化疗对三阴性乳腺癌CD44+CD24-/low细胞亚群的影响

目的:观察化疗对三阴性乳腺癌CD44+CD24-/low细胞亚群的影响。方法:用0.2、1、5倍药物血浆峰浓度(peak plasma concentration,PPC)的紫杉醇、多西紫杉醇、氟尿嘧啶、表柔比星、长春瑞滨和吉西他滨分别作用人三阴性乳腺癌MDA-MB-231细胞24、48和72h后,MTT法检测细胞生长情况;FCM法检测1倍PPC的各药物作用48h以及细胞复苏后CD44+CD24-/low细胞含量的变化;另外,FCM法检测10例转移性三阴性乳腺癌患者在化疗前后,外周血中CD44+CD24-/low细胞的含量变化。结果:6种药物均可抑制MDA-MB-231细胞增殖。1倍PPC的各药作用后,CD44+CD24-/low细胞含量未明显升高,以氟尿嘧啶组含量降低最为明显(P<0.05)。转移性三阴性乳腺癌患者在化疗后,外周血中CD44+CD24-/low细胞含量降低(P<0.05)。结论:化疗药物紫杉醇、多西紫杉醇、氟尿嘧啶和表柔比星可降低MDA-MB-231细胞株中CD44+CD24-/low细胞亚群的含量。化疗可使转移性三阴性乳腺癌患者外周血中CD44+CD24-/low细胞含量降低。     

CD44+ CD24-/low与ALDH1+在乳腺癌组织中的表达及其意义

乳腺癌是妇女常见的恶性肿瘤。近年的研究发现在恶性肿瘤中存在一种亚群细胞,其恶性程度高于一般的肿瘤细胞。如果分离得到乳腺癌干细胞,就可以通过其表面特异的标志物或异常表达的标志物,检测体内是否残留有肿瘤干细胞,同时把乳腺癌干细胞作为靶细胞,建立乳腺癌干细胞模型,为乳腺癌研究奠定细胞学基础,进而指导手术、放化疗及分子靶向治     

CD44+/CD24-/low在乳腺癌中的表达及其与含蒽环类药物化疗方案敏感度的关系

目的研究乳腺癌中CD44+/CD24-/low的表达及其与含蒽环类药物化疗方案敏感度的关系。方法 91例乳腺癌接受含蒽环类药物的术前新辅助化疗,2～4个疗程后进行效果评价;采用双染免疫组织化学方法检测化疗前后CD44+/CD24-/low的表达,t检验分析化疗前后CD44+/CD24-/low细胞比例的变化,χ2检验分析乳腺癌CD44+/CD24-/low表型与乳腺癌临床病理参数及化疗疗效的关系。结果乳腺癌中CD44+/CD24-/low阳性表达率为39.6%(36/91),在接受含蒽环类药物的新辅助化疗后乳腺癌中CD44+/CD24-/low细胞比例较化疗前明显增加(P=0.028)。CD44+/CD24-/low阳性组ER阳性率明显低于CD44+/CD24-/low阴性组(25.0%vs.47.3%,P=0.033)。三阴性乳腺癌中CD44+/CD24-/low阳性率明显高于非三阴性乳腺癌(61.9%vs.32.9%,P=0.017)。CD44+/CD24-/low表型与年龄、肿瘤大小、临床分期、病理类型、组织学分级等乳腺癌临床病理参数无明显关系(P>0.05)。CD44+/CD24-/low阳性组的总有效率高于CD44+/CD24-/low阴性组,但两组之间差异无统计学意义(75%vs.69.1%,P=0.542);CD44+/CD24-/low阳性组的病理完全缓解率明显高于CD44+/CD24-/low阴性组(38.9%vs.18.2%,P=0.028)。结论 CD44+/CD24-/low细胞仅存在于部分乳腺癌,CD44+/CD24-/low表型与ER(﹣)、三阴性乳腺癌相关,CD44+/CD24-/low表型与乳腺癌对含蒽环类药物化疗方案的敏感度相关,CD44+/CD24-/low表型可能成为乳腺癌临床化疗疗效的预测指标之一。     

