不同转移潜能骨肉瘤细胞差异表达基因的筛查

目的: 研究不同转移潜能骨肉瘤细胞差异表达的基因,筛选骨肉瘤转移相关的基因。方法: 分别提取低转移骨肉瘤细胞株M6和高转移骨肉瘤细胞株M8细胞总RNA,采用cDNA基因芯片筛查M6和M8细胞差异表达的基因,杂交信号用Generation Ⅲ array扫描,结果用Imagequant 5.0软件分析。选择基因芯片筛选到的典型差异表达基因用实时定量PCR进行验证。结果: M6和M8骨肉瘤细胞株差异表达的基因共有330个,其中与低转移组（M6）相比,在高转移组（M8）中显著性上调表达的基因有178个,下调表达的基因有152个。其中发生非常显著性上调表达的基因43个,发生非常显著性下调表达的基因49个。差异基因主要包括与细胞增殖相关的基因,提示与M8细胞增殖受抑相关;其次是与基因表达调控及信号转导相关的基因,提示这些基因和肿瘤转移有关联性。结论: 基因芯片方法对于筛选骨肉瘤转移相关基因有独特的优势,MG63细胞M8亚株中筛查到显著性上调的基因43个,显著性下调的基因49个,与骨肉瘤的转移有关。     

Serum endostatin levels correlate with enhanced extracellular matrix degradation and poor patients' prognosis in bladder cancer

Endostatin, the proteolytic fragment of collagen XVIII, is an inhibitor of angiogenesis and tumor growth. Interestingly, elevated circulating endostatin levels have been found to correlate with poor patients' prognosis in several cancers. The aim of this study was to assess the prognostic value of endostatin in bladder cancer (BC) and to gain insight into the mechanisms involved in its production. This retrospective study included a total of 337 patients with BC and 103 controls. Collagen XVIII gene expression was analyzed using real-time PCR (n = 82). Endostatin tissue localization was assessed by immunohistochemistry (n = 27). Endostatin serum (n = 87) and urine (n = 153) levels were determined by ELISA. In 12 cases, both serum and paraffinized tissue samples from the same patients were available. We found decreased collagen XVIII tissue expression and increased endostatin urine and serum concentration in samples of patients with BC compared to controls. High serum endostatin levels correlated with the presence of lymph node metastases and MMP-7 concentrations and were independently associated with poor metastasis-free and disease-specific survival. Immunohistochemical analysis revealed a strong endostatin staining in the wall of tumor associated blood vessels in superficial but not in muscle-invasive BCs. Based on these, we concluded that elevated endostatin levels in patients with BC are the consequence of enhanced extracellular matrix degradation and are independent from collagen XVIII expression. Furthermore, serum endostatin levels may provide prognostic information independent from histopathological parameters and may therefore help to optimize therapy decisions. Loss of endostatin expression in tumor associated blood vessels might represent an important step supporting tumor-induced angiogenesis.     

伽玛刀治疗40例骨肉瘤肺转移患者的生存分析

目的探讨伽马刀治疗骨肉瘤肺转移患者的生存情况,并分析影响其预后的相关因素。方法回顾性分析上海交通大学附属第六人民医院2008-01-01-2012-12-31共40例骨肉瘤肺转移患者接受伽马刀治疗的临床资料,使用Kaplan-Meier法绘制生存曲线,并采用Log-rank进行单因素检验,并通过Cox回归模型分析与患者生存有关的独立影响因素。结果 40例骨肉瘤肺转移患者2年生存率为42.5%,中位生存时间为27个月,95%CI为19.4~34.6个月。Log-rank单因素分析结果显示,伽玛刀治疗骨肉瘤肺转移患者的预后与性别(P=0.901)、年龄(P=0.903)、KPS评分(P=0.936)、单/双肺转移(P=0.522)、有无肿瘤原发部位的复发(P=0.985)、有无除肺以外的远处转移(P=0.333)、原发部位的手术方式(P=0.359)及有无行新辅助化疗(P=0.415)均无关,而与肺转移瘤数目有关,P=0.032。Cox模型多因素回归分析结果显示,肺转移瘤数目是影响预后的独立相关因素,P=0.039。结论伽玛刀治疗骨肉瘤肺转移患者预后较好,值得做进一步临床研究。肺转移瘤数目对接受伽玛刀治疗的肺转移患者的生存时间有影响。     

