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Xu X, Wang D, Li N, Sheng J, Xie M, Zhou Z, Cheng G, Fan Y. The Novel Tumor Microenvironment-Related Prognostic Gene AIF1 May Influence Immune Infiltrates and is Correlated with TIGIT in Esophageal Cancer. Ann Surg Oncol 2021; 29:2930-2940. [PMID: 34751872 DOI: 10.1245/s10434-021-10928-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 09/28/2021] [Indexed: 01/10/2023]
Abstract
BACKGROUND Esophageal carcinoma (EC) is the sixth most common cause of cancer-related mortality worldwide. Studying the associations of the tumor microenvironment (TME) with pathology and prognosis would illustrate the underlying mechanism of prognostic prediction and provide novel targets for immunotherapy in the treatment of EC. METHODS Transcriptomic profiles of 159 EC patients were obtained from The Cancer Genome Atlas (TCGA) database. Stromal and immune scores were calculated using the ESTIMATE algorithm. Differentially expressed genes (DEGs) were identified by the optimal score cutoff. Functional enrichments were analyzed by DAVID, while prognostic genes were explored using the Kaplan-Meier method. Validation analysis was performed using immunohistochemistry in tissue microarrays containing samples from 145 EC patients. Multiplex immunofluorescence staining was performed to detect a panel of 6 immune markers, including T-cell immunoreceptor with Ig and ITIM domains (TIGIT), in 90 EC patients. RESULTS Immune scores significantly increased with increasing age, while stromal scores were dramatically elevated with increasing tumor stage. Fifteen TME-related DEGs including allograft inflammatory factor 1 (AIF1) were identified as prognostic factors of EC. Furthermore, the validation cohort indicated that AIF1 was negatively associated with the prognosis of esophageal squamous cell carcinoma patients. Subsequent analyses suggested that AIF1 may affect immune infiltrates, including T cells and natural-killer cells. Moreover, a correlation between AIF1 and TIGIT was identified. CONCLUSIONS These results indicate that the TME-related gene AIF1 is a promising predictor of prognosis and is related to immune infiltrates and TIGIT expression in EC. However, further mechanistic studies are needed.
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Affiliation(s)
- Xiaoling Xu
- Department of Thoracic Oncology, Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Hangzhou City, China.,Key Laboratory of Head & Neck Cancer Translational Research of Zhejiang Province, Institute of Cancer and Basic Medicine (IBMC), Chinese Academy of Sciences, Hangzhou City, China.,The Second Clinical Medical College of Zhejiang, Chinese Medical University, Hangzhou, China
| | - Ding Wang
- The Second Clinical Medical College of Zhejiang, Chinese Medical University, Hangzhou, China
| | - Na Li
- The Second Clinical Medical College of Zhejiang, Chinese Medical University, Hangzhou, China
| | - Jiamin Sheng
- Department of Thoracic Oncology, Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Hangzhou City, China.,Key Laboratory of Head & Neck Cancer Translational Research of Zhejiang Province, Institute of Cancer and Basic Medicine (IBMC), Chinese Academy of Sciences, Hangzhou City, China
| | - Mingying Xie
- The Second Clinical Medical College of Zhejiang, Chinese Medical University, Hangzhou, China
| | - Zichao Zhou
- The Second Clinical Medical College of Zhejiang, Chinese Medical University, Hangzhou, China
| | - Guoping Cheng
- Key Laboratory of Head & Neck Cancer Translational Research of Zhejiang Province, Institute of Cancer and Basic Medicine (IBMC), Chinese Academy of Sciences, Hangzhou City, China.,The Second Clinical Medical College of Zhejiang, Chinese Medical University, Hangzhou, China.,Department of Pathology, Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Hangzhou, China
| | - Yun Fan
- Department of Thoracic Oncology, Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Hangzhou City, China. .,Key Laboratory of Head & Neck Cancer Translational Research of Zhejiang Province, Institute of Cancer and Basic Medicine (IBMC), Chinese Academy of Sciences, Hangzhou City, China. .,The Second Clinical Medical College of Zhejiang, Chinese Medical University, Hangzhou, China.