外周血P糖蛋白功能检测及其与乳腺癌多药耐药性的关系

目的 建立人外周血NK细胞P糖蛋白功能检测的方法,分析P糖蛋白功能与乳腺癌患者原发性多药耐药之间的关系.方法 选择经含蒽环类和紫杉类药物联合化疗的初治乳腺癌患者16例,治疗后化疗敏感和耐药者各8例.采集患者外周血标本,分离NK细胞,与荧光物质罗丹明123(Rh123)孵育,应用流式细胞仪检测不同时间点外周血NK细胞内Rh123的荧光强度;以Rh123的荧光强度(F)和相应时间点(t)作图,通过曲线估计回归分析,构建P糖蛋白药泵功能检测的最佳数学模型,计算每例患者相应的外排速率常数;分析化疗敏感组和耐药组患者速率常数的差异,以及以速率常数预测乳腺癌原发性多药耐药的可行性.结果 所有患者的NK细胞在撤离Rh123后60min,基本不再外排Rh123,NK细胞内Rh123的蓄积量、排出量和残留量均与化疗敏感性之间无明显相关性.通过回归分析建立了P糖蛋白功能检测的最佳数学模型F1=F0·e-kt(F1为t时间点的荧光强度,k为外排速率常数),化疗敏感组与耐药组患者外排速率常数差异有统计学意义(P=0.025).以k>3.9为标准,诊断乳腺癌原发性多药耐药,其诊断敏感性为75.0%,特异性为100%.准确率87.5%.结论 外周血NK细胞P糖蛋白药泵外排功能与乳腺癌患者原发性多药耐药密切相关,外排速率常数可能是预测乳腺癌化疗敏感性的理想指标.     

多药耐药性相关蛋白在乳腺癌组织中的表达及其与预后关系

目的:研究多药耐药相关蛋白（Multidrug　resistance-associated　protein　1,MRP1）在乳腺癌组织中的表达,评估其在乳腺癌预后中的作用。方法:采用免疫组织化学方法（IHC）检测47例手术切除的乳腺癌组织中MRP1的表达,并分析其与临床、病理特征的关系及对预后的影响。结果:（1）MRP1在乳腺癌组织中的阳性表达率为85.1％（40/47例）,其中高表达者占53.2％（25/47例）;（2）腋淋巴结阳性者MRP1表达水平明显高于腋淋巴结阴性者（P<0.05）,MRP1表达与月经状况、肿瘤大小、组织分级和激素受体状况均无关（P>0.05）;（3）Kaplan-Meier生存分析结果表明MRP1表达与无病生存期明显相关（P<0.05）,但和总生存期无关（P>0.05）;（4）Cox单因素分析显示肿瘤大小和MRP1表达与无病生存期明显相关（P<0.05）,但仅有肿瘤大小和总生存期明显相关（P<0.05）;而多因素分析却显示只有腋淋巴结转移和无病生存期（P<0.01）和总生存期（P<0.05）明显相关。结论:MRP1在乳腺癌组织中具有较高的表达水平,与乳腺癌患者的无病生存期有关,而与总生存期无关。     

乳腺浸润性导管癌组织中ALDH1+/CD133+干细胞样细胞与血管生成的关系

目的 探讨乳腺浸润性导管癌组织中肿瘤干细胞标志物ALDH1、CD133的表达及其与肿瘤血管生成的关系。方法 应用免疫组织化学双染法检测120例乳腺浸润性导管癌组织中ALDH1⁺/CD133⁺ 干细胞样细胞,单染法检测血管性标记CD34、CD105及VEGF的表达情况。统计ALPH1⁺/CD133⁺干细胞样细胞与临床病理因素;CD34、CD105与VEGF的关系。结果 25.83％（31/120）的病例存在ALDH1⁺/CD133⁺干细胞样细胞,ALDH1⁺/CD133⁺干细胞样细胞与ER、VEGF的表达及MVD均相关（P＜0.05）,但与年龄、肿瘤直径、PR、Her-2、组织学分级及淋巴结转移均无关（P＞0.05）。结论 乳腺浸润性导管癌组织中ALDH1⁺/CD133⁺干细胞样细胞可能通过调节VEGF的表达促进肿瘤新生血管的生成。     

