVD and LVD than cancer-adjacent normal (CAN) tissues. High MVD and LVD were associated with lymph node metastasis and advanced tumor clinical stages. Additionally, both high MVD and high LVD were strongly linked to poorer prognosis among cancer patients. Furthermore, a positive correlation was found between high MVD and high LVD (p < 0.05). The presence of these markers individually indicated a worse prognosis, with their combined assessment showcasing enhanced prognostic value. Conclusions Overall, the increased MVD and LVD indicates higher invasion and metastasis of ESCC, closely correlating with unfavorablefor poor prognosis of ESCC patients.
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Affiliation(s)
- Li Wen Qi
- Pathology, Shihezi University School of Medicine/The First Affiliated Hospital of Shihezi University, Shihezi, Xinjiang, China
- Department of Oncology, The First Affiliated Hospital of Shihezi University, Shihezi, Xinjiang, China
| | - Yu Fang Xie
- Pathology, Shihezi University School of Medicine/The First Affiliated Hospital of Shihezi University, Shihezi, Xinjiang, China
- Department of Pathology, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, Henan, China
| | - Wei Nan Wang
- Pathology, Shihezi University School of Medicine/The First Affiliated Hospital of Shihezi University, Shihezi, Xinjiang, China
| | - Jia Liu
- Pathology, Shihezi University School of Medicine/The First Affiliated Hospital of Shihezi University, Shihezi, Xinjiang, China
| | - Kai Ge Yang
- Pathology, Shihezi University School of Medicine/The First Affiliated Hospital of Shihezi University, Shihezi, Xinjiang, China
| | - Kai Chen
- Pathology, Shihezi University School of Medicine/The First Affiliated Hospital of Shihezi University, Shihezi, Xinjiang, China
| | - Cheng Hua Luo
- Pathology, Shihezi University School of Medicine/The First Affiliated Hospital of Shihezi University, Shihezi, Xinjiang, China
| | - Jing Fei
- Department of Oncology, The First Affiliated Hospital of Shihezi University, Shihezi, Xinjiang, China
| | - Jian Ming Hu
- Pathology, Shihezi University School of Medicine/The First Affiliated Hospital of Shihezi University, Shihezi, Xinjiang, China
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Zhang H, Li F, Jing M, Xi H, Zheng Y, Liu J. Nomogram combining pre-operative clinical characteristics and spectral CT parameters for predicting the WHO/ISUP pathological grading in clear cell renal cell carcinoma. Abdom Radiol (NY) 2024; 49:1185-1193. [PMID: 38340180 DOI: 10.1007/s00261-024-04199-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 01/04/2024] [Accepted: 01/12/2024] [Indexed: 02/12/2024]
Abstract
PURPOSE To develop a novel clinical-spectral-computed tomography (CT) nomogram incorporating clinical characteristics and spectral CT parameters for the preoperative prediction of the WHO/ISUP pathological grade in clear cell renal cell carcinoma (ccRCC). METHODS Seventy-three ccRCC patients who underwent spectral CT were included in this retrospective analysis from December 2020 to June 2023. The subjects were pathologically divided into low- and high-grade groups (WHO/ISUP 1/2, n = 52 and WHO/ISUP 3/4, n = 21, respectively). Information on clinical characteristics, conventional CT imaging features, and spectral CT parameters was collected. Multivariate logistic regression analyses were conducted to create a nomogram combing clinical data and image data for preoperatively predicting the pathological grade of ccRCC, and the area under the curve (AUC) was utilized to assess the predictive performance of the model. RESULTS Multivariate logistic regression analyses revealed that age, systemic immune-inflammation index (SII), and the slope of the spectrum curve in the cortex phase (CP-K) were independent predictors for predicting high-grade ccRCC. The clinical-spectral-CT model exhibited high evaluation efficacy, with an AUC of 0.933 (95% confidence interval [CI]: 0.878-0.998; sensitivity: 0.810; specificity: 0.923). The calibration curve revealed that the predicted probability of the clinical-spectral-CT nomogram could better fit the actual probability, with high calibration. The Hosmer-Lemeshow test showed that the model had a good fitness (χ2 = 5.574, p = 0.695). CONCLUSION The clinical-spectral-CT nomogram has the potential to predict WHO/ISUP grading of ccRCC preoperatively.
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Affiliation(s)
- Hongyu Zhang
- Second Clinical School, Lanzhou University, Lanzhou, China
- Key Laboratory of Medical Imaging of Gansu Province, Lanzhou, China
- Department of Radiology, Lanzhou University Second Hospital, Lanzhou, China
| | - Fukai Li
- Second Clinical School, Lanzhou University, Lanzhou, China
- Key Laboratory of Medical Imaging of Gansu Province, Lanzhou, China
- Department of Radiology, Lanzhou University Second Hospital, Lanzhou, China
| | - Mengyuan Jing
- Second Clinical School, Lanzhou University, Lanzhou, China
- Key Laboratory of Medical Imaging of Gansu Province, Lanzhou, China
- Department of Radiology, Lanzhou University Second Hospital, Lanzhou, China
| | - Huaze Xi
- Second Clinical School, Lanzhou University, Lanzhou, China
- Key Laboratory of Medical Imaging of Gansu Province, Lanzhou, China
- Department of Radiology, Lanzhou University Second Hospital, Lanzhou, China
| | - Yali Zheng
- Key Laboratory of Medical Imaging of Gansu Province, Lanzhou, China
- Department of Radiology, Lanzhou University Second Hospital, Lanzhou, China
| | - Jianli Liu
- Second Clinical School, Lanzhou University, Lanzhou, China.
- Key Laboratory of Medical Imaging of Gansu Province, Lanzhou, China.
- Department of Radiology, Lanzhou University Second Hospital, Lanzhou, China.
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Zhang Y, Shi C, Yang Y, Hu X, Ni H, Li L, Cheng Z, Huang J, Chen P. Identifying key genes related to the peritubular capillary rarefaction in renal interstitial fibrosis by bioinformatics. Sci Rep 2023; 13:19611. [PMID: 37949939 PMCID: PMC10638415 DOI: 10.1038/s41598-023-46934-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 11/07/2023] [Indexed: 11/12/2023] Open
Abstract
Renal interstitial fibrosis (RIF) is a key feature of progressive chronic kidney disease (CKD), characterized by tubular epithelial cell (TEC) hypoxia and peritubular capillary (PTC) rarefaction. However, the mechanisms underlying these processes remain poorly understood. To address this knowledge gap, we conducted a comparative transcriptome analysis of hypoxic and normoxic HK-2 cells, identifying 572 differentially expressed genes (DEGs). Subsequent Gene Ontology (GO), protein‒protein interaction (PPI) network, and hub gene analyses revealed significant enrichment of DEGs in the HIF-1 signaling pathway based on KEGG enrichment analysis. To further explore TEC modulation under hypoxic conditions, we performed chromatin immunoprecipitation (ChIP) sequencing targeting HIF-1α, identifying 2915 genes potentially regulated by HIF-1α. By comparing RNA sequencing and ChIP sequencing data, we identified 43 overlapping DEGs. By performing GO analysis and peak annotation with IGV, we identified two candidate molecules, VEGFA and BTG1, that are associated with angiogenesis and whose gene sequences were reliably bound by HIF-1α. Our study elucidates the molecular mechanisms underlying RIF, providing valuable insights for potential therapeutic interventions.
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Affiliation(s)
- Yu Zhang
- Department of Pathology, School of Medicine, Southeast University, Nanjing, Jiangsu, China
| | - Chuanbing Shi
- Department of Pathology, Pukou Branch of Jiangsu People's Hospital, Nanjing, Jiangsu, China
| | - Yiqiong Yang
- Department of Pathology, School of Medicine, Southeast University, Nanjing, Jiangsu, China
| | - Xiuxiu Hu
- Department of Pathology, School of Medicine, Southeast University, Nanjing, Jiangsu, China
| | - Haifeng Ni
- Institute of Nephrology, Zhong Da Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, China
| | - Li Li
- Department of Pathology, School of Medicine, Southeast University, Nanjing, Jiangsu, China
| | - Zhengyuan Cheng
- Department of Internal Medicine, Ma'anshan People's Hospital Affiliated to Medical School of Southeast University, Ma'anshan, Anhui, China
| | - Jing Huang
- Department of Respiratory and Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, China
| | - Pingsheng Chen
- Department of Pathology, School of Medicine, Southeast University, Nanjing, Jiangsu, China.
- Institute of Nephrology, Zhong Da Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, China.
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Zhu Q, Sun J, Zhu W, Chen W, Ye J. Spectral CT imaging versus conventional CT post-processing technique in differentiating malignant and benign renal tumors. Br J Radiol 2023; 96:20230147. [PMID: 37750940 PMCID: PMC10607386 DOI: 10.1259/bjr.20230147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 08/02/2023] [Accepted: 08/04/2023] [Indexed: 09/27/2023] Open
Abstract
OBJECTIVE Quantitative comparison of the diagnostic value of spectral CT imaging and conventional CT post-processing technique in differentiating malignant and benign renal tumors. METHODS A total of 209 patients with renal tumors who had undergone CT enhancement were assigned to three groups-clear cell renal cell carcinoma (ccRCC, n = 106), non-ccRCC (n = 60), and benign renal tumor (n = 43) groups. Parametric CT enhancement of each tumor based on spectral CT and conventional CT was performed using in-house software, and the iodine concentration, water content, slope, and density values among the three groups were compared. The receiver operating characteristic (ROC) curve analysis was performed to determine the optimum diagnostic thresholds, the area under the ROC curve (AUC), sensitivity, specificity, and accuracy of the above parameters. RESULTS The iodine concentration, slope, and density values were higher in the ccRCCs group compared to the non-ccRCCs and benign renal tumor groups (p < 0.05). Moreover, the iodine concentration, slope, and density values were higher in benign renal tumors compared to non-ccRCCs (p < 0.05). According to the ROC curve analysis, iodine concentration presented the highest diagnostic efficacy in differentiating ccRCCs/non-ccRCCs from benign renal tumors. The pairwise comparisons of the ROC curves and the diagnostic efficacies revealed that ROI-based CT enhancement was worse than the spectral CT imaging analysis in terms of density (p < 0.05). CONCLUSION Iodine concentration presented the highest diagnostic efficacy in differentiating ccRCCs/non-ccRCCs from benign renal tumors. ADVANCES IN KNOWLEDGE 1. The iodine concentration, slope, and density values were higher for the ccRCCs compared to non-ccRCCs and benign renal tumors.2. Iodine concentration presented the highest diagnostic efficacy in differentiating ccRCCs/non-ccRCCs from benign renal tumors.3. Spectral CT imaging analysis performed better than conventional CT in differentiating malignant and benign renal tumors.
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Affiliation(s)
- Qingqiang Zhu
- Department of Medical Imaging, Clinical Medical College, Yangzhou University, Yangzhou, China
| | - Jun Sun
- Department of Medical Imaging, Clinical Medical College, Yangzhou University, Yangzhou, China
| | - Wenrong Zhu
- Department of Medical Imaging, Clinical Medical College, Yangzhou University, Yangzhou, China
| | - Wenxin Chen
- Department of Medical Imaging, Clinical Medical College, Yangzhou University, Yangzhou, China
| | - Jing Ye
- Department of Medical Imaging, Clinical Medical College, Yangzhou University, Yangzhou, China
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Gao F, Feng Y, Hu X, Zhang X, Li T, Wang Y, Ge S, Wang C, Chi J, Tan X, Wang N. Neutrophils regulate tumor angiogenesis in oral squamous cell carcinoma and the role of Chemerin. Int Immunopharmacol 2023; 121:110540. [PMID: 37354780 DOI: 10.1016/j.intimp.2023.110540] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Revised: 06/13/2023] [Accepted: 06/16/2023] [Indexed: 06/26/2023]
Abstract
Oral squamous cell carcinoma (OSCC) is the most common malignant tumor of the oral cavity. Tumor angiogenesis plays a crucial role in tumor progression. Studies have established the correlation between neutrophils and tumor angiogenesis in the tumor microenvironment. A previous study found that overexpression of Chemerin- in OSCC increased the infiltration of neutrophils in tumor tissues. This study aims to investigate the mechanisms underlying the regulation of the development and progression of OSCC, which have great significance in enhancing the postoperative survival of patients with OSCC. This study evaluated the accuracy of neutrophil count combined with MVD in predicting patients' survival time and its relationship with clinicopathological parameters and prognosis. Additionally, the study explored the effects of the Chemerin-neutrophil interaction on the angiogenic function of HUVECs. In OSCC, the overexpression of Chemerin promoted the angiogenesis of HUVECs through neutrophils. Moreover, Chemerin upregulated pro-angiogenic factors (e.g., VEGF-A, MMP-9, MMP-2, and S100A9) in neutrophils by activating MEK/ERK signaling pathway. In vivo experiments demonstrated that Chemerin may promote tumor growth by regulating tumor angiogenesis. In conclusion, the results suggest that neutrophil count and MVD serve as poor prognostic factors for patients with OSCC, and their combination is a more effective factor in predicting the survival time of OSCC patients. Neutrophils potentially contribute to angiogenesis through MEK/ERK signaling pathway via Chemerin and participate in the progression and metastasis of OSCC.
