Evaluation of the correlation of vasculogenic mimicry, ALDH1, KAI1 and microvessel density in the prediction of metastasis and prognosis in colorectal carcinoma

Mesenchymal and Vascular Dissemination Markers, Erythroblastosis Virus E26 Oncogene Homolog (ERG) and Alpha Smooth Muscle Actin (α-SMA), in Colorectal Cancer and Adjacent Tissue, Pericytes or Microvascular Density

The harmony between malignant cells and the adjacent microenvironment is a sophisticated subject; however, it seems to play an important role in cancer evolution. This study aimed to assess the microvascular density (MVD) and the mean pericyte number in the tumor and adjacent tissue, and to correlate the results with special histopathological prognostic variables of the tumor. The study included 48 colorectal cancer (CRC) cases diagnosed in the central lab of Duhok. The immunohistochemical (IHC) expressions of the mesenchymal and vascular dissemination markers, erythroblastosis virus E26 oncogene homolog (ERG, a member of the ETS family of transcription factors) and alpha smooth muscle actin (α-SMA) for microvascular density and pericytes, were assessed in tumor cells and in adjacent tissue around the tumor and then correlated to clinicopathological variables with a special concentration on inflammatory reaction, tumor budding, tumor deposition, and lymphovascular invasion. The results showed that the MVD was significantly higher outside the tumor in T1 and T2 compared with T3 and T4. Moreover, it was significantly higher in grade I when compared to grades II and III within the tumor. However, no correlation was found between the MVD and the special histopathological variables that had been studied. On the other hand, the low mean pericyte showed multiple significant associations outside tumor areas, with special histopathological features including a severe inflammatory reaction, a positive tumor deposit, and a negative lymphovascular invasion. These findings may indicate that defective or transformed pericytes around the tumor can participate in the development of the tumor and, subsequently, the outcome and prognosis.

Expression of KAI1 and AGR2 in lung adenocarcinoma and their clinicopathological significance

OBJECTIVE

Anticancer 1 (KAI1, tumor metastasis suppressor gene) and Anterior gradient-2 (AGR2, considered a valuable prognostic factor for some cancers) are associated with metastasis and prognosis of various types of human cancers. Nevertheless, the relationship between KAI1 and AGR2 in lung adenocarcinoma (LUAD) remains unclear. In this research, we analyzed the correlations between KAI1 and AGR2 in LUAD, and explored their correlations with clinicopathological parameters and overall survival time (OS) in patients with LUAD.

METHODS

Immunohistochemical staining was used to detect KAI1 and AGR2 expression in 132 cases of LUAD samples. At the same time, all clinicopathological parameters and postoperative survival information were collected.

RESULTS

AGR2 positive rate was significantly increased and KAI1 positive rate was significantly decreased in LUAD and control tissues. KAI1 positive rates were negatively correlated with tumor stage, LNM stage and TNM stage, and KAI1 subgroup positive expression of OS was significantly higher than negative KAI1 subgroup. The positive rate of AGR2 was positively correlated with tumor grade, LNM stage and TNM stage, and negatively correlated with patients OS. Active expression of AGR2 and KAI1, tumor stage, and LNM stage in multivariate analyses may be independent prognostic factors for OS in LUAD patients.

CONCLUSION

KAI1 and AGR2 may be potential biomarkers for prognosis and metastasis, and they are also promising therapeutic targets for LUAD patients.

Signaling pathways in the regulation of cancer stem cells and associated targeted therapy

Cancer stem cells (CSCs) are defined as a subpopulation of malignant tumor cells with selective capacities for tumor initiation, self-renewal, metastasis, and unlimited growth into bulks, which are believed as a major cause of progressive tumor phenotypes, including recurrence, metastasis, and treatment failure. A number of signaling pathways are involved in the maintenance of stem cell properties and survival of CSCs, including well-established intrinsic pathways, such as the Notch, Wnt, and Hedgehog signaling, and extrinsic pathways, such as the vascular microenvironment and tumor-associated immune cells. There is also intricate crosstalk between these signal cascades and other oncogenic pathways. Thus, targeting pathway molecules that regulate CSCs provides a new option for the treatment of therapy-resistant or -refractory tumors. These treatments include small molecule inhibitors, monoclonal antibodies that target key signaling in CSCs, as well as CSC-directed immunotherapies that harness the immune systems to target CSCs. This review aims to provide an overview of the regulating networks and their immune interactions involved in CSC development. We also address the update on the development of CSC-directed therapeutics, with a special focus on those with application approval or under clinical evaluation.

KAI1/CD82 gene and autotaxin-lysophosphatidic acid axis in gastrointestinal cancers

The KAI1/CD82 gene inhibits the metastasis of most tumors and is remarkably correlated with tumor invasion and prognosis. Cell metabolism dysregulation is an important cause of tumor occurrence, development, and metastasis. As one of the important characteristics of tumors, cell metabolism dysregulation is attracting increasing research attention. Phospholipids are an indispensable substance in the metabolism in various tumor cells. Phospholipid metabolites have become important cell signaling molecules. The pathological role of lysophosphatidic acid (LPA) in tumors was identified in the early 1990s. Currently, LPA inhibitors have entered clinical trials but are not yet used in clinical treatment. Autotaxin (ATX) has lysophospholipase D (lysoPLD) activity and can regulate LPA levels in vivo. The LPA receptor family and ATX/lysoPLD are abnormally expressed in various gastrointestinal tumors. According to our recent pre-experimental results, KAI1/CD82 might inhibit the migration and metastasis of cancer cells by regulating the ATX-LPA axis. However, no relevant research has been reported. Clarifying the mechanism of ATX-LPA in the inhibition of cancer metastasis by KAI1/CD82 will provide an important theoretical basis for targeted cancer therapy. In this paper, the molecular compositions of the KAI1/CD82 gene and the ATX-LPA axis, their physiological functions in tumors, and their roles in gastrointestinal cancers and target therapy are reviewed.

