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Jabbour SK, Williams TM, Sayan M, Miller ED, Ajani JA, Chang AC, Coleman N, El-Rifai W, Haddock M, Ilson D, Jamorabo D, Kunos C, Lin S, Liu G, Prasanna PG, Rustgi AK, Wong R, Vikram B, Ahmed MM. Potential Molecular Targets in the Setting of Chemoradiation for Esophageal Malignancies. J Natl Cancer Inst 2021; 113:665-679. [PMID: 33351071 PMCID: PMC8600025 DOI: 10.1093/jnci/djaa195] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 10/03/2020] [Accepted: 11/30/2020] [Indexed: 11/14/2022] Open
Abstract
Although the development of effective combined chemoradiation regimens for esophageal cancers has resulted in statistically significant survival benefits, the majority of patients treated with curative intent develop locoregional and/or distant relapse. Further improvements in disease control and survival will require the development of individualized therapy based on the knowledge of host and tumor genomics and potentially harnessing the host immune system. Although there are a number of gene targets that are amplified and proteins that are overexpressed in esophageal cancers, attempts to target several of these have not proven successful in unselected patients. Herein, we review our current state of knowledge regarding the molecular pathways implicated in esophageal carcinoma, and the available agents for targeting these pathways that may rationally be combined with standard chemoradiation, with the hope that this commentary will guide future efforts of novel combinations of therapy.
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Affiliation(s)
- Salma K Jabbour
- Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey, Rutgers University, New Brunswick, NJ, USA
| | - Terence M Williams
- Department of Radiation Oncology, The Ohio State University, Columbus, OH, USA
- Department of Radiation Oncology, City of Hope National Medical Center, Duarte, CA, USA
| | - Mutlay Sayan
- Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey, Rutgers University, New Brunswick, NJ, USA
| | - Eric D Miller
- Department of Radiation Oncology, The Ohio State University, Columbus, OH, USA
| | - Jaffer A Ajani
- Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Andrew C Chang
- Department of Surgery, University of Michigan, Ann Arbor, MI, USA
- Department of Surgery, Section of Thoracic Surgery, University of Michigan, Ann Arbor, MI, USA
| | - Norman Coleman
- National Cancer Institute, National Institutes of Health, Rockville, MD, USA
| | - Wael El-Rifai
- Department of Surgery, Sylvester Comprehensive Cancer Center, Miller School of Medicine, University of Miami, Miami, FL, USA
- Department of Veterans Affairs, Miami Healthcare System, Miami, FL, USA
| | - Michael Haddock
- Department of Radiation Oncology, Mayo Clinic, Rochester, MN, USA
| | - David Ilson
- Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | | | - Charles Kunos
- Investigational Drug Branch, Cancer Therapy Evaluation Program, National Cancer Institute, National Institutes of Health, Rockville, MD, USA
| | - Steven Lin
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Geoffrey Liu
- Division of Medical Oncology, Princess Margaret Cancer Centre, Toronto, Canada
| | - Pataje G Prasanna
- Radiation Research Program, Division of Cancer Treatment and Diagnosis, National Cancer Institute, National Institutes of Health, Rockville, MD, USA
| | - Anil K Rustgi
- Herbert Irving Comprehensive Cancer Center, Columbia University, New York, NY, USA
| | - Rosemary Wong
- Radiation Research Program, Division of Cancer Treatment and Diagnosis, National Cancer Institute, National Institutes of Health, Rockville, MD, USA
| | - Bhadrasain Vikram
- Radiation Research Program, Division of Cancer Treatment and Diagnosis, National Cancer Institute, National Institutes of Health, Rockville, MD, USA
| | - Mansoor M Ahmed
- Radiation Research Program, Division of Cancer Treatment and Diagnosis, National Cancer Institute, National Institutes of Health, Rockville, MD, USA
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Increased angiogenesis and FGFR protein expression indicate a favourable prognosis in bladder cancer. Virchows Arch 2014; 465:687-95. [PMID: 25326864 DOI: 10.1007/s00428-014-1672-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2014] [Revised: 09/18/2014] [Accepted: 10/08/2014] [Indexed: 10/24/2022]
Abstract
Compared to other members of the fibroblast growth factor receptor (FGFR) family, only few studies investigate FGFR3 in tumour angiogenesis. We investigated the connection between angiogenesis and FGF/FGFR expression including FGFR3 mutation status in urothelial carcinomas. Immunohistochemistry was performed in invasive and non-invasive urothelial cancers of 61 patients. Protein expression of CD31, factor VIII (FVIII), FGF-1/2, FGFR1, FGFR3 and FGFR4 and FGFR3 mutation status were evaluated. Morphometric assessment of angiogenesis including microvessel count (MVC) and vascular surface area (VSA) was analysed. Correlation and survival analyses (overall survival (OS) and disease-free survival (DFS)) with univariate and multivariate analyses were performed. CD31 values (MVC and VSA) significantly correlated with OS and DFS. OS and DFS were significantly better in patients with FGFR3 overexpression. Multivariate analysis revealed FGFR3 protein expression and tumour grading (WHO classification 2004) as independent prognostic factors of OS and VSA of CD31 and FGFR3 protein expression of DFS. FGFR3 mutation status was correlated with VSA measured by FVIII. FGFR3 may be able to induce a pro-angiogenic phenotype in urothelial carcinomas and significantly influence prognosis. Consequently, FGFR3 is a potential therapeutic target also from the angiogenesis perspective.