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Affiliation(s)
- Fei Gao
- Department of Pathology, School of Basic Medicine, Qingdao University, Qingdao city, Shandong Province, China
| | - Yuanyong Feng
- Department of Oral and Maxillofacial Surgery, the Affiliated Hospital of Qingdao University, Qingdao city, Shandong Province, China
| | - Xiaoyuan Hu
- Biological Therapy Center, The Third Affiliated Hospital of Kunming Medical University, Kunzhou Road No. 519, Kunming, Yunnan Province, China
| | - Xuan Zhang
- Department of Pathology, School of Basic Medicine, Qingdao University, Qingdao city, Shandong Province, China
| | - Tongtong Li
- Department of Pathology, School of Basic Medicine, Qingdao University, Qingdao city, Shandong Province, China
| | - Yueqi Wang
- Department of Pathology, School of Basic Medicine, Qingdao University, Qingdao city, Shandong Province, China
| | - Shengyou Ge
- Department of Oral and Maxillofacial Surgery, the Affiliated Hospital of Qingdao University, Qingdao city, Shandong Province, China
| | - Chengqin Wang
- Department of Oral and Maxillofacial Surgery, the Affiliated Hospital of Qingdao University, Qingdao city, Shandong Province, China
| | - Jinghua Chi
- Department of Pathology, School of Basic Medicine, Qingdao University, Qingdao city, Shandong Province, China
| | - Xiaohua Tan
- Department of Pathology, School of Basic Medicine, Qingdao University, Qingdao city, Shandong Province, China
| | - Ning Wang
- Department of Pathology, School of Basic Medicine, Qingdao University, Qingdao city, Shandong Province, China.
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Takao S, Ushijima Y, Motomura Y, Sakamoto K, Hirakawa M, Nishie A, Mimori K, Yamashita Y, Tsutsumi T, Ishigami K. Radiology- and gene-based risk stratification in small renal cell carcinoma: A preliminary study. PLoS One 2021; 16:e0256471. [PMID: 34492075 PMCID: PMC8423232 DOI: 10.1371/journal.pone.0256471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 08/06/2021] [Indexed: 11/18/2022] Open
Abstract
PURPOSE Most small renal cell carcinomas (small RCCs) will remain indolent after detection, but some stage I RCCs still metastasize. There are no risk-stratification imaging factors that could be used to identify poor-prognosis patients based on genomic profiling. Here, we evaluated the relationships between imaging parameters and RNA expressions in small RCC and attempted to identify imaging factors that could be used as effective biomarkers. METHODS We acquired biopsy specimens of 18 clear cell carcinomas that had undergone perfusion CT (pCT) and MRI between April 2018 and March 2019. We performed RNA sequencing, assessed RNA expressions, and calculated each tumor's cell-cycle progression (CCP) score, which has prognostic value in predicting metastatic progression. We classified the tumors into two groups: clear cell type A (ccA) and type B (ccB). CcA has better survival compared to ccB. We evaluated the following characteristics of each tumor: tumor size, presence of pseudocapsule, and fat. We used the pCT and MRI to measure each tumor's volume transfer constant (Ktrans), rate constant (Kep), extracellular extravascular volume fraction (VE), fractional plasma volume (VP), and apparent diffusion coefficient (ADC). The correlations between these small RCC imaging parameters and the tumor size and RNA expressions were determined. RESULTS The tumor size was significantly correlated with Kep and inversely correlated with VE, VP, ADC, and hallmark angiogenesis. The CCP score was significantly inversely correlated with Ktrans and Kep. The ccA tumors tended to show a pseudocapsule on MRI. CONCLUSION Tumor size was correlated with low perfusion, but not with prognostic factors based on genomic profiling. Imaging parameters (e.g., Ktrans and Kep) and tumor characteristics (e.g., pseudocapsule) may enable gene-based risk stratification in small RCC.
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Affiliation(s)
- Seiichiro Takao
- Department of Radiology, Beppu Hospital, Kyushu University, Beppu, Japan
| | - Yasuhiro Ushijima
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
- * E-mail:
| | - Yushi Motomura
- Department of Radiology, Beppu Hospital, Kyushu University, Beppu, Japan
| | - Katsumi Sakamoto
- Department of Radiology, Beppu Hospital, Kyushu University, Beppu, Japan
| | - Masakazu Hirakawa
- Department of Radiology, Beppu Hospital, Kyushu University, Beppu, Japan
| | - Akihiro Nishie
- Department of Advanced Imaging and Interventional Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Koshi Mimori
- Department of Surgery, Beppu Hospital, Kyushu University, Beppu, Japan
| | - Yasuo Yamashita
- Department of Medical Technology, Kyushu University Hospital, Fukuoka, Japan
| | | | - Kousei Ishigami
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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Drljevic-Nielsen A, Rasmussen F, Nielsen PS, Stilling C, Thorup K, Mains JR, Madsen HHT, Donskov F. Prognostic value of DCE-CT-derived blood volume and flow compared to core biopsy microvessel density in patients with metastatic renal cell carcinoma. Eur Radiol Exp 2021; 5:32. [PMID: 34327591 PMCID: PMC8322257 DOI: 10.1186/s41747-021-00232-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 07/01/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Angiogenesis is prominent in metastatic renal cell carcinoma (mRCC). We compared two angiogenesis assessment methods: dynamic contrast-enhanced computed tomography (DCE-CT)-derived blood volume (BV) and blood flow (BF) and core biopsy microvessel density (MVD). METHODS As planned in DaRenCa Study-1 study, DCE-CT and core biopsy were performed from the same tumour/metastasis at baseline. MVD was assessed by CD34 immunostaining in tumour (CD34-indexT) or tumour including necrosis (CD34-indexTN). BV and BF were assessed using the DCE-CT software. Overall survival (OS) and progression-free survival (PFS) were assessed by Kaplan-Meier analysis. Spearman coefficient (rho) tested the correlation between MVD and BV, BF, or CT density (HU). RESULTS At baseline, 25 patients had analysable scans and tissue. BVdeconv, BVPatlak, and BFdeconv > median were associated with favourable OS (43.2 versus 14.6 months, p = 0.002; 31.6 versus 20.2 months, p = 0.015; and 31.6 versus 24.5 months, p = 0.019). CD34-indexT and CD34-indexTN did not correlate with age (p = 0.543), sex (p = 0.225), treatment (p = 0.848), International mRCC Database Consortium category (p = 0.152), synchronous versus metachronous metastatic disease (p = 0.378), or tumour volume (p = 0.848). CD34-indexT or CD34-indexTN > median was not associated with PFS (p = 0.441 and p = 0.854, respectively) or OS (p = 0.987 and p =0.528, respectively). CD34-indexT or CD34-indexTN was not correlated with BV, BF, or HU (rho 0.20-0.26). CONCLUSIONS Differently from MVD, DCE-CT-derived BV and BF had prognostic impact and may better reflect angiogenesis in mRCC. TRIAL REGISTRATION NCT01274273.
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Affiliation(s)
- Aska Drljevic-Nielsen
- Department of Oncology, Aarhus University Hospital (AUH), Palle Juul-Jensens Blvd. 99, 8200, Aarhus N, Denmark. .,Department of Radiology, Aarhus University Hospital (AUH), Palle Juul-Jensens Blvd. 99, 8200, Aarhus N, Denmark.
| | - Finn Rasmussen
- Department of Radiology, Aarhus University Hospital (AUH), Palle Juul-Jensens Blvd. 99, 8200, Aarhus N, Denmark
| | - Patricia Switten Nielsen
- Department of Pathology, Aarhus University Hospital (AUH), Palle Juul-Jensen Blvd. 99, 8200, Aarhus N, Denmark
| | - Christina Stilling
- Department of Pathology, Aarhus University Hospital (AUH), Palle Juul-Jensen Blvd. 99, 8200, Aarhus N, Denmark
| | - Kennet Thorup
- Department of Radiology, Aarhus University Hospital (AUH), Palle Juul-Jensens Blvd. 99, 8200, Aarhus N, Denmark
| | - Jill Rachel Mains
- Department of Radiology, Aarhus University Hospital (AUH), Palle Juul-Jensens Blvd. 99, 8200, Aarhus N, Denmark
| | - Hans Henrik Torp Madsen
- Department of Radiology, Aarhus University Hospital (AUH), Palle Juul-Jensens Blvd. 99, 8200, Aarhus N, Denmark
| | - Frede Donskov
- Department of Oncology, Aarhus University Hospital (AUH), Palle Juul-Jensens Blvd. 99, 8200, Aarhus N, Denmark
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Ma W, Yang J, Liu N, Pu X, Qu F, Xu L, Zhao X, Li X, Zhang G, Guo H, Li D, Gan W. Are tumor-associated micro-angiogenesis and lymphangiogenesis considered as the novel prognostic factors for patients with Xp11.2 translocation renal cell carcinoma? BMC Cancer 2020; 20:1182. [PMID: 33267784 PMCID: PMC7709278 DOI: 10.1186/s12885-020-07696-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Accepted: 11/26/2020] [Indexed: 12/15/2022] Open
Abstract
Background Tumor micro-angiogenesis and lymphangiogenesis are effective prognostic predictors in many solid malignancies. However, its role on Xp11.2 translocation RCC has not been fully elucidated. Herein, we purposed to explore the correlation between quantitative parameters of tumor-related micro-angiogenesis or lymphangiogenesis and the prognosis of Xp11.2 translocation renal cell carcinoma (Xp11.2 translocation RCC). Methods Tissue samples were obtained from 34 Xp11.2 translocation RCC and 77 clear cell renal cell carcinoma (ccRCC) between January 2007 and December 2018. Micro-angiogenesis was detected using CD34 antibody and quantified with microvessel density (MVD) and microvessel area (MVA), while the lymphangiogenesis in RCC was immunostained with D2–40 antibody and assessed using lymphatic vessel density (LVD) and lymphatic vessel area (LVA). The Kaplan-Meier method of survival analysis was used to estimate prognosis, and both univariate and multivariate analysis was performing using the Cox proportional hazards. Results The MVD and MVA of Xp11.2 translocation RCC in two detected areas (intratumoral and peritumoral area) were not significantly different from that of ccRCC (all P > 0.05). Notably, D2–40-positive lymphatic vessels of Xp11.2 translocation RCC were highly detected in the peritumoral area compared to the intratumoral area. Interestingly, the peritumoral LVD and LVA of Xp11.2 translocation RCC were higher than that of ccRCC (all P < 0.05). Furthermore, both intratumoral MVD or MVA and peritumoral LVD or LVA were significantly associated with pT stage, pN stage, cM stage, AJCC stage, and WHO/ISUP grade (all P < 0.05). Univariate analysis of Cancer-specific survival (CSS) revealed that CSS was substantially longer in patients with low intratumoral MVD or MVA than in patients with high intratumoral MVD or MVA (P = 0.005 and P = 0.001, respectively). Lastly, the Cox proportional hazards model in CSS demonstrated that both intratumoral MVD or MVA and peritumoral LVD or LVA were not independent prognostic parameters (all P > 0.05). Conclusions This study outlines that Xp11.2 translocation RCC is a highly vascularized solid RCC, characterized by rich lymph vessels in the peritumoral area. Quantitative parameters of micro-angiogenesis and lymphangiogenesis could not be considered as novel prognostic factors for patients with xp11.2 translocation RCC.
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Affiliation(s)
- Wenliang Ma
- Department of Urology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, No. 321 Zhongshan Road, Nanjing, Jiangsu Province, People's Republic of China, 210008
| | - Jun Yang
- Department of Pathology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu, China
| | - Ning Liu
- Department of Urology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, No. 321 Zhongshan Road, Nanjing, Jiangsu Province, People's Republic of China, 210008
| | - Xiaohong Pu
- Department of Pathology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu, China
| | - Feng Qu
- Department of Urology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, No. 321 Zhongshan Road, Nanjing, Jiangsu Province, People's Republic of China, 210008
| | - Linfeng Xu
- Department of Urology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, No. 321 Zhongshan Road, Nanjing, Jiangsu Province, People's Republic of China, 210008
| | - Xiaozhi Zhao
- Department of Urology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, No. 321 Zhongshan Road, Nanjing, Jiangsu Province, People's Republic of China, 210008
| | - Xiaogong Li
- Department of Urology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, No. 321 Zhongshan Road, Nanjing, Jiangsu Province, People's Republic of China, 210008
| | - Gutian Zhang
- Department of Urology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, No. 321 Zhongshan Road, Nanjing, Jiangsu Province, People's Republic of China, 210008
| | - Hongqian Guo
- Department of Urology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, No. 321 Zhongshan Road, Nanjing, Jiangsu Province, People's Republic of China, 210008
| | - Dongmei Li
- Immunology and Reproduction Biology Laboratory & State Key Laboratory of Analytical Chemistry for Life Science, Medical School, Nanjing University, Nanjing, Jiangsu, China.,Jiangsu Key Laboratory of Molecular Medicine, Nanjing University, Nanjing, Jiangsu, China
| | - Weidong Gan
- Department of Urology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, No. 321 Zhongshan Road, Nanjing, Jiangsu Province, People's Republic of China, 210008.
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Wu Y, Du K, Guan W, Wu D, Tang H, Wang N, Qi J, Gu Z, Yang J, Ding J. A novel definition of microvessel density in renal cell carcinoma: Angiogenesis plus vasculogenic mimicry. Oncol Lett 2020; 20:192. [PMID: 32952661 PMCID: PMC7479517 DOI: 10.3892/ol.2020.12054] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2020] [Accepted: 06/19/2020] [Indexed: 01/14/2023] Open
Abstract
The present study proposed the novel concept of total microvessel density (TMVD), which is the combination of the MVD and the vasculogenic mimicry (VM) status, and evaluated its clinical significance in patients with renal cell carcinoma (RCC). For that purpose, tumor samples from 183 patients with primary RCC were examined by CD34 single or periodic acid Schiff (PAS)/CD34 dual histology staining. MVD and VM were determined according to previous literature. Clinical information (tumor stage and grade, and duration of survival) was retrieved and analyzed. Survival information and VM-associated gene expression data of patients with RCC were also retrieved from The Cancer Genome Atlas (TCGA) database and the clinical significance of each individual gene was analyzed. The results indicated that MVD exhibited obvious differences among patients with RCC; however, it was not correlated with the stage/grade or length of survival in patients with RCC. In total, 81 patients (44.3%) were CD34(−)/PAS(+) and defined as VM(+), and they had a significantly shorter survival compared with that of VM(−) patients (P=0.0002). VM was not associated with MVD. TMVD was able to distinguish between patients with high and low MVD in terms of survival, thus TMVD was better compared with MVD alone at distinguishing between patients with different survival prognoses. TCGA data analysis revealed that among the VM-associated genes, nodal growth differentiation factor, caspase-3, matrix metalloproteinase-9 and galectin-3 had a statistically significant impact on the overall/disease-free survival of patients with RCC. In conclusion, the TMVD concept may be more appropriate and sensitive compared with the MVD or VM alone in predicting tumor aggressiveness and patient survival, particularly in RCC, which is a highly vascularized, VM-rich neoplasm, and certain VM formation-associated genes are negatively associated with the survival of patients with RCC.