Serological immune response to cancer testis antigens in patients with pancreatic cancer

Serological screening approaches have allowed for the identification of a large number of potentially relevant tumor antigens in cancer patients. Within this group, cancer testis antigens represent promising targets for cancer immunotherapy, since they are widely expressed in a variety of human cancer entities. In pancreatic cancer, however, there are only few data available about the expression pattern and serological response to cancer testis antigens and other serological-defined tumor antigens. Therefore, we investigated the IgG antibody response against 11 cancer testis antigens (SCP-1, GAGE, LAGE-1a,-1b, CT-7, NY-ESO-1, SSX-1-5) recombinantly expressed on yeast surface (RAYS) in patients with pancreatic cancer (n = 96), chronic pancreatitis (n = 18) and healthy donors (n = 48). We found in 14% of all patients antibody responses to SCP-1, but not to other cancer testis antigens (GAGE, LAGE-1a,-1b, CT-7, NY-ESO-1, SSX-1-5). Antibody response correlated with the expression of SCP-1 in the primary tumor of the respective patient as shown by RT-PCR, immunohistochemistry and Western blot. In contrast, no serological response to cancer testis antigens was observed in healthy donors. The humoral immune response against SCP-1 was associated with the size of tumor, but not with other clinico-pathological parameters such as histology, stage, presence of lymph node metastases, grading, age, gender or gemcitabine treatment. In conclusion, antibody response to cancer testis antigen SCP-1 is found in a proportion of pancreatic carcinoma patients. These results indicate that identification of additional tumor antigens by serological screening of tumor cDNA expression libraries by RAYS is a promising goal in pancreatic cancer.     

NY-ESO-1/LAGE-1 coexpression with MAGE-A cancer/testis antigens: a tissue microarray study

The characterization of the expression pattern of different families of cancer/testis (C/T) antigens in different tumors, at the protein level, might be of relevance in the development of multiantigen vaccine preparations for active specific immunotherapy. We have used tissue microarray (TMA) technology to explore in large numbers of tumor specimens the expression of NY-ESO-1/LAGE-1 C/T antigens and its correlation with MAGE-A expression by using D8.38 and 57B monoclonal antibodies (MAb). The epitopes recognized by these reagents in C/T antigens were identified by molecular mapping by using a bacterial expression system. Out of 2,052 samples, 119 (5.8%) scored positive upon staining with D8.38 NY-ESO-1/LAGE-1-specific MAb. Expression in >10% of cases was detectable in melanoma and basalioma (31.6 and 18.2%, respectively), large cell carcinomas and adenocarcinomas of the lung (17.8 and 10.5%, respectively), stomach adenocarcinomas of the intestinal type (13.2%), pT2-4 bladder TCC (18.2%), nonseminomatous carcinomas of the testis (10.4%) and liposarcomas (15.4%). Simultaneous expression of NY-ESO-1/LAGE-1 and MAGE-A C/T antigens was then addressed in a TMA where 101/845 and 73/845 samples (12 and 8.6%, respectively) showed evidence of MAGE-A or NY-ESO-1/LAGE-1 specific staining, respectively. In 35/845 specimens (4.1%) concomitant expression of MAGE-A and NY-ESO-1/LAGE-1 was observed (p = 0.0002). Discrepancies in the expression of NY-ESO-1/LAGE-1 and MAGE-A were conspicuously detectable in squamous cell carcinomas of the skin (MAGE-A positive but NY-ESO-1/LAGE-1 negative) and in liposarcomas (NY-ESO-1/LAGE-1 positive, but MAGE-A negative). Taken together, these data suggest novel areas of application of C/T antigens targeted active specific immunotherapy possibly based on multiantigen vaccine preparations.     

