From the Divisions of Plastic and Reconstructive Surgery and Vascular Surgery, Department of Surgery, and the Department of Oral and Maxillofacial Surgery, Medical University of Vienna.
Plast Reconstr Surg. 2019 Aug;144(2):207e-217e. doi: 10.1097/PRS.0000000000005839.
Assisted lipotransfer for breast reconstruction involves the isolation and supplementation of adipose-derived stromal cells. This procedure has raised concerns regarding safety with respect to promotion of tumor growth and relapse. Several in vitro and animal experimental studies have indicated increased survival, growth, and invasive characteristics of breast cancer cells on interaction with adipose-derived stromal cells. These results seem to be in poor concordance with clinical observations of a low rate of cancer recurrences after assisted lipotransfer.
The authors investigated the effects of adipose-derived stromal cells and adipose-derived stromal cells differentiated into adipocytes and fibroblasts on five breast cancer cell lines (i.e., T47D, MCF-7, BT20, MDA-MB-231, and ZR-75-1) and MCF-10A, a nonmalignant counterpart.
Conditioned media of adipose-derived stromal cells stimulated the proliferation of breast cancer cell lines depending on the individual adipose-derived stromal cell-breast cancer cell line combination. Conditioned media of adipose-derived stromal cells differentiated into adipocytes gave a lower response, and conditioned media of fibroblasts were also active. A putative cancer stem cell-like phenotype was not increased by adipose-derived stromal cell-conditioned media, no physical interaction of cancer cells with adipose-derived stromal cells was detectable on scanning electron microscopy, and cell migration was not enhanced. Adipogenic differentiation of adipose-derived stromal cells indicated that hepatocyte growth factor, insulin-like growth factor-binding protein-3, insulin-like growth factor-binding protein-6, interleukin-6, CCL2/MCP-1, and macrophage colony-stimulating factor are not linked to the proliferative activity of conditioned media.
The results indicate that the adipose-derived stromal cells used for assisted lipotransfer are not expected to increase the risk of tumor recurrence to a major degree in correspondence with the clinical observation of the affected breast cancer patients.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, V.
辅助脂肪转移用于乳房重建涉及脂肪来源基质细胞的分离和补充。 该程序引起了人们对促进肿瘤生长和复发的安全性的关注。 几项体外和动物实验研究表明，乳腺癌细胞与脂肪来源基质细胞相互作用后，其存活，生长和侵袭特性增加。 这些结果似乎与辅助脂肪转移后癌症复发率低的临床观察结果不一致。
作者研究了脂肪来源基质细胞及其分化为脂肪细胞和成纤维细胞的脂肪来源基质细胞对五种乳腺癌细胞系（即 T47D、MCF-7、BT20、MDA-MB-231 和 ZR-75-1）和 MCF-10A（一种非恶性对照物）的影响。
脂肪来源基质细胞的条件培养基根据个别脂肪来源基质细胞-乳腺癌细胞系组合刺激乳腺癌细胞系的增殖。 脂肪来源基质细胞分化为脂肪细胞的条件培养基反应较低，成纤维细胞的条件培养基也具有活性。 脂肪来源基质细胞条件培养基未增加假定的癌症干细胞样表型，扫描电子显微镜下未检测到癌细胞与脂肪来源基质细胞的物理相互作用，并且细胞迁移未增强。 脂肪来源基质细胞的成脂分化表明，肝细胞生长因子，胰岛素样生长因子结合蛋白-3，胰岛素样生长因子结合蛋白-6，白细胞介素-6，CCL2 / MCP-1 和巨噬细胞集落刺激因子与条件培养基的增殖活性无关。
这些结果表明，用于辅助脂肪转移的脂肪来源基质细胞不会增加肿瘤复发的风险，这与受影响的乳腺癌患者的临床观察相符。
临床问题/证据水平：治疗，V。