Interrogating the interplay of angiogenesis and immunity in metastatic colorectal cancer

Colon cancer is the third most common malignancy and the fifth most frequent cause of death from neoplastic disease worldwide. At the time of diagnosis, more than 20% of patients already have metastatic disease. In the last 20 years, the natural course of the disease has changed due to major changes in the management of metastatic disease such as the advent of novel surgical and local therapy approaches as well as the introduction of novel chemotherapy drugs and targeted agents such as anti-epidermal growth factor receptor, anti-BRAF and antiangiogenics. Angiogenesis is a complex biological process of new vessel formation from existing ones and is an integral component of tumor progression supporting cancer cells to grow, proliferate and metastasize. Many molecules are involved in this proangiogenic process, such as vascular endothelial growth factor and its receptors on endothelial cells. A well-standardized methodology that is applied to assess angiogenesis in the tumor microenvironment is microvascular density by using immunohistochemistry with antibodies against endothelial CD31, CD34 and CD105 antigens. Even smaller molecules, such as the microRNAs, which are small non-coding RNAs, are being studied for their usefulness as surrogate biomarkers of angiogenesis and prognosis. In this review, we will discuss recent advances regarding the investigation of angiogenesis, the crosstalk between elements of the immune microenvironment and angiogenesis and how a disorganized tumor vessel network affects the trafficking of CD8+ T cells in the tumor bed. Furthermore, we will present recent data from clinical trials that combine antiangiogenic therapies with immune checkpoint inhibitors in colorectal cancer.

Effect of HPV 16 E6 Oncoprotein Variants on the Alterations of the Proteome of C33A Cells

BACKGROUND/AIM

The E6 genotypic variants of HPV 16 identified in lesions of women with cervical cancer (CC) in Southern of Mexico include the E-G350, AAa, AAc, E-C188/G350, and E-A176/G350, transcriptomic analysis cells transfected with those variants showed to induce differential expression of the host genes involved in the development of CC, the aim of this work was to understand how the over-expression of the E6 oncoprotein and its variants can induce molecular mechanisms that lead to more aggressive HPV 16 phenotypes in cervical cancer and which proteins could be associated with the process.

MATERIALS AND METHODS

Total extracts from C33A, C33A mock, C33A AAa, C33A E-C188/G350, C33A E-A176/G350, and C33A E-prototype cells were analyzed using 2D electrophoresis, PDQuest software and mass spectrometry, validation of results was performed through qPCR.

RESULTS

Statistically significant differential expression of 122 spots was detected, 12 of the identified proteins were associated with metabolism and metabolic programming. Out of these CCT8, ENO and ALDH1A were further validated.

CONCLUSION

CCT8 and ALDH1A were found to be over-expressed in C33A AAa and C33A E-A176/G350, compared to the E prototype. Both proteins could be associated with a most aggressive phenotype due to their relationship with metabolism, protein folding and stemness, mechanisms associated to E6 that could be useful in the design of new therapies.

Cancer Stem Cells and Neovascularization

Cancer stem cells (CSCs) refer to a subpopulation of cancer cells responsible for tumorigenesis, metastasis, and drug resistance. Increasing evidence suggests that CSC-associated tumor neovascularization partially contributes to the failure of cancer treatment. In this review, we discuss the roles of CSCs on tumor-associated angiogenesis via trans-differentiation or forming the capillary-like vasculogenic mimicry, as well as the roles of CSCs on facilitating endothelial cell-involved angiogenesis to support tumor progression and metastasis. Furthermore, we discuss the underlying regulation mechanisms, including the intrinsic signals of CSCs and the extrinsic signals such as cytokines from the tumor microenvironment. Further research is required to identify and verify some novel targets to develop efficient therapeutic approaches for more efficient cancer treatment through interfering CSC-mediated neovascularization.

FOXM 1 induces Vasculogenic mimicry in esophageal cancer through β-catenin /Tcf4 signaling

Objective

To investigate the role of FOXM1, β-catenin and TCF4 in esophageal cancer (EC) and their relationship to VM (Vasculogenic Mimicry).

Methods

CCK-8 were performed to examine EC cell proliferation in FOXM1 silenced cells. EC cell migration and invasion were investigated through wound healing and Transwell assays, respectively. The formation of pipe like structures were assessed in 3D cultures. The expression of Foxm1, β-catenin, Tcf4 and E-cadherin were investigated through western blot, RT-qPCR and immunohistochemistry (IHC) staining. The relationship between FOXM1 expression, clinic-pathological features, and overall survival (OS) were further analyzed.

Results

A loss of FOXM1 expression correlated with the OS of ESCC patients. FOXM1 silencing led to a loss of cell growth and suppressed cell migration and invasion in ESCC cells. VM structures were identified in ESCC tissues and human EC cell lines. Mechanistically, FOXM1 was found to promote tumorigenesis through the regulation of β-catenin, Tcf4, and E-cadherin in EC cells, leading to the formation of VM structures.

Conclusions

These findings highlight FoxM1 as a novel therapeutic target in ESCC.

B7-H3 promotes colorectal cancer angiogenesis through activating the NF-κB pathway to induce VEGFA expression

Tumor angiogenesis is a hallmark of cancer and is involved in the tumorigenesis of solid tumors. B7-H3, an immune checkpoint molecule, plays critical roles in proliferation, metastasis and tumorigenesis in diverse tumors; however, little is known about the biological functions and molecular mechanism underlying B7-H3 in regulating colorectal cancer (CRC) angiogenesis. In this study, we first demonstrated that the expression of B7-H3 was significantly upregulated and was positively associated with platelet endothelial cell adhesion molecule-1 (CD31) level in tissue samples from patients with CRC. In addition, a series of in vitro and in vivo experiments showed that conditioned medium from B7-H3 knockdown CRC cells significantly inhibited the migration, invasion, and tube formation of human umbilical vein endothelial cells (HUVECs), whereas overexpression of B7-H3 had the opposite effect. Furthermore, B7-H3 promoted tumor angiogenesis by upregulating VEGFA expression. Recombinant VEGFA abolished the inhibitory effects of conditioned medium from shB7-H3 CRC cells on HUVEC angiogenesis, while VEGFA siRNA or a VEGFA-neutralizing antibody reversed the effects of conditioned medium from B7-H3-overexpressing CRC cells on HUVEC angiogenesis. Moreover, we verified that B7-H3 upregulated VEGFA expression and angiogenesis by activating the NF-κB pathway. Collectively, our findings identify the B7-H3/NF-κB/VEGFA axis in promoting CRC angiogenesis, which serves as a promising approach for CRC treatment.