Ferroptosis-related gene signature associates with immunity and predicts prognosis accurately in patients with osteosarcoma

Osteosarcoma has been the most common malignant bone tumor in children and adolescents, while the 5-y survival of osteosarcoma patients gained no significant improvement over the past decades. This study aimed to explore the role of ferroptosis-related genes (FRGs) in the development and prognosis of osteosarcoma. The datasets of osteosarcoma patients including RNA sequencing data and clinical information were acquired from the TRGET and Gene Expression Omnibus (GEO) databases. The identification of molecular subgroups with different FRG expression patterns was achieved through nonnegative matrix factorization (NMF) clustering. The prognostic model was constructed using the least absolute shrinkage and selection operator (LASSO) algorithm and multivariate Cox regression analysis. The ESTIMATE algorithm was applied for determining the stromal score, immune score, ESTIMA score, and tumor purity of osteosarcoma patients. Functional analyses including Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses, Gene Set Enrichment Analysis (GSEA), and Gene Set Variation Analysis (GSVA) were conducted to explore the underlying mechanisms in the development and prognosis of osteosarcoma. Two molecular subgroups with different FRGs expression patterns were identified. The molecular subgroups with higher immune score and more active immune status showed better prognostic survival. On the basis of FRGs, a prognostic model and a nomogram integrating clinical characteristics were constructed and their prediction efficiency for osteosarcoma prognosis were well validated. Gene functional enrichment analysis showed that these differentially expressed FRGs were mainly enriched in immunity-related signaling pathways, indicating that FRGs may affect the development and prognosis of osteosarcoma by regulating the immune microenvironment. The expression profiles of FRGs were closely related to the immunity status and prognostic survival of osteosarcoma patients. The interaction between ferroptosis and immunity in the development of osteosarcoma could provide a new insight into the exploration of molecular mechanisms and targeted therapies of osteosarcoma patients.     

BMPR2 expression level is correlated with low immune infiltration and predicts metastasis and poor survival in osteosarcoma

Osteosarcoma is the most common malignant bone tumor in adolescents and young adults, and identifying biomarkers for prognosis and therapy is necessary. Bone morphogenetic protein receptor 2 (BMPR2) is involved in various cellular functions, including cell adhesion, proliferation and invasion, inflammation, apoptosis and metastatic spread. However, the correlation between BMPR2 expression levels and prognosis and tumor-infiltrating immune cells in osteosarcoma is not well understood. In the present study, the expression level of BMPR2 was investigated using the Oncomine and R2 databases. The association between the expression level of BMPR2 and the clinical prognosis of patients with cancer was analyzed using the R2 database. The relationship between the expression level of BMPR2 and immune cell infiltration in the stroma of osteosarcoma was assessed using the Tumor Immune Estimation Resource (TIMER) and CIBERSORT. The correlations between BMPR2 expression level and infiltrated immune cell gene marker sets in osteosarcoma were validated in the TIMER and R2 databases. Analysis of a cohort of patients with osteosarcoma revealed that BMPR2 expression was significantly higher in osteosarcoma compared with in normal tissue and was correlated with poor prognosis. M0 macrophages, M2 macrophages, resting mast, γ δ T and CD8+ T cells were the top five immune cells with the highest degrees of infiltration in osteosarcoma. In addition, BMPR2 expression level showed a significant negative correlation with the gene markers of CD8+ T cells, monocytes and M2 macrophages. Low levels of infiltrating CD8+ T cells, monocytes or M2 macrophages in osteosarcoma was significantly associated with poor survival. These data suggested that CD8+ T cells, monocytes and M2 macrophages play significant roles in the establishment of the immune microenvironment of osteosarcoma. High BMPR2 expression was associated with poor prognosis and low infiltration of CD8+ T cells, monocytes and M2 macrophages in osteosarcoma. Hence, BMPR2 can be considered a biomarker of the immune infiltration, metastasis and prognosis of osteosarcoma.     