乳腺癌干细胞分选及其异质性

乳腺癌干细胞的成功分选是进行乳腺癌干细胞研究的基础,目前人们可以通过多种方法使乳腺癌干细胞得到一定程度的富集.然而,在越来越多乳腺癌干细胞表面标志物被发现的同时,其异质性也成为人们关注的热点.如何最大程度地富集乳腺癌干细胞及解释其异质性,将为乳腺癌的干细胞治疗提供新思路.     

乳腺癌组织多药耐药相关蛋白表达及其与化疗疗效的相关性研究

目的:探讨乳腺癌组织中多药耐药蛋白(P-gp)、乳腺癌耐药蛋白(BCRP)和肺耐药蛋白(LRP)的表达及其与乳腺癌化疗疗效的关系。方法:免疫组化法检测126例乳腺癌和42例癌旁组织中P-gp、BCRP和LRP蛋白的表达。结果:乳腺癌组织中P-gp、BCRP及LRP阳性表达率分别为41.26%(52/126)、38.89%(49/126)和65.87%(83/126),明显高于癌旁组织的14.28%(6/42)、16.67%(7/42)和19.05%(8/42),χ2值分别为10.147、7.020和27.820,P<0.05;5年内复发转移和无复发转移者P-gp阳性表达率差异有统计学意义(P=0.001),BCRP及LRP阳性表达率差异均无统计学意义,P>0.05。5年总生存率及无病生存率P-gp和BCRP阴性表达者明显高于阳性,χ2值分别为24.17、4.43、12.13和4.22,P值均<0.05;伴有2及3个耐药相关蛋白共表达的乳腺癌患者5年无病生存期及总生存期均较1或3个者明显缩短,χ2值分别为7.43和14.30,P值均<0.05。结论:P-gp、BCRP和LRP均参与了乳腺癌多药耐药,P-gp阳性...     

中药逆转乳腺癌多药耐药作用的研究进展

多药耐药性是导致乳腺癌化疗失败的重要原因之一,其发生机制非常复杂,涉及到药物在体内的转运、代谢、作用靶点等多个方面。近年来研究发现中药制剂不仅在提高患者抵抗力改善患者一般状态,增敏放化疗效果方面有良好的作用,而且在逆转乳腺癌多药耐药方面也有重要作用。     

肿瘤干细胞与肿瘤多药耐药相关性研究

肿瘤的多药耐药机制有多种,其中认为最主要的机制是由ABC转运蛋白介导的。随着干细胞研究的深入,有专家认为肿瘤的复发和转移是肿瘤干细胞逃脱药物杀伤作用的结果。肿瘤的多药耐药性可能是干细胞赋予肿瘤的能力。     

Tissue-specific promoters active in CD44+CD24-/low breast cancer cells

It has been proposed that human tumors contain stem cells that have a central role in tumor initiation and posttreatment relapse. Putative breast cancer stem cells may reside in the CD44(+)CD24(-/low) population. Oncolytic adenoviruses are attractive for killing of these cells because they enter through infection and are therefore not susceptible to active and passive mechanisms that render stem cells resistant to many drugs. Although adenoviruses have been quite safe in cancer trials, preclinical work suggests that toxicity may eventually be possible with more active agents. Therefore, restriction of virus replication to target tissues with tissues-specific promoters is appealing for improving safety and can be achieved without loss of efficacy. We extracted CD44(+)CD24(-/low) cells from pleural effusions of breast cancer patients and found that modification of adenovirus type 5 tropism with the serotype 3 knob increased gene delivery to CD44(+)CD24(-/low) cells. alpha-Lactalbumin, cyclo-oxygenase 2, telomerase, and multidrug resistance protein promoters were studied for activity in CD44(+)CD24(-/low) cells, and a panel of oncolytic viruses was subsequently constructed. Each virus featured 5/3 chimerism of the fiber and a promoter controlling expression of E1A, which was also deleted in the Rb binding domain for additional tumor selectivity. Cell killing assays identified Ad5/3-cox2L-d24 and Ad5/3-mdr-d24 as the most active agents, and these viruses were able to completely eradicate CD44(+)CD24(-/low) cells in vitro. In vivo, these viruses had significant antitumor activity in CD44(+)CD24(-/low)-derived tumors. These findings may have relevance for elimination of cancer stem cells in humans.     

