1
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Keerthika R, Devi A, Kamboj M, Narwal A. Association of Cellular Cannibalism with Immunohistochemical Expression of CD31, CD68 and BCL2 in Oral Squamous Cell Carcinoma: An Observational Study. J Maxillofac Oral Surg 2024; 23:881-889. [PMID: 39118920 PMCID: PMC11303648 DOI: 10.1007/s12663-024-02217-1] [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: 02/25/2024] [Accepted: 05/23/2024] [Indexed: 08/10/2024] Open
Abstract
Objective Cellular cannibalism (CC) is a prime metabolic event to determine the aggressive potential of oral squamous cell carcinoma (OSCC). However, the etiology and mechanism behind this degradation are still ambiguous. The aim of the study was to explore the etiopathogenetic mechanism behind CC, along with its association with degree of differentiation, angiogenic, phagocytic and antiapoptotic activity in OSCC. Design Seventy-three tissue sections of various histological grades of OSCC were retrieved from departmental archives and scanned for cannibalistic cells. Immunohistochemical analysis using CD31, CD68, and BCL2 was performed. The data obtained were analyzed using Chi-square, Spearman's correlation test and multiple regression analysis (p < 0.05). Results CCs were present significantly in various grades of OSCC (p < 0.00). Immunohistochemical analysis revealed a significant difference in CD68, BCL2 (p < 0.05 in both), and CD31 (p < 0.001) expression with CC. The internalized cells showed positivity for CD68 and negativity for BCL2. Regression analysis revealed that tumor grade, CD31 and BCL2 immunoreactivity were significant predictors of frequency of CC. Conclusion The association of CC with degree of differentiation, CD31, CD68, and BCL2 expression could predict the biological behavior of OSCC and might serve as a promising histopathological parameter in future.
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Affiliation(s)
- R. Keerthika
- Department of Oral Pathology and Microbiology, Faculty of Dental Sciences, Trauma Centre, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh 221005 India
| | - Anju Devi
- Department of Oral Pathology and Microbiology, Post Graduate Institute of Dental Sciences (PGIDS), Pt. Bhagwat Dayal Sharma University of Health Sciences, Rohtak, Haryana 124001 India
| | - Mala Kamboj
- Department of Oral Pathology and Microbiology, Post Graduate Institute of Dental Sciences (PGIDS), Pt. Bhagwat Dayal Sharma University of Health Sciences, Rohtak, Haryana 124001 India
| | - Anjali Narwal
- Department of Oral Pathology and Microbiology, Post Graduate Institute of Dental Sciences (PGIDS), Pt. Bhagwat Dayal Sharma University of Health Sciences, Rohtak, Haryana 124001 India
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2
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Gaptulbarova KА, Tsydenova IA, Dolgasheva DS, Kravtsova EA, Ibragimova MK, Vtorushin SV, Litviakov NV. Mechanisms and significance of entosis for tumour growth and progression. Cell Death Discov 2024; 10:109. [PMID: 38429285 PMCID: PMC10907354 DOI: 10.1038/s41420-024-01877-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 02/08/2024] [Accepted: 02/19/2024] [Indexed: 03/03/2024] Open
Abstract
To date, numerous mechanisms have been identified in which one cell engulfs another, resulting in the creation of 'cell-in-cell' (CIC) structures, which subsequently cause cell death. One of the mechanisms of formation of these structures is entosis, which is presumably associated with possible carcinogenesis and tumour progression. The peculiarity of the process is that entotic cells themselves actively invade the host cell, and afterwards have several possible variants of fate. Entotic formations are structures where one cell is engulfed by another cell, creating a cell-in-cell structure. The nucleus of the outer cell has a crescent shape, while the inner cell is surrounded by a large entotic vacuole. These characteristics differentiate entosis from cell cannibalism. It's worth noting that entotic formations are not necessarily harmful and may even be beneficial in some cases. In this article we will consider the mechanism of entosis and variants of entotic cell death, and also put forward hypothesis about possible variants of participation of this process on the formation and progression of cancer. This article also presents our proposed classification of functional forms of entosis.
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Affiliation(s)
- Ksenia Аndreevna Gaptulbarova
- Cancer Research Institute "Tomsk National Research Medical Centre of the Russian Academy of Sciences", Kooperativniy Lane, 5, 634009, Tomsk, Russia.