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2
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Patel S, Raghavan S, Prem A. Prognostic impact of pathological response in lymph nodes in esophageal squamous cell cancers: Is it over-rated? Eur J Surg Oncol 2021; 47:2959. [PMID: 34462141 DOI: 10.1016/j.ejso.2021.07.031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 07/30/2021] [Indexed: 10/20/2022] Open
Affiliation(s)
- Swapnil Patel
- Department of Surgical Oncology, MPMMMCC & Homi Bhabha Cancer Hospital, Tata Memorial Centre, Varanasi, 221005, India
| | - Sriniket Raghavan
- Department of Surgical Oncology, MPMMMCC & Homi Bhabha Cancer Hospital, Tata Memorial Centre, Varanasi, 221005, India.
| | - Amar Prem
- Department of Surgical Oncology, MPMMMCC & Homi Bhabha Cancer Hospital, Tata Memorial Centre, Varanasi, 221005, India
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3
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Yu L, Zhang XT, Guan SH, Cheng YF, Li LX. The Number of Negative Lymph Nodes is Positively Associated with Survival in Esophageal Squamous Cell Carcinoma Patients in China. Open Med (Wars) 2020; 15:152-159. [PMID: 32190739 PMCID: PMC7065439 DOI: 10.1515/med-2020-0023] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Accepted: 11/26/2019] [Indexed: 12/24/2022] Open
Abstract
Background There is a controversial relationship between the negative lymph nodes (NLNs) and survival in patients with esophageal squamous cell carcinoma (ESCC). This study investigates the implications of total number of NLNs on thoracic ESCC patient prognosis. Methods 579 thoracic ESCC patients were categorized into four groups (0-9, 10-14, 15-19 and ≥20 NLNs). Univariate analysis was done by the log-rank tests while multivariate analysis was undertaken using Cox regression models. Survival analysis was determined employing the Kaplan-Meier method. Results When the numbers of NLNs were 9 or less, 10 to 14, 15 to 19 and 20 or more, patients of 3-year survival rates were 21.7%, 40.0%, 61.2% and 77.5%, respectively (P<0.001). In the node-negative and node-positive subgroups, 3-year survival rates were 34.9% and 14.3%, 50.9% and 19.3%, 65.6% and 51.8%, 81.4% and 68.9% respectively (P<0.001). Gender, tumor length, tumor differentiation, T and N stage as well as the total NLNs were found to be significantly linked to survival rates. Multivariate analysis showed tumor length, T stage, N stage and total NLNs were independent prognostic factors for ESCC patients. Conclusion NLNs numbers is a significant independent prognostic indicator for thoracic ESCC patients' survival after curative esophagectomy.
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Affiliation(s)
- Lan Yu
- School of Medicine, Shandong University, Jinan 250012, China.,Cancer Prevention Center, Qingdao Central (Cancer) Hospital, The Second Affiliated Hospital of University Qingdao, Qingdao 266042, China
| | - Xiao-Tao Zhang
- Cancer Prevention Center, Qingdao Central (Cancer) Hospital, The Second Affiliated Hospital of University Qingdao, Qingdao 266042, China
| | - Shang-Hui Guan
- Department of Radiotherapy, Qilu Hospital of Shandong University, No 107, Wenhua West Road, Lixia District, Jinan 250012, Shandong, China
| | - Yu-Feng Cheng
- Department of Radiotherapy, Qilu Hospital of Shandong University, No 107, Wenhua West Road, Lixia District, Jinan 250012, Shandong, China
| | - Lin-Xi Li
- Queen Mary School, Medical college of Nanchang University, Nanchang 330088, China
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4
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Li XM, Song X, Zhao XK, Hu SJ, Cheng R, Lv S, Du DF, Zhang XY, Lu JL, Ku JW, Zhang DY, Zhang Y, Fan ZM, Wang LD. The alterations of cytokeratin and vimentin protein expressions in primary esophageal spindle cell carcinoma. BMC Cancer 2018; 18:356. [PMID: 29609569 PMCID: PMC5880062 DOI: 10.1186/s12885-018-4301-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Accepted: 03/23/2018] [Indexed: 11/16/2022] Open