CD44+CD24-/low在基底样乳腺癌中过表达与其恶性预后的相关性研究

目的探讨乳腺癌干细胞样标志物CD44⁺CD24^-/low在基底样乳腺癌(basal-like breast carcinoma, BLBC)中过表达与BLBC恶性预后的相关性。方法 在乳腺癌基因表达分型的基础上, 根据雌激素受体(ER)、孕激素受体(PR)、人类表皮生长因子受体2(Her-2)免疫表型的表达选取乳腺癌组织四组:管腔A组、管腔B/C组、Her-2高表达组及三阴性组;对三阴性组检测CK5/6、EGFR, 分为正常乳腺样型和BLBC型两组;对上述5组进行免疫组化Envision法染色, 选用抗体为CD44、CD24, 观察CD44⁺CD24^-/low表型表达并比较BLBC组与其它各组的差异。结果 (1)三阴性组共60例, CK5/6和或EGFR阳性者41例(68.3%), 确定为BLBC;CK5/6、EGFR阴性者19例(31.7%), 确定为正常乳腺样组;(2)CD44⁺CD24^-/low表型在BLBC组中占78.0%(32/41), 相对于管腔A组37.9%(11/29)、管腔B组25.9%(7/27)、Her-2高表达组17.2%(5/29)、正常乳腺样组26.3%(5/21), 表达增高并具有显著性(P＜0.05);(3)所有150例乳腺癌中(可评价145例)具有CD44⁺CD24^-/low免疫表型者其Ki-67指数增高相对于非CD44⁺CD24^-/low表型具有统计学差异(P＜0.001)。结论 BLBC型乳腺癌表达乳腺癌干细胞样标志物CD44⁺CD24^-/low显著高于其它各型乳腺癌, CD44⁺CD24^-/low与BLBC独特的恶性生物学行为相关。     

乳腺浸润性微乳头状癌中CD44^＋／CD24^-／low和CD24^＋表型细胞的研究

目的研究乳腺浸润性微乳头状癌（invasive micropapillary carcinoma,IMPC）的干细胞表型,从干细胞和上皮间质转化（epithelial—mesenchymal transition,EMT）角度探讨IMPC高侵袭、高转移恶性生物学行为的原因。方法选取术前未经放化疗治疗患者的IMPC82例和乳腺非特殊型浸润性导管癌（invasive ductal carcinoma not otherwise specified,IDC—NOS）80例石蜡包埋组织标本切片,通过免疫组织化学双染技术检测两组肿瘤组织中CD44^＋／CD24^-/low（CD24^-）和CD24^＋的表达、定位和分布情况,并分析其与各临床病理学特征之间的关系。定量资料采用Student’s t检验,定性资料采用Mann-Whitney U检验、Kruskal—Waliis检验、x^2检验或校正x^2检验。两组之间相关性采用Spearman＇s秩相关分析。结果（1）IMPC组肿瘤细胞的CD44^＋／CD24^-/low阳性表达率（48．8％,40／82例）,明显高于IDC—NOS组（31．3％,25／80例）（x^2=5．180,P=0．023）。（2）53．7％（44／82例）的IMPC微细间质组织内见单个散在的CD44^＋／CD24^-/low肿瘤细胞,且该细胞免疫组织化学染色Vimentin及α—SMA阳性,E—Cadherin阴性。IDC—NOS间质内罕见CD44^＋／CD24^-/low肿瘤细胞。（3）IMPC微乳头结构中CD44^＋／CD24^-/low与间质内的CD44^＋／CD24^-/low阳性表达细胞呈明显正相关（r=0．516,P〈0．001）,并且IMPC微乳头结构及间质中CD44^＋／CD24^-/low阳性表达在有无淋巴管侵犯和有无淋巴结外软组织浸润方面的差异均有统计学意义（P〈0．050）,即有淋巴管侵犯及淋巴结外软组织浸润者CD44^＋／CD24^-/low阳性表达率较高。（4）IMPC组中CD24^＋细胞阳性表达率79．3％（65／82例）,明显高于IDC-NOS组（60．0％,48／80例）（x^2=7．126,P=0．008）,且IMPC中淋巴结转移阳性组CD24的表达高于阴性组,差异有统计学意义（x^2=8．834,P=0．003）。结论IMPC肿瘤细胞中干细胞     