Late peritoneal metastasis in a patient with osteosarcoma

A 19-year-old man with a high-grade osteosarcoma of the femur, treated with neoadjuvant chemotherapy, surgery, and adjuvant chemotherapy suffered from lung metastases 15 months after diagnosis. They were resected. Thirteen months later, he had vague abdominal complaints which, after analysis, proved to be caused by peritoneal metastasis. A review of the literature, possible physiopathological mechanisms of increased occurrence of unusual metastases and the role of bone scintigraphy in the follow-up of patients with osteosarcoma are discussed.     

MTA1基因表达与人骨肉瘤细胞浸润和转移的关系

背景与目的:骨肉瘤具有很高的转移特性,以肺转移多见。尽管能成功控制原发瘤,但5年内仍然有超过30%的患者死于肺转移。肿瘤转移相关基因(MTA1)是新近发现的一个肿瘤转移候选基因,其表达增高与乳腺癌及胃癌、结直肠癌的侵袭转移能力成正相关。MTA1在骨肉瘤中的表达国内外尚未见相关研究报道,通过比较MTA1基因在人骨肉瘤细胞高低转移株的表达水平,探讨MTA1表达与骨肉瘤细胞浸润和转移潜能的相关性。方法:采用半定量逆转录聚合酶链反应(RT-PCR)检测MG-63骨肉瘤细胞高低转移株MTA1的表达情况,用Boyden小室体外侵袭实验检测两株MG-63细胞的体外侵袭力;用脂质体介导的MTA1基因转染MG-63低转移株细胞,通过RT-PCR检测MTA1的表达;Boyden小室体外侵袭实验检测转染前后细胞侵袭力的变化。结果:RT-PCR结果显示MTA1在MG-63低转移细胞株中表达水平低(1.32),在高转移细胞株中表达水平高(6.27)(P<0.05);Boyden小室体外侵袭实验显示MG-63高转移株细胞体外侵袭力强,其穿膜细胞相对百分率为(46.3±2.4)%,低转移株细胞体外侵袭力较弱,其穿膜细胞相对百分率(12.6±1.1)%,两者差异有显著性(P<0.05);转染MTA1基因后,低转移细胞株转移潜能较未转染细胞明显增高。结论:MTA1与人骨肉瘤细胞转移潜能有密切关系,MTA1对肿瘤转移的作用机制以及作为干预肿瘤转移靶基因的可能性值得进一步探讨。     

CXCL12 expression in intrahepatic cholangiocarcinoma is associated with metastasis and poor prognosis

Intrahepatic cholangiocarcinoma is a rare malignant biliary neoplasm that causes a poor prognosis even after curative hepatectomy. Liver metastasis is the major recurrence pattern of intrahepatic cholangiocarcinoma; therefore, the prevention of liver metastasis is a desirable objective. The aim of this study is to identify gene(s) related to liver metastasis of intrahepatic cholangiocarcinoma and to examine the inhibitory effects on metastasis of intrahepatic cholangiocarcinoma by controlling such gene(s). We collected 3 pairs of intrahepatic cholangiocarcinoma frozen samples, and 36 pairs (primary and metastatic lesions) of intrahepatic cholangiocarcinoma formalin‐fixed paraffin‐embedded samples, from patients who underwent surgical resection at hospitals related to the Kyushu Study Group of Liver Surgery between 2002 and 2016. We carried out cDNA microarray analyses and immunohistochemistry to identify candidate genes, and evaluated one of them as a therapeutic target using human cholangiocarcinoma cell lines. We identified 4 genes related to liver metastasis using cDNA microarray, and found that CXCL12 was the only gene whose expression was significantly higher in liver metastasis than in primary intrahepatic cholangiocarcinoma by immunohistochemistry (P = .003). In prognosis, patients in the high CXCL12 group showed a significantly poor prognosis in disease‐free (P < .0001) and overall survival (P = .0004). By knockdown of CXCL12, we could significantly suppress the invasive and migratory capabilities of 2 human cholangiocarcinoma cell lines. Therefore, CXCL12 might be associated with metastasis and poor prognosis in intrahepatic cholangiocarcinoma.     