Abstract
Background The accumulated evidence has indicated the diagnostic role of cytokeratin (CK) and vimentin protein immunoassay in primary esophageal spindle cell carcinoma (PESC), which is a rare malignant tumor with epithelial and spindle components. However, it is largely unknown for the expression of CK and vimentin in pathological changes and prognosis of PESC. Methods Eighty-two PESC patients were identified from the esophageal and gastric cardia cancer database established by Henan Key Laboratory for Esophageal Cancer Research of Zhengzhou University. We retrospectively evaluated CK and vimentin protein expressions in PESC. Clinicopathological features were examined by means of univariate and multivariate survival analyses. Furthermore, the co-expression value of cytokeratin and vimentin was analyzed by receiver operating characteristic (ROC) curve. Results The positive pan-cytokeratins AE1/AE3 (AE1/AE3 for short) staining was chiefly observed in cytoplasm of epithelial component tumor cells, with a positive detection rate of 85.4% (70/82). Interestingly, 19 cases showed AE1/AE3 positive staining both in epithelial and spindle components (23.2%). However, AE1/AE3 expression was not observed with any significant association with age, gender, tumor location, gross appearance, lymph node metastasis and TNM stage. Furthermore, AE1/AE3 protein expression does not show any effect on survival. Similar results were observed for vimentin immunoassay. However, in comparison with a single protein, the predictive power of AE1/AE3 and vimentin proteins signature was increased apparently than with single signature [0.75 (95% CI = 0.68–0.82) with single protein v.s. 0.89 (95% CI = 0.85–0.94) with AE1/AE3 and vimentin proteins]. The 1-, 3-, 5- and 7-year survival rates for PESC patients in this study were 79.3%, 46.3%, 28.0% and 15.9%, respectively. Multivariate analysis demonstrated age and TNM stage were independent prognostic factors for overall survival (P = 0.036 and 0.003, respectively). It is noteworthy that only 17.1% patients had a PESC accurate diagnosis by biopsy pathology before surgery (14/82). 72.4% PESC patients with biopsy pathology before surgery had been diagnosed as squamous cell carcinoma. Conclusion The present study demonstrates that cytokeratin and vimentin protein immunoassay is a useful biomarker for PESC accurate diagnosis, but not prognosis. The co-expression of cytokeratin and vimentin in both epithelial and spindle components suggest the possibility of single clone origination for PESC.
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Affiliation(s)
- Xin Min Li
- Henan Key Laboratory for Esophageal Cancer Research of the First Affiliated Hospital, Zhengzhou University, 40 Daxue Road, Zhengzhou, Henan, 450052, People's Republic of China
| | - Xin Song
- Henan Key Laboratory for Esophageal Cancer Research of the First Affiliated Hospital, Zhengzhou University, 40 Daxue Road, Zhengzhou, Henan, 450052, People's Republic of China
| | - Xue Ke Zhao
- Henan Key Laboratory for Esophageal Cancer Research of the First Affiliated Hospital, Zhengzhou University, 40 Daxue Road, Zhengzhou, Henan, 450052, People's Republic of China
| | - Shou Jia Hu
- Henan Key Laboratory for Esophageal Cancer Research of the First Affiliated Hospital, Zhengzhou University, 40 Daxue Road, Zhengzhou, Henan, 450052, People's Republic of China
| | - Rang Cheng
- Henan Key Laboratory for Esophageal Cancer Research of the First Affiliated Hospital, Zhengzhou University, 40 Daxue Road, Zhengzhou, Henan, 450052, People's Republic of China
| | - Shuang Lv
- Henan Key Laboratory for Esophageal Cancer Research of the First Affiliated Hospital, Zhengzhou University, 40 Daxue Road, Zhengzhou, Henan, 450052, People's Republic of China.,Department of Pathology, Xinxiang Medical University, Xinxiang, 453003, Henan, China