Therapeutic Targeting of the Colorectal Tumor Stroma

Colorectal tumors have been classified based on histologic factors, genetic factors, and consensus molecular subtypes, all of which affect the tumor microenvironment. Elements of the tumor microenvironment serve as therapeutic targets and might be used as prognostic factors. For example, immune checkpoint inhibitors are used to treat tumors with microsatellite instability, and anti-angiogenic agents may be used in combination with other drugs to slow or inhibit tumor growth. We review the features of the colorectal tumor stroma that are associated with patient outcomes and discuss potential therapeutic agents that target these features.

Galectin-1 Promotes Vasculogenic Mimicry in Gastric Cancer by Upregulating EMT Signaling

Background: Galectin-1 (Gal-1) expression was positively associated with vasculogenic mimicry (VM) in primary gastric cancer (GC) tissue, and that both Gal-1 expression and VM in GC tissue are indicators of poor prognosis. However, whether Gal-1 promotes VM, and by what mechanismsremains unknown.

Methods: To investigate the underlying mechanisms,wound healing assay, proliferation assay, invasion assay, and three-dimensional culture were used to evaluate the invasion, metastasis and promoted VM formation effects of the Gal-1. We monitored the expression level of sociated proteins in GC tissues, cell lines in vitro and nude mice tumorigenicity in vivo by immunohistochemistry and western blot.

Results: Gal-1 overexpression significantly promoted the proliferation, invasion, migration, and VM formation of MGC-803 cells. Gal-1 was associated with E-cadherin and vimentin in vitro and in clinical samples. The epithelial-to-mesenchymal transition (EMT) induced in MGC-803 cells by TGF-β1 was accompanied by Gal-1 activation and promotion of VM formation, while knockdown of Gal-1 reduced the response to TGF-β1, suggesting that Gal-1 promotes VM formation by activating EMT signaling. Overexpression of Gal-1 accelerated subcutaneous xenograft growth and facilitated pulmonary metastasis in athymic mice, enhanced the expression of EMT markers, and promoted VM formation in vivo.

Conclusion: Our results indicated that Gal-1 promotes VM in GC by upregulating EMT signaling; thus, Gal-1 and this pathway are potential novel targets to treat VM in GC.

Mechanisms of Vasculogenic Mimicry in Ovarian Cancer

Solid tumors carry out the formation of new vessels providing blood supply for growth, tumor maintenance, and metastasis. Several processes take place during tumor vascularization. In angiogenesis, new vessels are derived from endothelial cells of pre-existing vessels; while in vasculogenesis, new vessels are formed de novo from endothelial progenitor cells, creating an abnormal, immature, and disorganized vascular network. Moreover, highly aggressive tumor cells form structures similar to vessels, providing a pathway for perfusion; this process is named vasculogenic mimicry (VM), where vessel-like channels mimic the function of vessels and transport plasma and blood cells. VM is developed by numerous types of aggressive tumors, including ovarian carcinoma which is the second most common cause of death among gynecological cancers. VM has been associated with poor patient outcome and survival in ovarian cancer, although the involved mechanisms are still under investigation. Several signaling molecules have an important role in VM in ovarian cancer, by regulating the expression of genes related to vascular, embryogenic, and hypoxic signaling pathways. In this review, we provide an overview of the current knowledge of the signaling molecules involved in the promotion and regulation of VM in ovarian cancer. The clinical implications and the potential benefit of identification and targeting of VM related molecules for ovarian cancer treatment are also discussed.

Prognostic value of microvessel density in stage II and III colon cancer patients: a retrospective cohort study

Background

Microvessel density (MVD), as a derived marker for angiogenesis, has been associated with poor outcome in several types of cancer. This study aimed to evaluate the prognostic value of MVD in stage II and III colon cancer and its relation to tumour-stroma-percentage (TSP) and expression of HIF1A and VEGFA.

Methods

Formalin-fixed paraffin-embedded (FFPE) colon cancer tissues were collected from 53 stage II and 54 (5-fluorouracil-treated) stage III patients. MVD was scored by digital morphometric analysis of CD31-stained whole tumour sections. TSP was scored using haematoxylin-eosin stained slides. Protein expression of HIF1A and VEGFA was determined by immunohistochemical evaluation of tissue microarrays.

Results

Median MVD was higher in stage III compared to stage II colon cancers (11.1% versus 5.6% CD31-positive tissue area, p < 0.001). High MVD in stage II patients tended to be associated with poor disease free survival (DFS) in univariate analysis (p = 0.056). In contrast, high MVD in 5FU-treated stage III patients was associated with better DFS (p = 0.006). Prognostic value for MVD was observed in multivariate analyses for both cancer stages.

Conclusions

MVD is an independent prognostic factor associated with poor DFS in stage II colon cancer patients, and with better DFS in stage III colon cancer patients treated with adjuvant chemotherapy.

Electronic supplementary material

The online version of this article (10.1186/s12876-019-1063-4) contains supplementary material, which is available to authorized users.

Fact or Fiction, It Is Time for a Verdict on Vasculogenic Mimicry?

