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Jacob S, Balonov I, Jurinovic V, Heiliger C, Tschaidse T, Kumbrink J, Kirchner T, Werner J, Angele MK, Michl M, Neumann J. TGFβ signalling pathway impacts brain metastases profiles in locally advanced colorectal cancer. Clin Exp Metastasis 2024:10.1007/s10585-024-10277-3. [PMID: 38498101 DOI: 10.1007/s10585-024-10277-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 02/02/2024] [Indexed: 03/20/2024]
Abstract
RATIONALE Colorectal Cancer (CRC) represents the third most common type of cancer in Germany and the second most common cancer-related cause of death worldwide. Distant metastases are still the main limit for patient survival. While liver metastases as well as peritoneal carcinomatosis can often either be resected or treated with systemic therapy, little options remain for brain metastases. Additionally, a number of studies has already investigated hepatic, peritoneal, pulmonary as well as continuing distant metastases in colorectal cancer. Yet, with respect to tumor biology and brain metastases, little is known so far. MATERIAL AND METHODS Two cohorts, M0 without distant spread and BRA with brain metastases were build. RNA was isolated from paraffin embedded specimen. Gene expression was performed by an RNA NanoString-Analysis using the nCounter® PanCancer Progression Panel by NanoString-Technologies (Hamburg, Germany). Results were analysed by principal component analysis, gene expression and pathway analysis using commonly available databases such as KEGG as benchmark for comparison. RESULTS We were able to determine a gene signature that provides a sophisticated group separation between M0 and BRA using principal component analysis. All genes with strong loading characteristics on principal component 1 were cross-referenced with the subsequently performed accurate gene set enrichment analysis (GSEA). The GSEA revealed a clear dysregulation of the TGFβ pathway in compared cohorts M0 and BRA. Interestingly, the targeted pathways analysis of the identified genes confirmed that in fact almost all strong loading genes of PC1 play a role in the TGFβ pathway. CONCLUSION Our results suggest the TGFβ pathway as a crucial player in the development of brain metastases in primary CRC. In some types of colorectal cancer, downregulation of the TGFβ pathway might hinder primary colorectal cancer to metastasize to the nervous system. While the paradoxical functioning of the TGFβ pathway is still not fully understood, these shed light on yet another clinical implication of this complex pathway.
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Affiliation(s)
- Sven Jacob
- Department of General, Visceral and Transplantation Surgery, University Hospital, LMU Munich, Munich, Germany
| | - Ilja Balonov
- Department of General, Visceral and Transplantation Surgery, University Hospital, LMU Munich, Munich, Germany
| | - Vindi Jurinovic
- The Institute for Medical Information Processing, Ludwig-Maximilians-University (LMU) Munich, Biometry, and Epidemiology, Munich, Germany
| | - Christian Heiliger
- Department of General, Visceral and Transplantation Surgery, University Hospital, LMU Munich, Munich, Germany
| | - Tengis Tschaidse
- Department of General, Visceral and Transplantation Surgery, University Hospital, LMU Munich, Munich, Germany
| | - Jörg Kumbrink
- Institute of Pathology, Medical Faculty, Ludwig-Maximilians-University (LMU) Munich, Marchioninistr. 15, 81377, Munich, Germany
| | - Thomas Kirchner
- Institute of Pathology, Medical Faculty, Ludwig-Maximilians-University (LMU) Munich, Marchioninistr. 15, 81377, Munich, Germany
| | - Jens Werner
- Department of General, Visceral and Transplantation Surgery, University Hospital, LMU Munich, Munich, Germany
| | - Martin K Angele
- Department of General, Visceral and Transplantation Surgery, University Hospital, LMU Munich, Munich, Germany
| | - Marlies Michl
- Department of Medicine III, University Hospital, LMU Munich, Munich, Germany
| | - Jens Neumann
- Institute of Pathology, Medical Faculty, Ludwig-Maximilians-University (LMU) Munich, Marchioninistr. 15, 81377, Munich, Germany.
