Ikemura Shinnosuke, Aramaki Nao, Fujii Satoshi, Kirita Keisuke, Umemura Shigeki, Matsumoto Shingo, Yoh Kiyotaka, Niho Seiji, Ohmatsu Hironobu, Kuwata Takeshi, Kojima Motohiro, Ochiai Atsushi, Betsuyaku Tomoko, Tsuboi Masahiro, Goto Koichi, Ishii Genichiro
Division of Pathology, Exploratory Oncology Research and Clinical Trial Center, National Cancer Center, Kashiwa, Japan.
Division of Thoracic Oncology, National Cancer Center, Kashiwa, Japan.
Cancer Sci. 2017 Jan;108(1):136-142. doi: 10.1111/cas.13110. Epub 2017 Jan 21.
Metastasis and growth in neoplastic lesions requires the multistep regulation of microenvironmental factors. We aimed to elucidate the microenvironmental changes in the process of lymphatic metastasis of lung squamous cell carcinoma. We examined the morphological characteristics of 102 cases of primary tumor (PT), 50 of intralymphatic tumor (ILT), 51 of lymph node (LN) micrometastasis (LN-Mic; ≤2 mm in size), and 82 of LN macrometastasis (LN-Mac; ≥10 mm in size). Afterwards we evaluated the expression of nine molecules (epidermal growth factor receptor, fibroblast growth factor receptor 2, CD44, aldehyde dehydrogenase 1, Podoplanin, E-cadherin, S100A4, geminin, and ezrin) in matched PT, ILT, LN-Mic, and LN-Mac from 23 of these cases. The number of smooth muscle actin α-positive fibroblasts, CD34-positive microvessels and CD204-positive macrophages were also examined. As a result, the mitotic index of tumor cells was significantly lower in ILT and LN-Mic than PT and LN-Mac (P < 0.001). Moreover, stromal reaction in ILT and LN-Mic was less prominent than in PT and LN-Mac (P < 0.001). Immunohistochemical study revealed that epidermal growth factor receptor expression level and frequency of geminin-positive cells in ILT and LN-Mic were significantly lower than in PT and LN-Mac (P < 0.05). The number of stromal cells indicated by staining of CD34, CD204, and smooth muscle actin α in ILT and LN-Mic was also significantly lower than in PT and LN-Mac (P < 0.05). In lung squamous cell carcinoma, drastic microenvironmental changes (e.g., growth factor receptor expression and proliferative capacity of tumor cells and structural changes in stromal cells) occur during both the process of lymphatic permeation and the progression into macrometastases.
肿瘤病变中的转移和生长需要对微环境因素进行多步骤调控。我们旨在阐明肺鳞状细胞癌淋巴转移过程中的微环境变化。我们检查了102例原发性肿瘤(PT)、50例淋巴管内肿瘤(ILT)、51例淋巴结(LN)微转移(LN-Mic;大小≤2mm)和82例LN大转移(LN-Mac;大小≥10mm)的形态学特征。之后,我们评估了其中23例匹配的PT、ILT、LN-Mic和LN-Mac中9种分子(表皮生长因子受体、成纤维细胞生长因子受体2、CD44、醛脱氢酶1、血小板内皮细胞黏附分子、E-钙黏蛋白、S100A4、geminin和埃兹蛋白)的表达。还检查了平滑肌肌动蛋白α阳性成纤维细胞、CD34阳性微血管和CD204阳性巨噬细胞的数量。结果,ILT和LN-Mic中肿瘤细胞的有丝分裂指数明显低于PT和LN-Mac(P<0.001)。此外,ILT和LN-Mic中的基质反应不如PT和LN-Mac中明显(P<0.001)。免疫组织化学研究显示,ILT和LN-Mic中表皮生长因子受体表达水平和geminin阳性细胞频率明显低于PT和LN-Mac(P<0.05)。ILT和LN-Mic中CD34、CD204和平滑肌肌动蛋白α染色所示的基质细胞数量也明显低于PT和LN-Mac(P<0.05)。在肺鳞状细胞癌中,在淋巴渗透过程和进展为大转移的过程中都会发生剧烈的微环境变化(例如,生长因子受体表达、肿瘤细胞的增殖能力以及基质细胞的结构变化)。