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Affiliation(s)
- Yanyuan Wu
- Department of Urology, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University, School of Medicine, Shanghai 200092, P.R. China
| | - Kun Du
- Department of Laboratory, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University, School of Medicine, Shanghai 200092, P.R. China
| | - Wenbin Guan
- Department of Pathology, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University, School of Medicine, Shanghai 200092, P.R. China
| | - Di Wu
- Department of Urology, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University, School of Medicine, Shanghai 200092, P.R. China
| | - Haixiao Tang
- Department of Urology, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University, School of Medicine, Shanghai 200092, P.R. China
| | - Ning Wang
- Department of Urology, The People's Hospital of Zhengzhou University, Zhengzhou, Henan 450000, P.R. China
| | - Jun Qi
- Department of Urology, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University, School of Medicine, Shanghai 200092, P.R. China
| | - Zhengqin Gu
- Department of Urology, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University, School of Medicine, Shanghai 200092, P.R. China
| | - Junyao Yang
- Department of Laboratory, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University, School of Medicine, Shanghai 200092, P.R. China
| | - Jie Ding
- Department of Urology, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University, School of Medicine, Shanghai 200092, P.R. China
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Fujita T, Hirayama T, Ishii D, Matsumoto K, Yoshida K, Iwamura M. Efficacy and safety of sunitinib in elderly patients with advanced renal cell carcinoma. Mol Clin Oncol 2018; 9:394-398. [PMID: 30214728 DOI: 10.3892/mco.2018.1684] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2018] [Accepted: 06/25/2018] [Indexed: 01/19/2023] Open
Abstract
Elderly individuals represent a consistent proportion of all cancer patients. However, they are under-represented in clinical trials. The present study evaluated the actual tolerability of sunitinib in elderly Japanese patients with advanced renal cell carcinoma (RCC). A total of 56 consecutive patients with advanced RCC treated with sunitinib were enrolled. Patients were divided into two groups according to their age at the time of sunitinib initiation: i) elderly cohort (≥70 years); and ii) younger cohort (<70 years). Disease control rate, progression-free survival, overall survival and relative dose intensity (RDI) were compared between the two cohorts. The elderly cohort comprised of 14 patients (25.0%), and the younger cohort included 42 patients (75.0%). The elderly cohort had a significantly higher Charlson comorbidity index than the younger cohort (mean, 9.7 vs. 7.9; P<0.0001). Disease control rate, progression-free survival, and overall survival were not significantly different. The elderly cohort had a significantly lower RDI than the younger cohort (mean, 51.7 vs. 65.0%; P=0.0340). Thus, treatment with sunitinib is feasible and effective in elderly Japanese patients with advanced RCC. However, the RDI of elderly patients was significantly lower, and a relatively low dose of sunitinib provided optimal therapeutic efficacy.
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Affiliation(s)
- Tetsuo Fujita
- Department of Urology, Kitasato University School of Medicine, Sagamihara, Kanagawa 252-0374, Japan
| | - Takahiro Hirayama
- Department of Urology, Kitasato University School of Medicine, Sagamihara, Kanagawa 252-0374, Japan
| | - Daisuke Ishii
- Department of Urology, Kitasato University School of Medicine, Sagamihara, Kanagawa 252-0374, Japan
| | - Kazumasa Matsumoto
- Department of Urology, Kitasato University School of Medicine, Sagamihara, Kanagawa 252-0374, Japan
| | - Kazunari Yoshida
- Department of Urology, Kitasato University School of Medicine, Sagamihara, Kanagawa 252-0374, Japan
| | - Masatsugu Iwamura
- Department of Urology, Kitasato University School of Medicine, Sagamihara, Kanagawa 252-0374, Japan
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11
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de Vilhena AF, das Neves Pereira JC, Parra ER, Balancin ML, Ab Saber A, Martins V, Farhat C, Abrantes MM, de Campos JRM, Tedde ML, Takagaki T, Capelozzi VL. Histomorphometric evaluation of the Ki-67 proliferation rate and CD34 microvascular and D2-40 lymphovascular densities drives the pulmonary typical carcinoid outcome. Hum Pathol 2018; 81:201-210. [PMID: 30031097 DOI: 10.1016/j.humpath.2018.07.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Revised: 06/22/2018] [Accepted: 07/03/2018] [Indexed: 12/16/2022]
Abstract
Ki-67 has shown promise as a prognostic factor in pulmonary carcinoids. In this study, we sought to validate the importance of Ki-67 and study the relationships between Ki-67 and other stromal biomarkers of vascular density. We examined Ki-67, CD34, and D2-40 in tumor tissues from 128 patients with surgically excised typical carcinoid of the lung. We used immunohistochemistry and morphometry to evaluate the amount of tumor staining for cellular proliferation (Ki-67), microvascular density (CD34-MVD), and D2-40 lymphovascular density. The main outcome was overall survival, considered as life expectancy until death from metastasis. Specimens from patients with central tumors showed high CD34-MVD (P = .01), which was also significantly associated with a compromised surgical margin, lymph node metastasis, and clinical stage Ib. Equally significant was high D2-40 lymphovascular density in central specimens with a compromised surgical margin and lymph node metastasis. A high Ki-67 proliferation rate was significantly associated with tumors from patients with clinical stage IIb, IIIa, and IV disease. Multivariate Cox model analysis demonstrated that tumor location and stage, surgical margin, tumor size, and N stage were significantly related to survival time (P < .05). Quantitative staining of the tumor for Ki-67 and CD34-MVD served as prognostic factors (P < .05), which were more relevant than the surgical and pathological stage. Ki-67 greater than 5% and CD34-MVD greater than 7% staining comprise a subset of patients with higher death hazard; this outcome may harbor evidence for further prospective studies of target therapy after surgical resection.
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Affiliation(s)
| | | | - Edwin Roger Parra
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Marcelo Luiz Balancin
- Laboratory of Genomic and Histomorphometry, Department of Pathology, University of São Paulo Medical School, São Paulo 01246-903, Brazil
| | - Alexandre Ab Saber
- Laboratory of Genomic and Histomorphometry, Department of Pathology, University of São Paulo Medical School, São Paulo 01246-903, Brazil
| | - Vanessa Martins
- Laboratory of Genomic and Histomorphometry, Department of Pathology, University of São Paulo Medical School, São Paulo 01246-903, Brazil
| | - Cecilia Farhat
- Laboratory of Genomic and Histomorphometry, Department of Pathology, University of São Paulo Medical School, São Paulo 01246-903, Brazil
| | | | | | - Miguel Lia Tedde
- Department of Thoracic Surgery, Heart Institute (Incor), São Paulo 05403-000, Brazil
| | - Teresa Takagaki
- Division of Pneumology, Heart Institute (Incor), Faculty of Medicine, University of São Paulo, São Paulo 05403-000, Brazil
| | - Vera Luiza Capelozzi
- Laboratory of Genomic and Histomorphometry, Department of Pathology, University of São Paulo Medical School, São Paulo 01246-903, Brazil.
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12
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Jilaveanu LB, Puligandla M, Weiss SA, Wang XV, Zito C, Flaherty KT, Boeke M, Neumeister V, Camp RL, Adeniran A, Pins M, Manola J, DiPaola RS, Haas NB, Kluger HM. Tumor Microvessel Density as a Prognostic Marker in High-Risk Renal Cell Carcinoma Patients Treated on ECOG-ACRIN E2805. Clin Cancer Res 2017; 24:217-223. [PMID: 29066509 DOI: 10.1158/1078-0432.ccr-17-1555] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Revised: 09/29/2017] [Accepted: 10/20/2017] [Indexed: 01/10/2023]
Abstract
Purpose: Increased vascularity is a hallmark of renal cell carcinoma (RCC). Microvessel density (MVD) is one measurement of tumor angiogenesis; however, its utility as a biomarker of outcome is unknown. ECOG-ACRIN 2805 (E2805) enrolled 1,943 resected high-risk RCC patients randomized to adjuvant sunitinib, sorafenib, or placebo. We aimed to determine the prognostic and predictive role of MVD in RCC.Experimental Design: We obtained pretreatment primary RCC nephrectomy tissues from 822 patients on E2805 and constructed tissue microarrays. Using quantitative immunofluorescence, we measured tumor MVD as the area of CD34-expressing cells. We determined the association with disease-free survival (DFS), overall survival (OS), treatment arm, and clinicopathologic variables.Results: High MVD (above the median) was associated with prolonged OS for the entire cohort (P = 0.021) and for patients treated with placebo (P = 0.028). The association between high MVD and OS was weaker in patients treated with sunitinib or sorafenib (P = 0.060). MVD was not associated with DFS (P = 1.00). On multivariable analysis, MVD remained independently associated with improved OS (P = 0.013). High MVD correlated with Fuhrman grade 1-2 (P < 0.001), clear cell histology (P < 0.001), and absence of necrosis (P < 0.001) but not with gender, age, sarcomatoid features, lymphovascular invasion, or tumor size.Conclusions: High MVD in resected high-risk RCC patients is an independent prognostic, rather than predictive, biomarker of improved OS. Further studies should assess whether incorporating MVD into clinical models will enhance our ability to predict outcome and if low MVD can be used for selection of high-risk patients for adjuvant therapy trials. Clin Cancer Res; 24(1); 217-23. ©2017 AACR.
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Affiliation(s)
- Lucia B Jilaveanu
- Division of Medical Oncology, Department of Medicine, Yale University School of Medicine, New Haven, Connecticut
| | - Maneka Puligandla
- Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Sarah A Weiss
- Division of Medical Oncology, Department of Medicine, Yale University School of Medicine, New Haven, Connecticut
| | - Xin Victoria Wang
- Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Christopher Zito
- Division of Medical Oncology, Department of Medicine, Yale University School of Medicine, New Haven, Connecticut
- Department of Biology, University of Saint Joseph, School of Health and Natural Sciences, West Hartford, Connecticut
| | - Keith T Flaherty
- Division of Hematology/Oncology, Department of Medicine, Harvard Medical School and Massachusetts General Hospital, Boston, Massachusetts
| | - Marta Boeke
- Department of Urology, Yale University School of Medicine, New Haven, Connecticut
| | - Veronique Neumeister
- Department of Pathology, Yale University School of Medicine, New Haven, Connecticut
| | - Robert L Camp
- Department of Pathology, Yale University School of Medicine, New Haven, Connecticut
| | - Adebowale Adeniran
- Department of Pathology, Yale University School of Medicine, New Haven, Connecticut
| | - Michael Pins
- Department of Pathology, Advocate Lutheran General Hospital, Park Ridge, Illinois
| | - Judith Manola
- Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | | | - Naomi B Haas
- Department of Medicine, Division of Hematology/Oncology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Harriet M Kluger
- Division of Medical Oncology, Department of Medicine, Yale University School of Medicine, New Haven, Connecticut.
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13
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Mikami S, Oya M, Kosaka T, Mizuno R, Miyazaki Y, Sato Y, Okada Y. Increased vasohibin-1 expression is associated with metastasis and poor prognosis of renal cell carcinoma patients. J Transl Med 2017; 97:854-862. [PMID: 28287633 DOI: 10.1038/labinvest.2017.26] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Revised: 01/19/2017] [Accepted: 01/26/2017] [Indexed: 02/01/2023] Open
Abstract
The microvascular density detected by markers of endothelial cells (ECs), such as CD31 and CD34, is considered to be a biomarker for angiogenesis, and it is generally associated with the malignant potential of solid tumors. However, there is a conflicting relationship between the microvascular density and prognosis in clear-cell renal cell carcinoma (ccRCC) patients. It may be explained by the suggestion that the microvascular density cannot fully reflect the angiogenic activity in ccRCC, as the markers of ECs are expressed by both quiescent and activated ECs. To investigate the real angiogenic activity, we examined vasohibin-1 (VASH1), a recently identified regulator of angiogenesis, which was demonstrated to be specifically expressed by ECs of newly formed blood vessels. Expression of VASH1 and CD34 were immunohistochemically examined in 116 primary untreated ccRCCs, 10 metastatic untreated ccRCCs, and 9 metastatic ccRCCs treated with sunitinib. ECs in the tumor microvessels were sporadically immunostained for VASH1, although no VASH1 staining was observed in the non-neoplastic renal tissues. CD34 was ubiquitously expressed by all ECs in both ccRCC and non-neoplastic renal tissues. Multivariate Cox analysis indicated that an elevated VASH1 density, but not microvascular density, was a significant and independent predictor of overall survival (odds ratio, 7.71; P=0.003). The microvascular density was significantly decreased in the sunitinib-treated metastases compared with untreated tumors (P=0.001). On the other hand, the VASH1 density was significantly higher in the metastatic ccRCCs treated with sunitinib compared with non-treated ones (P=0.010), indicating that VASH1 may be associated with the resistance of ECs to sunitinib treatment. Thus, VASH1 expression may reflect the actual activity of angiogenesis, and VASH1 can serve as a new prognostic and predictive biomarker in patients with ccRCC.