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Wiseman EF, Ang YS. Risk factors for neoplastic progression in Barrett’s esophagus. World J Gastroenterol 2011; 17:3672-83. [PMID: 21990948 PMCID: PMC3181452 DOI: 10.3748/wjg.v17.i32.3672] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2010] [Revised: 10/11/2010] [Accepted: 10/18/2010] [Indexed: 02/06/2023] Open
Abstract
Barrett’s esophagus (BE) confers a significant increased risk for development of esophageal adenocarcinoma (EAC), with the pathogenesis appearing to progress through a “metaplasia-dysplasia-carcinoma” (MDC) sequence. Many of the genetic insults driving this MDC sequence have recently been characterized, providing targets for candidate biomarkers with potential clinical utility to stratify risk in individual patients. Many clinical risk factors have been investigated, and associations with a variety of genetic, specific gastrointestinal and other modifiable factors have been proposed in the literature. This review summarizes the current understanding of the mechanisms involved in neoplastic progression of BE to EAC and critically appraises the relative roles and contributions of these putative risk factors from the published evidence currently available.
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Kang S, Li SZ, Wang N, Zhou RM, Wang T, Wang DJ, Li XF, Bui J, Li Y. Association between genetic polymorphisms in fibroblast growth factor (FGF)1 and FGF2 and risk of endometriosis and adenomyosis in Chinese women. Hum Reprod 2010; 25:1806-11. [PMID: 20504870 DOI: 10.1093/humrep/deq128] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Angiogenesis appears to be an important event in the pathophysiology of endometriosis (EM) and adenomyosis. Two angiogenic factors, fibroblast growth factor (FGF) 1 and 2, play a central role in the initiation of angiogenesis. We investigated whether FGF1 -1385A/G and FGF2 754C/G polymorphisms are associated with a risk of developing EM and adenomyosis. METHODS Genotypes were analyzed by the PCR-restriction fragment length polymorphism method in two groups of women, of Han ethnicity in north China, aged 16-55 years: (1) 421 EM patients and 421 controls; (2) 269 adenomyosis patients and 269 controls. RESULTS There was no difference in genotype distribution of the FGF1 -1385A/G polymorphism between adenomyosis cases and controls (P > 0.05), but the frequency of the A allele in EM patients was lower than that in controls (P = 0.013). Genotype and allele frequencies of the FGF2 754C/C polymorphism were significantly different in both EM and adenomyosis cases versus control groups. Compared with C/C homozygotes, the G allele (C/G + G/G) was associated with a decreased susceptibility to developing EM [odds ratio (OR) = 0.575, 95% confidence interval (CI) = 0.387-0.854] and adenomyosis (OR = 0.577, 95% CI = 0.367-0.906). Combined genotype analysis of both polymorphisms also showed differences between cases versus controls (all P < 0.001). CONCLUSIONS Our study shows for the first time that the FGF2 754C/G polymorphism may be associated with a risk of developing EM and adenomyosis in north Chinese women. Carriers of the G allele in the FGF2 gene appear to be protected from these gynecological diseases. Further studies in other populations, and of other candidate genes, are now warranted.