- Siberian State Medical University, Moskovsky trakt, 2, 634050, Tomsk, Russia.
- National Research Tomsk State University, Lenin Avenue 36, 634050, Tomsk, Russia.
| | - Irina Alexandrovna Tsydenova
- Cancer Research Institute "Tomsk National Research Medical Centre of the Russian Academy of Sciences", Kooperativniy Lane, 5, 634009, Tomsk, Russia
- National Research Tomsk State University, Lenin Avenue 36, 634050, Tomsk, Russia
| | - Daria Sergeevna Dolgasheva
- Cancer Research Institute "Tomsk National Research Medical Centre of the Russian Academy of Sciences", Kooperativniy Lane, 5, 634009, Tomsk, Russia
- National Research Tomsk State University, Lenin Avenue 36, 634050, Tomsk, Russia
| | - Ekaterina Andreevna Kravtsova
- Cancer Research Institute "Tomsk National Research Medical Centre of the Russian Academy of Sciences", Kooperativniy Lane, 5, 634009, Tomsk, Russia
- National Research Tomsk State University, Lenin Avenue 36, 634050, Tomsk, Russia
| | - Marina Konstantinovna Ibragimova
- Cancer Research Institute "Tomsk National Research Medical Centre of the Russian Academy of Sciences", Kooperativniy Lane, 5, 634009, Tomsk, Russia
- Siberian State Medical University, Moskovsky trakt, 2, 634050, Tomsk, Russia
- National Research Tomsk State University, Lenin Avenue 36, 634050, Tomsk, Russia
| | - Sergey Vladimirovich Vtorushin
- Cancer Research Institute "Tomsk National Research Medical Centre of the Russian Academy of Sciences", Kooperativniy Lane, 5, 634009, Tomsk, Russia
- Siberian State Medical University, Moskovsky trakt, 2, 634050, Tomsk, Russia
| | - Nikolai Vasilievich Litviakov
- Cancer Research Institute "Tomsk National Research Medical Centre of the Russian Academy of Sciences", Kooperativniy Lane, 5, 634009, Tomsk, Russia
- Siberian State Medical University, Moskovsky trakt, 2, 634050, Tomsk, Russia
- National Research Tomsk State University, Lenin Avenue 36, 634050, Tomsk, Russia
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3
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Siquara da Rocha LDO, Souza BSDF, Coletta RD, Lambert DW, Gurgel Rocha CA. Mapping Cell-in-Cell Structures in Oral Squamous Cell Carcinoma. Cells 2023; 12:2418. [PMID: 37830632 PMCID: PMC10572403 DOI: 10.3390/cells12192418] [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: 07/27/2023] [Revised: 09/10/2023] [Accepted: 09/11/2023] [Indexed: 10/14/2023] Open
Abstract
Cell-in-cell (CIC) structures contribute to tumor aggressiveness and poor prognosis in oral squamous cell carcinoma (OSCC). In vitro 3D models may contribute to the understanding of the underlying molecular mechanisms of these events. We employed a spheroid model to study the CIC structures in OSCC. Spheroids were obtained from OSCC (HSC3) and cancer-associated fibroblast (CAF) lines using the Nanoshuttle-PLTM bioprinting system (Greiner Bio-One). Spheroid form, size, and reproducibility were evaluated over time (EvosTM XL; ImageJ version 1.8). Slides were assembled, stained (hematoxylin and eosin), and scanned (Axio Imager Z2/VSLIDE) using the OlyVIA System (Olympus Life Science) and ImageJ software (NIH) for cellular morphology and tumor zone formation (hypoxia and/or proliferative zones) analysis. CIC occurrence, complexity, and morphology were assessed considering the spheroid regions. Well-formed spheroids were observed within 6 h of incubation, showing the morphological aspects of the tumor microenvironment, such as hypoxic (core) and proliferative zone (periphery) formation. CIC structures were found in both homotypic and heterotypic groups, predominantly in the proliferative zone of the mixed HSC3/CAF spheroids. "Complex cannibalism" events were also noted. These results showcase the potential of this model in further studies on CIC morphology, formation, and relationship with tumor prognosis.
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Affiliation(s)
- Leonardo de Oliveira Siquara da Rocha
- Gonçalo Moniz Institute, Oswaldo Cruz Foundation (IGM-FIOCRUZ/BA), Salvador 40296-710, BA, Brazil; (L.d.O.S.d.R.); (B.S.d.F.S.)