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Affiliation(s)
- Shuji Mikami
- Division of Diagnostic Pathology, Keio University School of Medicine, Tokyo, Japan
| | - Mototsugu Oya
- Department of Urology, Keio University School of Medicine, Tokyo, Japan
| | - Takeo Kosaka
- Department of Urology, Keio University School of Medicine, Tokyo, Japan
| | - Ryuichi Mizuno
- Department of Urology, Keio University School of Medicine, Tokyo, Japan
| | - Yasumasa Miyazaki
- Department of Urology, Keio University School of Medicine, Tokyo, Japan
| | - Yasufumi Sato
- Department of Vascular Biology, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
| | - Yasunori Okada
- Department of Pathophysiology for Locomotive and Neoplastic Diseases, Juntendo University Graduate School of Medicine, Tokyo, Japan
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14
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Bray LJ, Werner C. Evaluation of Three-Dimensional in Vitro Models to Study Tumor Angiogenesis. ACS Biomater Sci Eng 2017; 4:337-346. [DOI: 10.1021/acsbiomaterials.7b00139] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- Laura J. Bray
- Institute
of Health and Biomedical Innovation, Queensland University of Technology (QUT), 60 Musk Avenue, Kelvin Grove 4059 Queensland Australia
- Mater
Research Institute - University of Queensland (MRI-UQ), Translational Research Institute, 37 Kent Street, Woolloongabba 4102, QLD Australia
| | - Carsten Werner
- Leibniz
Institute of Polymer Research Dresden e.V., Max Bergmann Center of Biomaterials Dresden, Hohe Straße 6, 01069 Dresden, Saxony, Germany
- Center
for Regenerative Therapies Dresden, Technische Universität Dresden, Fetscherstraße 105, 01307 Dresden, Saxony, Germany
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15
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López JI, Erramuzpe A, Guarch R, Cortés JM, Pulido R, Llarena R, Angulo JC. CD34 immunostaining enhances a distinct pattern of intratumor angiogenesis with prognostic implications in clear cell renal cell carcinoma. APMIS 2017; 125:128-133. [PMID: 28120493 DOI: 10.1111/apm.12649] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Accepted: 11/15/2016] [Indexed: 12/12/2022]
Abstract
Clear cell renal cell carcinoma is an aggressive neoplasm related to VHL gene inactivation. The molecular events derived from this initial alteration lead to a permanent intracellular pseudo-hypoxic status that stimulates vascular proliferation. The resulting increased intratumor angiogenesis is the target of most modern therapies. Although intratumor angiogenesis has received full attention in the last years, few studies have focused on its potential importance from a strict morphological approach. Intratumor angiogenesis has been analyzed in a retrospective series of clear cell renal cell carcinomas (n = 208) with long-term follow-up (n = 177). Two different patterns of angiogenesis have been highlighted with CD34 at the front of tumor invasion, termed continuous and discontinuous, respectively. The continuous pattern of angiogenesis showed a complete microvascular network surrounding totally tumor nests. Conversely, the discontinuous pattern displayed an incomplete network around tumor nests. The continuous pattern was associated to shorter 5-year (p = 0.00064, hazard ratio = 2.8) and 15-year (p = 0.014, hazard ratio = 1.7) survivals. Cox regression multivariate analysis also showed that the continuous pattern (p = 0.016373) remains a significant variable when considered together with grade (p = 0.001755) and stage (p = 0.000952). These findings support the notion that a continuous CD34+ pattern of intratumor angiogenesis may be useful for pathologists in predicting tumor behavior in clear cell renal cell carcinomas.
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Affiliation(s)
- José I López
- Department of Pathology, Cruces University Hospital, University of the Basque Country (UPV/EHU), Barakaldo, Bizkaia, Spain.,Biomarkers in Cancer Unit, BioCruces Health Research Institute, Barakaldo, Bizkaia, Spain
| | - Asier Erramuzpe
- Quantitative Biomedicine Unit, BioCruces Health Research Institute, Barakaldo, Bizkaia, Spain
| | - Rosa Guarch
- Department of Pathology, Complejo Hospitalario B de Navarra, Pamplona, Navarra, Spain
| | - Jesús M Cortés
- Quantitative Biomedicine Unit, BioCruces Health Research Institute, Barakaldo, Bizkaia, Spain.,Ikerbasque, Basque Foundation for Science, Bilbao, Bizkaia, Spain.,Department of Cell Biology and Histology, University of the Basque Country (UPV/EHU), Leioa, Bizkaia, Spain
| | - Rafael Pulido
- Biomarkers in Cancer Unit, BioCruces Health Research Institute, Barakaldo, Bizkaia, Spain.,Ikerbasque, Basque Foundation for Science, Bilbao, Bizkaia, Spain
| | - Roberto Llarena
- Department of Urology, Cruces University Hospital, University of the Basque Country (UPV/EHU), Barakaldo, Bizkaia, Spain
| | - Javier C Angulo
- Department of Urology, Hospital de Getafe, Universidad Europea de Madrid, Madrid, Spain
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16
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Mei KC, Bai J, Lorrio S, Wang JTW, Al-Jamal KT. Investigating the effect of tumor vascularization on magnetic targeting in vivo using retrospective design of experiment. Biomaterials 2016; 106:276-85. [PMID: 27573135 PMCID: PMC5027889 DOI: 10.1016/j.biomaterials.2016.08.030] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2016] [Revised: 08/15/2016] [Accepted: 08/17/2016] [Indexed: 02/09/2023]
Abstract
Nanocarriers take advantages of the enhanced permeability and retention (EPR) to accumulate passively in solid tumors. Magnetic targeting has shown to further enhance tumor accumulation in response to a magnetic field gradient. It is widely known that passive accumulation of nanocarriers varies hugely in tumor tissues of different tumor vascularization. It is hypothesized that magnetic targeting is likely to be influenced by such factors. In this work, magnetic targeting is assessed in a range of subcutaneously implanted murine tumors, namely, colon (CT26), breast (4T1), lung (Lewis lung carcinoma) cancer and melanoma (B16F10). Passively- and magnetically-driven tumor accumulation of the radiolabeled polymeric magnetic nanocapsules are assessed with gamma counting. The influence of tumor vasculature, namely, the tumor microvessel density, permeability and diameter on passive and magnetic tumor targeting is assessed with the aid of the retrospective design of experiment (DoE) approach. It is clear that the three tumor vascular parameters contribute greatly to both passive and magnetically targeted tumor accumulation but play different roles when nanocarriers are targeted to the tumor with different strategies. It is concluded that tumor permeability is a rate-limiting factor in both targeting modes. Diameter and microvessel density influence passive and magnetic tumor targeting, respectively.
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Affiliation(s)
- Kuo-Ching Mei
- Institute of Pharmaceutical Science, Faculty of Life Sciences & Medicine, King's College London, London, SE1 9NH, United Kingdom
| | - Jie Bai
- Institute of Pharmaceutical Science, Faculty of Life Sciences & Medicine, King's College London, London, SE1 9NH, United Kingdom
| | - Silvia Lorrio
- Division of Imaging Sciences and Biomedical Engineering, King's College London, King's Health Partners, St. Thomas' Hospital, SE1 7EH, United Kingdom
| | - Julie Tzu-Wen Wang
- Institute of Pharmaceutical Science, Faculty of Life Sciences & Medicine, King's College London, London, SE1 9NH, United Kingdom
| | - Khuloud T Al-Jamal
- Institute of Pharmaceutical Science, Faculty of Life Sciences & Medicine, King's College London, London, SE1 9NH, United Kingdom.
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17
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Nestin expression on tumour vessels and tumour-infiltrating macrophages define a poor prognosis subgroup of pt1 clear cell renal cell carcinoma. Virchows Arch 2016; 469:331-7. [PMID: 27311769 DOI: 10.1007/s00428-016-1973-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Revised: 04/27/2016] [Accepted: 06/08/2016] [Indexed: 02/07/2023]
Abstract
The behaviour of clear cell renal cell carcinoma (CCRCC) is highly unpredictable. Despite adequate initial surgery, 20 to 30 % of patients will develop local recurrence or metastasis during follow-up. Usual clinical and pathology parameters tend to classify most patients in an intermediate prognosis group, and molecular markers to determine prognosis more accurately are needed. A key feature of CCRCC is its abundant vascularization. Factors that upregulate angiogenesis, such as hypoxia and the presence of immune cells including macrophages, also modulate tumour proliferation and metastasis. We studied angiogenesis, as defined by nestin-positive capillaries, and tumour infiltration by macrophages especially in the good prognosis pT1 subgroup of CCRCC. We assessed whether these parameters are associated with metastatic extension and survival in CCRCC. The expression of HIF1α, CAIX, nestin, CD68 and CD163 was assessed by immunohistochemistry on a tissue microarray (TMA) containing tissue samples from 257 consecutive patients with sporadic CCRCC. Factors associated with progression-free (PFS) and overall survival (OS) were analysed. The presence of nestin-positive tumour vessels was independently associated with shorter PFS in the whole cohort and in the pT1 subgroup. The presence of tumour-infiltrating macrophages was independently associated with shorter OS in the whole cohort and in the pT1 subgroup. The presence of nestin-positive endothelial cells is associated with early relapse, especially in the pT1 subgroup and may help to select patients for antiangiogenic treatment. The presence of tumour-infiltrating M2-type macrophages is a strong predictor of short survival and may be used to adapt treatment strategy.
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18
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Low G, Huang G, Fu W, Moloo Z, Girgis S. Review of renal cell carcinoma and its common subtypes in radiology. World J Radiol 2016; 8:484-500. [PMID: 27247714 PMCID: PMC4882405 DOI: 10.4329/wjr.v8.i5.484] [Citation(s) in RCA: 96] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Revised: 01/20/2016] [Accepted: 03/09/2016] [Indexed: 02/06/2023] Open
Abstract
Representing 2%-3% of adult cancers, renal cell carcinoma (RCC) accounts for 90% of renal malignancies and is the most lethal neoplasm of the urologic system. Over the last 65 years, the incidence of RCC has increased at a rate of 2% per year. The increased incidence is at least partly due to improved tumor detection secondary to greater availability of high-resolution cross-sectional imaging modalities over the last few decades. Most RCCs are asymptomatic at discovery and are detected as unexpected findings on imaging performed for unrelated clinical indications. The 2004 World Health Organization Classification of adult renal tumors stratifies RCC into several distinct histologic subtypes of which clear cell, papillary and chromophobe tumors account for 70%, 10%-15%, and 5%, respectively. Knowledge of the RCC subtype is important because the various subtypes are associated with different biologic behavior, prognosis and treatment options. Furthermore, the common RCC subtypes can often be discriminated non-invasively based on gross morphologic imaging appearances, signal intensity on T2-weighted magnetic resonance images, and the degree of tumor enhancement on dynamic contrast-enhanced computed tomography or magnetic resonance imaging examinations. In this article, we review the incidence and survival data, risk factors, clinical and biochemical findings, imaging findings, staging, differential diagnosis, management options and post-treatment follow-up of RCC, with attention focused on the common subtypes.
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19
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Ogul H, Bayraktutan U, Kizrak Y, Pirimoglu B, Yuceler Z, Sagsoz ME, Yilmaz O, Aydinli B, Ozturk G, Kantarci M. Abdominal perfusion computed tomography. Eurasian J Med 2015; 45:50-7. [PMID: 25610249 DOI: 10.5152/eajm.2013.09] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2012] [Accepted: 06/16/2012] [Indexed: 01/03/2023] Open
Abstract
The purpose of this article is to provide an up to date review on the spectrum of applications of perfusion computed tomography (CT) in the abdomen. New imaging techniques have been developed with the objective of obtaining a structural and functional analysis of different organs. Recently, perfusion CT has aroused the interest of many researchers who are studying the applicability of imaging modalities in the evaluation of abdominal organs and diseases. Per-fusion CT enables fast, non-invasive imaging of the tumor vascular physiology. Moreover, it can act as an in vivo biomarker of tumor-related angiogenesis.
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Affiliation(s)
- Hayri Ogul
- Department of Radiology, School of Medicine, Atatürk University, Erzurum, Turkey
| | | | - Yesim Kizrak
- Department of Radiology, School of Medicine, Atatürk University, Erzurum, Turkey
| | - Berhan Pirimoglu
- Department of Radiology, School of Medicine, Atatürk University, Erzurum, Turkey
| | - Zeynep Yuceler
- Department of Radiology, School of Medicine, Atatürk University, Erzurum, Turkey
| | - M Erdem Sagsoz
- Department of Biophysics, School of Medicine, Atatürk University, Erzurum, Turkey
| | - Omer Yilmaz
- Department of General Surgery, School of Medicine, Atatürk University, Erzurum, Turkey
| | - Bulent Aydinli
- Department of General Surgery, School of Medicine, Atatürk University, Erzurum, Turkey
| | - Gurkan Ozturk
- Department of General Surgery, School of Medicine, Atatürk University, Erzurum, Turkey
| | - Mecit Kantarci
- Department of Radiology, School of Medicine, Atatürk University, Erzurum, Turkey
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Qiao PG, Huang Q, Zhou J, Wang XC, Li M, Ma JL, Tian N, Li GJ. Feasibility of quantitative parameters of dynamically enhanced patterns of spiral computed tomography scanning integrated into tumour progression before targeted treatment of non-small cell lung cancer. J Med Imaging Radiat Oncol 2015; 59:216-20. [PMID: 25597329 DOI: 10.1111/1754-9485.12277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2014] [Accepted: 12/03/2014] [Indexed: 11/29/2022]
Abstract
INTRODUCTION The relationship between quantitative parameters of contrast-enhanced computed tomography (CT) and non-small cell lung cancer (NSCLC) progression remains controversial. We aimed to explore the usefulness of contrast-enhanced spiral CT scanning for confirming the time of tumour progression before targeted treatment of NSCLC. METHODS Contrast-enhanced spiral CT scanning was performed on 33 NSCLC patients with a biopsy-proven diagnosis of NSCLC. All the patients were divided into three groups according to times of tumour progression (<6 weeks, 6-20 weeks, and >20 weeks). The perfusion CT data were used to calculate quantitative parameters, including enhanced peak values, peak time of tumour enhancement, ratio of tumour mass and enhanced aorta peak value and perfusion value of blood flow. Variance analysis was used for statistical analysis among the three groups using SAS 9.13 statistical software. RESULTS Tumour perfusion values among the three group with different stage of TTP were significantly different from each other with P = 0.0129 (<6 weeks, perfusion value = 0.35 ± 0.15 mL/(min × mL); 6-20 weeks, perfusion value = 0.41 ± 0.086 mL/(min × mL); > 20 weeks, perfusion value = 0.47 ± 0.087 mL/(min × mL)). However, no significant differences were found in other parameters (enhanced peak values, peak time of tumour enhancement, ratios of tumour mass, and enhanced aorta peak value) among three groups (P > 0.05). CONCLUSION The NSCLC patients with high perfusion value before targeted therapy are more sensitive to targeted therapy, and further experiments with larger sample size are needed.