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Ralki M, Serrien A, Lambert J, Leys M, Nackaerts K. Brown-Séquard Syndrome in a Desmoplastic Malignant Mesothelioma Patient: A Rare Complication. Clin Lung Cancer 2020; 22:e552-e554. [PMID: 33229302 DOI: 10.1016/j.cllc.2020.09.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 09/09/2020] [Accepted: 09/21/2020] [Indexed: 11/16/2022]
Affiliation(s)
- Mike Ralki
- Department of Pneumology, KU Leuven University Hospitals Leuven, Leuven, Belgium.
| | - Anouk Serrien
- Department of Neurology, KU Leuven University Hospitals Leuven, Leuven, Belgium
| | - Julie Lambert
- Department of Radiology, KU Leuven University Hospitals Leuven, Leuven, Belgium
| | - Mathias Leys
- Department of Pneumology, AZ Groeninge Hospital, Kortrijk, Belgium
| | - Kristiaan Nackaerts
- Department of Pneumology, KU Leuven University Hospitals Leuven, Leuven, Belgium
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Abstract
BACKGROUND Adenomyoepithelioma (AME) of the breast is a very rare tumor and is generally considered to be benign. However, some show malignant transformation, which results in local recurrences or distant metastases. The morphological features of AME that might predict malignant potential have not been elucidated. Moreover, there is also no established multidisciplinary treatment for malignant AME aside from complete excision at an early stage. CASE PRESENTATION A 64-year-old female diagnosed with AME of the left breast underwent lumpectomy. The surgical margins were negative. Six months after the operation, however, malignant AME recurred locally in the left breast. MRI showed multiple masses, which invaded the skin. A left mastectomy with axillary lymph node dissection was performed. Additional areas of AME were found in about one third of the entire breast. Eight months after the mastectomy, lung metastases were detected. She underwent chemotherapy with fluorouracil, epirubicin, and cyclophosphamide (FEC) for 9 cycles with little response. Lung metastasectomy was performed. Nine months after lung metastasectomy, the metastases were widespread to the brain, heart, and kidney; she subsequently died 2 months later. CONCLUSIONS Malignant AME has various morphological features, and in this report, we characterize new findings from both imaging and pathology/autopsy. Malignant potency is related to the tumor size, tumor appearance, and mitoses, even if only a few. Given that ductal spread is one of the morphological features of malignant AME, it is of paramount importance to assess the surgical margins.
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Affiliation(s)
- Kazuki Moro
- Department of Breast Surgery, Niigata City General Hospital, 463-7 Shumoku, Chuo-ku, Niigata, 950-1197, Japan.
| | - Eiko Sakata
- Department of Breast Surgery, Niigata City General Hospital, 463-7 Shumoku, Chuo-ku, Niigata, 950-1197, Japan
| | - Asa Nakahara
- Department of Pathology, Niigata City General Hospital, 463-7 Shumoku, Chuo-ku, Niigata, 950-1197, Japan.,Department of Pathology, Brain Research Institute, Niigata University, Niigata City, 950-8585, Japan
| | - Hideki Hashidate
- Department of Pathology, Niigata City General Hospital, 463-7 Shumoku, Chuo-ku, Niigata, 950-1197, Japan
| | - Emmanuel Gabriel
- Department of Surgery, Mayo Clinic, Jacksonville, FL, 32224, USA
| | - Haruhiko Makino
- Department of Breast Surgery, Niigata City General Hospital, 463-7 Shumoku, Chuo-ku, Niigata, 950-1197, Japan.,Makino Breast Clinic, Niigata, 950-0861, Japan
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Bai S, Zhu W, Coffman L, Vlad A, Schwartz LE, Elishaev E, Drapkin R, Buckanovich RJ. CD105 Is Expressed in Ovarian Cancer Precursor Lesions and Is Required for Metastasis to the Ovary. Cancers (Basel) 2019; 11:E1710. [PMID: 31684072 DOI: 10.3390/cancers11111710] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 10/28/2019] [Accepted: 10/29/2019] [Indexed: 12/19/2022] Open
Abstract