| | - Dan Feng Du
- Henan Key Laboratory for Esophageal Cancer Research of the First Affiliated Hospital, Zhengzhou University, 40 Daxue Road, Zhengzhou, Henan, 450052, People's Republic of China.,Department of Pathology of Basic Medical College, Zhengzhou University, Zhengzhou, 450001, Henan, China
| | - Xiang Yang Zhang
- Henan Key Laboratory for Esophageal Cancer Research of the First Affiliated Hospital, Zhengzhou University, 40 Daxue Road, Zhengzhou, Henan, 450052, People's Republic of China
| | - Jian Liang Lu
- Henan Key Laboratory for Esophageal Cancer Research of the First Affiliated Hospital, Zhengzhou University, 40 Daxue Road, Zhengzhou, Henan, 450052, People's Republic of China.,Department of Pathology, Xinxiang Medical University, Xinxiang, 453003, Henan, China
| | - Jian Wei Ku
- Henan Key Laboratory for Esophageal Cancer Research of the First Affiliated Hospital, Zhengzhou University, 40 Daxue Road, Zhengzhou, Henan, 450052, People's Republic of China.,Department of Gastroenterology, the Second Affiliated Hospital of Nanyang Medical College, Nanyang, 473061, Henan, China
| | - Dong Yun Zhang
- Henan Key Laboratory for Esophageal Cancer Research of the First Affiliated Hospital, Zhengzhou University, 40 Daxue Road, Zhengzhou, Henan, 450052, People's Republic of China.,Department of Pathology of Nanyang Medical College, Nanyang, 473061, Henan, China
| | - Yao Zhang
- Department of Pathology, Women & Infants Hospital of Zhengzhou, Zhengzhou, 450012, Henan, China
| | - Zong Min Fan
- Henan Key Laboratory for Esophageal Cancer Research of the First Affiliated Hospital, Zhengzhou University, 40 Daxue Road, Zhengzhou, Henan, 450052, People's Republic of China
| | - Li Dong Wang
- Henan Key Laboratory for Esophageal Cancer Research of the First Affiliated Hospital, Zhengzhou University, 40 Daxue Road, Zhengzhou, Henan, 450052, People's Republic of China.
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Metastatic to negative lymph node ratio demonstrates significant prognostic value in patients with esophageal squamous cell carcinoma after esophagectomy. Oncotarget 2017; 8:86908-86916. [PMID: 29156845 PMCID: PMC5689735 DOI: 10.18632/oncotarget.19673] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Accepted: 05/16/2017] [Indexed: 12/26/2022] Open
Abstract
Aims The prognostic value of metastatic lymph node ratio (LNR) has been reported in some studies; however, there is no report on the prognostic significance of metastatic to negative lymph node ratio (MNLNR) in cancer patients. The aim of this study was to compare the prognostic value of pN, LNR and MNLNR on the survival of patients with esophageal squamous cell carcinoma (ESCC) after esophagectomy. Methods The data of 290 patients with ESCC after curative esophagectomy was retrospectively analyzed. The optimal cut-point for LNR and MNLNR were set as 0, 01-0.2, and >0.2. Univariate and multivariate analyses were performed to identify prognostic factors for overall survival (OS). Results Patients classified as LNR 0, 0.01-0.20, and 0.21-1.0, the observed 5-year OS rates were 46.6%, 26.0%, and 11.6%, respectively (P = 0.000). Patients classified as MNLNR 0, 0.01-0.20, and >0.2, the observed 5-year OS rates were 46.6%, 31.2%, and 7.4%, respectively, respectively (P = 0.000). The pN stage, LNR or MNLNR category was confirmed as a significant independent prognostic factor, respectively (P = 0.032, P = 0.011 and P = 0.003, respectively); However, only the MNLNR category (P = 0.003) remained as a significant prognostic factor when the pN stage, LNR and MNLNR category simultaneously included in the multivariate analysis models. Conclusions The MNLNR was recognized as an independent prognostic factor in ESCC patients after curative esophagectomy. In addition, MNLNR showed better prognostic value than pN stage and LNR category.