The term vasculogenic mimicry (VM) refers to the capacity of certain cancer cells to form fluid-conducting structures within a tumor in an endothelial cell (EC)-free manner. Ever since its first report by Maniotis in 1999, the existence of VM has been an extremely contentious issue. The overwhelming consensus of the literature suggests that VM is frequently observed in highly aggressive tumors and correlates to lower patient survival. While the presence of VM in vivo in animal and patient tumors are claimed upon the strong positive staining for glycoproteins (Periodic Acid Schiff, PAS), it is by no means universally accepted. More controversial still is the existence of an in vitro model of VM that principally divides the scientific community. Original reports demonstrated that channels or tubes occur in cancer cell monolayers in vitro when cultured in matrigel and that these structures may support fluid movement. However, several years later many papers emerged stating that connections formed between cancer cells grown on matrigel represented VM. We speculate that this became accepted by the cancer research community and now the vast majority of the scientific literature reports both presence and mechanisms of VM based on intercellular connections, not the presence of fluid conducting tubes. In this opinion paper, we call upon evidence from an exhaustive review of the literature and original data to argue that the majority of in vitro studies presented as VM do not correspond to this phenomenon. Furthermore, we raise doubts on the validity of concluding the presence of VM in patient samples and animal models based solely on the presence of PAS+ staining. We outline the requirement for new biomarkers of VM and present criteria by which VM should be defined in vitro and in vivo.

The clinicopathological significance of ubiquitin-conjugating enzyme E2C, leucine-rich repeated-containing G protein-coupled receptor, WW domain-containing oxidoreductase, and vasculogenic mimicry in invasive breast carcinoma

Ubiquitin-conjugating enzyme E2C (UBE2C), a crucial part of the ubiquitin-conjugating enzyme complex, is reported to promote progression of various cancers. Leucine-rich repeated-containing G protein-coupled receptor (LGR5), a biomarker of cancer stem cells, is reported to be responsible for the initiation and progression of cancers. WW domain-containing oxidoreductase (WWOX), a suppressor of tumor, is reported to inhibit initiation and progression of cancers. Vasculogenic mimicry (VM), a new blood supply pattern, is associated with progression of cancers. However, the clinicopathological significance of UBE2C, LGR5, WWOX, and VM in invasive breast carcinoma (IBC) remains elusive. The aim of this study is to investigate the positive rate of UBE2C, LGR5, WWOX, and VM in IBC and their clinical significance.Positive rates of UBE2C, LGR5, WWOX, and VM in 247 whole IBC samples were detected through immunohistochemistry. Patients data (including clinical, demography, follow-up) were collected.Levels of UBE2C, LGR5, VM, and microvessel density (MVD) were significantly higher, and level of WWOX was significantly lower in IBC specimens when compared with normal mammary gland tissues. Levels of UBE2C, LGR5, VM, and MVD were all positively associated with tumor stages, lymph node metastasis (LNM) stages, tumor grades, and tumor-node-metastasis (TNM) stages, and unfavorably with patients' overall survival (OS) and disease-free survival (DFS). Level of WWOX was negatively associated with tumor stages, LNM stages, grades, and TNM stages, and favorably with patients' OS and DFS. Multivariate analysis indicated that levels of UBE2C, LGR5, VM, MVD, and WWOX, as well as TNM stages were independently prognostic factors for OS and DFS in patients with IBC.UBE2C, LGR5, VM, MVD, and WWOX may be considered as promising indicator of IBC prognosis.

The expression of metastasis-associated in colon cancer-1, Snail, and KAI1 in esophageal carcinoma and their clinical significance

OBJECTIVE

Metastasis-associated in colon cancer-1 (MACC1) is a key transcriptional regulator of mesenchymal-epithelial transition (MET) gene and so involved in the hepatocyte growth factor/MET signaling pathway. Snail has been reported to be associated with tumor epithelial-mesenchymal transition (EMT) and involved in the process of invasion and metastasis. KAI1 is a suppressor gene of tumor metastasis. The aim of this study is to explore the associations of MACC1, Snail, and KAI1 expression in esophageal squamous cell carcinoma (ESCC) and clinicopathologic characteristics of ESCC patients and their associations with each other.

METHODS

Immunohistochemistry was conducted to detect the expression of MACC1, Snail, and KAI1 in 214 whole-ESCC-tissue samples and corresponding normal esophageal mucosa tissues. All clinicopathologic, demographic, and follow-up data were collected.

RESULTS

MACC1 and Snail were significantly up-regulated in ESCC samples when compared with control samples; KAI1 was significantly down-regulated in ESCC group when compared with control group. Furthermore, positive expression of MACC1 and Snail was positively associated with tumor stages, lymph-node-metastasis (LNM) stages, and tumor-node-metastasis (TNM) stages. Positive expression of KAI1 was negatively associated with tumor grade, tumor stage, and LNM stages as well as TNM stage. The MACC1- or Snail-positive expression group had more unfavorable overall survival (OS) time than did the MACC1- or Snail-negative group; the positive expression of KAI1 group had significantly longer OS time than did the KiSS-1 negative group. Multivariate analysis of OS showed that overexpression of MACC1 and Snail, and down expression of KAI1 and tumor stages as well as TNM stages were independent prognostic factors for patients with ESCC.

CONCLUSIONS

Levels of expression of MACC1, Snail, and KAI1 are associated with the duration of OS in patients with ESCC. MACC1, Snail, and KAI1 should be considered as useful biomarkers and therapeutic targets in ESCC.

Knockdown of USF1 Inhibits the Vasculogenic Mimicry of Glioma Cells via Stimulating SNHG16/miR-212-3p and linc00667/miR-429 Axis

The anti-angiogenic treatment of malignant glioma cells is an effective method to treat high-grade gliomas. However, due to the presence of vasculogenic mimicry (VM), the anti-angiogenic treatment of gliomas is not significantly effective in improving overall patient median survival. Therefore, this study investigated the mechanism of mimic formation of angiogenesis in gliomas. The results of this experiment indicate that the expression of upstream transcription factor 1 (USF1) is upregulated in glioma tissues and cells. USF1 knockdown inhibits the proliferation, migration, invasion, VM, and expression of VM-associated proteins in glioma cells by stimulating SNHG16 and linc00667. These two long non-coding RNAs (lncRNAs) regulate ALHD1A1 through the competing endogenous RNA (ceRNA) mechanism influencing the VM of glioma. This study is the first to demonstrate that the USF1/SNHG16/miR-212-3p/ALDH1A1 (aldehyde dehydrogenase-1) and USF1/linc00667/miR-429/ALDH1A1 axis regulates the VM of glioma cells, and these findings might provide a novel strategy for glioma treatment.