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Affiliation(s)
- Shan Kang
- Department of Obstetrics and Gynaecology, Hebei Cancer Institute, Hebei Medical University, Fourth Hospital, Jiankanglu 12, Shijiazhuang 050011, China
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Awan AK, Iftikhar SY, Morris TM, Clarke PA, Grabowska AM, Waraich N, Watson SA. Androgen receptors may act in a paracrine manner to regulate oesophageal adenocarcinoma growth. Eur J Surg Oncol 2007; 33:561-8. [PMID: 17254742 DOI: 10.1016/j.ejso.2006.12.001] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2006] [Accepted: 12/05/2006] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND The role of androgen receptors (ARs) in tumorigenesis, including transcription of fibroblast growth factors (FGFs), is established in prostate cancer. This study examined the role of ARs and FGFs in oesophageal adenocarcinoma (EAC), where tumour incidence in males is higher. METHODS AR gene expression was analysed using quantitative RT-PCR; AR, fibroblast growth factor receptor-1 (FGFR-1) and fibroblast growth factor-8 isoform b (FGF-8b) protein by immunohistochemistry; and serum steroid levels (testosterone, progesterone, luteinising hormone and follicle stimulating hormone (FSH)) by immunoassay. A human oesophageal adenocarcinoma cell line was grown subcutaneously in nude mice. RESULTS AR gene expression was of significantly higher levels than oesophageal adenocarcinomas (n=21, p=0.002) and in the squamous carcinoma line (OE21) compared with the adenocarcinoma lines (OE33 and OE19). Median serum testosterone levels in oesophageal carcinoma patients were higher than in age-matched controls (p=0.01) and reduced postoperatively, in patients undergoing curative resection (p=0.006). No significant differences were observed in hormones except FSH, where preoperative levels were significantly higher in the EAC group. AR protein was expressed in normal oesophageal squamous epithelial cells and also in the stroma of 18/23 EAC samples. FGFR-1 protein was expressed in malignant epithelium of 23/23 tumour samples. OE19 xenografts grew faster in male versus female mice (tumour weight at day 21, 1.14 g and 0.28 g, respectively, p=0.005) and had elevated FGF receptor expression. CONCLUSIONS AR expressed in the stroma of oesophageal adenocarcinomas may induce paracrine effects following stimulation by androgens (including tumour-derived), possibly via FGFs, including FGF-8b.
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Affiliation(s)
- A K Awan
- Division of Pre-Clinical Oncology, University of Nottingham, D Floor, West Block, Queen's Medical Centre, University Hospital, Nottingham, NG7 2UH, UK
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Abstract
OBJECTIVES/HYPOTHESIS Abnormal interaction of epithelial cells with laminin component of basement membrane may account for altered biological behavior of cells, influencing proliferation, adhesion, and motility. In the current study, we investigated the role of 67-kDa laminin receptor (67LR), a high affinity receptor for laminin, in aggressiveness of laryngeal squamous cell carcinoma. METHODS Thirty paraffin-embedded specimens and 20 fresh tissues of patients with laryngeal squamous cell carcinoma were analyzed using immunohistologic and reverse-transcriptase polymerase chain reaction techniques, respectively. Expression of 67LR on the surface of AMC-HN-8 cells was examined by flow cytometry. The effect of 67LR monoclonal antibody (MLuC5) on the adhesive and invasive abilities of AMC-HN-8 cells was determined by adherence and invasion inhibition assay in vitro. RESULTS Both at the mRNA and protein level, laryngeal carcinoma cells expressed higher level of 67LR than normal epithelial cells (P < .01). The expression of 67LR correlated inversely with differentiation extent of tumor (P < .05). 67LR level was significantly increased in patients with lymph node metastases than those without lymph node involvement (P < .05). Flow cytometry showed 80.9 +/- 0.9% of AMC-HN-8 cells expressed 67LR. After 60 minutes and 120 minutes of incubation, MluC5 induced 57.1 +/- 3.6% and 63.2 +/- 2.8% inhibition of adhesion, respectively. The invasive ability of AMC-HN-8 cells to matrigel was reduced by MLuC5. CONCLUSIONS Laryngeal carcinoma cells over-expressing 67LR have a stronger aggressive potential, which might make 67LR a promising target for the treatment of metastatic tumor.
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Affiliation(s)
- Liang Zhou
- Department of Otolaryngology, Eye and ENT Hospital, FuDan University, Shanghai, China.