Metformin-induced preferential killing of breast cancer initiating CD44+CD24-/low cells is sufficient to overcome primary resistance to trastuzumab in HER2+ human breast cancer xenografts

Trastuzumab-refractory breast cancer stem cells (CSCs) could also explain the high rate of primary resistance to single-agent trastuzumab in HER2 gene-amplified breast cancer patients. The identification of agents with strong selective toxicity for trastuzumab-resistant breast CSCs may have tremendous relevance for how HER2+ breast cancer patients should be treated. Using the human breast cancer cell line JIMT-1, which was established from the pleural metastasis of a patient who was clinically resistant to trastuzumab ab initio, we examined whether preferential killing of the putative CD44+CD24-/low breast CSC population might be sufficient to overcome primary resistance to trastuzumab in vivo. Because recent studies have shown that the anti-diabetic biguanide metformin can exert antitumor effects by targeted killing of CSC-like cells, we explored whether metformin's ability to preferentially kill breast cancer initiating CD44+CD24-/low cells may have the potential to sensitize JIMT-1 xenograft mouse models to trastuzumab. Upon isolation for breast cancer initiating CD44+CD24-/low cells by employing magnetic activated cell sorting, we observed the kinetics of metformin-induced killing drastically varied among CSC and non-CSC subpopulations. Metformin's cell killing effect increased dramatically by more than 10-fold in CD44+CD24-/low breast CSC cells compared to non-CD44+CD24-/low immunophenotypes. While seven-weeks treatment length with trastuzumab likewise failed to reduce tumor growth of JIMT-1 xenografts, systemic treatment with metformin as single agent resulted in a significant two-fold reduction in tumor volume. When trastuzumab was combined with concurrent metformin, tumor volume decreased sharply by more than four-fold. Given that metformin-induced preferential killing of breast cancer initiating CD44+CD24-/low subpopulations is sufficient to overcome in vivo primary resistance to trastuzumab, the incorporation of metformin into trastuzumab-based regimens may provide a valuable strategy for treatment of HER2+ breast cancer patients.     

Brca1 breast tumors contain distinct CD44+/CD24- and CD133+ cells with cancer stem cell characteristics

Introduction

Whether cancer stem cells occur in BRCA1-associated breast cancer and contribute to therapeutic response is not known.

Methods

We generated and characterized 16 cell lines from five distinct Brca1deficient mouse mammary tumors with respect to their cancer stem cell characteristics.

Results

All cell lines derived from one tumor included increased numbers of CD44⁺/CD24^- cells, which were previously identified as human breast cancer stem cells. All cell lines derived from another mammary tumor exhibited low levels of CD44⁺/CD24^- cells, but they harbored 2% to 5.9% CD133⁺ cells, which were previously associated with cancer stem cells in other human and murine tumors. When plated in the absence of attachment without presorting, only those cell lines that were enriched in either stem cell marker formed spheroids, which were further enriched in cells expressing the respective cancer stem cell marker. In contrast, cells sorted for CD44⁺/CD24^- or CD133⁺ markers lost their stem cell phenotype when cultured in monolayers. As few as 50 to 100 CD44⁺/CD24^- or CD133⁺ sorted cells rapidly formed tumors in nonobese diabetic/severe combined immunodeficient mice, whereas 50-fold to 100-fold higher numbers of parental or stem cell depleted cells were required to form few, slow-growing tumors. Expression of stem cell associated genes, including Oct4, Notch1, Aldh1, Fgfr1, and Sox1, was increased in CD44⁺/CD24^- and CD133⁺ cells. In addition, cells sorted for cancer stem cell markers and spheroid-forming cells were significantly more resistant to DNA-damaging drugs than were parental or stem cell depleted populations, and they were sensitized to the drugs by the heat shock protein-90 inhibitor 17-DMAG (17-dimethylaminoethylamino-17-demethoxygeldanamycin hydrochloride).