- Department of Pathology and Forensic Medicine, School of Medicine, Federal University of Bahia, Salvador 40110-100, BA, Brazil
| | - Bruno Solano de Freitas Souza
- Gonçalo Moniz Institute, Oswaldo Cruz Foundation (IGM-FIOCRUZ/BA), Salvador 40296-710, BA, Brazil; (L.d.O.S.d.R.); (B.S.d.F.S.)
- D’Or Institute for Research and Education (IDOR), Salvador 41253-190, BA, Brazil
| | - Ricardo Della Coletta
- Department of Oral Diagnosis, School of Dentistry, University of Campinas, Piracicaba 13414-903, SP, Brazil
- Graduate Program in Oral Biology, School of Dentistry, University of Campinas, Piracicaba 13414-903, SP, Brazil
| | - Daniel W. Lambert
- School of Clinical Dentistry, The University of Sheffield, Sheffield S10 2TA, UK
| | - Clarissa A. Gurgel Rocha
- Gonçalo Moniz Institute, Oswaldo Cruz Foundation (IGM-FIOCRUZ/BA), Salvador 40296-710, BA, Brazil; (L.d.O.S.d.R.); (B.S.d.F.S.)
- Department of Pathology and Forensic Medicine, School of Medicine, Federal University of Bahia, Salvador 40110-100, BA, Brazil
- D’Or Institute for Research and Education (IDOR), Salvador 41253-190, BA, Brazil
- Department of Propaedeutics, School of Dentistry, Federal University of Bahia, Salvador 40110-150, BA, Brazil
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4
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Liu X, Yang J. Cell-in-cell: a potential biomarker of prognosis and a novel mechanism of drug resistance in cancer. Front Oncol 2023; 13:1242725. [PMID: 37637068 PMCID: PMC10449025 DOI: 10.3389/fonc.2023.1242725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 07/24/2023] [Indexed: 08/29/2023] Open
Abstract
The cell-in-cell (CIC) phenomenon has received increasing attention over recent years because of its wide existence in multiple cancer tissues. The mechanism of CIC formation is considerably complex as it involves interactions between two cells. Although the molecular mechanisms of CIC formation have been extensively investigated, the process of CIC formation remains ambiguous. Currently, CIC is classified into four subtypes based on different cell types and inducing factors, and the underlying mechanisms for each subtype are distinct. Here, we investigated the subtypes of CIC and their major mechanisms involved in cancer development. To determine the clinical significance of CIC, we reviewed several clinical studies on CIC and found that CIC could serve as a diagnostic and prognostic biomarker. The implications of CIC on the clinical management of cancers also remain largely unknown. To clarify this aspect, in the present review, we highlight the findings of recent investigations on the causal link between CIC and cancer treatment. We also indicate the existing issues that need to be resolved urgently to provide a potential direction for future research on CIC.
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Affiliation(s)
| | - Jun Yang
- Department of Pathology, The Second Affiliated Hospital, Xi’an Jiao Tong University, Xi’an, Shaanxi, China
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5
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Druzhkova I, Ignatova N, Shirmanova M. Cell-in-Cell Structures in Gastrointestinal Tumors: Biological Relevance and Clinical Applications. J Pers Med 2023; 13:1149. [DOI: https:/doi.org/10.3390/jpm13071149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/30/2023] Open
Abstract
This review summarizes information about cell-in-cell (CIC) structures with a focus on gastrointestinal tumors. The phenomenon when one cell lives in another one has attracted an attention of researchers over the past decades. We briefly discuss types of CIC structures and mechanisms of its formation, as well as the biological basis and consequences of the cell-engulfing process. Numerous clinico-histopathological studies demonstrate the significance of these structures as prognostic factors, mainly correlated with negative prognosis. The presence of CIC structures has been identified in all gastrointestinal tumors. However, the majority of studies concern pancreatic cancer. In this field, in addition to the assessment of the prognostic markers, the attempts to manipulate the ability of cells to form CISs have been done in order to stimulate the death of the inner cell. Number of CIC structures also correlates with genetic features for some gastrointestinal tu-mors. The role of CIC structures in the responses of tumors to therapies, both chemotherapy and immunotherapy, seems to be the most poorly studied. However, there is some evidence of involvement of CIC structures in treatment failure. Here, we summarized the current literature on CIC structures in cancer with a focus on gastrointestinal tumors and specified future perspectives for investigation.