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Caygill CPJ, Watson A, Lao-Sirieix P, Fitzgerald RC. Barrett's oesophagus and adenocarcinoma. World J Surg Oncol 2004; 2:12. [PMID: 15132744 PMCID: PMC420492 DOI: 10.1186/1477-7819-2-12] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2004] [Accepted: 05/07/2004] [Indexed: 12/23/2022] Open
Affiliation(s)
- Christine PJ Caygill
- Registrar UK National Barrett's Oesophagus Registry (UKBOR), and Honorary Senior Lecturer, University Department of Surgery, Royal Free Hospital, Rowland Hill Street, London NW3 2PF, UK
| | - Anthony Watson
- Joint director UK National Barrett's Oesophagus Registry (UKBOR), and visiting Professor, University Department of Surgery, Royal Free Hospital, Rowland Hill Street, London NW3 2PF, UK
| | | | - Rebecca C Fitzgerald
- Joint director UK National Barrett's Oesophagus Registry (UKBOR) and Group Leader MRC Cancer cell Unit, Hutchison Research Centre, Cambridge, CB2 2XZ, UK
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Liang Z, Lei T, LuYing Z, YuPing G. The expression of proto-oncogene eIF4E in laryngeal squamous cell carcinoma. Laryngoscope 2003; 113:1238-43. [PMID: 12838026 DOI: 10.1097/00005537-200307000-00024] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES/HYPOTHESIS The translation initiation factor eukaryotic initiation factor 4E (eIF4E) binds to the cap of messenger RNA in the first step of messenger RNA recruitment. Overexpression of eIF4E results in the upregulation of specific angiogenic factor basic fibroblast growth factor (bFGF). The study aims to demonstrate that the overexpression of eIF4E could facilitate recognizing initiation start sites for the translation of bFGF and play an important role in the tumorigenesis of laryngeal squamous cell carcinoma. STUDY DESIGN Retrospective. METHODS Paraffin-embedded sections of 37 samples of laryngeal squamous cell carcinoma, 10 samples of vocal cords polyps, and 20 fresh samples of laryngeal squamous cell carcinoma were analyzed using immunohistochemical streptavidin peroxidase technique, Western blot analysis, and reverse transcriptase-polymerase chain reaction. RESULTS The overexpression of eIF4E was observed in all 37 paraffin-embedded samples of laryngeal squamous cell carcinoma, whereas no staining was noticed in vocal cords polyps samples. There were significant correlations between the overexpression of protein eIF4E and TN stages, histological grades, local recurrence, and the states of metastasis (P <.01). Moreover, the overexpressions of both bFGF protein and bFGF messenger RNA correlated with the histological grades and the states of metastasis (P <.01), but the overexpression of eIF4E and bFGF did not correlate with age, sex, and tumor sites (P >.05). CONCLUSIONS Eukaryotic initiation factor 4E can enhance the expression of bFGF at translation level. The eIF4E and bFGF collaborate in tumorigenesis, development, invasion, and metastasis of laryngeal squamous cell carcinoma, in view of which the former can be considered as a tumor molecular marker and an independent prognostic molecular marker of laryngeal squamous cell carcinoma.
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Affiliation(s)
- Zhou Liang
- Department of Otolaryngology, Eye and ENT Hospital, Fudan University, 83 FenYang Road, Shanghai 200 031, China.
