Hospital AC Camargo, Rua Taguá, 440, São Paulo, SP, 01508-010, Brazil.
BMC Med Genomics. 2011 Apr 13;4:33. doi: 10.1186/1755-8794-4-33.
Cancer shows a great diversity in its clinical behavior which cannot be easily predicted using the currently available clinical or pathological markers. The identification of pathways associated with lymph node metastasis (N+) and recurrent head and neck squamous cell carcinoma (HNSCC) may increase our understanding of the complex biology of this disease.
Tumor samples were obtained from untreated HNSCC patients undergoing surgery. Patients were classified according to pathologic lymph node status (positive or negative) or tumor recurrence (recurrent or non-recurrent tumor) after treatment (surgery with neck dissection followed by radiotherapy). Using microarray gene expression, we screened tumor samples according to modules comprised by genes in the same pathway or functional category.
The most frequent alterations were the repression of modules in negative lymph node (N0) and in non-recurrent tumors rather than induction of modules in N+ or in recurrent tumors. N0 tumors showed repression of modules that contain cell survival genes and in non-recurrent tumors cell-cell signaling and extracellular region modules were repressed.
The repression of modules that contain cell survival genes in N0 tumors reinforces the important role that apoptosis plays in the regulation of metastasis. In addition, because tumor samples used here were not microdissected, tumor gene expression data are represented together with the stroma, which may reveal signaling between the microenvironment and tumor cells. For instance, in non-recurrent tumors, extracellular region module was repressed, indicating that the stroma and tumor cells may have fewer interactions, which disable metastasis development. Finally, the genes highlighted in our analysis can be implicated in more than one pathway or characteristic, suggesting that therapeutic approaches to prevent tumor progression should target more than one gene or pathway, specially apoptosis and interactions between tumor cells and the stroma.
癌症在其临床行为上表现出很大的多样性,使用当前可用的临床或病理标志物很难对其进行预测。识别与淋巴结转移(N+)和复发性头颈部鳞状细胞癌(HNSCC)相关的途径可能会增加我们对这种疾病复杂生物学的理解。
从接受手术的未经治疗的 HNSCC 患者中获得肿瘤样本。根据病理淋巴结状态(阳性或阴性)或治疗后(颈部清扫术加放疗后)肿瘤复发(复发性或非复发性肿瘤)对患者进行分类。使用微阵列基因表达,我们根据相同途径或功能类别中的基因组成的模块筛选肿瘤样本。
最常见的改变是负淋巴结(N0)和非复发性肿瘤中模块的抑制,而不是 N+或复发性肿瘤中模块的诱导。N0 肿瘤中含有细胞存活基因的模块受到抑制,非复发性肿瘤中细胞-细胞信号和细胞外区模块受到抑制。
N0 肿瘤中含有细胞存活基因的模块的抑制加强了细胞凋亡在调节转移中的重要作用。此外,由于这里使用的肿瘤样本没有进行显微解剖,因此肿瘤基因表达数据与基质一起被表示出来,这可能揭示了微环境与肿瘤细胞之间的信号传递。例如,在非复发性肿瘤中,细胞外区模块受到抑制,表明基质和肿瘤细胞之间的相互作用较少,这会阻止转移的发展。最后,我们分析中突出的基因可能涉及不止一个途径或特征,这表明预防肿瘤进展的治疗方法应该针对不止一个基因或途径,特别是细胞凋亡和肿瘤细胞与基质之间的相互作用。