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Affiliation(s)
- Peng-Gang Qiao
- Department of Radiology, Affiliated Hospital of the Academy of Military Medical Sciences, Beijing, China
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Time-intensity curve parameters in rectal cancer measured using endorectal ultrasonography with sterile coupling gels filling the rectum: correlations with tumor angiogenesis and clinicopathological features. BIOMED RESEARCH INTERNATIONAL 2014; 2014:587806. [PMID: 24900973 PMCID: PMC4036556 DOI: 10.1155/2014/587806] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/25/2014] [Accepted: 04/20/2014] [Indexed: 02/08/2023]
Abstract
The primary aim of this study was to investigate the relationship between contrast-enhanced ultrasonography (CEUS) imaging parameters and clinicopathological features of rectal carcinoma and assess their potential as new radiological prognostic predictors. A total of 66 rectal carcinoma patients were analyzed with the time-intensity curve of CEUS. The parameter arrival time (AT), time to peak enhancement (TTP), wash-in time (WIT), enhanced intensity (EI), and ascending slope (AS) were measured. Microvessel density (MVD) was evaluated by immunohistochemical staining of surgical specimens. All findings were analysed prospectively and correlated with tumor staging, histological grading, and MVD. The mean values of AT, TTP, WIT, EI, and AS value of the rectal carcinoma were 10.84 ± 3.28 s, 20.61 ± 5.52 s, 9.78 ± 2.83 s, 28.68 ± 4.67 dB, and 3.20 ± 1.10, respectively. A positive linear correlation was found between the EI and MVD in rectal carcinoma (r = 0.295, P = 0.016), and there was a significant difference for EI among histological grading (r = -0.264, P = 0.007). EI decreased as T stage increased with a trend of association noted (P = 0.096). EI of contrast enhanced endorectal ultrasonography provides noninvasive biomarker of tumor angiogenesis in rectal cancer. CEUS data have the potential to predict patient prognosis.
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Efficacy and safety of sunitinib in elderly patients with metastatic renal cell carcinoma. Br J Cancer 2014; 110:1125-32. [PMID: 24434434 PMCID: PMC3950861 DOI: 10.1038/bjc.2013.832] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2013] [Revised: 12/16/2013] [Accepted: 12/17/2013] [Indexed: 12/13/2022] Open
Abstract
Background: We retrospectively analyzed sunitinib outcome as a function of age in metastatic renal cell carcinoma (mRCC) patients. Methods: Data were pooled from 1059 patients in six trials. Kaplan–Meier estimates of progression-free survival (PFS) and overall survival (OS) were compared by log-rank test between patients aged <70 (n=857; 81%) and ⩾70 (n=202; 19%) years. Results: In first-line patients, median PFS was comparable in younger and older patients, 9.9 vs 11.0 months, respectively (HR, 0.89; 95% CI: 0.73–1.09; P=0.2629), as was median OS, 23.6 vs 25.6 months (HR, 0.93; 95% CI: 0.74–1.18; P=0.5442). Similarly, in cytokine-refractory patients, median PFS was 8.1 vs 8.4 months (HR, 0.79; 95% CI: 0.49–1.28; P=0.3350), while median OS was 20.2 vs 15.8 months (HR, 1.14; 95% CI: 0.73–1.79; P=0.5657). Some treatment-emergent adverse events were significantly less common in younger vs older patients, including fatigue (60% vs 69%), cough (20% vs 29%), peripheral edema (17% vs 27%), anemia (18% vs 25%), decreased appetite (13% vs 29%), and thrombocytopenia (16% vs 25% all P<0.05). Hand–foot syndrome was more common in younger patients (32% vs 24%). Conclusions: Advanced age should not be a deterrent to sunitinib therapy and elderly patients may achieve additional clinical benefit.
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Belsante M, Darwish O, Youssef R, Bagrodia A, Kapur P, Sagalowsky AI, Lotan Y, Margulis V. Lymphovascular invasion in clear cell renal cell carcinoma—Association with disease-free and cancer-specific survival. Urol Oncol 2014; 32:30.e23-8. [DOI: 10.1016/j.urolonc.2012.11.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2012] [Revised: 10/14/2012] [Accepted: 11/07/2012] [Indexed: 11/16/2022]
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Lack of association of microvessel density with prognosis of renal cell carcinoma: evidence from meta-analysis. Tumour Biol 2013; 35:2769-76. [DOI: 10.1007/s13277-013-1367-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2013] [Accepted: 10/28/2013] [Indexed: 01/15/2023] Open
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Computed tomography perfusion imaging of renal cell carcinoma: systematic comparison with histopathological angiogenic and prognostic markers. Invest Radiol 2013; 48:183-91. [PMID: 23328912 DOI: 10.1097/rli.0b013e31827c63a3] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE The aim of this study was to systematically analyze the correlation between computed tomography (CT) perfusion and histopathological angiogenic and prognostic markers in patients with renal cell carcinoma (RCC). MATERIAL AND METHODS Fifteen patients (12 men; mean age, 64.5 ± 9.4 years) with RCC underwent contrast-enhanced CT perfusion imaging (scan range, 10 cm; scan time, 40 seconds; dual-source 128-section CT) 1 day before surgery. The procedure for surgical specimen processing was modified to obtain an exact match with CT images. Microvessel density (MVD) was quantified by CD34 staining, and lymphatic vessel density (LVD) was stained with D2-40 antibodies. The CT perfusion values blood flow (BF), blood volume (BV), and flow extraction product (K(Trans)) were calculated using the maximum-slope and a delay-corrected modified Patlak approach and were correlated to MVD and LVD. The relationship between CT perfusion and the prognostic markers pT stage, Fuhrman grade, and tumor necrosis was evaluated. RESULTS Histopathology revealed varying high MVD but low or absent intratumoral LVD. The BF and BV of RCC, both including and excluding necrotic regions, showed significant correlations with MVD (r = 0.600-0.829, P < 0.05 each). Significant correlations between MVD and K(Trans) were found only in small tumor areas exhibiting no necrosis (r = 0.550, P < 0.05). No significant correlation was found between BF, BV, and K(Trans) with intratumoral LVD (P = 0.35-0.82). With higher pT stage and Fuhrman grade, BF, BV, and K(Trans) were lower, similar to the MVD, but without reaching statistical significance. Blood flow, BV, and K(Trans) were significantly higher in RCCs with less than 50% necrosis than in those with 50% or grater necrosis (P < 0.05 each). CONCLUSION Our study indicates that BF and BV from CT perfusion reflect blood vessels of RCC. Computed tompgraphic perfusion parameters differ significantly depending upon the degree of tumor necrosis.
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Kanomata N, Sato Y, Miyaji Y, Nagai A, Moriya T. Vasohibin-1 is a new predictor of disease-free survival in operated patients with renal cell carcinoma. J Clin Pathol 2013; 66:613-9. [DOI: 10.1136/jclinpath-2013-201444] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundVasohibin-1 (VASH1) is an endothelium-produced angiogenesis inhibitor. Renal cell carcinoma is highly vascularised, but the significance of endogenous VASH1 in renal cell carcinoma has not been defined.AimsTo identify VASH1 expression and its possible relationship with various clinicopathological factors and prognosis in renal cell carcinoma.MethodsA retrospective analysis of 122 tumours obtained from 118 consecutive patients with renal cell carcinoma was performed. The expression patterns of VASH1, CD31, vascular endothelial growth factor (VEGF) and VEGF receptor type 2 (VEGFR2) were examined immunohistochemically and their relationships with clinicopathological factors were analysed.ResultsMicrovessel density, VASH1 and VEGFR2 expression were significantly higher in clear cell carcinoma than in other subtypes. The VEGF expression pattern differed significantly between clear cell carcinoma and other histological subtypes. VASH1, pT factor and TNM stage were significantly associated with disease-free survival (p=0.030, p = 0.0012 and p = 0.0018, respectively). Cox models of multivariable disease-free survival analyses indicated that VASH1 and stage are independent prognostic factors (p=0.019 and p = 0.024).ConclusionsVASH1 expression may be useful for estimating the prognosis of renal cell carcinoma. Further studies of the role of VASH1 in renal cell carcinoma involving larger sample sizes are warranted.
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Abstract
OBJECTIVE To investigate whether the microRNA-21 gene (miR-21) could regulate renal cancer cells invasion by downregulation of TFC21 and KISS1. METHODS Quantitative real-time polymerase chain reaction was applied to evaluate the expression level of miRNA-21 in renal cancer and normal renal cell samples. The regulated effects of miR-21 to TCF21 were detected by Western blot after pre/anti-miR-21 was transfected to Caki-1 cells. The luciferase activity assay was used to reveal the predicted target gene of miR-21 was direct and specific. Small interfering RNA-TCF21 was transfected to Caki-1 cells to inhibit the expression of the TCF21 gene. Next, the expression of the KISS1 gene was detected by Western blot in Caki-1 cells with TCF21 gene silencing. The expression vector, pcDNA3.1-KISS1, was transfected to Caki-1 cells to upregulate the expression of the KISS1 gene. The invasion ability of Caki-1 cells with KISS1 overexpression was analyzed using the Transwell assay. RESULTS Our study showed that miR-21 was upregulated in human renal cell carcinoma specimens compared with its expression in normal renal cell specimens. Pre-miR-21 could upregulate the expression of miR-21 and downregulate the expression of TCF21, and anti-miR-21 showed the opposite effects. siRNA-TCF21 decreased the expression of the TCF21 protein, and the expression of KISS1 was downregulated in Caki-1 cells with TCF21 gene silencing. pcDNA3.1-KISS1 transfection upregulated the expression of the KISS1 protein, and the invasion ability of Caki-1 cells with KISS1 overexpression decreased markedly. CONCLUSION Aberrantly expressed miR-21 might regulate the TCF21-KISS1-associated renal cell carcinoma cell invasion pathway, and this miRNA signature could offer a novel potential therapeutic strategy for renal cell carcinoma.
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Shindo T, Masumori N, Kobayashi K, Fukuta F, Hirobe M, Tonooka A, Hasegawa T, Kitamura H, Tsukamoto T. Long-term outcome of small, organ-confined renal cell carcinoma (RCC) is not always favourable. BJU Int 2013; 111:941-5. [DOI: 10.1111/j.1464-410x.2012.11771.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Tetsuya Shindo
- Department of Urology; Sapporo Medical University School of Medicine; Sapporo Japan
| | - Naoya Masumori
- Department of Urology; Sapporo Medical University School of Medicine; Sapporo Japan
| | - Ko Kobayashi
- Department of Urology; Sapporo Medical University School of Medicine; Sapporo Japan
| | - Fumimasa Fukuta
- Department of Urology; Sapporo Medical University School of Medicine; Sapporo Japan
| | - Megumi Hirobe
- Department of Urology; Sapporo Medical University School of Medicine; Sapporo Japan
| | - Akiko Tonooka
- Department of Urology; Sapporo Medical University School of Medicine; Sapporo Japan
| | - Tadashi Hasegawa
- Department of Surgical Pathology; Sapporo Medical University School of Medicine; Sapporo Japan
| | - Hiroshi Kitamura
- Department of Urology; Sapporo Medical University School of Medicine; Sapporo Japan
| | - Taiji Tsukamoto
- Department of Urology; Sapporo Medical University School of Medicine; Sapporo Japan
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Eisenberg MS, Cheville JC, Thompson RH, Kaushik D, Lohse CM, Boorjian SA, Costello BA, Leibovich BC. Association of microvascular and capillary-lymphatic invasion with outcome in patients with renal cell carcinoma. J Urol 2013; 190:37-43. [PMID: 23353044 DOI: 10.1016/j.juro.2013.01.044] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/16/2013] [Indexed: 11/15/2022]
Abstract
PURPOSE We evaluated the association of microvascular and capillary-lymphatic invasion with patient outcome after nephrectomy for renal cell carcinoma. MATERIALS AND METHODS We identified 1,433 patients surgically treated for sporadic, unilateral renal cell carcinoma between 2001 and 2008. All specimens were reviewed by a single uropathologist for microvascular and capillary-lymphatic invasion. Associations with time to metastasis and death from renal cell carcinoma were evaluated using Cox proportional hazards models, controlling for established clinicopathological prognostic variables. RESULTS Microvascular invasion and capillary-lymphatic invasion were identified in 119 (11%) and 17 (2%) of the 1,103 patients with clear cell, 5 (2%) and 1 (less than 1%) of the 219 with papillary, and 1 (1%) and 0 of the 86 with chromophobe renal cell carcinoma, respectively. Median followup in survivors was 6.4 years (range 0 to 11). In clear cell renal cell carcinoma cases microvascular invasion was univariately associated with an increased risk of metastasis and cancer specific death (HR 3.5 and 3.0, respectively, each p <0.001). However, on multivariate analysis these associations were no longer statistically significant (HR 1.2, p = 0.4 and HR 1.3, p = 0.1, respectively). Capillary-lymphatic invasion remained significantly associated with an increased risk of metastasis and death on univariate analysis (HR 15.9 and 11.6) and on multivariate analysis (HR 3.2 and HR 3.1, respectively, each p <0.001). CONCLUSIONS Microvascular invasion is associated with an increased risk of metastasis and cancer death in patients with clear cell renal cell carcinoma, although this did not remain significant after controlling for established prognostic variables. Capillary-lymphatic invasion appears to be independently associated with metastasis and cancer death even after controlling for known prognostic risk factors. However, given its rarity, this feature may prove to be of limited clinical significance.
