Ech1 is a potent suppressor of lymphatic metastasis in hepatocarcinoma

We have previously demonstrated that Ech1 is involved in the lymphatic metastasis of tumors in vitro. Here, we gain an insight into the role that Ech1 is playing in Hca-F cell. The expression of Annexin A7, Gelsolin and Clic1 genes, which were also relevant to tumor lymphatic metastasis, had been inhibited due to downregulation Ech1 gene by Western blot analysis. And downregulated of Ech1 inhibits the metastasic capability of Hca-F cells to peripheral lymph nodes in vivo. Our work indicates although the involvement of Ech1 in tumor metastasis development and progression, but the subcellular location of Ech1 has not much contribution to that.     

Annexin A7 gene is an important factor in the lymphatic metastasis of tumors

In the tumor malignancy progression, lymph node metastasis (LNM) is recognized as an important factor. In this study, RNA interference (RNAi) was employed to down-regulate ANXA7 gene in Hca-F cells, a hepatocarcinoma cell line with high LNM rate. There was no significant effect on cell proliferation ability, but cell division, motility, and invasion abilities were markedly inhibited. By contrast, up-regulating the expression of ANXA7 gene in Hca-P cells with lower LNM rate, cell migration ability was improved and the percentage of cells in S phase was significantly decreased in vitro. Here, we reported that the expression of Ech1, GSN and JNK1 genes, which were relevant to tumor lymphatic metastasis, had been inhibited due to down-regulation ANXA7 gene and promoted due to up-regulation ANXA7 gene by western blot analysis. These results indicated that ANXA7 is a critical factor in the development of lymphatic metastasis in hepatocarcinoma progression.     

Enhanced tumorigenesis and lymphatic metastasis of CD133+ hepatocarcinoma ascites syngeneic cell lines mediated by JNK signaling pathway in vitro and in vivo

Cancer stem cells (CSCs), stem-like cells, or tumor-initiating cells (TICs) may initiate tumorigenesis and metastasis, but neither the basic cell biology of CSCs nor the mechanisms of CSC-mediated tumor growth and lymphoid node metastasis are understood. Evidence suggests that CSC phenotype is maintained, at least in part, by altered JNK signaling. In this study, factors influencing the growth and metastatic potential of CSCs were examined by comparing CD133 surface antigen expression, proliferation, clonogenicity, invasive capacity, tumorigenicity, and expression of JNK-associated signaling molecules between the highly metastatic mouse hepatocarcinoma ascites syngeneic cell line Hca-F and the low metastasis potential line Hca-P. The Hca-F line exhibited higher clonogenic, proliferative, and invasive capacities than Hca-P cells, and a greater proportion of Hca-F cells were CD133 positive. In both cell lines, the CD133+ subpopulation showed significantly enhanced tumorigenicity and metastatic potential. An in vivo tumorigenicity assay in nude mice indicated that Hca-F cells possessed significantly higher tumorigenicity than Hca-P cells as indicated by larger tumors after inoculation. Expression levels of E-cadherin (CDH1), annexin VII, and JNK1 proteins were inversely correlated with CD133 expression in both Hca-F and Hca-P cells. These results demonstrate that CD133+ subpopulations of both Hca-F and Hca-P lines show CSC-like properties. However, Hca-F cells showed greater tumorigenicity and invasiveness, consistent with greater lymphatic metastasis capacity. We propose that tumorigenesis and lymphatic metastasis are regulated by JNK/P53/annexin VII and JNK/ATF-2/CDH1/annexin VII signal transduction pathways.     