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Beilstein M, Silberg D. Cellular and molecular mechanisms responsible for progression of Barrett's metaplasia to esophageal carcinoma. Hematol Oncol Clin North Am 2003. [DOI: 10.1016/s0889-8588(03)00010-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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10
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Lord RVN, Park JM, Wickramasinghe K, DeMeester SR, Oberg S, Salonga D, Singer J, Peters JH, Danenberg KD, Demeester TR, Danenberg PV. Vascular endothelial growth factor and basic fibroblast growth factor expression in esophageal adenocarcinoma and Barrett esophagus. J Thorac Cardiovasc Surg 2003; 125:246-53. [PMID: 12579092 DOI: 10.1067/mtc.2003.203] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVE This study was undertaken to investigate the role of the angiogenic factors vascular endothelial growth factor and basic fibroblast growth factor in the development and progression of Barrett esophagus and adenocarcinomas of the esophagus and gastroesophageal junction. METHODS Vascular endothelial growth factor and basic fibroblast growth factor messenger RNA expression levels, relative to the control gene encoding beta-actin, were measured by using a quantitative reverse transcription-polymerase chain reaction method (ABI 7700 Sequence Detector system) in specimens of Barrett intestinal metaplasia (n = 16), dysplasia (n = 11), adenocarcinoma (n = l 5), and matching normal squamous esophageal tissues (n = 35). Vascular endothelial growth factor and basic fibroblast growth factor protein expression and CD31(+) microvessel density were assessed by means of immunohistochemistry in 25 tissue sections that included representative areas for each of these Barrett stages. RESULTS Expression levels were significantly increased in adenocarcinoma compared with in either normal squamous mucosa (P <.0001 for both genes) or intestinal metaplasia (vascular endothelial growth factor, P =.002; basic fibroblast growth factor, P <.0001). Vascular endothelial growth factor levels were also significantly higher in cancer tissues compared with dysplasia tissues (P =.024, Mann-Whitney U test). Basic fibroblast growth factor expression was also significantly increased in Barrett dysplastic mucosa compared with in intestinal metaplasia or normal esophageal mucosa. Microvessel density was generally higher in adenocarcinoma compared with in preneoplastic Barrett tissues. The pattern of vascular endothelial growth factor and basic fibroblast growth factor protein expression was similar to the messenger RNA expression pattern, with the exception that mucin-containing goblet cells stained intensely for vascular endothelial growth factor and only weak vascular endothelial growth factor staining was present in some adenocarcinomas. CONCLUSIONS Vascular endothelial growth factor and basic fibroblast growth factor messenger RNA expression levels are significantly upregulated in esophageal and gastroesophageal junction adenocarcinomas, suggesting a role for these angiogenic factors in the development of these cancers. Vascular endothelial growth factor and basic fibroblast growth factor messenger RNA expression levels are also increased in some Barrett esophagus tissues, with this increase occurring at an earlier stage for basic fibroblast growth factor than for vascular endothelial growth factor. Basic fibroblast growth factor protein expression pattern is similar to the messenger RNA expression pattern, but unlike the messenger RNA findings, vascular endothelial growth factor protein expression is strongest in goblet cells.
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Affiliation(s)
- Reginald V N Lord
- Department of Surgery and Cardiothoracic Surgery, University of Southern California Keck School of Medicine, Los Angeles, USA
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Billottet C, Janji B, Thiery JP, Jouanneau J. Rapid tumor development and potent vascularization are independent events in carcinoma producing FGF-1 or FGF-2. Oncogene 2002; 21:8128-39. [PMID: 12444548 DOI: 10.1038/sj.onc.1205935] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2002] [Revised: 08/02/2002] [Accepted: 08/05/2002] [Indexed: 11/09/2022]
Abstract
FGF-1 and FGF-2 are pleiotropic growth factors for many cell types, operating through the activation of specific transmembrane FGF receptors (FGFRs). The role of these factors in tumor progression was investigated, with specific discrimination between their autocrine and non autocrine cellular activity. The rat bladder carcinoma NBT-II cells were engineered to produce FGF-1 or 18 kDa FGF-2 in the presence or absence of their specific receptor. Non-autocrine cells that produced FGF-1 or FGF-2 but lacked FGFRs were epithelial and reminiscent of the parental NBT-II cells. Whilst autocrine cells, which both constitutively produced and secreted the growth factor and expressed FGFRs, had a highly invasive mesenchymal phenotype. Correspondingly, the autocrine cells were highly tumorigenic in vivo compared to the parental and non-autocrine cells, which correlated with the increased production of uPAR and active uPA and increased in vitro invasive potential. Although all cells produced VEGF, only tumors derived from cells that produced FGF-1 or FGF-2 were highly vascularized, suggesting that these two growth factors could be involved in the angiogenic process by activating host endothelial cells. As a result of activation of the FGFR in autocrine cells, changes in cell morphology and an increase in the invasive and tumorigenic properties were observed, however no in vitro or in vivo differential functions between FGF-1 and FGF-2 could be identified in this system. In conclusion, our data demonstrates that rapid tumor development is not dependent upon increased tumor vascularization, suggesting that 'basal' angiogenesis, probably mediated by VEGF, is sufficient to support tumor growth.