Relationship of vasculogenic mimicry, SphK1 expression, and Cx43 expression to metastasis and prognosis in colorectal cancer

OBJECTIVE

To determine the presence of vasculogenic mimicry (VM) and expression of Sphingosine kinase 1 (SphK1) and Connexin43 (Cx43) in colorectal cancer (CRC) tissues, and to identify their inter-relationships and associations with multiple pathologic parameters.

METHODS

Ninety-two CRC specimens and normal pericarcinoma tissues were analyzed for expression of SphK1 and Cx43 using immunohistochemistry, and for identification of VM using CD34-periodic acid-Schiff dual staining.

RESULTS

The positive rate of SphK1 expression was greater in CRC cells than pericarcinoma cells (85.87% vs. 33.70%, P < 0.05). In contrast, the positive rate of Cx43 expression was greater in pericarcinoma cells than in CRC cells (58.70% vs. 92.39%, P < 0.05). Analysis of CRC tissues indicated that expression of SphK1 was associated with poor differentiation, advanced tumor stage, lymph node metastasis, and the presence of VM (P < 0.05 for each comparison). Expression of Cx43 was associated with high differentiation and the presence of VM (P < 0.05 for each comparison). Patient sex, age, tumor size, depth of invasion, and distant metastasis were unrelated to the expression of either protein. There was a significant correlation between the expression of SphK1 and Cx43 (P < 0.05). Analysis of overall patient survival indicated that SphK1 positivity and the presence of VM were significantly associated with poor survival, but Cx43 positivity had no relationship with survival.

CONCLUSION

SphK1 protein expression was significantly greater in CRC tissues than pericarcinoma tissues, suggesting this protein may be associated with the pathogenesis of CRC. In addition, the significant correlation between expression of SphK1 and Cx43 in CRC tissues suggests their interaction may impact the pathogenesis of CRC.

Correlation Between Tumor Vasculogenic Mimicry and Poor Prognosis of Human Digestive Cancer Patients: A Systematic Review and Meta-Analysis

Vasculogenic mimicry (VM) is a new pattern of blood supplement independent of endothelial vessels, which is related with tumor invasion, metastasis and prognosis. However, the role of VM in the prognosis of cancer patients is controversial. This study aimed to perform a meta-analysis of the published data to attempt to clarify the prognostic value of VM in the digestive cancer. Relevant studies were retrieved from the PubMed, Web of Science, Cochrane Library, Chinese National Knowledge Infrastructure and VIP databases published before March 29, 2018. Studies were included if they detected VM in the digestive cancer and analyzed the overall survival (OS) or disease-free survival (DFS) according to VM status. Two independent reviewers screened the studies, extracted data, and evaluated the quality of included studies with the Newcastle-Ottawa scale. Meta-analysis was performed using STATA 12.0 software. A total of 22 studies with 2411 patients were included in this meta-analysis. Meta-analysis showed that VM was related with the poor OS (HR = 2.30, 95% CI: 2.06-2.56, P < 0.001) and DFS (HR = 2.60, 95% CI: 2.07-3.27, P < 0.001) of patients with digestive cancer. Subgroup analysis showed VM was related with tumor differentiation, lymph node metastasis and TNM stage. Moreover, the present meta-analysis was reliable, and there was no obvious publication bias. This meta-analysis suggested that VM was a poor prognosis of digestive cancer patients. Further large and well-designed studies are required.

The clinical significance of CD133, MACC1, and KAI1 expression in sebaceous gland carcinoma of the eyelid

BACKGROUND AND PURPOSE

CD133, which is considered a useful biomarker for the prediction of metastasis and prognosis for various cancers, is a biomarker of cancer stem cells (CSCs). Metastasis-associated in colon cancer 1 (MACC1) has been considered an oncogene that promotes invasion and metastasis in many solid tumors. KAI1 is a suppressor gene of metastasis and is also considered a valuable biomarker for the prediction of tumor invasion and metastasis. The purpose of this study is to investigate the expression of CD133, MACC1, and KAI1 in sebaceous gland carcinoma of the eyelid (SGCE) and to analyze their respective associations with clinicopathologic characteristics and survival in SGCE.

METHODS

Positive expression of CD133, MACC1, and KAI1 in 77 whole SGCE tissues and the corresponding normal tissues were detected by immunohistochemistry. Patient demographics, clinical data, and follow-up data were collected.

RESULTS

The positive expression of CD133 and MACC1 was significantly higher and KAI1 significantly lower in SGCE tissues compared to the control tissues. The Positive expression of CD133 and MACC1 was positively associated with local invasion, lymph node metastasis (LNM), and TNM stages. KAI1 expression was inversely associated with tumor grade, local invasion, LNM, and TNM stages. A Kaplan-Meier survival analysis demonstrated that CD133+ or MACC1+ patients had a significantly lower overall survival (OS) time when compared with CD133- or MACC1- patients. And KAI1+ patients had a significantly longer OS time compared with KAI1- patients. Multivariate analysis showed that positive expression of CD133, MACC1, and KAI1, as well as the TNM stages were independent prognostic factors in SGCE patients.

CONCLUSION

The expression of CD133, MACC1, and KAI1 should be considered promising biomarkers for invasion, metastasis, and prognosis, as well as potential therapeutic targets for SGCE.

Expressions of KAI1 and E-cadherin in nonsmall cell lung cancer and their correlation with vasculogenic mimicry

BACKGROUND

Metastasis and recurrence are the most common reasons for treatment failure of nonsmall cell lung cancer (NSCLC). Vasculogenic mimicry (VM, new blood supply formation in malignant tumors), E-Cadherin (a calcium-dependent transmembrane glycoprotein that mediates intercellular adhesion), KAI1 (a suppressor gene of tumor metastasis) are all valuable factors for metastasis and prognosis in diverse common human cancers. However, the correlation of VM, E-Cadherin, and KAI1 in NSCLC is still unclear. In this study, we analyzed the correlations among these factors as well as their respective correlations with clinicopathological parameters and survival in NSCLC.