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Affiliation(s)
- Irina Druzhkova
- Research Institute of Experimental Oncology and Biomedical Technologies, Privolzhsky Research Medical University, 603005 Nizhny Novgorod, Russia
| | - Nadezhda Ignatova
- Research Institute of Experimental Oncology and Biomedical Technologies, Privolzhsky Research Medical University, 603005 Nizhny Novgorod, Russia
| | - Marina Shirmanova
- Research Institute of Experimental Oncology and Biomedical Technologies, Privolzhsky Research Medical University, 603005 Nizhny Novgorod, Russia
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6
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Druzhkova I, Ignatova N, Shirmanova M. Cell-in-Cell Structures in Gastrointestinal Tumors: Biological Relevance and Clinical Applications. J Pers Med 2023; 13:1149. [PMID: 37511762 PMCID: PMC10381133 DOI: 10.3390/jpm13071149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 07/11/2023] [Accepted: 07/14/2023] [Indexed: 07/30/2023] Open
Abstract
This review summarizes information about cell-in-cell (CIC) structures with a focus on gastrointestinal tumors. The phenomenon when one cell lives in another one has attracted an attention of researchers over the past decades. We briefly discuss types of CIC structures and mechanisms of its formation, as well as the biological basis and consequences of the cell-engulfing process. Numerous clinico-histopathological studies demonstrate the significance of these structures as prognostic factors, mainly correlated with negative prognosis. The presence of CIC structures has been identified in all gastrointestinal tumors. However, the majority of studies concern pancreatic cancer. In this field, in addition to the assessment of the prognostic markers, the attempts to manipulate the ability of cells to form CISs have been done in order to stimulate the death of the inner cell. Number of CIC structures also correlates with genetic features for some gastrointestinal tu-mors. The role of CIC structures in the responses of tumors to therapies, both chemotherapy and immunotherapy, seems to be the most poorly studied. However, there is some evidence of involvement of CIC structures in treatment failure. Here, we summarized the current literature on CIC structures in cancer with a focus on gastrointestinal tumors and specified future perspectives for investigation.
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Affiliation(s)
- Irina Druzhkova
- Research Institute of Experimental Oncology and Biomedical Technologies, Privolzhsky Research Medical University, 603005 Nizhny Novgorod, Russia
| | - Nadezhda Ignatova
- Research Institute of Experimental Oncology and Biomedical Technologies, Privolzhsky Research Medical University, 603005 Nizhny Novgorod, Russia
| | - Marina Shirmanova
- Research Institute of Experimental Oncology and Biomedical Technologies, Privolzhsky Research Medical University, 603005 Nizhny Novgorod, Russia
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7
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Dziuba I, Gawel AM, Tyrna P, Machtyl J, Olszanecka M, Pawlik A, Wójcik C, Bialy LP, Mlynarczuk-Bialy I. Homotypic Entosis as a Potential Novel Diagnostic Marker in Breast Cancer. Int J Mol Sci 2023; 24:ijms24076819. [PMID: 37047791 PMCID: PMC10095369 DOI: 10.3390/ijms24076819] [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: 03/15/2023] [Revised: 03/30/2023] [Accepted: 04/03/2023] [Indexed: 04/14/2023] Open
Abstract
Homotypic entotic figures, which are a form of "cell-in-cell" structures, are considered a potential novel independent prognostic marker in various cancers. Nevertheless, the knowledge concerning the biological role of this phenomenon is still unclear. Since breast cancer cells are remarkably entosis-competent, we aimed to investigate and compare the frequency of entoses in a primary breast tumor and in its lymph node metastasis. Moreover, as there are limited data on defined molecular markers of entosis, we investigated entosis in correlation with classical breast cancer biomarkers used in routine pathomorphological diagnostics (HER2, ER, PR, and Ki67). In the study, a cohort of entosis-positive breast cancer samples paired into primary lesions and lymph node metastases was used. The inclusion criteria were a diagnosis of NOS cancer, lymph node metastases, the presence of entotic figures in the primary lesion, and/or lymph node metastases. In a selected, double-negative, HER2-positive NOS breast cancer case, entoses were characterized by a correlation between an epithelial-mesenchymal transition and proliferation markers. We observed that in the investigated cohort entotic figures were positively correlated with Ki67 and HER2, but not with ER or PR markers. Moreover, for the first time, we identified Ki67-positive mitotic inner entotic cells in clinical carcinoma samples. Our study performed on primary and secondary breast cancer specimens indicated that entotic figures, when examined by routine HE histological staining, present potential diagnostic value, since they correlate with two classical prognostic factors of breast cancer.
