Department of Neurosurgery, The First Affiliated Hospital of Nanchang University, Nanchang, China.
Department of Neurosurgery/Neuro-oncology, Sun Yat-sen University Cancer Center, Guangzhou, China.
Cancer Sci. 2023 Jun;114(6):2609-2621. doi: 10.1111/cas.15773. Epub 2023 Mar 10.
Glioblastomas are highly heterogeneous brain tumors. Despite the availability of standard treatment for glioblastoma multiforme (GBM), i.e., Stupp protocol, which involves surgical resection followed by radiotherapy and chemotherapy, glioblastoma remains refractory to treatment and recurrence is inevitable. Moreover, the biology of recurrent glioblastoma remains unclear. Increasing evidence has shown that intratumoral heterogeneity and the tumor microenvironment contribute to therapeutic resistance. However, the interaction between intracellular heterogeneity and drug resistance in recurrent GBMs remains controversial. The aim of this study was to map the transcriptome landscape of cancer cells and the tumor heterogeneity and tumor microenvironment in recurrent and drug-resistant GBMs at a single-cell resolution and further explore the mechanism of drug resistance of GBMs. We analyzed six tumor tissue samples from three patients with primary GBM and three patients with recurrent GBM in which recurrence and drug resistance developed after treatment with the standard Stupp protocol using single-cell RNA sequencing. Using unbiased clustering, nine major cell clusters were identified. Upregulation of the expression of stemness-related and cell-cycle-related genes was observed in recurrent GBM cells. Compared with the initial GBM tissues, recurrent GBM tissues showed a decreased proportion of microglia, consistent with previous reports. Finally, vascular endothelial growth factor A expression and the blood-brain barrier permeability were high, and the O -methylguanine DNA methyltransferase-related signaling pathway was activated in recurrent GBM. Our results delineate the single-cell map of recurrent glioblastoma, tumor heterogeneity, tumor microenvironment, and drug-resistance mechanisms, providing new insights into treatment strategies for recurrent glioblastomas.
胶质母细胞瘤是高度异质性的脑肿瘤。尽管存在胶质母细胞瘤多形性(GBM)的标准治疗方法,即 Stupp 方案,包括手术切除后放疗和化疗,但胶质母细胞瘤仍然对治疗有抗性,复发是不可避免的。此外,复发性胶质母细胞瘤的生物学特性仍不清楚。越来越多的证据表明,肿瘤内异质性和肿瘤微环境有助于治疗抵抗。然而,复发性 GBM 中细胞内异质性和药物抗性之间的相互作用仍存在争议。本研究旨在以单细胞分辨率绘制癌症细胞和复发性和耐药性 GBM 中的肿瘤异质性和肿瘤微环境的转录组图谱,并进一步探讨 GBM 耐药的机制。我们使用单细胞 RNA 测序分析了来自三名原发性 GBM 患者和三名接受标准 Stupp 方案治疗后出现复发和耐药的复发性 GBM 患者的六个肿瘤组织样本。通过无偏聚类,鉴定出九个主要细胞簇。在复发性 GBM 细胞中观察到与干细胞相关和细胞周期相关基因的表达上调。与初始 GBM 组织相比,复发性 GBM 组织中少突胶质细胞的比例降低,与之前的报道一致。最后,血管内皮生长因子 A 的表达和血脑屏障通透性高,O -甲基鸟嘌呤 DNA 甲基转移酶相关信号通路在复发性 GBM 中被激活。我们的研究结果描绘了复发性胶质母细胞瘤的单细胞图谱、肿瘤异质性、肿瘤微环境和耐药机制,为复发性胶质母细胞瘤的治疗策略提供了新的见解。
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