METHODS

The level of VM, E-Cadherin, and KAI1 in 163 tissue samples of NSCLC was examined by immunhistochemistry. Clinical data were also collected.

RESULTS

Levels of VM was significantly higher, and levels of KAI1 and E-Cadherin significantly lower in NSCLC tissues than in normal lung tissues. Levels of VM were positively associated with lymph node metastasis (LNM), size, grade, and tumor node metastasis (TNM) stages, and negatively associated with patients' overall survival (OS). Levels of KAI1 and E-Cadherin were negatively correlated with LNM, size, grade, and TNM stage, and positively associated with patients' OS. In multivariate analysis, high levels of VM, E-Cadherin, and KAI1, as well as TNM stages were independently correlated with lower OS in patients with NSCLC.

CONCLUSION

VM and the expression of E-Cadherin and KAI1 may represent promising metastatic and prognostic biomarkers, as well as potential therapeutic targets for NSCLC.

The correlation of KAI1, Slug and vasculogenic mimicry in the prediction of metastasis and prognosis in colorectal carcinoma

KAI1 and the epithelial-mesenchymal transition regulator Slug, as well as vasculogenic mimicry (VM), play a significant role in the process of metastasis and prognosis in many human cancers. This study investigated the relationship of KAI1, Slug and VM and their connection with clinicopathological features, metastasis and their prognostic value in colorectal carcinoma (CRC). Immunohistochemistry was performed to analyze the expression of KAI, Slug, VM, E-cadherin (E-cad) and vimentin in 134 human CRC and corresponding normal mucosal tissues. The results showed that the protein expressions of KAI1, Slug and VM in tumor tissues were significantly different from adjacent normal mucosal tissues. The expression of KAI1 was negatively related, while the expressions of Slug and VM are positively related with differentiation, lymph node metastasis, distant metastasis and TNM stage. KAI1 was negatively related, while VM was positively related with invasion. The expression of KAI1 showed a negative correlation with Slug and VM. Moreover, the expression of Slug was positively associated with VM. A Kaplan-Meier analysis showed that the expression of Slug and VM was negatively and KAI1 expression was positively correlated with overall survival. Low KAI1 expression and high Slug and VM expression showed a poorer prognosis in CRC. Multivariate Cox regression analysis showed that the expression of KAI1, Slug, VM and TNM stage were independent predictors of OS in CRC. The expression of KAI1, Slug and VM was correlated with metastasis and prognosis. These findings suggest that KAI1, Slug and VM can be novel therapeutic targets to predict metastasis and prognosis in CRC patients.

Value of CagA, HER2, ALDH1, and KiSS-1 in predicting metastasis and prognosis for gastric adenocarcinoma

BACKGROUND

Cytotoxin-associated gene A (CagA), is able to translocate into gastric epithelial cells. Human epidermal growth factor receptor 2 (also named as HER2, is a proto-oncogene which can encode a transmembrane receptor), Aldehyde dehydrogenase 1 (ALDH1, a biomarker of cancer stem cells), and KiSS-1 (a suppressor gene of cancer metastasis) are all valuably predictive biomarkers for various human cancers. The purpose of this study is to investigate the associations among CagA, HER2, ALDH1, and KiSS-1 in gastric adenocarcinoma (GAC), and their respective associations with clinical characteristics and survival in GAC.

METHODS

The expression of CagA, HER2, ALDH1, and KiSS-1 in 232 cases of whole GAC tissues were detected by immunohistochemical staining. Patient clinical and survival data were also collected.

RESULTS

Positive expression of CagA, HER2, and ALDH1 is significantly higher, and positive expression of KiSS-1 is significantly lower, in GAC tissues than in the corresponding normal tissues. Furthermore, the positive expression of CagA, HER2, ALDH1, and KiSS-1 were significantly associated with tumor grade, tumor stage, lymph node metastasis (LNM) stage, and tumor node metastasis (TNM) stages, and with patients' overall survival (OS); whereas the KiSS-1 positive group had longer OS than did the KiSS-1 negative group. In logistic analysis, positive expression of CagA, HER2, ALDH1, and KiSS-1 are significantly associated with LNM of patients with GAC. COX regression analysis indicated that positive expression of CagA, HER2, ALDH1, and KiSS-1, and tumor stages, LNM stages, and TNM stages were independent prognostic factors for patients with GAC.

CONCLUSIONS

Expression of CagA, HER2, ALDH1, and KiSS-1 should be considered as promising biomarkers for metastasis and prognosis, as well as potential therapeutic targets for GAC.

The expressions of CD133, ALDH1, and vasculogenic mimicry in osteosarcoma and their clinical significance

BACKGROUND AND PURPOSE

Osteosarcoma is an aggressive malignant bone tumor in children and adolescents, which is more likely to recur and metastasize at the early stages. Cancer stem cells (CSC, CD133 is a biomarker of cancer stem cells), angiogenesis, and vasculogenic mimicry (VM) are closely related to tumor metastasis and recurrence. In this study, we investigated the associations among CD133, aldehyde dehydrogenase 1 (ALDH1), and VM in osteosarcoma, and their associations with clinical characteristics.

METHODS

Positive rates of CD133, ALDH1, and VM in 96 whole osteosarcoma tissue samples were detected by immunohistochemistry (IHC) and histochemistry staining. Patients' clinical data were also collected.

RESULTS

Positive rates of CD133, ALDH1, and VM were significantly higher in osteosarcoma tissues compared with the control tissues. Positive rates of CD133, ALDH1, and VM were positively associated with lymph node metastasis, distant metastasis, Enneking stages, and patients' overall survival (OS). A multivariate analysis indicated that the positive rates of CD133, ALDH1, and VM, as well as the Enneking stages were independent prognostic factors of osteosarcoma.

CONCLUSION

The positive rates of CD133, ALDH1, and VM could represent potential biomarkers for metastasis and prognosis, which suggests these molecules might be promising therapeutic targets for osteosarcoma.