Chloride intracellular channel 1 is an important factor in the lymphatic metastasis of hepatocarcinoma

We have previously demonstrated that chloride intracellular channel 1 (CLIC1) is involved in the lymphatic metastasis of tumors. In this study, a self-designed shRNA sequence of mouse CLIC1 gene was synthesized and inserted into a pGPU6/GFP/Neo plasmid, then stably transfected into mouse hepatic carcinoma cell line Hca-F cells to down-regulate the expression of CLIC1 gene. The levels of expression of CLIC1 mRNA and protein were detected by real-time quantitative polymerase chain reaction (qRT-PCR) and western blot (WB) analysis, respectively. The down-regulation of CLIC1 enhanced proliferative activity, increased the ratio of G2/M and decreased percentage of apoptosis. In addition, the capability of migration and invasion decreased significantly. The results indicate that CLIC1 is a critical factor in the development of lymphatic metastasis.     

RACK1 promotes the proliferation,migration and invasion capacity of mouse hepatocellular carcinoma cell line in vitro probably by PI3K/Rac1 signaling pathway

Hca-P and Hca-F is a pair of synogenetic mouse hepatocarcinoma ascites cell lines, possessing different capacity of lymphatic metastasis. Receptor of activated C-kinase 1 (Rack1), together with Jnk1 and gelsolin (Gsn) were previously identified as differentially expressed proteins for lymphatic metastatic potential between the two cell lines. As an intracellular scaffold protein, Rack1 could recruit such signaling molecules as integrins, Src, PKC which are involved in many important biological processes and play key roles in cancer progression. In our present studies, pCDNA3.1(+)-Rack1, a eukaryotic expression plasmid, was constructed and stably transfected into Hca-P cells with a low metastatic potential. CCK8 assay and transwell system were used to evaluate the effects of Rack1 on proliferation, migration and invasion of Hca-P cells in vitro. Then, LY294002, an inhibitor of PI3K, was added into the culture medium of pCDNA3.1(+)-Rack1-Hca-P cells and their biological behaviors observed further. Moreover, the expression of Jnk1, Rac1 and Gsn of pCDNA3.1(+)-Rack1-Hca-P cells were detected by western blot after pretreated with various doses of LY294002. As a result, the proliferation, migration and invasion of pCDNA3.1(+)-Rack1-Hca-P cells were significantly enhanced and could be inhibited by LY294002. In addition, the expression of Gsn, Rac1 and Jnk1 of pCDNA3.1(+)-Rack1-Hca-P cells also decreased after pretreated with LY294002. The expression of Gsn can be inhibited by NSC33766 (an inhibitor of Rac1). Taken together, Rack1/PI3K/Rac1 signaling pathway may play a crucial role in malignant biological behaviors of mouse hepatocarcinoma cells with lymphatic metastasis potential. It may be a potential target for therapy of cancer lymphatic metastasis.     

Annexin A7 and its binding protein galectin-3 influence mouse hepatocellular carcinoma cell line in vitro

Lymph node metastasis is recognized as an important mode of liver cancer metastasis. Our previous study has built two hepatocarcinoma cell lines, Hca-F with high (75%) and Hca-P with low (25%) incidences of lymph node metastasis, and has indicated that annexin A7 is an important factor in the lymphatic metastasis of tumors. There is evidence that galectin-3 is the binding protein of annexin A7 and works in protein complexes. Our current study shows that both annexin A7 and galectin-3 express higher in Hca-F than Hca-P. Annexin A7 was successfully down-regulated in Hca-P by RNA interference, and this resulted in concomitant reduction of galactin 3 expression in annexin A7 down regulated compared to the control and N-control cells. Using CCK-8 assay, the expression level of annexin A7 and galectin-3 were found to have correlation with the proliferation ability; Transwell assay showed annexin A7 and galectin-3 are involved in cell migration and invasion regulation in mouse hepatocellular carcinoma cell lines, immunofluorescence assay indicate annexin A7 and galectin-3 were co-located annexin A7 and galectin-3 played roles in DNA damage and cell proliferation cycle checkpoint arrest pathway. Those phenomena indicated that annexin A7 influences lymphatic metastasis of tumors by interacting with galectin-3 through the regulation of tumor cell proliferation, attachment, migration and invasion.     