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Affiliation(s)
- Ireneusz Dziuba
- Department of Pathology, Faculty of Medicine, Academy of Silesia, 40-555 Katowice, Poland
| | - Agata M Gawel
- Histology and Embryology Students' Science Association, Department of Histology and Embryology, Faculty of Medicine, Medical University of Warsaw, 02-004 Warsaw, Poland
| | - Paweł Tyrna
- Histology and Embryology Students' Science Association, Department of Histology and Embryology, Faculty of Medicine, Medical University of Warsaw, 02-004 Warsaw, Poland
| | - Jędrzej Machtyl
- Histology and Embryology Students' Science Association, Department of Histology and Embryology, Faculty of Medicine, Medical University of Warsaw, 02-004 Warsaw, Poland
| | - Monika Olszanecka
- Histology and Embryology Students' Science Association, Department of Histology and Embryology, Faculty of Medicine, Medical University of Warsaw, 02-004 Warsaw, Poland
| | - Andrzej Pawlik
- Department of Physiology, Pomeranian Medical University in Szczecin, 70-111 Szczecin, Poland
| | | | - Lukasz P Bialy
- Department of Histology and Embryology, Faculty of Medicine, Medical University of Warsaw, 02-004 Warsaw, Poland
| | - Izabela Mlynarczuk-Bialy
- Department of Histology and Embryology, Faculty of Medicine, Medical University of Warsaw, 02-004 Warsaw, Poland
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8
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Cell-In-Cell Structures in Early Breast Cancer Are Prognostically Valuable. Cells 2022; 12:cells12010081. [PMID: 36611874 PMCID: PMC9818278 DOI: 10.3390/cells12010081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 12/15/2022] [Accepted: 12/21/2022] [Indexed: 12/28/2022] Open
Abstract
Cell-in-cell (CIC) structures in breast cancer have so far been studied in a small inhomogeneous patient population, suggesting the prognostic importance of CIC. In the present study, we focused on CIC in early hormone-sensitive breast cancer. With in vitro co-culture experiments, we compared the homotypic phagocytic capacity of two breast cancer cell lines to that of primary human fibroblasts. Afterward, we studied 601 tissue specimens from 147 patients participating in an institutional accelerated partial breast irradiation (APBI) phase II trial. Both breast cancer cell lines performed non-professional phagocytosis at a higher rate than primary human fibroblasts. In this study cohort, 93.2% of the patients had T1 tumours, and 6.8% had T2 tumours. CIC was found in 61.2% of the patients, with a CIC rate ranging from <1/mm2 to 556.5/mm2 with a mean of 30.9/mm2 ± 68.4/mm2. CIC structures were prognostically favourable for local recurrence-free survival and disease-free survival. Regarding metastasis-free survival, CIC-positive patients had an unfavourable prognosis. Subgroup analysis indicated a correlation between a high proliferation index and high CIC rates. CIC had the highest prognostic value in young breast cancer patients (p = 0.004). With this study, we provide further evidence of CIC as a prognostic marker in breast cancer.