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Aziz SA, Sznol J, Adeniran A, Colberg JW, Camp RL, Kluger HM. Vascularity of primary and metastatic renal cell carcinoma specimens. J Transl Med 2013; 11:15. [PMID: 23316728 PMCID: PMC3561185 DOI: 10.1186/1479-5876-11-15] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2012] [Accepted: 01/09/2013] [Indexed: 12/11/2022] Open
Abstract
Purpose Anti-angiogenic therapies are among the most commonly used drugs in renal cell carcinoma. Tumor vascularity, defined by microvessel area, may be associated with response to these drugs. Clinical studies suggest that metastatic sites are more responsive than primary tumors. Our purpose was to characterize microvessel area (MVA) in matched primary and metastatic samples and in samples of different histologies. Methods We employed a method of automated, quantitative analysis of in situ tumor components to identify the area of CD-34 staining endothelial cells within renal cell carcinoma tumors. MVA was assessed in corresponding primary and metastatic samples from 34 patients, as well as in 334 primary nephrectomy specimens with variable histologies. Results MVA measurements from different parts of the same tumor correlated well (R = 0.75), indicating that MVA was fairly uniform within a tumor. While MVA was slightly higher in primary tumors than corresponding metastatic sites, the difference was not statistically significant (P = 0.1). MVA in paired primary and metastatic samples correlated moderately well (R = 0.36). MVA was higher in clear cell than papillary histology and oncocytomas (P < 0.0001 and P = 0.018, respectively). Conclusions Lack of significant differences MVA in matched primary and metastatic samples suggests that both types of tumors should respond to anti-angiogenic drugs. This should be confirmed on additional cohorts. Given the small cohort, future predictive biomarker studies entailing MVA measurements should include specimens from both sites. Clear cell carcinomas are more vascular than other histologic subtypes, which may explain the higher response rates to anti-angiogenic therapies in clear cell tumors.
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Affiliation(s)
- Saadia A Aziz
- Department of the School of Medicine, Yale University School of Medicine, New Haven, CT, USA
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Ippolito D, Capraro C, Guerra L, De Ponti E, Messa C, Sironi S. Feasibility of perfusion CT technique integrated into conventional 18FDG/PET-CT studies in lung cancer patients: clinical staging and functional information in a single study. Eur J Nucl Med Mol Imaging 2013; 40:156-65. [PMID: 23143661 DOI: 10.1007/s00259-012-2273-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2012] [Accepted: 10/04/2012] [Indexed: 02/08/2023]
Abstract
PURPOSE To assess the additional functional vascular information and the relationship between perfusion measurements and glucose metabolism (SUVmax) obtained by including a perfusion CT study in a whole-body contrast-enhanced PET/CT protocol in primary lung cancer lesions. METHODS Enrolled in this prospective study were 34 consecutive patients with a biopsy-proven diagnosis of lung cancer who were referred for contrast-enhanced PET/CT staging. This prospective study was approved by our institutional review board, and informed consent was obtained from all patients. Perfusion CT was performed with the following parameters: 80 kV, 200 mAs, 30 scans during intravenous injection of 50 ml contrast agent, flow rate 5 ml/s. Another bolus of contrast medium (3.5 ml/s, 80 ml, 60-s delay) was administered to ensure a full diagnostic contrast-enhanced CT scan for clinical staging. The perfusion CT data were used to calculate a range of tumour vascularity parameters (blood flow, blood volume and mean transit time), and tumour FDG uptake (SUVmax) was used as a metabolic indicator. Quantitative and functional parameters were compared and in relation to location, histology and tumour size. The nonparametric Kruskal-Wallis rank sum test was used for statistical analysis. RESULTS A cut-off value of 3 cm was used according to the TNM classification to discriminate between T1 and T2 tumours (i.e. T1b vs. T2a). There were significant perfusion differences (lower blood volumes and higher mean transit time) between tumours with diameter >30 mm and tumours with diameter <30 mm (p < 0.05; blood volume 5.6 vs. 7.1 ml/100 g, mean transit time 8.6 vs. 3.9 s, respectively). Also there was a trend for blood flow to be lower in larger lesions (p < 0.053; blood flow 153.1 vs. 98.3 ml/100 g tissue/min). Significant inverse correlations (linear regression) were found between blood volume and SUVmax in tumours with diameter >30 mm in diameter. CONCLUSION Perfusion CT combined with PET/CT is feasible technique that may provide additional functional information about vascularity and tumour aggressiveness as a result of lower perfusion and higher metabolism shown by larger lesions.
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Affiliation(s)
- Davide Ippolito
- School of Medicine, University of Milano-Bicocca, Milan, Italy.
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High Level of Circulating Endothelial Progenitor Cells Positively Correlates with Serum Vascular Endothelial Growth Factor in Patients with Renal Cell Carcinoma. J Urol 2012; 188:2055-61. [PMID: 23088990 DOI: 10.1016/j.juro.2012.08.039] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2012] [Indexed: 12/12/2022]
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Zhan HL, Gao X, Zhou XF, Pu XY, Wang DJ. Presence of tumour-infiltrating FOXP3+ lymphocytes correlates with immature tumour angiogenesis in renal cell carcinomas. Asian Pac J Cancer Prev 2012; 13:867-72. [PMID: 22631663 DOI: 10.7314/apjcp.2012.13.3.867] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND FOXP3+ regulatory T cells (Tregs) inhibit effector T cell functions and are implicated in tumour progression. However, together with microvessel density (MVD) they remain controversial prognostic predictors for renal cell carcinoma (RCC), and potential associations have yet to be determined. The objective of this study was to determine the prognostic significance of Tregs and MVD and their potential relationship in RCCs. DESIGN Paraffin-embedded tissues from 62 RCC patients were analysed using immunohistochemistry to detect FOXP3+ lymphocytes, and double immunohistochemistry to detect different microvessel types in the tumour interior, rim and normal kidney tissue, and their correlation with clinicopathological characteristics. Survival analysis was also performed. RESULTS The presence of FOXP3+ cells in the tumour interior or the rim showed no correlation with death from RCC and other pathological characteristics. Negative correlations were noted between the immature MVD in the tumour interior or the rim and tumour size, tumour stage and overall survival; however, there was no correlation with the nuclear grade or pathological type. A positive correlation between FOXP3+ Tregs and immature MVD (r=0.363, P=0.014) and mature MVD (r=0.383, P=0.009) was confirmed in the tumour interior. However, there was no correlation between FOXP3+ Tregs and mature MVD (r=0.281, P=0.076) or immature MVD (r=0.064, P=0.692) in the tumour rim. CONCLUSIONS In this study, a positive correlation between the presence of FOXP3+ Tregs and immature and mature MVD in RCC was confirmed, which suggests a link between suppression of immunity, tumour angiogenesis and poor prognosis.
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Affiliation(s)
- Hai-Lun Zhan
- Department of Urology, the Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
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Mechanism of growth inhibition of prostate cancer xenografts by valproic acid. J Biomed Biotechnol 2012; 2012:180363. [PMID: 23093837 PMCID: PMC3471003 DOI: 10.1155/2012/180363] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2012] [Revised: 07/16/2012] [Accepted: 07/17/2012] [Indexed: 12/23/2022] Open
Abstract
Valproic Acid (VPA), a histone deacetylase inhibitor, has been demonstrated to cause a marked decrease in proliferation of prostate cancer (PCa) cells in vitro and a significant reduction in tumor volume in vivo. The goal of this study is to better understand the VPA-induced growth inhibition in vivo, by studying expression of various markers in PCa xenografts. Methods. For in vitro experiments, PCa cells were treated with 0, 0.6, and 1.2 mM VPA for 14 days. For in vivo models, experimental animals received 0.4% VPA in drinking water for 35 days. Tissue microarray was generated using cell pellets and excised xenografts. Results. VPA treatment causes cell cycle arrest in PCa cells in vivo, as determined by increase in p21 and p27 and decrease in cyclin D1 expression. Increased expression of cytokeratin18 was also seen in xenografts. LNCaP xenografts in treated animals had reduced androgen receptor (AR) expression. While decreased proliferation was found in vitro, increase in apoptosis was found to be the reason for decreased tumor growth in vivo. Also, an anti-angiogenic effect was observed after VPA treatment. Conclusion. VPA inhibits tumor growth by multiple mechanisms including cell cycle arrest, induction of differentiation, and inhibition of growth of tumor vasculature.
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Zhao G, Yang Y, Tang Y, Han R, Sun Y. Reduced expression of vasohibin-1 is associated with clinicopathological features in renal cell carcinoma. Med Oncol 2012; 29:3325-34. [PMID: 22865127 DOI: 10.1007/s12032-012-0313-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2012] [Accepted: 07/16/2012] [Indexed: 12/25/2022]
Abstract
Vasohibin-1(VASH1) has recently been isolated as a novel negative feedback inhibitor of angiogenesis. Several studies have demonstrated that VASH1 plays important roles in tumor angiogenesis but the role of this angiogenic inhibitor in renal cell carcinoma (RCC) has not been elucidated until now. In this study, we investigated the expression pattern of VASH1 and the association with clinicopathological features in RCC. Expression of VASH1, hypoxia-inducible factor-1α (HIF-1α), and microvessel density (MVD, labeled by CD34) was assessed by immunohistochemistry in 46 RCC specimens and 20 adjacent nontumorous renal tissues (ANRTs). Correlation between vasohibin-1 and HIF-1α, MVD, and clinicopathological features was then investigated. In RCC, VASH1 was expressed mainly in the cytoplasm and membrane of tumor cells and partly in vascular endothelial cells. In ANRT, it was mainly expressed in the cytoplasm and membrane of renal tubular epithelial cells and partly in vascular endothelial cells and glomerular mesangial cells. The expression level of VASH1 in RCC tissue was significantly lower than that in ANRT and was significantly reduced with the increased degree of malignancy in RCC tissues. In addition, a significantly negative correlation was noted between VASH1 expression and HIF-1α expression and a significantly negative correlation was noted between VASH1 expression and MVD in RCC. Therefore, VASH1 expression is reduced and it associates with clinicopathological features in RCC. Based on our findings and the knowledge of other angiogenesis inhibitors, we postulate that VASH1 would potentially be a biomarker and a candidate for molecular targeted therapy for patients with RCC in the future.
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Affiliation(s)
- Guangning Zhao
- Tianjin Institute of Urology, Department of Urology, Second Hospital of Tianjin Medical University, no 23, Pingjiang Road, Hexi District, Tianjin, China
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Angiogenesis and Expression of Vascular Endothelial Growth Factor, Tumour Necrosis Factor-α and Hypoxia Inducible Factor-1α in Canine Renal Cell Carcinoma. J Comp Pathol 2012; 147:129-38. [DOI: 10.1016/j.jcpa.2011.12.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2011] [Revised: 11/15/2011] [Accepted: 12/09/2011] [Indexed: 10/14/2022]
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Wang Y, Mao H, Hao Q, Wang Y, Yang Y, Shen L, Huang S, Liu P. Association of expression of XIAP-associated factor 1 (XAF1) with clinicopathologic factors, overall survival, microvessel density and cisplatin-resistance in ovarian cancer. ACTA ACUST UNITED AC 2012; 178:36-42. [PMID: 22759793 DOI: 10.1016/j.regpep.2012.06.005] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2012] [Revised: 05/30/2012] [Accepted: 06/20/2012] [Indexed: 11/17/2022]
Abstract
XIAP-associated factor 1 (XAF1) was identified as a novel X-linked inhibitor of apoptosis (XIAP) binding partner that can reverse the anti-apoptotic effect of XIAP. XAF1 levels are greatly decreased in many cancer tissues and cell lines. The aim of this study was to investigate the expression of XAF1 and XIAP in advanced epithelial ovarian cancer and role of XAF1 in cisplatin resistance of ovarian cancer cells. Tissues from 94 patients with advanced epithelial ovarian cancer (EOC) and 30 ovarian cystadenomas were obtained. We analyzed the association of the immunohistochemical-determined expression of these two factors and clinicopathologic variables, overall survival, and angiogenesis. We established SKOV3 cells stably overexpressing XAF1 and explored the possible functions of XAF1 in ovarian cancer cells in vitro and in vivo. The protein expression of XAF1 was significantly lower and that of XIAP higher in malignant than nonmalignant tissues. Low XAF1 expression was associated with high-grade tumors and poor overall survival for patients. XAF1 expression was associated with microvessel density. Overexpression of XAF1 suppressed cell proliferation and enhanced SKOV3 cells sensitivity to cisplatin, as well as inhibited tumor growth and decreased MVD in vivo. Overexpression of XAF1 induced XIAP inactivation, caspase-3 activation and cytosolic expression of cytochrome c. These results suggested that XAF1 may be involved in ovarian cancer development and up-regulation of XAF1 may confer sensitivity of ovarian cancer cells to cisplatin-mediated apoptosis.