Aberrant expression of ALDH1, MMP9, Integrin αvβ3, and KiSS-1 in invasive ductal carcinoma and their clinical significance

BACKGROUND

Aldehyde dehydrogenase 1 (ALDH1, a biomarker of cancer stem cells), matrix metalloproteinase 9 (MMP9, known as a matrilysin), Integrin αvβ3 (known as a biomarker of cell-matrix adhesion) and KiSS-1 (suppressor gene of tumor metastasis) are all related to cancer invasion and metastasis in many cancers. The purpose of this study was to investigate the expression of ALDH1, MMP9, Integrin αvβ3, and KiSS-1 in invasive ductal carcinoma (IDC), and their respective associations with clinical characteristics and survival in IDC.

METHODS

Immunohistochemical staining was used to detect the expression of ALDH1, MMP9, Integrin αvβ3, and KiSS-1 in 227 whole IDC tissue specimens. Patients' clinical and demographic data were both collected.

RESULTS

The expression of ALDH1, MMP9, and Integrin αvβ3 were significantly higher in IDC tissues than in the control tissues. The positive expressions of ALDH1, MMP9, and Integrin αvβ3 were positively associated with tumor grades, lymph node metastasis (LNM), tumor stages, and tumor node metastasis (TNM) stages, and inversely with overall survival (OS) and recurrence-free survival (RFS). Positive expression of KiSS-1 was negatively associated with tumor grades, LNM, tumor stages, and TNM stages, but positively with OS and RFS. A multivariate analysis demonstrated that the positive expression of ALDH1, MMP9, Integrin αvβ3, KiSS-1, ER, and HER-2, as well as TNM stages were independent prognostic factors for OS and RFS in IDC.

CONCLUSIONS

The expression of ALDH1, MMP9, Integrin αvβ3, and KiSS-11 should represent promising biomarkers in predicting metastasis and prognosis, as well as being potential therapeutic targets for IDC.

Vasculogenic mimicry and expression of slug and vimentin correlate with metastasis and prognosis in non-small cell lung cancer

Background: Non-small cell lung cancer (NSCLC) has been the leading cause of cancer death in recent years, its morbidity and mortality were increasing yearly. The presence of vasculogenic mimicry (VM) is associated with a high tumor grade, short survival, invasion, and metastasis. Slug is a key regulating factor in the process of EMT. Vimentin is one of the cytoskeleton proteins that plays an important role in EMT. However, associations among VM, Slug and vimentin and their clinicopathologic significance in NSCLC are unclear. In this study, we analyzed associations among VM, Slug and vimentin in NSCLC, and their respective associations with clinicopathologic characteristics and survival in NSCLC. Methods: Positive expression of VM, Slug and vimentin in 198 whole NSCLC tissue samples were detected by immunohistochemical staining. Patients' clinical data were also collected. Results: Levels of VM, Slug and vimentin were significantly higher in NSCLC tissues than in normal lung tissues. Levels of VM, Slug and vimentin were positively associated with tumor grade, distant metastasis (DM), lymph node metastasis (LNM), and tumor-node metastasis (TNM) stage, and inversely with patients overall survival time (OST). In multivariate analysis, high expression of VM, Slug, vimentin, and tumor grade, DM, LNM, TNM stage, were potential to be independent prognostic factors for OST in patients with NSCLC. Conclusion: VM, Slug and vimentin affect NSCLC evolution; and the combined detection of VM, Slug and vimentin are valuable factors for metastasis and prognosis in NSCLC patients.

Associations of MACC1, AGR2, and KAI1 expression with the metastasis and prognosis in head and neck squamous cell carcinoma

BACKGROUND

Metastasis-associated in colon cancer-1 (MACC1, was firstly found in colon cancer and associated metastasis and prognosis in various cancers), anterior gradient 2 (AGR2, was considered as a valuable prognostic factor for some cancers), and Kangai 1 (KAI1, was a tumor metastasis suppressor gene) are all related to metastasis and prognosis of many cancers. However, the associations of MACC1, AGR2, and KAI1 in head and neck squamous cell carcinoma (HNSCC) are still unclear. In this study, we analyzed associations among MACC1, AGR2, and KAI1 in HNSCC, and their respective associations with clinicopathological parameters and overall survival (OS) in HNSCC.

METHODS

Positive expression of MACC1, AGR2, and KAI1 in 106 whole HNSCC tissue samples was detected by immunohistochemical staining. Patient's clinical data and demographics were both collected.

RESULTS

Positive rates of MACC1 and AGR2 were significantly higher, and positive rate of KAI1 was significantly lower, in HNSCC and than those in control tissues. Positive rates of MACC1 and AGR2 were positively correlated with grades of tumor, TNM stages, and lymph node metastasis (LNM) stages, and negatively with patients OS; positive rate of KAI1 was negatively associated with grades of tumor, TNM stages, and LNM stages, and the positive expression of KAI1 subgroup had significantly longer OS than did the negative KAI1 subgroup. In multivariate analysis, positive expression MACC1, AGR2, and KAI1, and tumor stages, as well as LNM stages were potential to be independent prognostic factors for OS in patients with HNSCC.

CONCLUSIONS

MACC1, AGR2, and KAI1 may represent potential metastatic and prognostic biomarkers, as well as promising therapeutic targets for HNSCC.

Cancer stem cells in progression of colorectal cancer

Colorectal cancer is one of the most common cancers worldwide with high mortality. Distant metastasis and relapse are major causes of patient death. Cancer stem cells (CSCs) play a critical role in the metastasis and relapse of colorectal cancer. CSCs are a subpopulation of cancer cells with unique properties of self-renewal, infinite division and multi-directional differentiation potential. Colorectal CSCs are defined with a group of cell surface markers, such as CD44, CD133, CD24, EpCAM, LGR5 and ALDH. They are highly tumorigenic, chemoresistant and radioresistant and thus are critical in the metastasis and recurrence of colorectal cancer and disease-free survival. This review article updates the colorectal CSCs with a focus on their role in tumor initiation, progression, drug resistance and tumor relapse.