Clic1 plays a role in mouse hepatocarcinoma via modulating Annexin A7 and Gelsolin in vitro and in vivo

Clic1 is a member of the family of chloride intracellular ion channels. Previous studies suggest that Clic1 is involved in migration and invasion of the lymphatic metastasis in hepatocarcinoma, however, the mechanism is not fully understood. In the present study, we observed Clic1 is abundant in cytoplasm, higher expression in Hca-F cell than Hca-P cell, and we showed that downregulation of Clic1 by RNA interference was able to markedly enhance the expression of tumor metastasis genes Annexin A7 and Gelsolin in vitro, and downregulation of Annexin A7 and Gelsolin also enhanced the expression of Clic1 in vitro and in vivo. Our results provide novel insight that Clic1 have a role in migration and invasion in hepatocarcinoma maybe via modulating the expression of Annexin A7 and Gelsolin, and provide novel insight into the mechanisms of Clic1 for hepatocarcinoma treatment.     

磷酸化JNK在小鼠腹水型肝癌高、低淋巴道转移株中表达的研究

目的观察磷酸化JNK(p-JNK)在小鼠腹水型肝癌高、低淋巴道转移株(Hca-F、Hca-P)中的表达水平,分析其在这两个细胞株中表达的关系及意义,以进一步探讨JNK基因在肝癌淋巴道转移过程中的作用。方法以小鼠腹水型肝癌淋巴道高转移株(Hca-F)和低转移株(Hca-P)为研究对象,采用Western Blot检测p-JNK在Hca-F和Hca-P两细胞株的表达。结果p-JNK在Hca-F细胞株中的表达显著高于Hca-P,二者间差异有显著性(P<0.01)。结论p-JNK可能在促进肝癌淋巴道转移中发挥作用,本研究为进一步探讨其机制和功能奠定了基础。     

Evaluation of Annexin A7, Galectin-3 and Gelsolin as possible biomarkers of hepatocarcinoma lymphatic metastasis

We have previously demonstrated that Annexin A7 is involved in the lymphatic metastasis of hepatocarcinoma in vitro. The expression of Galectin-3 and Gelsolin, which were also relevant to tumor lymphatic metastasis, had shown the same tendency concordantly with the expression of Annexin A7 alteration by qRT-PCR and Western blot analysis. Here, we gain an insight into the role that Annexin A7 is playing in Hca-P, P_{Anxa7-upregulated} and P_{Anxa7-downregulated} cells in vivo. Then, Hca-P, P_{Anxa7-upregulated} and P_{Anxa7-downregulated} cells were injected into a mouse footpad to establish primary tumors in mice. On the fourth week after HCC cells inoculation, the mice were sacrificed for inspection the expression of Annexin A7, Galectin-3 and Gelsolin in primary tumors and in serum. Our work indicates that Annexin A7 and Gelsolin are both valuable in tumors and in serum evaluating lymph node metastasis in mice with hepatocarcinoma; Galectin-3 in tumors is significant but no much contribution in serum.     

Anxa5 mediates the in vitro malignant behaviours of murine hepatocarcinoma Hca-F cells with high lymph node metastasis potential preferentially via ERK2/p-ERK2/c-Jun/p-c-Jun(Ser73) and E-cadherin