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MESH Headings
- Adaptor Proteins, Signal Transducing
- Adult
- Aged
- Animals
- Antineoplastic Agents/pharmacology
- Apoptosis/drug effects
- Apoptosis Regulatory Proteins
- Carcinoma, Ovarian Epithelial
- Caspase 3/metabolism
- Cell Line, Tumor
- Cell Proliferation
- Cisplatin/pharmacology
- Cystadenoma/metabolism
- Cystadenoma/pathology
- Drug Resistance, Neoplasm
- Female
- Humans
- Intracellular Signaling Peptides and Proteins/genetics
- Intracellular Signaling Peptides and Proteins/metabolism
- Kaplan-Meier Estimate
- Mice
- Mice, Inbred BALB C
- Mice, Nude
- Microvessels/pathology
- Middle Aged
- Neoplasm Grading
- Neoplasm Proteins/genetics
- Neoplasm Proteins/metabolism
- Neoplasm Transplantation
- Neoplasms, Glandular and Epithelial/drug therapy
- Neoplasms, Glandular and Epithelial/metabolism
- Neoplasms, Glandular and Epithelial/mortality
- Neoplasms, Glandular and Epithelial/pathology
- Ovarian Neoplasms/drug therapy
- Ovarian Neoplasms/metabolism
- Ovarian Neoplasms/mortality
- Ovarian Neoplasms/pathology
- Tumor Burden
- X-Linked Inhibitor of Apoptosis Protein/metabolism
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Affiliation(s)
- YunXia Wang
- Department of Obstetrics and Gynecology, Qilu Hospital, Shandong University, Wenhua Xi Road 107, Jinan 250012, Shandong Province, China
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38
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Microvessel density is high in clear-cell renal cell carcinomas of Ukrainian patients exposed to chronic persistent low-dose ionizing radiation after the Chernobyl accident. Virchows Arch 2012; 460:611-9. [PMID: 22581103 DOI: 10.1007/s00428-012-1243-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2011] [Revised: 03/26/2012] [Accepted: 04/26/2012] [Indexed: 12/27/2022]
Abstract
During the 25-year period subsequent to the Chernobyl accident, the morbidity of malignant renal tumors in Ukraine has increased from 4.7 to 10.7 per 100,000 of the total population. Recent studies of our group have shown that increases in morbidity, aggressiveness, and proliferative activity of renal cell carcinomas (RCCs), especially clear-cell renal cell carcinoma (CCRCC), in Ukrainian patients continuously inhabiting the radio-contaminated areas could be explained by specific molecular changes influenced by the so-called "chronic persistent low-dose ionizing radiation" (CPLDIR) exposure. This study aimed to examine the role of angiogenesis in CCRCC carcinogenesis associated with CPLDIR in patients living more than 20 years in cesium 137 ((137)Cs) contaminated areas after the Chernobyl accident in Ukraine. Paraffin-embedded specimens of 106 CCRCs were studied: Control cases were 18 tumors from Spanish patients (group 1), 25 tumors from Ukrainian patients from so-called clean areas without known radio-contamination (group 2), and 63 tumors from Ukrainian patients from radio-contaminated areas (group 3). For intratumoral microvessel density (MVD) determination, anti-CD31 antibody was used. A computerized image analysis program was used to quantitatively calculate the vascular density. Seventy-three percent of group 3 and 72 % of group 2 CCRCCs displayed the highest MVD. A striking increase in MVD was seen in group 3 CCRCCs, in comparison with groups 1 and 2 (p < 0.001). The majority of the hot spot vessels in group 3 was poorly differentiated. Moreover, MVD values for total vessels as well as for capillaries and tumor grade were strongly correlated. When we compared only tumor-node-metastasis tumor stages I and II, the differences remained statistically significant (p < 0.1). The ratio of the average total vessels and capillaries in the Ukrainian groups combined was 1.65:1 in comparison to the Spanish group. Our results provide evidence that CPLDIR exposure increases MVD (particularly capillary) in CCRCCs and is associated with a higher histological grade.
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39
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The impact of immunohistochemical expression of nitric oxide synthases on clinical and pathological features of renal cell carcinoma. World J Urol 2012; 31:1197-203. [PMID: 22562149 DOI: 10.1007/s00345-012-0878-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2012] [Accepted: 04/20/2012] [Indexed: 10/28/2022] Open
Abstract
PURPOSE To evaluate the immunohistochemical expression of nitric oxide synthase (NOS) types 1, 2, and 3 in intratumoral and non-neoplastic samples of renal cell carcinoma (RCC) and correlate it with the clinical and pathological features of this malignancy. METHODS We analyzed 110 patients with RCC underwent radical nephrectomy (RN) or partial nephrectomy (PN) by streptavidin-biotin peroxidase method, tissue microarray, and digital microscopy. As endpoints, NOS expression was correlated with pathological features, overall survival (OS), and cancer-specific survival (CSS). RESULTS Non-neoplastic samples had higher NOS3 and lower NOS 2 levels than RCC tissues. Greater expression of all NOS isoforms was associated with larger tumors. High NOS1 expression correlated with microscopic venous invasion (MVI) (p = 0.046) and lymph node metastases (p = 0.007). High NOS2 expression was linked to MVI, more RN performed, and male gender (p = 0.035, p = 0.003, and p = 0.027, respectively). High NOS3 expression correlated with lymph node metastases (p = 0.039), microlymphatic invasion (p = 0.029), invasion of the renal pelvis and ureter (p = 0.004), RN (p = 0.003), and shorter OS (58.1 vs. 79.4 % respectively, p = 0.033) by univariate analysis. DFS was not influenced by any NOS isoform. By multivariate analysis, the risk factors for death were TNM stages III and IV (hazard ratio [HR] = 4.5), high Fuhrman's grade (HR = 2.9), Karnofsky performance status ≤80 (HR = 2.5), progression (HR = 5.5), and recurrence (HR = 6.3). Stage III disease was an independent risk factor for recurrence (HR = 9.5). CONCLUSIONS High NOS expression in RCC is associated with a poor prognosis and larger tumors. NOS3 influences OS by univariate analysis.
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40
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Wuttig D, Zastrow S, Füssel S, Toma MI, Meinhardt M, Kalman K, Junker K, Sanjmyatav J, Boll K, Hackermüller J, Rolle A, Grimm MO, Wirth MP. CD31, EDNRB and TSPAN7 are promising prognostic markers in clear-cell renal cell carcinoma revealed by genome-wide expression analyses of primary tumors and metastases. Int J Cancer 2012; 131:E693-704. [PMID: 22213152 DOI: 10.1002/ijc.27419] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2011] [Accepted: 12/12/2011] [Indexed: 11/10/2022]
Abstract
Currently used clinicopathological parameters are insufficient for a reliable prediction of metastatic risk and disease-free survival (DFS) of patients with clear-cell renal cell carcinoma (ccRCC). To identify prognostic genes, the expression profiles of primary ccRCC obtained from patients with different DFS--eight synchronously, nine metachronously and seven not metastasized tumors--were determined by genome-wide expression analyses. Synchronously and metachronously metastasized primary ccRCC differed in the expression of 167 genes. Thirty-six of these genes were also differentially expressed in synchronously vs. metachronously developed pulmonary metastases analyzed in a previous study. Because of their DFS-associated deregulation that is concordant in metastases and primary ccRCC, these genes are potentially functionally involved in metastatic tumor growth and are also prognostically useful. A prognostic impact was confirmed for the genes CD31, EDNRB and TSPAN7 at the mRNA level (n=86), and for TSPAN7 at the protein level (n=106). Patients with a higher gene expression of EDNRB or TSPAN7, or with TSPAN7-positive vessels in both cores investigated on tissue microarrays had a significantly longer DFS and tumor-specific survival (TSS). Patients with a higher CD31 gene expression showed a significantly longer TSS. EDNRB was an independent prognostic marker for the DFS. CD31, EDNRB and TSPAN7 had an independent impact on the TSS. In summary, comparative analysis of primary tumors and metastases is appropriate to identify independent prognostic markers in ccRCC. Gene expression of CD31 and EDNRB, and endothelial TSPAN7 protein level are potentially useful to improve outcome prediction because of their independent prognostic impact.
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Affiliation(s)
- Daniela Wuttig
- Department of Urology, University Hospital Carl Gustav Carus, Dresden, Germany.
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41
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Prognostic Value of Microvascular Invasion in Predicting the Cancer Specific Survival and Risk of Metastatic Disease in Renal Cell Carcinoma: A Multicenter Investigation. J Urol 2012; 187:418-23. [DOI: 10.1016/j.juro.2011.10.024] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2011] [Indexed: 12/23/2022]
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42
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Iakovlev VV, Gabril M, Dubinski W, Scorilas A, Youssef YM, Faragalla H, Kovacs K, Rotondo F, Metias S, Arsanious A, Plotkin A, Girgis AHF, Streutker CJ, Yousef GM. Microvascular density as an independent predictor of clinical outcome in renal cell carcinoma: an automated image analysis study. J Transl Med 2012; 92:46-56. [PMID: 22042086 DOI: 10.1038/labinvest.2011.153] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Tumor microvascular density (MVD) has been shown to correlate with the aggressiveness of several cancers. With the introduction of targeted anti-angiogenic therapy, assessment of MVD has the potential not only as a prognostic but also as a therapeutic marker. The significance of tumor vascularity in clear cell renal cell carcinoma (ccRCC) has been debated, with studies showing contradictory results. Previous studies were limited by manual quantification of MVD within a small area of tumor. Since then, the validity of this method has been questioned. To avoid the inaccuracies of manual quantification, we employed a computerized image analysis, which allowed assessment of large areas of tumor and adjacent normal tissue. The latter was used as an internal reference for normalization. MVD and vascular endothelial growth factor (VEGF) were assessed in 57 cases of ccRCC. Sections were immunostained for CD34 and VEGF. Areas of ccRCC and normal kidney medulla were analyzed within scanned images using software that counted CD34-positive vessels and measured the intensity of VEGF staining. We obtained unadjusted values from tumoral areas and calculated adjusted values as tumor/normal ratios. Unadjusted MVD had no association with clinical outcome. However, similarly to tumor stage, higher adjusted MVD was associated with shorter disease-free survival (log-rank P=0.037, Cox P=0.02). This was significant in univariate and multivariate analyses. MVD did not correlate with tumor stage, pointing to its independent prognostic value. As expected due to the known molecular abnormalities in ccRCC, most tumors showed higher VEGF expression than normal tissue. Higher adjusted VEGF was associated with high tumor grade (P=0.049). The finding of increased MVD as an independent marker of tumor aggressiveness may prove useful in the development of new tests for prognostic and therapeutic guidance. Digital techniques can provide more accurate assessment of immunomarkers and may reveal less obvious associations.
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Affiliation(s)
- Vladimir V Iakovlev
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
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43
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Dubinski W, Gabril M, Iakovlev VV, Scorilas A, Youssef YM, Faragalla H, Kovacs K, Rotondo F, Metias S, Arsanious A, Plotkin A, Girgis AHF, Streutker CJ, Yousef GM. Assessment of the prognostic significance of endoglin (CD105) in clear cell renal cell carcinoma using automated image analysis. Hum Pathol 2011; 43:1037-43. [PMID: 22204709 DOI: 10.1016/j.humpath.2011.08.012] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2011] [Revised: 08/24/2011] [Accepted: 08/26/2011] [Indexed: 12/01/2022]
Abstract
The behavior of clear cell renal cell carcinoma can be difficult to predict. Angiogenesis has proven to be a useful prognostic indicator in different malignancies. Endoglin (CD105) is a new marker of angiogenesis found to have prognostic utility in various tumors. Here, we provide the first automated digital assessment of intratumoral microvascular density in clear cell renal cell carcinoma using endoglin and CD31 and assess their utility as predictors of clinical outcome. Both endoglin and CD31 expression showed association with advanced tumor stage (P = .025 and P = .011, respectively). There was a significant correlation between CD31 and tumor grade (P = .034). Kaplan-Meier survival curves showed that patients with higher endoglin expression had significantly shorter progression-free survival (P = .010). Patients with higher CD31 expression tended to have a worse prognosis, although this was not statistically significant (P = .082). In univariate analysis using endoglin as a continuous variable, increased endoglin was strongly associated with reduced survival (hazard ratio, 1.74; 95% CI, 1.39-2.18; P = <.001). CD31 also correlated with poor outcomes (hazard ratio, 1.52; 95% CI, 1.24-1.86; P = .001). There was no correlation between CD31 and endoglin expression (r = -0.090, P = .541). Receiver operating characteristic analysis showed the area under the curve to be 0.749 for endoglin and 0.550 for CD31. In conclusion, increased endoglin and CD31 expression are associated with a higher tumor stage and decreased progression-free survival. Our automated approach overcomes many limitations of manual quantification. Advances in digital assessment of immunohistochemical markers can be helpful in standardizing the evaluation of tumor biomarkers.
