细胞角蛋白 5 阳性细胞代表腔面乳腺癌中一种激素受体阴性且治疗抵抗的亚群。

Cytokeratin 5 positive cells represent a steroid receptor negative and therapy resistant subpopulation in luminal breast cancers.

机构信息

Division of Medical Oncology, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, 80045, USA.

出版信息

Breast Cancer Res Treat. 2011 Jul;128(1):45-55. doi: 10.1007/s10549-010-1078-6. Epub 2010 Jul 28.

Abstract

A majority of breast cancers are estrogen receptor (ER) positive and have a luminal epithelial phenotype. However, these ER⁺ tumors often contain heterogeneous subpopulations of ER⁻ tumor cells. We previously identified a population of cytokeratin 5 (CK5) positive cells within ER⁺ and progesterone receptor positive (PR⁺) tumors that is both ER⁻PR⁻ and CD44⁺, a marker of breast tumor-initiating cells (TICs). These CK5⁺ cells have properties of TICs in luminal tumor xenografts, and we speculated that they are more resistant to chemo- and anti-ER-targeted therapies than their ER⁺ neighbors. To test this, we used ER⁺PR⁺ T47D and MCF7 breast cancer cells. CK5⁺ cells had lower proliferative indices than CK5⁻ cells, were less sensitive to 5-fluorouracil and docetaxel, and cultures became enriched for CK5⁺ cells after treatments. CK5⁺ cells were less prone to drug-induced apoptosis than CK5⁻ cells. In cells treated with 17β-estradiol (E) plus anti-estrogens tamoxifen or fulvestrant, ER protein levels decreased, and CK5 protein levels increased, compared to controls treated with E alone. In ER⁺ tumors from patients treated with neoadjuvant endocrine therapies ER gene expression decreased, and CK5 gene expression increased in post compared to pre-treatment tumors. The number of CK5⁺ cells in tumors also increased in post- compared to pre-treatment tumors. We conclude that an ER⁻PR⁻CK5⁺ subpopulation found in many luminal tumors is resistant to standard endocrine and chemotherapies, relative to the majority ER⁺PR⁺CK5⁻ cells. Compounds that effectively target these cells are needed to improve outcome in luminal breast cancers.

摘要

大多数乳腺癌是雌激素受体 (ER) 阳性的,具有腔上皮表型。然而,这些 ER⁺肿瘤通常包含 ER⁻肿瘤细胞的异质性亚群。我们之前在 ER⁺和孕激素受体阳性 (PR⁺) 肿瘤中发现了一个细胞角蛋白 5 (CK5) 阳性细胞群体,该群体既为 ER⁻PR⁻,也为 CD44⁺,这是乳腺癌起始细胞 (TIC) 的标志物。这些 CK5⁺细胞在腔型肿瘤异种移植物中具有 TIC 的特性,我们推测它们比其 ER⁺邻居更能抵抗化疗和抗 ER 靶向治疗。为了验证这一点,我们使用了 ER⁺PR⁺T47D 和 MCF7 乳腺癌细胞。CK5⁺细胞的增殖指数低于 CK5⁻细胞,对 5-氟尿嘧啶和多西他赛的敏感性较低,并且在处理后培养物中 CK5⁺细胞得到富集。与 CK5⁻细胞相比,CK5⁺细胞不易发生药物诱导的细胞凋亡。在用 17β-雌二醇 (E) 加抗雌激素他莫昔芬或氟维司群治疗细胞时,与单独用 E 治疗的对照组相比,ER 蛋白水平下降,而 CK5 蛋白水平升高。与治疗前相比,接受新辅助内分泌治疗的患者的 ER⁺肿瘤中 ER 基因表达降低,而 CK5 基因表达增加。与治疗前相比,肿瘤中 CK5⁺细胞的数量也增加了。我们得出的结论是,在许多腔型肿瘤中发现的 ER⁻PR⁻CK5⁺亚群对标准内分泌和化疗具有抗性,相对于大多数 ER⁺PR⁻CK5⁻细胞。需要有效的靶向这些细胞的化合物来改善腔型乳腺癌的预后。

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