MAGE-A10 is a nuclear protein frequently expressed in high percentages of tumor cells in lung, skin and urothelial malignancies

MAGE-A10 is a highly immunogenic member of the MAGE-A family of cancer/testis tumor-associated antigens (C/T TAAs). Studies performed with broadly reactive antibodies have helped to initially characterize this TAA. However, no specific reagents have been developed so far, thus preventing a thorough analysis of its expression in healthy and tumoral tissues. We have produced MAGE-A10 gene product in soluble recombinant form, and we have used it to generate specific monoclonal antibodies (mAbs). One of these reagents, recognizing an epitope located at the COOH terminus of the MAGE-A10 gene product, was used to stain a multitumor tissue microarray comprising more than 2,500 paraffin-embedded specimens including healthy tissues, benign tumors and malignancies of different histological origin. MAGE-A10 protein was identified as an intranuclear protein of an apparent molecular weight of 70 kDa, expressed in normal spermatogonia and spermatocytes but in no other healthy tissue. Most importantly, this C/T TAA appears to be expressed in high (>50%) percentages of cancer cells from a number of malignancies, including lung, skin and urothelial tumors. Unexpectedly, high expression of MAGE-A10 TAA at the protein level was also detectable in gynecological malignancies and stomach and gall bladder cancers. The characterization of MAGE-A10-specific reagents might set the stage for the development of targeted active immunotherapy by clarifying potential indications and by allowing the selection of patients eligible for treatment and the monitoring of its effectiveness.     

Development of a novel,quantitative protein microarray platform for the multiplexed serological analysis of autoantibodies to cancer‐testis antigens

The cancer‐testis antigens are a group of unrelated proteins aberrantly expressed in various cancers in adult somatic tissues. This aberrant expression can trigger spontaneous immune responses, a phenomenon exploited for the development of disease markers and therapeutic vaccines. However, expression levels often vary amongst patients presenting the same cancer type, and these antigens are therefore unlikely to be individually viable as diagnostic or prognostic markers. Nevertheless, patterns of antigen expression may provide correlates of specific cancer types and disease progression. Herein, we describe the development of a novel, readily customizable cancer‐testis antigen microarray platform together with robust bioinformatics tools, with which to quantify anti‐cancer testis antigen autoantibody profiles in patient sera. By exploiting the high affinity between autoantibodies and tumor antigens, we achieved linearity of response and an autoantibody quantitation limit in the pg/mL range—equating to a million‐fold serum dilution. By using oriented attachment of folded, recombinant antigens and a polyethylene glycol microarray surface coating, we attained minimal non‐specific antibody binding. Unlike other proteomics methods, which typically use lower affinity interactions between monoclonal antibodies and tumor antigens for detection, the high sensitivity and specificity realized using our autoantibody‐based approach may facilitate the development of better cancer biomarkers, as well as potentially enabling pre‐symptomatic diagnosis. We illustrated the usage of our platform by monitoring the response of a melanoma patient cohort to an experimental therapeutic NY‐ESO‐1‐based cancer vaccine; inter alia, we found evidence of determinant spreading in individual patients, as well as differential CT antigen expression and epitope usage.     