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9
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Choe YJ, Min JY, Lee H, Lee SY, Kwon J, Kim HJ, Lee J, Kim HM, Park HS, Cho MY, Hyun JY, Kim HM, Chung YH, Ha SK, Jeong HG, Choi I, Kim TD, Hong KS, Han EH. Heterotypic cell-in-cell structures between cancer and NK cells is associated with enhanced anti-cancer drug resistance. iScience 2022; 25:105017. [PMID: 36105584 PMCID: PMC9464952 DOI: 10.1016/j.isci.2022.105017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 07/13/2022] [Accepted: 08/19/2022] [Indexed: 11/17/2022] Open
Abstract
The heterotypic CIC structures formed of cancer and immune cells have been observed in tumor tissues. We aimed to assess the feasibility of using heterotypic CICs as a functional biomarker to predict NK susceptibility and drug resistance. The heterotypic CIC-forming cancer cells showed a lower response to NK cytotoxicity and higher proliferative ability than non-CIC cancer cells. After treatment with anticancer drugs, cancer cells that formed heterotypic CICs showed a higher resistance to anticancer drugs than non-CIC cancer cells. We also observed the formation of more CIC structures in cancer cells treated with anticancer drugs than in the non-treated group. Our results confirm the association between heterotypic CIC structures and anticancer drug resistance in CICs formed from NK and cancer cells. These results suggest a mechanism underlying immune evasion in heterotypic CIC cancer cells and provide insights into the anticancer drug resistance of cancer cells. Conformation of heterotypic CIC structures formed between cancer and NK cells Heterotypic CICs exhibit a higher proliferative ability than non-CIC cells Heterotypic CICs are associated with NK susceptibility Heterotypic CICs are involved in anticancer drug resistance
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10
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Siquara da Rocha LDO, Souza BSDF, Lambert DW, Gurgel Rocha CDA. Cell-in-Cell Events in Oral Squamous Cell Carcinoma. Front Oncol 2022; 12:931092. [PMID: 35847959 PMCID: PMC9280122 DOI: 10.3389/fonc.2022.931092] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 05/23/2022] [Indexed: 12/24/2022] Open
Abstract
For over a century, cells within other cells have been detected by pathologists as common histopathological findings in tumors, being generally identified as “cell-in-cell” structures. Despite their characteristic morphology, these structures can originate from various processes, such as cannibalism, entosis and emperipolesis. However, only in the last few decades has more attention been given to these events due to their importance in tumor development. In cancers such as oral squamous cell carcinoma, cell-in-cell events have been linked to aggressiveness, metastasis, and therapeutic resistance. This review aims to summarize relevant information about the occurrence of various cell-in-cell phenomena in the context of oral squamous cell carcinoma, addressing their causes and consequences in cancer. The lack of a standard terminology in diagnosing these events makes it difficult to classify the existing cases and to map the behavior and impacts of these structures. Despite being frequently reported in oral squamous cell carcinoma and other cancers, their impacts on carcinogenesis aren’t fully understood. Cell-in-cell formation is seen as a survival mechanism in the face of a lack of nutritional availability, an acid microenvironment and potential harm from immune cell defense. In this deadly form of competition, cells that engulf other cells establish themselves as winners, taking over as the predominant and more malignant cell population. Understanding the link between these structures and more aggressive behavior in oral squamous cell carcinoma is of paramount importance for their incorporation as part of a therapeutic strategy.
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Affiliation(s)
- Leonardo de Oliveira Siquara da Rocha
- Gonçalo Moniz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Salvador, Brazil
- Department of Pathology and Legal Medicine, School of Medicine, Federal University of Bahia (UFBA), Salvador, Brazil
| | - Bruno Solano de Freitas Souza
- Gonçalo Moniz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Salvador, Brazil
- Center for Biotechnology and Cell Therapy, D'Or Institute for Research and Education (IDOR), Salvador, Brazil
| | - Daniel W. Lambert
- School of Clinical Dentistry, The University of Sheffield, Sheffield, United Kingdom
| | - Clarissa de Araújo Gurgel Rocha
- Gonçalo Moniz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Salvador, Brazil
- Department of Pathology and Legal Medicine, School of Medicine, Federal University of Bahia (UFBA), Salvador, Brazil
- Center for Biotechnology and Cell Therapy, D'Or Institute for Research and Education (IDOR), Salvador, Brazil
- Department of Clinical Propedeutics, School of Dentistry, Federal University of Bahia (UFBA), Salvador, Brazil
- *Correspondence: Clarissa de Araújo Gurgel Rocha,
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11
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Elseragy A, Bello IO, Wahab A, Coletta RD, Mäkitie AA, Leivo I, Almangush A, Salo T. Emerging histopathologic markers in early-stage oral tongue cancer: A systematic review and meta-analysis. Head Neck 2022; 44:1481-1491. [PMID: 35229398 PMCID: PMC9545479 DOI: 10.1002/hed.27022] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 02/16/2022] [Accepted: 02/17/2022] [Indexed: 12/13/2022] Open
Abstract
Although there are many histopathologic prognosticators, grading of early oral tongue squamous cell carcinoma (OTSCC) is still based on morphological cell differentiation which has low prognostic value. Here we summarize the emerging histopathological markers showing powerful prognostic value, but are not included in pathology reports. Using PubMed, Scopus, Ovid Medline, and Web of Science databases, a systematic literature search was preformed to identify early OTSCC studies that investigated the prognostic significance of hematoxylin–eosin‐based histopathologic markers. Our meta‐analysis showed that tumor budding was associated with overall survival (hazard ratio [HR] 2.32; 95% CI 1.40–3.84; p < 0.01) and disease‐specific survival (DSS) (1.89; 95% CI 1.13–3.15; p = 0.02). Worst pattern of invasion was associated with disease‐free survival (DFS) (1.95; 95% CI 1.04–3.64; p = 0.04). Tumor–stroma ratio was also associated with DFS (1.75, 95% CI 1.24–2.48; p < 0.01) and DSS (1.69; 95% CI 1.19–2.42; p < 0.01). Tumor budding, worst pattern of invasion, and tumor–stroma ratio have a promising prognostic value in early OTSCC. The evaluation and reporting of these markers is cost‐effective and can be incorporated in daily practice.