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Liu J, Xia J, Zhang Y, Fu M, Gong S, Guo Y. Associations between the expression of MTA1 and VEGF-C in esophageal squamous cell carcinoma with lymph angiogenesis and lymph node metastasis. Oncol Lett 2017; 14:3275-3281. [PMID: 28927077 DOI: 10.3892/ol.2017.6530] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Accepted: 03/23/2017] [Indexed: 02/04/2023] Open
Abstract
The aim of the present study was to investigate the association between the expression levels of metastasis-related gene 1 (MTA1) and vascular endothelial growth factor C (VEGF-C) in esophageal squamous cell carcinoma (ESCC) with lymph angiogenesis and lymph node metastasis. The paraffin-embedded tissue samples of 107 cases of ESCC and 56 cases of normal esophageal tissues were collected from the Department of Cardiothoracic Surgery, Suining Central Hospital from March 2013 to January 2014. Immunohistochemical assays were performed to detect the expression levels of MTA1, VEGF-C and D2-40 in ESCC, and the micro-lymphatic vessel density (LVD) was evaluated. Their associations with various clinicopathological parameters were also analyzed. The protein expression levels of MTA1 and VEGF-C in ESCC were significantly higher compared with those in normal esophageal tissues (P<0.05); the high protein expression levels of MTA1 and VEGF-C in ESCC tissues at various tumor-node-metastasis stages exhibited statistically significant differences, as revealed by the Kruskal-Wallis test (P<0.05). The protein expression levels of MTA1 and VEGF-C in ESCC exhibited positive correlations (Spearman's ρ, r=0.512; P=0.000); the LVD level in the group with high expression of MTA1 and VEGF-C was significantly higher compared with in the low expression group (P<0.05). The comparison between MTA1 and VEGF-C protein expression levels in the group with a high rate of lymph node metastasis demonstrated statistically significant differences when compared with in the low lymph node metastasis group (P<0.05). The expression levels of MTA1 and VEGF-C in ESCC exhibited a positive correlation in ESCC, which may co-promote lymph angiogenesis and lymph node metastasis in ESCC; therefore, they may be used as biomarkers for determining the prognosis of ESCC.
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Affiliation(s)
- Jianping Liu
- Department of Cardiothoracic Surgery, Suining Central Hospital, Suining, Sichuan 629000, P.R. China
| | - Juan Xia
- Department of Pathology, Suining Central Hospital, Suining, Sichuan 629000, P.R. China
| | - Yongheng Zhang
- Department of Cardiothoracic Surgery, Suining Central Hospital, Suining, Sichuan 629000, P.R. China
| | - Maoyong Fu
- Department of Cardiothoracic Surgery, The Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan 637000, P.R. China
| | - Sheng Gong
- Department of Cardiothoracic Surgery, Suining Central Hospital, Suining, Sichuan 629000, P.R. China
| | - Yulong Guo
- Department of Cardiothoracic Surgery, Suining Central Hospital, Suining, Sichuan 629000, P.R. China.,Department of Cardiothoracic Surgery, The Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan 637000, P.R. China
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Cavallin F, Alfieri R, Scarpa M, Cagol M, Ruol A, Fassan M, Rugge M, Ancona E, Castoro C. Nodal skip metastasis in thoracic esophageal squamous cell carcinoma: a cohort study. BMC Surg 2017; 17:49. [PMID: 28464907 PMCID: PMC5414191 DOI: 10.1186/s12893-017-0247-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2017] [Accepted: 04/20/2017] [Indexed: 12/18/2022] Open
Abstract
Background Nodal skip metastasis is a prognostic factor in some sites of malignancies, but its role in esophageal cancer is still unclear. The present study aimed to investigate occurrence and effect of nodal skip metastases in thoracic esophageal squamous cell carcinoma. Methods All 578 patients undergoing esophagectomy for thoracic esophageal squamous cell carcinoma at the Center for Esophageal Diseases located in Padova between January 1992 and December 2010 were retrospectively evaluated. Selection criteria were R0 resection, pathological M0 stage and pathological lymph node involvement. Patients receiving neoadjuvant therapy were excluded. Results The selection identified 88 patients with lymph node involvement confirmed by pathological evaluation. Sixteen patients (18.2%) had nodal skip metastasis. Adjusting for the number of lymph node metastases, patient with nodal skip metastasis had similar 5-year overall survival (14% vs. 13%, p = 0.93) and 5-year disease free survival (14% vs. 9%, p = 0.48) compared to patients with both peritumoral and distant lymph node metastases. The risk difference of nodal skip metastasis was: −24.1% (95% C.I. -43.1% to −5.2%) in patients with more than one lymph node metastasis compared to those with one lymph node metastasis; −2.3% (95% C.I. -29.8% to 25.2%) in middle thoracic esophagus and −23.0% (95% C.I. -47.8% to 1.8%) in lower thoracic esophagus compared to upper thoracic esophagus; 18.1% (95% C.I. 3.2% to 33.0%) in clinical N0 stage vs. clinical N+ stage. Conclusions Nodal skip metastasis is a common pattern of metastatic lymph involvement in thoracic esophageal squamous cell carcinoma. However, neither overall survival nor disease free survival are associated with nodal skip metastasis occurrence.