Elevated serum matrix metalloproteinase 7 levels predict poor prognosis after radical prostatectomy

Elevated matrix metalloproteinase‐7 (MMP‐7) tissue expression and serum concentration have been shown to be associated with cancer progression and metastasis. The aim of our study was to assess the prognostic value of preoperative circulating MMP‐7 levels in serum samples of patients with clinically localized prostate cancer. Furthermore, we compared the serum MMP‐7 levels between patients with organ confined and metastatic prostate cancer. MMP‐7 levels were measured in 93 patients with localized prostate cancer, 13 patients with distant bone metastasis and in sera of 19 controls using enzyme‐linked immunosorbent assay. The results were compared to the clinical follow‐up data. We did not find any significant difference in MMP‐7 serum levels between patients and controls (p = 0.268). Circulating MMP‐7 serum concentration was significantly elevated in patients with distant metastasis (p < 0.001). For the detection of distant prostate cancer metastasis, using a cut‐off value of 3.7 ng/ml, a specificity of 69% and a sensitivity of 92% were observed. Multivariate analysis identified high MMP‐7 serum concentration as an independent risk factor for prostate cancer‐related death both in a preoperative and a postoperative model (p = 0.003 and 0.018, respectively). Furthermore, the evaluation of predictive models revealed that addition of serum MMP‐7 levels to the preoperatively available predictors improves prognostic accuracy (the concordance index increased from 0.631 to 0.734 when MMP‐7 was included). Based on these, we concluded that MMP‐7 is a potential marker to identify patients with metastatic prostate cancer. In clinically localized prostate cancer, MMP‐7 may provide independent prognostic information, thereby helping to optimize therapy decisions.     

骨肉瘤血行转移与CXCR4、VEGF相关性研究

Objective:We determine whether chemokine receptor CXCR4 and vascular endothelial growth factor (VEGF) expression related to the metastasis and survival outcome of patients with osteosarcoma. Methods:Tissue microarray (TMA) was used to detect the expression of CXCR4 and VEGF in 56 osteosarcoma patient samples. Two-year follow-up was per-formed to observe the metastatic behavior and overall survival of osteosarcema patients. Results:There was a significant correlation between the expression levels of CXCR4 and VEGF in 56 osteosarcoma patient samples (P=0.002). Univariate analysis revealed the expression of CXCR4 and VEGF was not associated with age, gender and the level of ALP but as-sociated with clinical stage. Conclusion:These data raises the possibility that VEGF could regulate the levels of CXCR4 to promote the migration of tumor cells to target organs. CXCR4 and VEGF expression are highly correlated with metastatic progression in patients with osteosarcoma and their immunohistochemical expression have predictive value for the metastatic development.     

High expression of tumour-associated trypsin inhibitor correlates with liver metastasis and poor prognosis in colorectal cancer

Increased expression of tumour-associated trypsin inhibitor (TATI) in tumour tissue and/or serum has been associated with poor survival in various cancer forms. Moreover, a proinvasive function of TATI has been shown in colon cancer cell lines. In this study, we have examined the prognostic significance of tumour-specific TATI expression in colorectal cancer, assessed by immunohistochemistry (IHC) on tissue microarrays (TMAs) with tumour specimens from two independent patient cohorts. Kaplan–Meier analysis and Cox proportional hazards modelling were used to estimate time to recurrence, disease-free survival and overall survival. In both cohorts, a high (>50% of tumour cells) TATI expression was an independent predictor of a significantly shorter overall survival. In cohort II, in multivariate analysis including age, gender, disease stage, differentiation grade, vascular invasion and carcinoembryonal antigen (CEA), high TATI expression was associated with a significantly decreased overall survival (HR=1.82; 95% CI=1.19–2.79) and disease-free survival (HR=1.56; 95% CI=1.05–2.32) in curatively treated patients. Moreover, there was an increased risk for liver metastasis in both cohorts that remained significant in multivariate analysis in cohort II (HR=2.85; 95% CI=1.43–5.66). In conclusion, high TATI expression is associated with liver metastasis and is an independent predictor of poor prognosis in patients with colorectal cancer.