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Affiliation(s)
- Amr Elseragy
- Cancer and Translational Medicine Research Unit, Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland.,Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland.,Department of Pathology, University of Helsinki, Helsinki, Finland
| | - Ibrahim O Bello
- Department of Pathology, University of Helsinki, Helsinki, Finland.,Department of Oral Medicine and Diagnostic Sciences, King Saud University College of Dentistry, Riyadh, Saudi Arabia
| | - Awais Wahab
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland.,Department of Pathology, University of Helsinki, Helsinki, Finland
| | - Ricardo D Coletta
- Department of Oral Diagnosis, School of Dentistry, University of Campinas, Piracicaba, São Paulo, Brazil.,Graduate Program in Oral Biology, School of Dentistry, University of Campinas, Piracicaba, São Paulo, Brazil
| | - Antti A Mäkitie
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Helsinki and HUS Helsinki University Hospital, Helsinki, Finland.,Division of Ear, Nose and Throat Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden.,Research Program in Systems Oncology, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Ilmo Leivo
- Institute of Biomedicine, Pathology, University of Turku, Turku, Finland.,Turku University Central Hospital, Turku, Finland
| | - Alhadi Almangush
- Department of Pathology, University of Helsinki, Helsinki, Finland.,Research Program in Systems Oncology, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Institute of Biomedicine, Pathology, University of Turku, Turku, Finland.,Faculty of Dentistry, Misurata University, Misurata, Libya
| | - Tuula Salo
- Cancer and Translational Medicine Research Unit, Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland.,Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland.,Department of Pathology, University of Helsinki, Helsinki, Finland
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Bauer MF, Hader M, Hecht M, Büttner-Herold M, Fietkau R, Distel LVR. Cell-in-cell phenomenon: leukocyte engulfment by non-tumorigenic cells and cancer cell lines. BMC Mol Cell Biol 2021; 22:39. [PMID: 34332531 PMCID: PMC8325834 DOI: 10.1186/s12860-021-00377-3] [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: 12/08/2020] [Accepted: 06/30/2021] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Research on cell-in-cell (CIC) phenomena, including entosis, emperipolesis and cannibalism, and their biological implications has increased in recent years. Homotypic and heterotypic engulfment of various target cells by numerous types of host cells has been studied in vitro and in tissue sections. This work has identified proteins involved in the mechanism and uncovered evidence for CIC as a potential histopathologic predictive and prognostic marker in cancer. Our experimental study focused on non-professional phagocytosis of leukocytes. RESULTS We studied the engulfment of peripheral blood mononuclear cells isolated from healthy donors by counting CIC structures. Two non-tumorigenic cell lines (BEAS-2B, SBLF-9) and two tumour cell lines (BxPC3, ICNI) served as host cells. Immune cells were live-stained and either directly co-incubated or treated with irradiation or with conventional or microwave hyperthermia. Prior to co-incubation, we determined leukocyte viability for each batch via Annexin V-FITC/propidium iodide staining. All host cells engulfed their targets, with uptake rates ranging from 1.0% ± 0.5% in BxPC3 to 8.1% ± 5.0% in BEAS-2B. Engulfment rates of the cancer cell lines BxPC3 and ICNI (1.6% ± 0.2%) were similar to those of the primary fibroblasts SBLF-9 (1.4% ± 0.2%). We found a significant negative correlation between leukocyte viability and cell-in-cell formation rates. The engulfment rate rose when we increased the dose of radiotherapy and prolonged the impact time. Further, microwave hyperthermia induced higher leukocyte uptake than conventional hyperthermia. Using fluorescent immunocytochemistry to descriptively study the proteins involved, we detected ring-like formations of diverse proteins around the leukocytes, consisting, among others, of α-tubulin, integrin, myosin, F-actin, and vinculin. These results suggest the involvement of actomyosin contraction, cell-cell adhesion, and the α-tubulin cytoskeleton in the engulfment process. CONCLUSIONS Both non-tumorigenic and cancer cells can form heterotypic CIC structures by engulfing leukocytes. Decreased viability and changes caused by microwave and X-ray irradiation trigger non-professional phagocytosis.
