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Souza da Silva R, Queiroga EM, de Toledo Osório C, Cunha KS, Neves FP, Andrade JP, Dias EP. Expression Profile of Microenvironmental Factors in the Interface Zone of Colorectal Cancer: Histological-Stromal Biomarkers and Cancer Cell-Cancer-Associated Fibroblast-Related Proteins Combined for the Assessment of Tumor Progression. Pathobiology 2023; 91:99-107. [PMID: 37369175 DOI: 10.1159/000531695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 06/19/2023] [Indexed: 06/29/2023] Open
Abstract
INTRODUCTION The characterization of tumor microenvironment (TME) related factors and their impact on tumor progression have attracted much interest. We investigated cancer cells and cancer-associated fibroblasts (CAFs) to evaluate biomarkers that are associated with neoplastic progression, observing them in different interface zones of colorectal cancer. METHODS On 357 CRC tissue microarrays, using immunohistochemistry, we examined the associations of podoplanin and α-SMA expressed in cancer cells and CAFs and evaluated them in different areas: tumor core, invasive front, tumor budding, tumor-stroma ratio (TSR) scoring, and desmoplastic stroma. RESULTS CAFs expressing α-SMA were found in more than 90% of the cases. Podoplanin+ was detected in cancer cells and CAFs, with positivities of 38.6% and 70%, respectively. Higher α-SMA+ CAFs and podoplanin+ cancer cells were observed predominantly at the TSR score area: 94.3% and 64.3% of cases, respectively. The status of podoplanin in CAFs+ was higher in the desmoplastic area (71.6%). Stroma-high tumors showed increased expression of α-SMA and podoplanin in comparison with stroma-low tumors. The status of podoplanin in cancer cells was observed in association with lymphatic invasion and distant metastasis. CONCLUSION The substance of the CRC was composed predominantly of the surrounding stroma-α-SMA+ CAFs. Podoplanin expressed in the prognosticator zones was associated with unfavorable pathological features. The combination of histologic and protein-related biomarkers can result in a tool for the stratification of patients with CRC.
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Affiliation(s)
- Ricella Souza da Silva
- Pathological Anatomy Service, Lauro Wanderley University Hospital of Federal University of Paraíba, João Pessoa, Brazil
| | - Eduardo M Queiroga
- Laboratory of Pathological Anatomy, Alcides Carneiro University Hospital of the Federal University of Campina Grande, Campina Grande, Brazil
| | | | - Karin S Cunha
- Department of Pathology, School of Medicine, Fluminense Federal University, Niterói, Brazil
| | - Fabiana P Neves
- Anatomopathological Diagnostic Center, Napoleão Laureano Hospital, João Pessoa, Brazil
| | - Julieth P Andrade
- Anatomopathological Diagnostic Center, Napoleão Laureano Hospital, João Pessoa, Brazil
| | - Eliane P Dias
- Department of Pathology, School of Medicine, Fluminense Federal University, Niterói, Brazil
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Rodas L, Barnadas E, Pereira A, Castrejon N, Saurina A, Calls J, Calzada Y, Madrid Á, Blasco M, Poch E, García-Herrera A, Quintana LF. The Density of Renal Lymphatics Correlates With Clinical Outcomes in IgA Nephropathy. Kidney Int Rep 2022; 7:823-830. [PMID: 35497787 PMCID: PMC9039908 DOI: 10.1016/j.ekir.2021.12.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 12/19/2021] [Accepted: 12/27/2021] [Indexed: 11/06/2022] Open
Abstract
Introduction IgA nephropathy (IgAN) is the most common primary glomerulonephritis (GN) worldwide. The disease course fluctuates, and the most important challenge is the considerable variation in the time lag between diagnosis and the development of a hard clinical end point, such as end-stage kidney disease (ESKD). The reaction of renal tissue to damage resembles the common wound-healing response. One part of this repair in IgAN is the expansion of lymphatic vessels known as lymphangiogenesis. The aim of this work was to establish the prognostic value of the density of lymphatic vessels in the renal biopsy at the time of diagnosis, for predicting the risk of ESKD in a Spanish cohort of patients with IgAN. Methods We performed a retrospective multicenter study of 76 patients with IgAN. The end point of the study was progression to ESKD. The morphometric analysis of lymphatic vessels was performed on tissue sections stained with antipodoplanin antibody. Results Density of lymphatic vessels was significantly higher in patients with IgAN with mesangial hypercellularity >50%, segmental sclerosis, higher degrees of interstitial fibrosis, and tubular atrophy. Patients with more lymphatic vessels had significantly higher values of proteinuria and lower estimated glomerular filtration rate (eGFR). A density of lymphatic vessels ≥8 per mm2 was associated with a significantly higher rate of progression to ESKD at 3 years from biopsy. After adjustment for the International IgAN prediction score, at the multivariate logistic regression, high density of lymphatic vessels (≥8 per mm2) remained significantly associated with a higher rate of early progression to ESKD. Conclusion This study contributes to the understanding of the natural history of the progression to ESKD in patients with IgAN revealing the density of lymphatics vessels may optimize the prognostic value of the International IgA predicting tool to calculate the risk of ESKD, favoring the evaluation of new targeted therapies.