Conclusion

Brca1-deficient mouse mammary tumors harbor heterogeneous cancer stem cell populations, and CD44⁺/CD24^- cells represent a population that correlates with human breast cancer stem cells.     

Impact of CD44+CD24- cells on non-sentinel axillary lymph node metastases in sentinel node-positive breast cancer

Although complete axillary lymph node dissection (ALND) is the standard for evaluating axillary status after the identification of a positive sentinel lymph node (SLN) in breast cancer; approximately 40-60% of SLN-positive patients have negative non-SLN. In this study, to explore putative breast cancer stem cells with CD44+CD24- in the SLN, we retrospectively analyzed the expression of CD44+CD24- on metastatic tumor cells within SLNs as a predictive factor for positive non-SLNs (NSLNs). We tested 271 patients for SLNs using serial sectioning with cytokeratin immunohistochemistry (IHC) and hematoxylin-eosin staining and identified 67 patients who had a positive SLN biopsy and complete ALND. CD44 and CD24 expression was detected using double-staining IHC. Twenty-eight (41.8%) out of 67 patients had positive NSLN metastases. Seven positive SLNs with micrometastases were not available for the evaluation of CD24 and CD44 expression. Out of the remaining 60?patients, 19?(31.7%), 44?(73.83%) and 37?(61.7%) patients had CD24+, CD44+ and CD44+CD24- metastatic tumor cells in SLNs, respectively. Positive NSLN metastasis was significantly associated with the primary tumor size (P=0.004), CD24- expression (P=0.04), CD44+ expression (P=0.01) and CD44+CD24- expression (P=0.02). This report provides the first evidence of the existence of a putative stem-like phenotype within the SLN, which is significantly associated with positive NSLN in early breast cancer patients.     

Selective regain of egfr gene copies in CD44+/CD24-/low breast cancer cellular model MDA-MB-468

Background

The objective of this retrospective study is to investigate laryngeal preservation and long-term treatment results in hypopharyngeal carcinoma treated with intensity-modulated radiotherapy (IMRT) combined with chemotherapy.

Methods

Twenty-seven patients with hypopharyngeal carcinoma (stage II-IV) were enrolled and underwent concurrent chemoradiotherapy. The chemotherapy regimens were monthly cisplatin and 5-fluorouracil for six patients and weekly cisplatin for 19 patients. All patients were treated with IMRT with simultaneous integrated boost technique. Acute and late toxicities were recorded based on CTCAE 3.0 (Common Terminology Criteria for Adverse Events).

Results

The median follow-up time for survivors was 53.0 months (range 36-82 months). The initial complete response rate was 85.2%, with a laryngeal preservation rate of 63.0%. The 5-year functional laryngeal, local-regional control, disease-free and overall survival rates were 59.7%, 63.3%, 51.0% and 34.8%, respectively. The most common greater than or equal to grade 3 acute and late effects were dysphagia (63.0%, 17 of 27 patients) and laryngeal stricture (18.5%, 5 of 27 patients), respectively. Patients belonging to the high risk group showed significantly higher risk of tracheostomy compared to the low risk group (p = 0.014).

Conclusions

After long-term follow-up, our results confirmed that patients with hypopharyngeal carcinoma treated with IMRT concurrent with platinum-based chemotherapy attain high functional laryngeal and local-regional control survival rates. However, the late effect of laryngeal stricture remains a problem, particularly for high risk group patients.