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MESH Headings
- Animals
- Autocrine Communication
- Carcinoma/blood supply
- Carcinoma/genetics
- Carcinoma/metabolism
- Carcinoma/pathology
- Disease Progression
- Endothelial Growth Factors/metabolism
- Epithelial Cells/pathology
- Female
- Fibroblast Growth Factor 1/genetics
- Fibroblast Growth Factor 1/physiology
- Fibroblast Growth Factor 2/genetics
- Fibroblast Growth Factor 2/physiology
- Gene Expression Regulation, Neoplastic
- Intercellular Signaling Peptides and Proteins/metabolism
- Lymphokines/metabolism
- Matrix Metalloproteinases/biosynthesis
- Matrix Metalloproteinases/genetics
- Mesoderm
- Mice
- Mice, Nude
- Neoplasm Invasiveness
- Neoplasm Proteins/physiology
- Neoplasm Transplantation
- Neovascularization, Pathologic/genetics
- Neovascularization, Pathologic/physiopathology
- Phenotype
- Rats
- Receptor Protein-Tyrosine Kinases/genetics
- Receptor Protein-Tyrosine Kinases/physiology
- Receptor, Fibroblast Growth Factor, Type 1
- Receptor, Fibroblast Growth Factor, Type 2
- Receptors, Cell Surface/biosynthesis
- Receptors, Cell Surface/genetics
- Receptors, Fibroblast Growth Factor/genetics
- Receptors, Fibroblast Growth Factor/physiology
- Receptors, Urokinase Plasminogen Activator
- Recombinant Fusion Proteins/physiology
- Sequence Deletion
- Tissue Inhibitor of Metalloproteinase-2/biosynthesis
- Tissue Inhibitor of Metalloproteinase-2/genetics
- Transfection
- Tumor Cells, Cultured/metabolism
- Tumor Cells, Cultured/pathology
- Tumor Cells, Cultured/transplantation
- Urinary Bladder Neoplasms/blood supply
- Urinary Bladder Neoplasms/genetics
- Urinary Bladder Neoplasms/metabolism
- Urinary Bladder Neoplasms/pathology
- Urokinase-Type Plasminogen Activator/biosynthesis
- Urokinase-Type Plasminogen Activator/genetics
- Vascular Endothelial Growth Factor A
- Vascular Endothelial Growth Factors
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Affiliation(s)
- Clotilde Billottet
- Laboratory of Cell Morphogenesis and Tumor Progression, UMR 144 CNRS, Institut Curie, Section de recherche, 26 rue d'Ulm, 75248 Paris, cedex 05, France
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Beilstein M, Silberg D. Cellular and molecular mechanisms responsible for progression of Barrett's metaplasia to esophageal carcinoma. Gastroenterol Clin North Am 2002; 31:461-79, ix. [PMID: 12134613 DOI: 10.1016/s0889-8553(02)00013-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Barrett's metaplasia is found in approximately 12% to 18% of patients undergoing upper endoscopy for symptoms of reflux. Barrett's metaplasia is a premalignant condition and remains the number one risk factor for developing esophageal adenocarcinoma. There has been an increase in the incidence of esophageal adenocarcinoma in the past two decades, making it the most rapidly rising cancer in the United States and Western Europe. This article describes the progression from Barrett's metaplasia to esophageal adenocarcinoma and predictors for the development of adenocarcinoma in Barrett's metaplasia. Barrett's metaplasia represents a histological mosaic, with dysplastic tissue adjacent to non-dysplastic tissue. The histologic changes leading to adenocarcinoma are accompanied by alterations at the molecular level, including the accumulation of gene mutations and changes in gene expression. The determination of the molecular events that occur in the transition from normal esophageal squamous mucosa to dysplasia and to esophageal adenocarcinoma have lead to a better understanding of the process of the transformation to adenocarcinoma. This knowledge will lead to better biomarkers to diagnose and assess cancer risk.
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Affiliation(s)
- Michelle Beilstein
- Division of Gastroenterology, Hospital of the University of Pennsylvania, 3rd Floor Ravdin, 2400 Spruce Street, Philadelphia, PA 10104, USA.
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13
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Guindi M, Riddell RH. Dysplasia in barrett's esophagus. New techniques and markers. CHEST SURGERY CLINICS OF NORTH AMERICA 2002; 12:59-68, viii-ix. [PMID: 11901933 DOI: 10.1016/s1052-3359(03)00088-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
In this article, the authors describe the histologic features and classification of dysplasia in Barrett's esophagus. The histologic problems in the diagnosis and grading of dysplasia are discussed. Techniques that can serve as aids to the histologic diagnosis of dysplasia, such as flow cytometry and molecular markers, are reviewed.