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Affiliation(s)
- Lida Rodas
- Department of Nephrology and Renal Transplantation, Hospital Clínic, Department of Medicine, University of Barcelona, IDIBAPS and Centro de Referencia en Enfermedad Glomerular Compleja del Sistema Nacional de Salud de España (CSUR), Barcelona, Spain
| | - Esther Barnadas
- Department of Pathology, Hospital Clínic, University of Barcelona, IDIBAPS and Centro de Referencia en Enfermedad Glomerular Compleja del Sistema Nacional de Salud de España (CSUR), Barcelona, Spain
| | - Arturo Pereira
- Department of Hematology, Hospital Clínic, University of Barcelona, IDIBAPS, Barcelona, Spain
| | - Natalia Castrejon
- Department of Pathology, Hospital Clínic, University of Barcelona, IDIBAPS and Centro de Referencia en Enfermedad Glomerular Compleja del Sistema Nacional de Salud de España (CSUR), Barcelona, Spain
| | - Anna Saurina
- Department of Nephrology, Hospital Terrasa, Cataluña, Spain
| | - Jordi Calls
- Department of Nephrology, Hospital de Mollet, Cataluña, Spain
| | - Yolanda Calzada
- Department of Nephrology, Hospital Sant Joan de Déu Barcelona, Barcelona, Spain
| | - Álvaro Madrid
- Department of Nephrology, Hospital Sant Joan de Déu Barcelona, Barcelona, Spain
| | - Miquel Blasco
- Department of Nephrology and Renal Transplantation, Hospital Clínic, Department of Medicine, University of Barcelona, IDIBAPS and Centro de Referencia en Enfermedad Glomerular Compleja del Sistema Nacional de Salud de España (CSUR), Barcelona, Spain
| | - Esteban Poch
- Department of Nephrology and Renal Transplantation, Hospital Clínic, Department of Medicine, University of Barcelona, IDIBAPS and Centro de Referencia en Enfermedad Glomerular Compleja del Sistema Nacional de Salud de España (CSUR), Barcelona, Spain
| | - Adriana García-Herrera
- Department of Pathology, Hospital Clínic, University of Barcelona, IDIBAPS and Centro de Referencia en Enfermedad Glomerular Compleja del Sistema Nacional de Salud de España (CSUR), Barcelona, Spain
| | - Luis F. Quintana
- Department of Nephrology and Renal Transplantation, Hospital Clínic, Department of Medicine, University of Barcelona, IDIBAPS and Centro de Referencia en Enfermedad Glomerular Compleja del Sistema Nacional de Salud de España (CSUR), Barcelona, Spain
| | - Catalán Group for the Study of Glomerular Diseases (GLOMCAT)
- Department of Nephrology and Renal Transplantation, Hospital Clínic, Department of Medicine, University of Barcelona, IDIBAPS and Centro de Referencia en Enfermedad Glomerular Compleja del Sistema Nacional de Salud de España (CSUR), Barcelona, Spain
- Department of Pathology, Hospital Clínic, University of Barcelona, IDIBAPS and Centro de Referencia en Enfermedad Glomerular Compleja del Sistema Nacional de Salud de España (CSUR), Barcelona, Spain
- Department of Hematology, Hospital Clínic, University of Barcelona, IDIBAPS, Barcelona, Spain
- Department of Nephrology, Hospital Terrasa, Cataluña, Spain
- Department of Nephrology, Hospital de Mollet, Cataluña, Spain
- Department of Nephrology, Hospital Sant Joan de Déu Barcelona, Barcelona, Spain
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