ObjectiveAnnexin A5 (Anxa5) is associated with the progression of some cancers, while its role and regulation mechanism in tumor lymphatic metastasis is rarely reported. This study aims to investigate the influence of Anxa5 knockdown on the malignant behaviours of murine hepatocarcinoma Hca-F cell line with high lymph node metastatic (LNM) potential and the underlying regulation mechanism.MethodsRNA interfering was performed to silence Anxa5 in Hca-F. Monoclonal shRNA-Anxa5- Hca-F cells were obtained via G418 screening by limited dilution method. Quantitative real-time RT-PCR (qRT-PCR) and Western blotting (WB) were applied to measure Anxa5 expression levels. CCK-8, Boyden transwell-chamber and in situ LN adhesion assays were performed to explore the effects of Anxa5 on the proliferation, migration, invasion and adhesion capacities of Hca-F. WB and qRT-PCR were used to detect the level changes of key molecules in corresponding signal pathways.ResultsWe obtained two monoclonal shRNA-Anxa5-transfected Hca-F cell lines with stable knockdowns of Anxa5. Anxa5 knockdown resulted in significantly reduced proliferation, migration, invasion and in situ LN adhesion potentials of Hca-F in proportion to its knockdown extent. Anxa5 downregulation enhanced E-cadherin levels in Hca-F. Moreover, Anxa5 affected Hca-F behaviours specifically via ERK2/p-ERK2/c-Jun/p-c-Jun(Ser73) instead of p38MAPK/c-Jun, Jnk/c-Jun and AKT/c-Jun pathways.ConclusionsAnxa5 mediates the in vitro malignant behaviours of murine hepatocarcinoma Hca-F cells via ERK2/c-Jun/p-c-Jun(Ser73) and ERK2/E-cadherin pathways. It is an important molecule in metastasis (especially LNM) and a potential therapeutic target for hepatocarcinoma.     

Subcellular proteomics: Determination of specific location and expression levels of lymphatic metastasis associated proteins in hepatocellular carcinoma by subcellular fractionation

Background

Subcellular fractionation and proteomics form an ideal partnership when it comes to specific location and analysis of intracellular organelles and expression levels of multiprotein complexes. Lymphatic metastasis is the major complicated system involving multiple factors. However, to date lymphatic metastatic mechanism is poorly understood.

Aim

To specifically locate expression site by subcellular fractionation, based on expression levels, interpret the involvement of different lymphatic metastasis associated proteins in hepatocellular carcinoma cell lines with different lymphatic metastasis potential.

Method

Mouse hepatocellular cell lines Hca-F and Hca-P are used to evaluate the location and expression levels of some lymphatic metastasis-associated proteins in the cell by using subcellular fractionation kit and Western blot analysis. The proteins under studies were Gelsolin, JNK and Annexin 7.

Results

Gelsolin was sequestered in cytoplasm, membrane and cytoskeleton in F-cells but in P-cells, it was found in cytoplasm and cytoskeleton .JNK was located in nuclear fraction and cytoskeleton in F and P cells, Annexin7 was in cytoplasm with its two isoforms only at this location, cell membrane and cytoskeleton in F and P cells. With the high expression level of Gelsolin, JNK and Annexin 7 in Hca-F cell line than Hca-P cell line.

Conclusion

With subcellular fractionation specific location of Gelsolin, JNK and Annexin 7 at various cell sites during lymphatic metastasis were determined. High expression levels were found in high lymphatic metastasis potential cell lines which indicate their roles according to different expression sites in the disease.     

Toll样受体2/核转录因子-κB基因表达与小鼠肝癌淋巴道转移关系研究

目的：探讨Toll样受体2（TLR-2）和核转录因子-κB（NF-κB）基因在小鼠肝癌淋巴道转移中的作用。方法：采用实时定量聚合酶链反应（RQ-PCR）方法检测TLR-2和NF-κB基因在淋巴道低转移潜能小鼠肝癌细胞系Hca-P和高转移潜能小鼠肝癌细胞系Hca-F中的表达水平。结果：TLR-2基因在Hca-P和HcaF细胞系基因表达分别为（2.14±0.42）×10-3、（4.31±0.62）×10-3,NF-κB基因在Hca-P和Hca-F细胞系表达分别为（1.41±0.48）×10-3、（2.95±0.22）×10-3,差异有统计学意义（P〈0.01）,随转移潜能的增高,其表达水平增加。结论：TLR2基因和NF-κB基因表达水平增高提示其在肝癌的淋巴道侵袭转移中起作用,TLR2基因和NF-κB基因有可能成为肝癌转移预测指标和潜在治疗靶点。     