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Affiliation(s)
- Maha Guindi
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Department of Pathology, Toronto General Hospital, Toronto, Ontario, Canada.
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Soslow RA, Petersen CG, Remotti H, Altorki N. Acidic fibroblast growth factor is expressed sequentially in the progression from Barrett's esophagus to esophageal adenocarcinoma. Dis Esophagus 2001; 14:23-7. [PMID: 11422301 DOI: 10.1111/j.1442-2050.2001.00146.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Acidic fibroblast growth factor 1 (FGF-1) is sequentially accumulated in Barrett's esophagus and its expression in glandular dysplasias is independent of esophageal adenocarcinoma. This suggests that FGF-1 immunohistochemistry could be used as an adjunct to the routine histopathologic diagnosis of dysplasia in Barrett's esophagus. The data also underscore the important role of fibroblast growth factors in tumorigenesis.
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Affiliation(s)
- R A Soslow
- Department of Pathology, New York Presbyterian Hospital-Weill Medical College of Cornell University (NYPH-WMC), New York, NY 10021, USA.
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16
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Abstract
OBJECTIVE To review the current knowledge on the genetic alterations involved in the development and progression of Barrett's esophagus-associated neoplastic lesions. SUMMARY BACKGROUND DATA Barrett's esophagus (BE) is a premalignant condition in which the normal squamous epithelium of the esophagus is replaced by metaplastic columnar epithelium. BE predisposes patients to the development of esophageal adenocarcinoma. Endoscopic surveillance can detect esophageal adenocarcinomas when they are early and curable, but most of the adenocarcinomas are detected at an advanced stage. Despite advances in multimodal therapy, the prognosis for invasive esophageal adenocarcinoma is poor. A better understanding of the molecular evolution of the Barrett's metaplasia to dysplasia to adenocarcinoma sequence may allow improved diagnosis, therapy, and prognosis. METHODS The authors reviewed data from the published literature to address what is known about the molecular changes thought to be important in the pathogenesis of BE-associated neoplastic lesions. RESULTS The progression of Barrett's metaplasia to adenocarcinoma is associated with several changes in gene structure, gene expression, and protein structure. Some of the molecular alterations already showed promise as markers for early cancer detection or prognostication. Among these, alterations in the p53 and p16 genes and cell cycle abnormalities or aneuploidy appear to be the most important and well-characterized molecular changes. However, the exact sequence of events is not known, and probably multiple molecular pathways interact and are involved in the progression of BE to adenocarcinoma. CONCLUSIONS Further research into the molecular biology of BE-associated adenocarcinoma will enhance our understanding of the genetic events critical for the initiation and progression of Barrett's adenocarcinoma, leading to more effective surveillance and treatment.
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Affiliation(s)
- B P Wijnhoven
- Department of Surgery, University Hospital Rotterdam, Erasmus University Rotterdam, Rotterdam, The Netherlands
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Abstract
Barrett's metaplasia is associated with an increased risk for adenocarcinoma. Adenocarcinoma develops through a multistep process characterized by defects in genes and morphological abnormalities. The early morphological changes of the process are called 'dysplasia'. Dysplasia is defined as an unequivocal neoplastic (premalignant) transformation confined within the basement membrane. For most Western pathologists malignancy is defined as invasion and characterized by a breach through the basement membrane. Japanese pathologists rely on cytological atypia and complex branching of crypts. Cytological and architectural abnormalities allow identification of dysplasia on routinely stained sections. A distinction is made between low- and high-grade dysplasia. The differential diagnosis between low-grade dysplasia and reactive changes can be difficult. Therefore a second opinion is strongly recommended, not only for high-grade dysplasia but also for low-grade. Immunohistochemistry for p53 and flow cytometry for detection of aneuploidy can support the diagnosis. Identification of dysplasia and malignancy depends on the number of biopsy samples examined. The minimum number of biopsies required has not yet been determined and depends partly on the length of the metaplastic segment. It has been proposed to sample with four quadrant biopsies at 20-mm intervals. New endoscopic techniques can increase the diagnostic yield. Endoscopically visible lesions increase the risk of finding malignancy. The time sequence for the progression of dysplasia is not known but progression from low- to high-grade and cancer has been shown to occur over a period of years although it may not be inevitable.
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Affiliation(s)
- K Geboes
- Department of Pathology, University Hospital KUL, Leuven, Belgium
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