Hiyama Noriko, Ando Takahiro, Maemura Keita, Sakatani Toshio, Amano Yosuke, Watanabe Kousuke, Kage Hidenori, Yatomi Yutaka, Nagase Takahide, Nakajima Jun, Takai Daiya
Department of Thoracic Surgery, The University of Tokyo Graduate School of Medicine.
Department of Respiratory Medicine, The University of Tokyo Graduate School of Medicine.
Jpn J Clin Oncol. 2018 Apr 1;48(4):303-307. doi: 10.1093/jjco/hyy013.
Cisplatin is a key drug for treating lung adenocarcinoma, and its sensitivity to cisplatin is directly related to prognosis. We aimed to reveal the roles of genes related to glutathione synthesis (glutamate-cysteine ligase catalytic subunit, GCLC) and cystine uptake (cystine/glutamate transporter, xCT and CD44v8-10) in cisplatin resistance and prognosis in lung adenocarcinoma.
We established cell lines stably expressing GCLC, xCT, standard isoform of CD44, and CD44v8-10, and investigated their sensitivities to cisplatin. We also measured mRNA expression levels of these genes in the tumor tissues from 92 lung adenocarcinoma patients. Patients were divided into high-expression (upper quartile, N = 23) and low-expression groups (remaining patients, N = 69). Recurrence-free survival, overall survival (N = 92), and post-recurrence survival (N = 22) were selected as endpoints.
Compared with the control green fluorescent protein-expressing cell line (inhibitory concentration 50:6.9 μM), all the stable cell lines were more resistant to cisplatin (12.9 μM, P = 0.025; 13.9 μM, P = 0.028; 26.7 μM, P = 0.001; 17.7 μM, P = 0.008, respectively). In contrast, there was no significant difference in recurrence-free or overall survival between the high- and low-expression groups for any of the genes. However, high expression of GCLC was a risk factor for poorer post-recurrence survival (hazard ratio, 6.26; 95% confidence interval, 1.37-28.7; P = 0.018).
High expression levels of genes related to glutathione synthesis and cystine uptake promote cisplatin resistance in lung adenocarcinoma cell lines. High expression of GCLC in tumor tissue may be a potential predictor of treatment failure.
顺铂是治疗肺腺癌的关键药物,其对顺铂的敏感性直接关系到预后。我们旨在揭示与谷胱甘肽合成相关的基因(谷氨酸 - 半胱氨酸连接酶催化亚基,GCLC)和胱氨酸摄取相关的基因(胱氨酸/谷氨酸转运体,xCT和CD44v8 - 10)在肺腺癌顺铂耐药性及预后中的作用。
我们建立了稳定表达GCLC、xCT、CD44标准异构体和CD44v8 - 10的细胞系,并研究它们对顺铂的敏感性。我们还检测了92例肺腺癌患者肿瘤组织中这些基因的mRNA表达水平。患者被分为高表达组(上四分位数,N = 23)和低表达组(其余患者,N = 69)。选择无复发生存期、总生存期(N = 92)和复发后生存期(N = 22)作为终点。
与表达绿色荧光蛋白的对照细胞系相比(半数抑制浓度:6.9 μM),所有稳定细胞系对顺铂的耐药性更强(分别为12.9 μM,P = 0.025;13.9 μM,P = 0.028;26.7 μM,P = 0.001;17.7 μM,P = 0.008)。相比之下,任何基因的高表达组和低表达组在无复发生存期或总生存期方面均无显著差异。然而,GCLC高表达是复发后生存期较差的危险因素(风险比,6.26;95%置信区间,1.37 - 28.7;P = 0.018)。
与谷胱甘肽合成和胱氨酸摄取相关的基因高表达促进肺腺癌细胞系对顺铂的耐药性。肿瘤组织中GCLC高表达可能是治疗失败的潜在预测指标。