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Affiliation(s)
- Francesco Cavallin
- Esophageal and Digestive Tract Surgical Unit, Regional Centre for Esophageal Disease, Veneto Institute of Oncology IOV IRCCS, Padova, Italy.
| | - Rita Alfieri
- Esophageal and Digestive Tract Surgical Unit, Regional Centre for Esophageal Disease, Veneto Institute of Oncology IOV IRCCS, Padova, Italy
| | - Marco Scarpa
- Esophageal and Digestive Tract Surgical Unit, Regional Centre for Esophageal Disease, Veneto Institute of Oncology IOV IRCCS, Padova, Italy
| | - Matteo Cagol
- Esophageal and Digestive Tract Surgical Unit, Regional Centre for Esophageal Disease, Veneto Institute of Oncology IOV IRCCS, Padova, Italy
| | - Alberto Ruol
- 3rd Surgical Clinic, Azienda Ospedaliera di Padova, Padova, Italy
| | - Matteo Fassan
- Department of Medicine (DIMED), Surgical Pathology & CytopathologyUnit, University of Padova, Padova, Italy
| | - Massimo Rugge
- Department of Medicine (DIMED), Surgical Pathology & CytopathologyUnit, University of Padova, Padova, Italy
| | - Ermanno Ancona
- Esophageal and Digestive Tract Surgical Unit, Regional Centre for Esophageal Disease, Veneto Institute of Oncology IOV IRCCS, Padova, Italy
| | - Carlo Castoro
- Esophageal and Digestive Tract Surgical Unit, Regional Centre for Esophageal Disease, Veneto Institute of Oncology IOV IRCCS, Padova, Italy
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Sato T, Takemura T, Ouchi T, Mori S, Sakamoto M, Arai Y, Kodama T. Monitoring of Blood Vessel Density Using Contrast-Enhanced High Frequency Ultrasound May Facilitate Early Diagnosis of Lymph Node Metastasis. J Cancer 2017; 8:704-715. [PMID: 28382132 PMCID: PMC5381158 DOI: 10.7150/jca.18027] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Accepted: 01/12/2017] [Indexed: 12/25/2022] Open
Abstract
Time-dependent alterations in the ultrasonography characteristics of lymph nodes during early-stage metastasis have not been compared with those of tumor-draining lymph nodes that do not develop tumor; this is partly due to the absence of an appropriate experimental model. In a previous study of lymph nodes with experimental early-stage metastasis, we used contrast-enhanced high-frequency ultrasound to demonstrate that an increase in lymph node blood vessel density preceded any changes in lymph node volume. In the present study, we used an experimental model of lymph node metastasis in which tumor cells metastasized from the subiliac lymph node to the proper axillary lymph node (the tumor-draining lymph node). We utilized contrast-enhanced high-frequency ultrasound to perform a longitudinal analysis of tumor-draining lymph nodes, comparing those at an early-stage of metastasis with those that did not develop detectable metastasis. We found that the normalized blood vessel density of an early-stage metastatic lymph node exhibited a progressive rise, whereas that of a tumor-draining lymph node not containing tumor began to increase later. For both types of lymph nodes, the normalized blood vessel density on the final day of experiments showed a trend towards being higher than that measured in controls. We further found that mice with an initially low value for lymph node blood vessel density subsequently showed a larger increase in the blood vessel density of the metastatic lymph node; this differed significantly from measurements in controls. The present study indicates that a longitudinal analysis of the blood vessel densities of tumor-draining lymph nodes, made using contrast-enhanced high-frequency ultrasound imaging, may be a potentially promising method for detecting early-stage lymph node metastasis in selected patients. Furthermore, our findings suggest that tumor in an upstream lymph node may induce alteration of the vascular structures in draining lymph nodes that do not contain tumor.