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Affiliation(s)
- Mareike F Bauer
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Universitätsstraße 27, D-91054, Erlangen, Germany
| | - Michael Hader
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Universitätsstraße 27, D-91054, Erlangen, Germany
| | - Markus Hecht
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Universitätsstraße 27, D-91054, Erlangen, Germany
| | - Maike Büttner-Herold
- Department of Nephropathology, Institute of Pathology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Krankenhausstraße 8-10, 91054, Erlangen, Germany
| | - Rainer Fietkau
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Universitätsstraße 27, D-91054, Erlangen, Germany
| | - Luitpold V R Distel
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Universitätsstraße 27, D-91054, Erlangen, Germany.
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Almangush A, Alabi RO, Troiano G, Coletta RD, Salo T, Pirinen M, Mäkitie AA, Leivo I. Clinical significance of tumor-stroma ratio in head and neck cancer: a systematic review and meta-analysis. BMC Cancer 2021; 21:480. [PMID: 33931044 PMCID: PMC8086072 DOI: 10.1186/s12885-021-08222-8] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 04/12/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND The clinical significance of tumor-stroma ratio (TSR) has been examined in many tumors. Here we systematically reviewed all studies that evaluated TSR in head and neck cancer. METHODS Four databases (Scopus, Medline, PubMed and Web of Science) were searched using the term tumo(u)r-stroma ratio. The preferred reporting items for systematic reviews and meta-analyses (PRISMA) were followed. RESULTS TSR was studied in nine studies of different subsites (including cohorts of nasopharyngeal, oral, laryngeal and pharyngeal carcinomas). In all studies, TSR was evaluated using hematoxylin and eosin staining. Classifying tumors based on TSR seems to allow for identification of high-risk cases. In oral cancer, specifically, our meta-analysis showed that TSR is significantly associated with both cancer-related mortality (HR 2.10, 95%CI 1.56-2.84) and disease-free survival (HR 1.84, 95%CI 1.38-2.46). CONCLUSIONS The assessment of TSR has a promising prognostic value and can be implemented with minimum efforts in routine head and neck pathology.
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Affiliation(s)
- Alhadi Almangush
- Department of Pathology, University of Helsinki, Haartmaninkatu 3, P.O. Box 21, Helsinki, Finland.
- Research Program in Systems Oncology, Faculty of Medicine, University of Helsinki, Helsinki, Finland.
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland.
- Institute of Biomedicine, Pathology, University of Turku, Turku, Finland.
- Faculty of Dentistry, Misurata University, Misurata, Libya.
| | - Rasheed Omobolaji Alabi
- Department of Industrial Digitalization, School of Technology and Innovations, University of Vaasa, Vaasa, Finland
| | - Giuseppe Troiano
- Department of Clinical and Experimental Medicine, Foggia University, Foggia, Italy
| | - Ricardo D Coletta
- Department of Oral Diagnosis, School of Dentistry, University of Campinas, Piracicaba, São Paulo, Brazil
| | - Tuula Salo
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
- Department of Pathology, University of Helsinki, Helsinki, Finland
- Cancer and Translational Medicine Research Unit, Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - Matti Pirinen
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
- Department of Public Health, University of Helsinki, Helsinki, Finland
- Department of Mathematics and Statistics, University of Helsinki, Helsinki, Finland
| | - Antti A Mäkitie
- Research Program in Systems Oncology, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Division of Ear, Nose and Throat Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - Ilmo Leivo
- Institute of Biomedicine, Pathology, University of Turku and Turku University Hospital, Turku, Finland
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