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Affiliation(s)
- William Dubinski
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada, M5S 1A8
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44
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Waengertner LE, Meurer L, Cerski MR. Microvessel Density (Chalkley Method) in a Series of 79 Gastrointestinal Stromal Tumors. Gastroenterology Res 2011; 4:252-256. [PMID: 27957024 PMCID: PMC5139862 DOI: 10.4021/gr373w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/24/2011] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Evaluation of the MVD (modified Chalkley method) in a series of 79 cases of GISTs diagnosed by the Pathology Service at the HCPA (Hospital de Clinicas de Porto Alegre) from January 1993 to December 2009. METHODS Seventy nine cases of GISTs were submitted to immunohistochemical analysis for CD31, an endothelial marker, to analyze MVD. Hot spots were identified for each case, and the mean numbers of stained blood vessels collected through Chalkley count, with the use of a 25 point grid, placed onto a scanned image. Images were analysed through an image analysis system. We used a cutoff of six vessels. RESULTS Our series was composed of 42 males and 37 females and presented an average age of 58.9 years. GISTs were predominately located in the stomach (45.6%) followed by the small intestine (38.0%). Sixty seven GISTs (84.8%) showed an average of less than six vessels stained by CD31 (MVD) and 12 (15.2%) GISTs an average of more than six vessels. A statistically significant difference was observed between survival rate of patients having GISTs with MVD of ≤ 6 vessels (mean = 2.4, CI 95%: 1.67 - 3.17) and patients having GISTs with MVD of ≥ 6 vessels (mean = 2.4, CI 95%: 1.67 - 3.17), P = 0.001. No association for MVD was observed related to sex, age, histological type, risk category, location and metastasis. CONCLUSIONS Seventy nine cases of GISTs diagnosed at a single center in South Brazil were studied for MVD (Chalkley method). There was a statistically significant difference between MVD and the survival rate for these patients. The use of Chalkley method in GISTs may be helpful to evaluate clinical outcome.
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Affiliation(s)
- Luiz Eduardo Waengertner
- Programa de Pos Graduacao, Ciencias em Gastroenterologia, RS, Brazil; Servico de Patologia do Hospital de Clinica de Porto Alegre, RS, Brazil
| | - Luise Meurer
- Programa de Pos Graduacao, Ciencias em Gastroenterologia, RS, Brazil; Servico de Patologia do Hospital de Clinica de Porto Alegre, RS, Brazil; Departamento de Patologia da Universidade Federal do Rio Grande do Sul, RS, Brazil
| | - Marcelle Reesink Cerski
- Programa de Pos Graduacao, Ciencias em Gastroenterologia, RS, Brazil; Servico de Patologia do Hospital de Clinica de Porto Alegre, RS, Brazil; Departamento de Patologia da Universidade Federal do Rio Grande do Sul, RS, Brazil
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Roy C, Chaudron V, Benhaim R, Renard C, Bachelier P, Charton J, Lang H, Jacqmin D. Métastases pancréatiques métachrones des carcinomes rénaux : rôle de l’imagerie à propos de 17 patients avec corrélations chirurgicales. ACTA ACUST UNITED AC 2011; 92:1091-100. [DOI: 10.1016/j.jradio.2011.09.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2011] [Revised: 07/19/2011] [Accepted: 09/16/2011] [Indexed: 10/15/2022]
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Izutsu T, Konda R, Sugimura J, Iwasaki K, Fujioka T. Brain-specific angiogenesis inhibitor 1 is a putative factor for inhibition of neovascular formation in renal cell carcinoma. J Urol 2011; 185:2353-8. [PMID: 21511296 DOI: 10.1016/j.juro.2011.02.019] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2010] [Indexed: 11/30/2022]
Abstract
PURPOSE Renal cell carcinoma is a typical hypervascular tumor in which neovascularization may have a large part in progression. We examined expression of the cancer regulating, p53 targeted angiogenesis inhibitor brain-specific angiogenesis inhibitor 1 in renal cell carcinoma tissue to elucidate the clinical significance of its expression. MATERIALS AND METHODS We examined brain-specific angiogenesis inhibitor 1 mRNA and protein expression in 47 renal cell carcinoma and 10 normal kidney tissues using real-time quantitative polymerase chain reaction and immunohistochemistry, respectively. Levels of VEGF and bFGF mRNA, and immunohistochemical expression of p53 protein were also investigated in the same renal cell carcinoma tissues. RESULTS A significant decrease in BAI1 mRNA was noted in renal cell carcinoma tissue compared with that in normal kidney tissue (p <0.001). Immunostaining for brain-specific angiogenesis inhibitor 1 was also decreased in carcinoma tissue compared with normal kidney tissue. BAI1 mRNA and protein expression were lower in advanced renal cell carcinoma (pT3-4) than in localized renal cell carcinoma (pT1-2) tissues (p <0.03 and 0.003, respectively). A significant negative correlation was observed between microvessel density and brain-specific angiogenesis inhibitor 1 protein expression (r = -0.4056, p = 0.002). No significant correlation was noted between BAI1 and VEGF or bFGF mRNA levels. Brain-specific angiogenesis inhibitor 1 protein expression did not correlate with p53 protein expression. CONCLUSIONS These observations suggest that down-regulation of brain-specific angiogenesis inhibitor 1 expression may be a critical factor in renal cell carcinoma development and BAI1 may be a promising candidate for gene therapy of renal cell carcinoma.
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Affiliation(s)
- Toshikazu Izutsu
- Department of Urology, Iwate Medical University School of Medicine, Morioka, Japan
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47
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[Immunohistochemical expression of microvascular density and carbonic anhidrase IX in renal carcinoma. Relation to histological type and tumoral progression]. Actas Urol Esp 2011; 35:80-6. [PMID: 21256634 DOI: 10.1016/j.acuro.2010.10.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2010] [Accepted: 10/10/2010] [Indexed: 11/21/2022]
Abstract
PURPOSE to correlate the immunohistochemical expression of microvascular density (MVD) and the carbonic anhydrase IX (CAIX) with the different histological subtypes of renal carcinoma and its progression. MATERIAL AND METHODS we studied 93 patients with renal cell carcinoma operated between 1990 and 2008. Antibodies employed for immunohistochemistry (IHC); CD31 (1: 40, Dako) and CD34 (1: 50, Dako) for MVD and CAIX (1: 100, Santa Cruz). CAIX was validated semiquantitatively as: strongly positive (>85%); weakly positive (10% -85%); and negative (< 10%), independently of the intensity of the stain. MVD was validated with both anti-CD31 and anti-CD34 by means of a whole section, to select the microscopic field (x100) with highest density of stained vessels, counting the number of vessels in a photographic field of 0.53 mm(2). Results are expressed as the maximal number of vessels by mm(2) of tumour tissue. RESULTS median follow up was 40 months (1-160). We found no differences of expression with any of the 3 IHC markers between tumours that progressed (49) and tumours that did not progress (44). The IHC expression of CAIX was strongly related to MVD, measured for both CD31 and CD34 (p<0.0001). MVD with both antibodies was inversely related to tumour size and Fuhrman grade and was also stronger in clear cell carcinomas compared to the rest of histological subtypes, measured by CD31 (p = 0.001) and CD34 (p = 0.003). CONCLUSIONS neither MVD nor CAIX expressions were related to tumour progression, but were related to histological subtypes. This fact, added to their co-expression, could prompt the use of the CAIX expression, which is far more reproducible, as a quick and easy approximation to MVD. More research should be done to use it as marker for targeted therapy.
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48
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Cappabianca S, Porto A, Petrillo M, Greco B, Reginelli A, Ronza F, Setola F, Rossi G, Di Matteo A, Muto R, De Rimini ML, Piccolo S, Catalano M, Muto P, De Rosa N, Barra E, De Rosa I, Antinolfi F, Antinolfi G, Caputi M, Brunese L, Grassi R, Rotondo A. Preliminary study on the correlation between grading and histology of solitary pulmonary nodules and contrast enhancement and [18F]fluorodeoxyglucose standardised uptake value after evaluation by dynamic multiphase CT and PET/CT. J Clin Pathol 2010; 64:114-9. [PMID: 21169276 PMCID: PMC3030774 DOI: 10.1136/jcp.2010.076562] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Aim To evaluate whether the histology and grading of solitary pulmonary nodules (SPNs) correlated with the results of dynamic multiphase multidetector CT (MDCT) and the [18F]fluorodeoxyglucose standardised uptake value (SUV) in 30 patients. Methods Chest x-rays of 270 patients with incidentally detected SPNs were retrospectively evaluated. Thirty patients with histologically proven SPNs were enrolled. On MDCT and positron emission tomography (PET)/CT images, two experts measured the density of nodules in all perfusion phases and the SUV. Net enhancement (NE) was calculated by subtracting peak pre-contrast density from peak post-contrast density. The Pearson test was used to correlate nodule NE, SUV, grading, histology and diameter. Results Of the 30 malignant SPNs, six were classified as G1 (median NE, 31.5 Hounsfield units (HU); median SUV, 4.8 units), 15 were classified as G2 (median NE, 49 HU; median SUV, 6 units), and nine were classified as G3 (median NE, 32 HU; median SUV, 4.5 units). A highly negative correlation was found in G3 SPNs between NE and the corresponding diameters (r=−0.834; p=0.00524). NE increased with the increase in diameter (r=0.982; p=0.284). SUV increased as the SPN diameter increased (r=0.789; p=0.421). NE and SUV were higher in G2 than G1 SPNs, and lower in G2 than G3 SPNs (r=0.97; p=0.137). Conclusions The significant correlation in dedifferentiated (G3) SPNs between NE and diameter (r=−0.834; p=0.00524) supports the theory that stroma and neoangiogenesis are fundamental in SPN growth. The highly negative correlation between NE and diameter demonstrates a net decrease in perfusion despite an increase in dimension. The multidisciplinary approach used herein may result in a more precise prognosis and consequently a better therapeutic outcome, particularly in patients with undifferentiated lung cancer.
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Affiliation(s)
- Salvatore Cappabianca
- Department of Clinical Internal Medicine F Magrassi-L Lanzara, Science Section of Radiology, Second University of Studies of Naples, Naples, Italy.
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49
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Chen Y, Zhang J, Dai J, Feng X, Lu H, Zhou C. Angiogenesis of renal cell carcinoma: perfusion CT findings. ABDOMINAL IMAGING 2010; 35:622-8. [PMID: 19763683 DOI: 10.1007/s00261-009-9565-0] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2009] [Revised: 07/08/2009] [Accepted: 07/30/2009] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To observe the perfusion CT findings of renal cell carcinoma (RCC) and prospectively correlate perfusion CT parameters with tumor MVD and VEGF expression. METHODS Dynamic contrast-enhanced multislice spiral CT was performed prospectively in 73 cases with histologically proven RCC (65 clear cell, 3 papillary, and 5 chromophobe). Blood flow (BF), blood volume (BV), mean transit time (MTT), and permeability surface-area product (PS) of RCC and normal renal cortex were measured, respectively. The tumor MVD count and VEGF expression level were determined by immunohistochemistry with specific monoclonal antibodies. RESULTS There was significant difference between BF, BV, MTT, and PS of normal renal cortex (454.32 ± 110.90 mL/min/100 g, 23.53 ± 5.71 mL/100 g, 3.62 ± 1.38 s, 63.95 ± 18.85 mL/min/100 g) and RCC (261.96 ± 175.86 mL/min/100 g, 17.17 ± 8.34 mL/100 g, 7.08 ± 3.42 s, 25.07 ± 13.20 mL/min/100 g) (P < 0.01). BF and BV among RCC histologic subtypes were significantly different (P < 0.05), MTT and PS were not (P > 0.05). MVD (42.29 ± 21.00) of RCC is positively correlated with BF, BV, and PS (P < 0.01), not with MTT (P > 0.05). No relationship was found between the expression levels of VEGF and any perfusion CT parameter. CONCLUSIONS Perfusion CT is a feasible technique to assess tissue perfusion in patients with RCC. BV, BF, and PS correlate positively with MVD and may reflect angiogenesis of RCC.
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Affiliation(s)
- Yan Chen
- Department of Diagnostic Radiology, Cancer Hospital and Institute, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
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50
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Meehan B, Appu S, St Croix B, Rak-Poznanska K, Klotz L, Rak J. Age-related properties of the tumour vasculature in renal cell carcinoma. BJU Int 2010; 107:416-24. [PMID: 20804487 DOI: 10.1111/j.1464-410x.2010.09569.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To assess whether ageing processes influence angiogenesis in renal cell carcinoma (RCC) we carried out a pilot study of vascular properties in a series of archival primary kidney tumours in patients of different ages. PATIENTS AND METHODS A cohort of patients with RCC was identified restrospectively, with an age range of 35-84 years. Paraffin-embedded, formalin-fixed sections of surgical tumour specimens were stained for endothelial (CD31, von Willebrand factor [vWF]), pericyte (alpha smooth muscle actin [SMA]) and leucocytic (CD45) markers, as well as for proliferative (Ki67) and angiogenic activity (tumour endothelial markers [TEMs], delta-like 4 [Dll4], Dll1, endothelial nitric oxide synthase [eNOS]). Vascular properties were compared between patients above and below 65 years of age. RESULTS Microvascular density (MVD) within capillary hot spots was generally higher in patients with non-metastatic clear-cell RCC (ccRCC; n = 21) than in those with metastatic RCC (mRCC; n= 9). Patients with ccRCC who were more than 65 years old showed significantly higher MVD than their younger (< 65 years) counterparts. There were dividing (Ki67-positive) endothelial and mural cells in both small (< 20 µm) capillary and large (> 20 µm), pre-capillary vessels, suggesting the involvement of both angiogenic and remodelling/arteriogenic processes. Tumour endothelial markers (TEM1, TEM7, TEM8), Notch ligands (Dll1, Dll4), and other molecular characteristics (eNOS) were analysed. Age-related differences were observed in the frequency of pre-capillary vessels expressing Dll1, which was significantly higher in tumours of younger patients (< 65 years), while eNOS was more prevalent among capillaries associated with ccRCC in older patients (>6 5 years). CONCLUSIONS The results of the present study suggest that age influences the structural and molecular properties of the tumour vasculature in ccRCC. We postulate that vascular ageing could also be relevant in the context of anti-angiogenic therapy.
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Affiliation(s)
- Brian Meehan
- Montreal Children's Hospital Research Institute, McGill University, Montreal, QC, Canada
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