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Affiliation(s)
- Takuma Sato
- Graduate School of Biomedical Engineering, Tohoku University, 4-1 Seiryo-machi, Aoba, Sendai, Miyagi 980-8575, Japan;; Department of Urology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba, Sendai, Miyagi 980-8575, Japan
| | - Tomoaki Takemura
- Graduate School of Biomedical Engineering, Tohoku University, 4-1 Seiryo-machi, Aoba, Sendai, Miyagi 980-8575, Japan
| | - Tomoki Ouchi
- Graduate School of Biomedical Engineering, Tohoku University, 4-1 Seiryo-machi, Aoba, Sendai, Miyagi 980-8575, Japan
| | - Shiro Mori
- Graduate School of Biomedical Engineering, Tohoku University, 4-1 Seiryo-machi, Aoba, Sendai, Miyagi 980-8575, Japan;; Department of Oral and Maxillofacial Surgery, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba, Sendai, Miyagi 980-8575, Japan
| | - Maya Sakamoto
- Department of Oral Diagnosis, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba, Sendai, Miyagi 980-8575, Japan
| | - Yoichi Arai
- Department of Urology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba, Sendai, Miyagi 980-8575, Japan
| | - Tetsuya Kodama
- Graduate School of Biomedical Engineering, Tohoku University, 4-1 Seiryo-machi, Aoba, Sendai, Miyagi 980-8575, Japan
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Hijiya N, Shibata T, Daa T, Hamanaka R, Uchida T, Matsuura K, Tsukamoto Y, Nakada C, Iha H, Inomata M, Moriyama M. Overexpression of cannabinoid receptor 1 in esophageal squamous cell carcinoma is correlated with metastasis to lymph nodes and distant organs, and poor prognosis. Pathol Int 2016; 67:83-90. [PMID: 27976824 DOI: 10.1111/pin.12495] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Accepted: 11/30/2016] [Indexed: 01/11/2023]
Abstract
In patients with esophageal squamous cell carcinoma (ESCC), the status of metastasis to lymph nodes is strongly associated with prognosis. Consequently, development of a biomarker to detect the presence of metastasis would be clinically valuable. In this study, we found that overexpression of cannabinoid receptor 1 (CB1R) was applicable as a marker for prediction of metastasis in ESCC. CB1R overexpression was detected immunohistochemically in 54 of 88 cases (61.4%). The intensity of CB1R expression was uniform in both intraepithelial and invasive regions in each case, and was significantly correlated with the status of metastasis to lymph nodes (P = 0.046) and distant organs (P = 0.047). Furthermore, multivariate analysis revealed that CB1R overexpression was independently associated with poor prognosis (P = 0.019). Biological analysis of CB1R overexpression using ESCC cell lines revealed that CB1R activation appeared to promote cell proliferation and invasion. On the basis of these findings, we propose that evaluation of CB1R expression status in biopsy specimens of ESCC using immunohistochemistry might be clinically useful for prediction of metastasis to lymph nodes and distant organs.