Mechanisms of lymphatic metastasis

Malignant tumors release growth factors such as VEGF-C to induce lymphatic vessel expansion (lymphangiogenesis) in primary tumors and in draining sentinel LNs, thereby promoting LN metastasis. Surprising recent evidence suggests that lymphatic vessels do not merely represent passive channels for tumor spread, but that they may actively promote tumor cell recruitment to LNs, cancer stem cell survival, and immune modulation. New imaging approaches allow the sensitive visualization of the earliest LN metastases and the quantitative, noninvasive measurement of the function of tumor-draining lymphatic vessels, with potential applications in the development of biomarkers for prognosis and measurement of therapeutic response.Cancer metastasis, the dissemination of cancer cells from the primary tumor to organs, where they initiate malignant growth, is the primary cause of cancer-related deaths. There has been a plethora of studies addressing the mechanisms of tumor metastasis via the bloodstream to distant organs; however, the majority of epithelial cancers first develop metastatic growth by spreading via lymphatic vessels to their draining LNs. Indeed, the detection of metastases within the sentinel LNs (SLNs; the first LNs into which a tumor drains) has major prognostic implications for patient survival and often also determines the choice of adjuvant therapies (1). Despite the obvious clinical importance of LN metastasis, the mechanisms leading to tumor spread via lymphatic vessels have remained unknown for decades. In fact, the prevailing view suggested that lymphatic vessels only play a passive role in tumor metastasis, serving merely as channels for tissue-invading tumor cells. The limited knowledge in this field was due to the relatively low scientific interest in lymphatic vessels as compared to the blood vasculature, the lack of reliable molecular markers to distinguish between lymphatic and blood vessels, the absence of identified growth factors for the lymphatic system, and the paucity of suitable experimental models to study and quantify LN metastasis. During the last 15 years, however, there has been substantial progress in the field of lymphatic vessel biology, which has rapidly lead to the recognition of the lymphatic vascular system as a major player involved in a multitude of human diseases (2). In this article, we will discuss the major discoveries made by our laboratory and many other researchers that have led to the recognition of a major role for the lymphatic vasculature in promoting cancer metastasis and to the new concepts of tumor-associated and LN lymphangiogenesis with a specific focus on the development of new strategies to image and therapeutically target the lymphatic system in cancer.     

LyP-1-conjugated PEGylated liposomes: A carrier system for targeted therapy of lymphatic metastatic tumor

The application of liposomes in targeted therapy of lymphatic metastatic tumors has been hampered by the low uptake rate of liposome by metastatic lymph nodes. In this report, LyP-1, a peptide that can specifically bind tumor cells, tumor lymphatics and tumor-associated macrophages, was conjugated to liposomes for targeting and treating lymphatic metastatic tumors. Firstly, LyP-1-conjugated PEGylated liposomes loaded with fluorescein or doxorubicin (DOX) were prepared and showed satisfactory vesicle size and size distribution. The in vitro cellular uptake and in vivo near-infrared fluorescence imaging results showed that LyP-1 modification increased liposome uptake by tumor cells and metastatic lymph nodes, but did not increase uptake by normal lymph nodes. The immunofluorescence analysis evidenced that LyP-1-conjugated liposomes were distributed adjacent to tumor lymphatics and tumor-associated macrophages in metastatic lymph nodes. The pharmacodynamic study suggested that compared with unmodified liposomes, LyP-1-conjugated DOX-loaded liposomes exhibited enhanced inhibition effect on tumor cells in vitro and lymphatic metastatic tumors in vivo. Pathological examination showed that liposomal DOX caused reduced tissue damage to injection site compared with DOX solution. In summary, LyP-1-conjugated PEGylated liposomes could be targeted to metastatic lymph nodes based on their specific binding to tumor cells, tumor lymphatics and tumor-associated macrophages. They are a safe and effective drug delivery system of antineoplastic agents for targeted therapy of lymphatic metastatic tumors.     

