Dalberg K, Eriksson E, Enberg U, Kjellman M, Bäckdahl M
Department of Surgery, P 9.03, Karolinska Hospital, S-171 76 Stockholm, Sweden.
World J Surg. 2000 Mar;24(3):334-40. doi: 10.1007/s002689910053.
Invasive breast cancer varies widely in biologic aggressiveness, from fairly indolent tumors to rapidly disseminating carcinomas. Matrix metalloproteinases have enzymatic activity and assist in tumor invasion by degrading basement membranes and extracellular matrix. The extracellular matrix metalloproteinase inducer EMMPRIN is thought to stimulate fibroblasts to produce the zymogen pro-gelatinase A. The membrane type 1-matrix metalloproteinase (MT1-MMP) is thought to assist in tumor invasion and metastasis by activating pro-gelatinase A, which shows enhanced expression in various tumors. Overexpression of gelatinase A has shown to correlate with a malignant phenotype in many tumor forms. The aim of the study was to investigate the mRNA expression pattern of MT1-MMP, gelatinase A, and EMMPRIN in breast tumors. Formalin-fixed paraffin-embedded breast tissue samples from 18 patients operated on with breast-conserving surgery for invasive breast carcinoma <20 mm between 1977 and 1985 were analyzed using the mRNA in situ hybridization technique. Most of the patients were node-negative (15/18) and underwent postoperative irradiation to the breast (16/18). The median age at diagnosis was 52 years (21-83 years). At the time of the study 11 patients were alive, 4 without recurrence; 7 patients had been operated for ipsilateral breast tumor recurrences, and 2 had distant metastases. The median follow-up was 112 months (102-193 months). Seven patients died of disseminated breast cancer; their median follow-up was 43 months (22-116 months). (35)S-labeled antisense and sense mRNA probes transcribed from linearized plasmids containing cDNA for the matrix metalloproteinases gelatinase A and MT1-MMP and the glycoprotein EMMPRIN were hybridized to 5 microm paraffin-embedded tissue sections. Several invasive carcinomas were surrounded by normal tissue and carcinoma in situ lesions. Gelatinase A, MT1-MMP, and EMMPRIN mRNA expression were detected in all of the carcinomas. The gelatinase A mRNA expression was mainly localized to stromal cells at moderate to high levels surrounding the invading carcinoma cells but was also seen in single cells at low levels in in situ lesions and in some normal glandular cells. MT1-MMP and EMMPRIN were expressed in all of the carcinomas and were mainly localized to tumor cells; but they were also seen to some extent in single cells at low levels in in situ lesions and in normal glandular cells. No differences in levels of expression for gelatinase A, MT1-MMP, or EMMPRIN were seen in patients who survived compared to patients who died from metastatic disease. The co-expression of gelatinase A, MT1-MMP, and EMMPRIN mRNA in invasive breast carcinoma supports the theory that these proteins interact and are important for the invasive phenotype in breast carcinoma. Hence EMMPRIN may be a central factor for stimulation of gelatinase A activation. Specific inhibition for individual MMP members could in the future be target-specific events in breast tumor progression. Inhibition of EMMPRIN could be such a target.
浸润性乳腺癌的生物学侵袭性差异很大,从生长相当缓慢的肿瘤到迅速扩散的癌。基质金属蛋白酶具有酶活性,通过降解基底膜和细胞外基质协助肿瘤侵袭。细胞外基质金属蛋白酶诱导剂EMMPRIN被认为可刺激成纤维细胞产生酶原前明胶酶A。膜型1-基质金属蛋白酶(MT1-MMP)被认为通过激活前明胶酶A协助肿瘤侵袭和转移,前明胶酶A在各种肿瘤中表达增强。明胶酶A的过表达已显示与多种肿瘤形式的恶性表型相关。本研究的目的是调查MT1-MMP、明胶酶A和EMMPRIN在乳腺肿瘤中的mRNA表达模式。使用mRNA原位杂交技术分析了1977年至1985年间接受保乳手术治疗的18例浸润性乳腺癌直径<20 mm患者的福尔马林固定石蜡包埋乳腺组织样本。大多数患者淋巴结阴性(15/18),并接受了乳腺术后放疗(16/18)。诊断时的中位年龄为52岁(21 - 83岁)。在研究时,11例患者存活,4例无复发;7例患者因同侧乳腺肿瘤复发接受了手术,2例有远处转移。中位随访时间为112个月(102 - 193个月)。7例患者死于播散性乳腺癌;他们的中位随访时间为43个月(22 - 116个月)。从含有基质金属蛋白酶明胶酶A和MT1-MMP以及糖蛋白EMMPRIN cDNA的线性化质粒转录的(35)S标记反义及正义mRNA探针与5微米石蜡包埋组织切片杂交。几个浸润性癌被正常组织和原位癌病变包围。在所有癌中均检测到明胶酶A、MT1-MMP和EMMPRIN mRNA表达。明胶酶A mRNA表达主要定位于侵袭性癌细胞周围中度至高度水平的基质细胞,但也可见于原位病变中低水平的单个细胞以及一些正常腺细胞中。MT1-MMP和EMMPRIN在所有癌中均有表达,主要定位于肿瘤细胞;但在原位病变中低水平的单个细胞以及正常腺细胞中也有一定程度的表达。与死于转移性疾病的患者相比,存活患者的明胶酶A、MT1-MMP或EMMPRIN表达水平无差异。浸润性乳腺癌中明胶酶A、MT1-MMP和EMMPRIN mRNA的共表达支持了这些蛋白相互作用且对乳腺癌侵袭表型很重要的理论。因此,EMMPRIN可能是刺激明胶酶A激活的核心因素。未来对单个MMP成员进行特异性抑制可能是乳腺肿瘤进展中的靶向特异性事件。抑制EMMPRIN可能就是这样一个靶点。