Prognostic role of CD82/KAI1 in multiple human malignant neoplasms: a meta-analysis of 31 studies

Tetraspanin CD82, also known as KAI1, was revealed as an attractive prognostic tumor biomarker in recent studies. However, some results of these studies remained debatable and inconclusive. Therefore, we conducted a meta-analysis to clarify the precise predictive value of CD82 in various neoplasms. Qualified studies were identified up to April 27, 2017, by searching PubMed, EMBASE, and the Web of Science. In total, 29 eligible studies were ultimately enrolled in this meta-analysis. Pooled hazard ratios (HRs) with 95% CIs of overall survival and disease/recurrence/progression-free survival were calculated to evaluate the correct prognostic role of CD82. Statistical analysis demonstrated that high expression of CD82 was significantly associated with enhanced overall survival (HR =0.56, 95% CI: 0.47–0.67) and disease/recurrence/progression-free survival (HR =0.42, 95% CI: 0.30–0.59) in cancer patients. Furthermore, we also conducted the subgroup analysis and the results revealed that CD82 was associated with favorable outcomes in cancer patients. Taken together, CD82 could be a promising biomarker for predicting the prognosis of patients with malignant neoplasms, and the biological functions of CD82 are of great research value of the subject.

Collateral Damage Intended-Cancer-Associated Fibroblasts and Vasculature Are Potential Targets in Cancer Therapy

After oncogenic transformation, tumor cells rewire their metabolism to obtain sufficient energy and biochemical building blocks for cell proliferation, even under hypoxic conditions. Glucose and glutamine become their major limiting nutritional demands. Instead of being autonomous, tumor cells change their immediate environment not only by their metabolites but also by mediators, such as juxtacrine cell contacts, chemokines and other cytokines. Thus, the tumor cells shape their microenvironment as well as induce resident cells, such as fibroblasts and endothelial cells (ECs), to support them. Fibroblasts differentiate into cancer-associated fibroblasts (CAFs), which produce a qualitatively and quantitatively different extracellular matrix (ECM). By their contractile power, they exert tensile forces onto this ECM, leading to increased intratumoral pressure. Moreover, along with enhanced cross-linkage of the ECM components, CAFs thus stiffen the ECM. Attracted by tumor cell- and CAF-secreted vascular endothelial growth factor (VEGF), ECs sprout from pre-existing blood vessels during tumor-induced angiogenesis. Tumor vessels are distinct from EC-lined vessels, because tumor cells integrate into the endothelium or even mimic and replace it in vasculogenic mimicry (VM) vessels. Not only the VM vessels but also the characteristically malformed EC-lined tumor vessels are typical for tumor tissue and may represent promising targets in cancer therapy.

The Effect of Aquaporin 1-Inhibition on Vasculogenic Mimicry in Malignant Mesothelioma

Malignant mesothelioma (MM) is an aggressive malignancy of the serosal membranes, with poor overall survival and quality of life. Limited targeted treatment strategies exist due to restricted knowledge of pathogenic pathways. Vasculogenic mimicry (VM) is a newly described phenomenon associated with increased aggressiveness in other malignancies, and has been characterized in MM. Normal mesothelium expresses aquaporin 1 (AQP1) and retained expression has been associated with improved survival in MM. AQP1 is expressed by normal vascular endothelium and is involved in mediating MM cell motility and proliferation. We investigated the role of AQP1 in VM, and its interaction with the pro-angiogenic factor vascular endothelial growth factor A (VEGFA), which is variably expressed in MM. Matrigel VM assays were performed using NCI-H226 and NCI-H28 MM cell lines and primary cells in hypoxia and normoxia. The synthetic blocker AqB050 and siRNA were used to inhibit AQP1, and bevacizumab was used to inhibit VEGF. Inhibition of AQP1 resulted in increased VEGFA secretion by MM cells and reduced VM in MM cell lines in hypoxia but not normoxia. No change in VM was seen in MM primary cells. Combined inhibition of AQP1 and VEGF had no effect on VM in normoxia. In a heterotopic xenograft mouse model, AqB050 treatment did not alter vessel formation. AQP1 may interact with VEGFA and play a role in VM, especially under hypoxic conditions, but the heterogeneity of MM cells may result in different dominant pathways between patients.

Vasculogenic mimicry and expression of Twist1 and KAI1 correlate with metastasis and prognosis in lung squamous cell carcinoma

BACKGROUND

Vasculogenic mimicry (VM) is a new blood supply development often seen in highly aggressive cancers and has been considered as a usefully metastatic and prognostic factor for many cancers. Twist1 (a biomarker of epithelial-mesenchymal transition), and KAI1 (a suppressor of tumor metastasis) are both usefully predictive factors for metastasis in many cancers. However, the metastatic and prognostic value of VM, Twist1, or KAI1 in lung squamous cell carcinoma (LSCC) is unclear. In this study, we analyzed associations among VM, Twist1, and KAI1 in LSCC, and their respective associations with clinicopathological parameters and survival in LSCC.

CASE PRESENTATION

Positive rates of VM, Twist1, and KAI1 in 157 whole LSCC tissue specimens were detected by immunohistochemistry and histochemical staining. Patient's clinical data were also collected. Levels of VM and Twist1 were significantly higher, and levels of KAI1 were significantly lower, in LSCC tissues than in normal lung tissues. Levels of VM and Twist1 were positively associated with tumor grade, lymph node metastasis (LNM), and tumor-node-metastasis (TNM) stage, and inversely with patients overall survival (OS) time; levels of KAI1 was negatively associated with tumor grade, LNM, and TNM stage, and the KAI1+ subgroup had significantly longer OS time than did the KAI1- subgroup. In multivariate analysis, high VM, or Twist1 levels, TNM stage, size of tumors, and low KAI1 levels were potential to be independent prognostic factors for OS time in patients with LSCC.

CONCLUSIONS

VM, and the expression of Twist1 and KAI1 represent promising markers for metastasis and prognosis, and potential therapeutic targets for LSCC.