Differential response of primary tumor versus lymphatic metastasis to VEGFR-2 and VEGFR-3 kinase inhibitors cediranib and vandetanib

Blood vessels are required for a tumor to grow and functional lymphatic vessels are required for it to disseminate to lymph nodes. In an attempt to eradicate both the primary tumor and its lymphatic metastasis, we targeted both blood and lymphatic vessels using two different tyrosine kinase inhibitors (TKIs): cediranib and vandetanib, which block vascular endothelial growth factor receptor (VEGFR)-2 and -3 in enzymatic assays. We found that although both cediranib and vandetanib slowed the growth rate of primary tumors and reduced blood vessel density, neither agent was able to prevent lymphatic metastasis when given after tumor cells had seeded the lymph node. However, when given during tumor growth, cediranib reduced the diameters of the draining lymphatic vessels, the number of tumor cells arriving in the draining lymph node, and the incidence of lymphatic metastasis. On the other hand, vandetanib had minimal effect on any of these variables, suggesting that vandetanib did not effectively block VEGFR-3 on lymphatic endothelial cells in our animal model. Collectively, these data indicate that the response of lymphatic vessels to a TKI can determine the incidence of lymphatic metastasis, independent of the effect of the TKI on blood vessels.     

乳腺良恶性肿瘤组织中CD44的表达及其与淋巴管生成的关系

目的 研究细胞黏附分子44(CD44)在乳腺良恶性肿瘤组织中的表达及其与淋巴管生成的关系,探讨其在鉴别诊断中的应用价值。方法 收集2005～2015年广州医科大学附属肿瘤医院乳腺肿瘤患者组织样品75例(均为女性)并分为良性肿瘤组、乳腺浸润性导管癌淋巴结转移组和未转移组,每组各25例。免疫组织化学法(IHC)检测CD44在各组患者肿瘤组织样品中的表达并以CD44作为淋巴管内皮细胞标记物比较各组样品中的淋巴管生成情况。生物信息分析验证研究结果。结果 在良性肿瘤组、乳腺浸润性导管癌淋巴结转移组和未转移组中,CD44的IHC评分结果分别为0.60±0.82,3.16±2.70和3.52±2.47,乳腺浸润性导管癌淋巴结转移组和未转移组的CD44表达水平均高于乳腺良性肿瘤组,差异具有统计学意义(F=13.52,P<0.000 1)。以CD44作为淋巴管内皮细胞特异性标记物可有效辅助三组样品的淋巴管生成计数。在乳腺良性肿瘤组、乳腺浸润性导管癌伴淋巴结转移组和未伴淋巴结转移组中,淋巴管生成数分别为4.08±2.43,13.80±13.54和12.72±13.69,乳腺浸润性导管癌淋巴结转移组和未转移组的淋巴管生成数均高于乳腺良性肿瘤组,差异具有统计学意义(F=4.94,P=0.009 7)。生物信息分析结果也显示CD44在乳腺癌中的表达较正常乳腺增加。结论 乳腺癌的发生与CD44表达以及淋巴管的生成有关。CD44有望成为乳腺良性肿瘤与乳腺癌的辅助鉴别诊断指标,同时其也可作为乳腺淋巴管内皮细胞的特异性标记物。     

Inhibition of annexin A7 gene and protein induces the apotosis and decreases the invasion,migration of the hepatocarcinoma cell line

Our previous studies have shown that annexin A7 (ANXA7) gives different expressions in the mouse hepatocarcinoma cell lines with low or high lymphatic metastatic potential in both gene and protein levels. In this study, whether by using RNA interference (RNAi) technique downregulating ANXA7 in the gene level or by using antibody against ANXA7 in the protein level, the depressed expression of ANXA7 could induce apotosis and decrease the invasion, migration capacities of the Hca-P cell, a hepatocarcinoma cell line with low lymphatic metastatic potential in vitro. The results indicate that ANXA7 is an important factor in tumors with the lymphatic metastasis.     

