van der Voort van Zyp Jochem, Conway William C, Thamilselvan Vijayalakshmi, Polin Lisa, Basson Marc D
Wayne State University, John D. Dingell VAMC, 4646 John R. Street, Detroit, MI 48201-1932, USA.
Am J Surg. 2005 Nov;190(5):701-7. doi: 10.1016/j.amjsurg.2005.07.006.
Cancer cells adhere principally by integrins, matrix receptors that may be influenced by divalent cations. Surgical wound fluid is high in Mg2+ and low in Ca2+. We hypothesized that Mg+ and Mn2+ promote perioperative adhesion of shed cancer cells to surgical sites and that washing surgical wounds with Ca2+ inhibits implantation.
We tested our hypothesis in a murine colon 26 adenocarcinoma model. We added 10 mmol/L CaCl2, 0.25 mmol/L MgCl2, or 0.5 mmol/L MnCl2 to suspended murine colon 26 cancer cells and placed these suspensions into wounds in anesthetized mice. After 30 minutes, we washed away nonadherent cells. In some studies, we 51Cr-labeled the cells and assayed tumor adhesion by wound radioactivity. In parallel studies, we closed the wounds and observed the mice for 90 days.
Mg2+ increased adhesion to 188% +/- 15% of control (n = 10, P < .001) and Mn2+ to 130% +/- 6% (n = 7, P < .001). However, Ca2+ inhibited adhesion to 61% +/- 12% (n = 7, P = .006) of control. Seventy-two percent of survival controls developed tumors during follow-up. Mg2+ and Mn2+ stimulated tumor formation to 96% and 92%, respectively, but adding Ca2+ to the wounds reduced subsequent tumor formation to 56% without altering serum Ca2+. The survival curves each differed significantly by log-rank test (P < .01 each). All pair-wise multiple comparisons were significant (Holm-Sidak, P < .05 each).
Thus, the high Mg2+ in endogenous wound fluid may potentiate tumor cell adhesion. However, 10 micromol/L Ca2+ inhibits cancer cell adhesion to murine wounds and subsequent tumor development. Irrigating with dilute CaCl2 could decrease local tumor recurrence by inhibiting the adhesion of shed tumor cells.
癌细胞主要通过整合素黏附,整合素是一种基质受体,可能受二价阳离子影响。手术伤口渗出液中镁离子含量高而钙离子含量低。我们推测镁离子和锰离子会促进脱落癌细胞在围手术期黏附于手术部位,而用钙离子冲洗手术伤口可抑制癌细胞着床。
我们在小鼠结肠26腺癌模型中验证这一假设。我们向悬浮的小鼠结肠26癌细胞中添加10 mmol/L氯化钙、0.25 mmol/L氯化镁或0.5 mmol/L氯化锰,然后将这些悬浮液置于麻醉小鼠的伤口中。30分钟后,洗去未黏附的细胞。在一些研究中,我们用51Cr标记细胞,并通过伤口放射性测定肿瘤黏附情况。在平行研究中,我们缝合伤口并观察小鼠90天。
镁离子使黏附增加至对照组的188%±15%(n = 10,P <.001),锰离子使黏附增加至130%±6%(n = 7,P <.001)。然而,钙离子使黏附抑制至对照组的61%±12%(n = 7,P =.006)。72%的存活对照组在随访期间发生肿瘤。镁离子和锰离子分别将肿瘤形成刺激至96%和92%,但在伤口中添加钙离子可将后续肿瘤形成减少至56%,且不改变血清钙离子水平。各生存曲线经对数秩检验均有显著差异(P均<.01)。所有两两多重比较均有显著性(Holm-Sidak法,P均<.05)。
因此,内源性伤口渗出液中的高镁离子可能增强肿瘤细胞黏附。然而,10 μmol/L钙离子可抑制癌细胞黏附于小鼠伤口及后续肿瘤发展。用稀氯化钙冲洗可通过抑制脱落肿瘤细胞的黏附来降低局部肿瘤复发。