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Affiliation(s)
- Naoki Hijiya
- Department of Molecular Pathology, Faculty of Medicine, Oita University, 1-1, Idaigaoka, Hasama-machi, Yufu-city, Oita, Japan
| | - Tomotaka Shibata
- Department of Gastroenterological and Pediatric Surgery, Faculty of Medicine, Oita University, 1-1, Idaigaoka, Hasama-machi, Yufu-city, Oita, Japan
| | - Tsutomu Daa
- Department of Diagnostic Pathology, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama-machi, Yufu-city, Oita, Japan
| | - Ryoji Hamanaka
- Department of Health Sciences, Oita University of Nursing and Health Sciences, 2944-9, Megusuno, Oita-city, Oita, Japan
| | - Tomohisa Uchida
- Department of Molecular Pathology, Faculty of Medicine, Oita University, 1-1, Idaigaoka, Hasama-machi, Yufu-city, Oita, Japan
| | - Keiko Matsuura
- Department of Biology, Faculty of Medicine, Oita University, 1-1, Idaigaoka, Hasama-machi, Yufu-city, Oita, Japan
| | - Yoshiyuki Tsukamoto
- Department of Molecular Pathology, Faculty of Medicine, Oita University, 1-1, Idaigaoka, Hasama-machi, Yufu-city, Oita, Japan
| | - Chisato Nakada
- Department of Molecular Pathology, Faculty of Medicine, Oita University, 1-1, Idaigaoka, Hasama-machi, Yufu-city, Oita, Japan
| | - Hidekatsu Iha
- Department of Microbioloby, Faculty of Medicine, Oita University, 1-1, Idaigaoka, Hasama-machi, Yufu-city, Oita, Japan
| | - Masafumi Inomata
- Department of Gastroenterological and Pediatric Surgery, Faculty of Medicine, Oita University, 1-1, Idaigaoka, Hasama-machi, Yufu-city, Oita, Japan
| | - Masatsugu Moriyama
- Department of Molecular Pathology, Faculty of Medicine, Oita University, 1-1, Idaigaoka, Hasama-machi, Yufu-city, Oita, Japan
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FDG-PET/CT lymph node staging after neoadjuvant chemotherapy in patients with adenocarcinoma of the esophageal-gastric junction. Abdom Radiol (NY) 2016; 41:2089-2094. [PMID: 27405645 PMCID: PMC5059406 DOI: 10.1007/s00261-016-0820-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Objectives The aim of the analysis was to assess the accuracy of various FDG-PET/CT parameters in staging lymph nodes after neoadjuvant chemotherapy. Methods In this prospective study, 74 patients with adenocarcinoma of the esophageal–gastric junction were examined by FDG-PET/CT in the course of their neoadjuvant chemotherapy given before surgical treatment. Data from the final FDG-PET/CT examinations were compared with the histology from the surgical specimens (gold standard). The accuracy was calculated for four FDG-PET/CT parameters: (1) hypermetabolic nodes, (2) large nodes, (3) large-and-medium large nodes, and (4) hypermetabolic or large nodes. Results In 74 patients, a total of 1540 lymph nodes were obtained by surgery, and these were grouped into 287 regions according to topographic origin. Five hundred and two nodes were imaged by FDG-PET/CT and were grouped into these same regions for comparison. In the analysis, (1) hypermetabolic nodes, (2) large nodes, (3) large-and-medium large nodes, and (4) hypermetabolic or large nodes identified metastases in particular regions with sensitivities of 11.6%, 2.9%, 21.7%, and 13.0%, respectively; specificity was 98.6%, 94.5%, 74.8%, and 93.6%, respectively. The best accuracy of 77.7% reached the parameter of hypermetabolic nodes. Accuracy decreased to 62.0% when also smaller nodes (medium-large) were taken for the parameter of metastases. Conclusions FDG-PET/CT proved low sensitivity and high specificity. Low sensitivity was based on low detection rate (32.6%) when compared nodes imaged by FDG-PET/CT to nodes found by surgery, and in inability to detect micrometastases. Sensitivity increased when also medium-large LNs were taken for positive, but specificity and accuracy decreased.
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Abstract
INTRODUCTION Esophageal cancer (EC) is one of the most common causes of cancer-related death worldwide. Identifying suitable biomarkers for early diagnosis as well as predicting lymph node metastasis, prognosis and the therapeutic response of EC is essential for the effective and efficient management for EC. There is an urgent need to develop effective, novel approaches for patients who do not respond to conventional treatment. Areas covered: EC is characterized by the presence of two main histological types such as squamous cell carcinoma and adenocarcinoma, which differ in their response to treatments and prognosis. Thus, this review describes the latest research into biomarkers and novel treatment targets generated by cancer proteomics for the two main histological types. Finally, the main difficulties facing the translation of biomarkers and novel treatment targets into the clinical settings are discussed. Expert commentary: EC proteomics have provided useful results and, after their validation, novel clinical tools should be developed to improve the clinical outcomes for EC patients.
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Affiliation(s)
- Norihisa Uemura
- a Department of Gastroenterological Surgery , Aichi Cancer Center Hospital , Nagoya , Japan
| | - Tadashi Kondo
- b Division of Rare Cancer Research, Department of Innovative Seeds Evaluation , National Cancer Center Research Institute , Tokyo , Japan
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