VEGF-A induces tumor and sentinel lymph node lymphangiogenesis and promotes lymphatic metastasis

The mechanisms of tumor metastasis to the sentinel lymph nodes are poorly understood. Vascular endothelial growth factor (VEGF)-A plays a principle role in tumor progression and angiogenesis; however, its role in tumor-associated lymphangiogenesis and lymphatic metastasis has remained unclear. We created transgenic mice that overexpress VEGF-A and green fluorescent protein specifically in the skin, and subjected them to a standard chemically-induced skin carcinogenesis regimen. We found that VEGF-A not only strongly promotes multistep skin carcinogenesis, but also induces active proliferation of VEGF receptor-2-expressing tumor-associated lymphatic vessels as well as tumor metastasis to the sentinel and distant lymph nodes. The lymphangiogenic activity of VEGF-A-expressing tumor cells was maintained within metastasis-containing lymph nodes. The most surprising finding of our study was that even before metastasizing, VEGF-A-overexpressing primary tumors induced sentinel lymph node lymphangiogenesis. This suggests that primary tumors might begin preparing their future metastatic site by producing lymphangiogenic factors that mediate their efficient transport to sentinel lymph nodes. This newly identified mechanism of inducing lymph node lymphangiogenesis likely contributes to tumor metastasis, and therefore, represents a new therapeutic target for advanced cancer and/or for the prevention of metastasis.     

Expansion of the indications for endoscopic mucosal resection in patients with superficial esophageal carcinoma

BACKGROUND AND STUDY AIMS: Endoscopic mucosal resection (EMR) is a minimally invasive local treatment for superficial esophageal carcinoma (SEC). The use of EMR in patients with m3 or sm1 SEC remains controversial, however. The aim of this retrospective study was to evaluate the histopathological risk factors for lymph-node metastasis and recurrence in patients with m3 or sm1 SEC. PATIENTS AND METHODS: The study subjects were 43 patients with m3 or sm1 esophageal squamous-cell carcinomas: 23 patients were treated surgically (the surgery group), and 20 were treated by EMR (the EMR group). We assessed the following variables of the specimens resected by surgery or EMR: tumor depth, maximal surface diameter of the tumor (superficial size), maximum diameter of tumor invasion at the lamina muscularis mucosae (LMM invasion width), and lymphatic invasion. The relationships of these variables to lymph-node metastasis and recurrence were examined. RESULTS: In the surgery group, lymph-node metastasis was found in four patients, all of whom had tumors with lymphatic invasion, a superficial size of at least 25 mm, and an LMM invasion width of at least 2500 microm. In the EMR group, no patient met all three of these criteria, and there was no evidence of lymph-node metastasis or distant metastasis on follow-up after EMR (median follow-up 39 months). CONCLUSIONS: In patients with m3 or sm1 SEC, tumors that have lymphatic invasion, larger superficial size, and wider LMM invasion are associated with a high risk for lymph-node metastasis. EMR might be indicated for the treatment of patients with m3 or sm1 SECs without these characteristics.     

LncRNA AFAP1-AS1 contributes to the progression of endometrial carcinoma by regulating miR-545-3p/VEGFA pathway

Endometrial carcinoma (EC) accounts for 20%–30% of female reproductive tumors. Targeted therapy for EC has shown great advantages with small side effects. To improve the survival of EC patients, more new therapeutic targets need to be found. Long non-coding RNAs (lncRNAs) are series of RNAs with over 200 nucleotides that regulate various cellular functions. LncRNA actin filamentin-1 antisense RNA 1 (AFAP1-AS1) is involved in the development of a variety of cancers, such as pancreas ductal adenocarcinoma and esophageal adenocarcinoma. However, it is not clear whether AFAP1-AS1 has any effects on EC or the exact regulatory mechanism. Herein, we found the high expression of AFAP1-AS1 in human EC tissues, and AFAP1-AS1 was correlated with EC patients’ prognosis and clinical features. AFAP-AS1 could affect EC cell proliferation, migration, and invasion, and contributed to endothelial cell angiogenesis. We further showed that AFAP-AS1 could promote the expression of VEGFA through the adsorption of miR-545-3p, thus promoting the angiogenesis and invasion of EC, and contribute to tumor growth and metastasis in vivo. Thus, we thought AFAP1-AS1 had the potential to serve as an EC therapeutic target.