: Most high-grade serous ovarian cancers (HGSCs) initiate from the fallopian tube epithelium and then metastasize to the ovary and throughout the abdomen. Genomic analyses suggest that most HGSCs seed the ovary prior to abdominal dissemination. Similarly, animal models support a critical role for the ovary in driving abdominal dissemination. Thus, HGSC cell recruitment to the ovary appears to be a critical component of HGSC cell metastasis. We sought to identify factors driving HGSC recruitment to the ovary. We identified CD105 (endoglin, or ENG, a TGF- receptor family member) as a mediator of HGSC cell ovarian recruitment. We found that CD105 was expressed on both serous tubal intraepithelial carcinoma (STIC) cells (STICs-HGSC precursors in the fallopian tube epithelium) and HGSC cells. Using data from The Cancer Genome Atlas (TCGA) and the Cancer Cell Line Encyclopedia (CCLE), we showed that high CD105 expression by HGSC cells correlated with a metastatic signature. Furthermore, intravenous injection of CD105(+) HGSC tumor cells, but not CD105(-), resulted in ovarian-specific metastasis and abdominal dissemination of disease. CD105 knockdown or blockade with a clinically relevant CD105-neutralizing mAb (TRC105), inhibited HGSC metastasis, reduced ascites, and impeded growth of abdominal tumor nodules, thereby improving overall survival in animal models of ovarian cancer. CD105 knockdown was associated with a reduction in TGF-signaling. Together, our data support CD105 as a critical mediator of ovarian cancer spread to the ovary and implicate it as a potential therapeutic target.
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Ikeda A, Nagayama S, Yamamoto N, Akiyoshi T, Konishi T, Fujimoto Y, Fukunaga Y, Ishikawa Y, Ueno M. A rare case of hepatocellular carcinoma metastasizing hematogenously to the rectum. Int Cancer Conf J 2016; 5:168-173. [PMID: 31149448 DOI: 10.1007/s13691-016-0251-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2015] [Accepted: 04/14/2016] [Indexed: 11/25/2022] Open
Abstract
Metastasis to the gastrointestinal tract from hepatocellular carcinoma is uncommon. Herein, we report a rare case of with a metastatic lesion in the rectum, which resembled a primary rectal cancer. An 82-year-old Japanese woman, who had been diagnosed with liver cirrhosis and hepatocellular carcinoma due to chronic hepatitis C, was admitted for further examination of bloody stool. She had undergone radiofrequency ablation twice and transarterial chemoembolization twice before the admission. A colonoscopy revealed a protruding rectal tumor, which was confirmed by biopsy to be poorly differentiated adenocarcinoma. Meanwhile multiple liver recurrences were recognized by an abdominal computed tomography scan. To improve her symptoms and resume the treatment of hepatocellular carcinoma, laparoscopic anterior resection of the rectum was performed to remove the primary rectal cancer. To our surprise, detailed histological examination confirmed that the rectal tumor was a metastatic lesion from the hepatocellular carcinoma.
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Affiliation(s)
- Atsushi Ikeda
- 1Department of Gastroenterological Surgery, Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku Tokyo, 135-8550 Japan
| | - Satoshi Nagayama
- 1Department of Gastroenterological Surgery, Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku Tokyo, 135-8550 Japan
| | - Noriko Yamamoto
- 2Department of Pathology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Takashi Akiyoshi
- 1Department of Gastroenterological Surgery, Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku Tokyo, 135-8550 Japan
| | - Tsuyoshi Konishi
- 1Department of Gastroenterological Surgery, Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku Tokyo, 135-8550 Japan
| | - Yoshiya Fujimoto
- 1Department of Gastroenterological Surgery, Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku Tokyo, 135-8550 Japan
| | - Yosuke Fukunaga
- 1Department of Gastroenterological Surgery, Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku Tokyo, 135-8550 Japan
| | - Yuichi Ishikawa
- 2Department of Pathology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Masashi Ueno
- 1Department of Gastroenterological Surgery, Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku Tokyo, 135-8550 Japan
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