Fukumura D, Yuan F, Monsky W L, Chen Y, Jain R K
Edwin L. Steele Laboratory, Department of Radiation Oncology, Massachusetts General Hospital, Boston 02114, USA.
Am J Pathol. 1997 Sep;151(3):679-88.
It is generally accepted that the host microenvironment influences tumor biology. There are discrepancies in growth rate, metastatic potential, and efficacy of systemic treatment between ectopic and orthotopic tumors. Liver is the most common and critical site of distant metastasis of colorectal carcinoma. Tumorigenicity and efficacy of chemotherapeutic agents in colorectal tumors are different in liver and subcutaneous sites. Thus, we hypothesize that the liver (orthotopic) versus subcutaneous (ectopic) microenvironment would have different effects on the angiogenesis and maintenance of the microcirculation of colorectal tumor. To this end, we developed a new method to monitor and to quantify microcirculatory parameters in the tumor grown in the liver. Using this approach, we compared the microcirculation of LS174T, a human colon adenocarcinoma, metastasized to the liver with that of the host liver vessels and that of the same tumor grown in the subcutaneous space. In the liver metastasis model, 5 x 10(6) LS174T cells were injected into the spleen of nude mice. Four to eight weeks later, the liver with metastatic tumors was exteriorized and placed on a special stage and observed under an intravital fluorescence microscope. The dorsal skinfold chamber model was used to study the subcutaneous tumors. Red blood cell velocity, vessel diameter, density, permeability, and leukocyte-endothelial interactions were measured using fluorescence microscopy and image analysis. Vascular endothelial growth factor/ vascular permeability factor (VEGF/VPF) mRNA expression was determined by the Northern blot analysis. LS174T tumor foci in the liver had tortuous vascular architecture, heterogeneous blood flow, significantly lower vascular density, and significantly higher vascular permeability than normal liver tissue. Tumors grown in the liver had significantly lower vessel density, especially in the center coincident with central necrosis, than the subcutaneous tumors. The frequency distribution of vessel diameters of liver tumor was slightly shifted to smaller size compared with that of subcutaneous tumor. Leukocyte rolling in liver tumor was twofold lower than that in subcutaneous tumor. These physiological findings were consistent with the measurement of VEGF/VPF in that the VEGF/VPF mRNA level was lower in the liver tumor than that in the subcutaneous tumor. However, macromolecular vascular permeability in the liver tumor was significantly higher than in the subcutaneous tumor. Liver sinusoidal endothelial cells, the origin of liver tumor vessel endothelium, are known to be fenestrated and not to have a basement membrane, suggesting that the difference in endothelial cell origin may explain the difference in tumor vascular permeability in two sites. These findings demonstrate that liver microenvironment has different effects on some aspects of the tumor angiogenesis and microcirculation compared with the subcutaneous tissues. The new model/method described in this paper has significant implications in two research areas: 1) the liver microenvironment and its effect on tumor pathophysiology in conjunction with cytokine/ growth factor regulation and 2) the delivery of drugs, cells, and genes to liver tumors.
一般认为,宿主微环境会影响肿瘤生物学。异位肿瘤和原位肿瘤在生长速率、转移潜能及全身治疗疗效方面存在差异。肝脏是结直肠癌远处转移最常见且关键的部位。结直肠癌在肝脏和皮下部位的致瘤性及化疗药物疗效有所不同。因此,我们推测肝脏(原位)与皮下(异位)微环境对结直肠癌的血管生成及微循环维持会产生不同影响。为此,我们开发了一种新方法来监测和量化肝脏中生长肿瘤的微循环参数。利用该方法,我们比较了转移至肝脏的人结肠腺癌LS174T与宿主肝脏血管以及皮下生长的同一肿瘤的微循环情况。在肝转移模型中,将5×10⁶个LS174T细胞注入裸鼠脾脏。4至8周后,将带有转移瘤的肝脏取出并置于特殊载物台上,在活体荧光显微镜下观察。采用背部皮褶小室模型研究皮下肿瘤。使用荧光显微镜和图像分析测量红细胞流速、血管直径、密度、通透性以及白细胞与内皮细胞的相互作用。通过Northern印迹分析测定血管内皮生长因子/血管通透因子(VEGF/VPF)mRNA表达。肝脏中的LS174T肿瘤灶血管结构迂曲,血流不均一,血管密度显著低于正常肝组织,血管通透性显著高于正常肝组织。与皮下肿瘤相比,肝脏中生长的肿瘤血管密度显著更低,尤其是在与中央坏死区对应的中心部位。肝肿瘤血管直径的频率分布相较于皮下肿瘤略向较小尺寸偏移。肝肿瘤中白细胞滚动比皮下肿瘤低两倍。这些生理学发现与VEGF/VPF的测量结果一致,即肝肿瘤中VEGF/VPF mRNA水平低于皮下肿瘤。然而,肝肿瘤中的大分子血管通透性显著高于皮下肿瘤。肝脏肿瘤血管内皮的起源——肝窦内皮细胞已知有窗孔且无基底膜,这表明内皮细胞起源的差异可能解释了两个部位肿瘤血管通透性的差异。这些发现表明,与皮下组织相比,肝脏微环境对肿瘤血管生成和微循环的某些方面具有不同影响。本文所述的新模型/方法在两个研究领域具有重要意义:1)肝脏微环境及其对肿瘤病理生理学的影响以及细胞因子/生长因子调控;2)向肝肿瘤递送药物、细胞和基因。