Basement membrane laminin and type IV collagen in endometrial adenocarcinoma: relation to differentiation and treatment

Expression of laminin-1 and matrix metalloproteinase-9 in benign and malignant endometrium

BACKGROUND

Laminin-1 and matrix metalloproteinase (MMP)-9 may play roles in the progression from benign to malignant endometrium, so we aimed to investigate their levels of expression in these tissues.

METHODS

This case-control study was conducted at a tertiary care center between January 2014 and December 2016. Paraffin blocks of 50 specimens of benign endometrium with proliferative (n = 20), secretory (n = 11), and atrophic (n = 5) endometrium; simple endometrial hyperplasia without atypia (n = 12); and endometrial polyp (n = 2) histology and 49 specimens of malignant endometrium with endometrioid (n = 40), serous (n = 7), clear cell (n = 1), and undifferentiated (n = 1) types were immunostained with laminin-1 and MMP-9 antibodies and assessed for basement membrane continuity for laminin-1 and the percentage and intensity of MMP-9 expression in epithelial cytoplasm.

RESULTS

: Laminin-1 continuity in the basement membrane was higher in benign (92%) compared to malignant (16.3%) endometrium (p < 0.0001) without any difference between the subgroups within each group (p > 0.05). All atrophic endometria and endometrial polyps and 23.5% of low grade endometrioid and none of the other endometrial cancers showed uninterrupted basement membrane staining with laminin-1. All cases in malignant endometrium expressed MMP-9 with either low or high immunoreactivity while none of the cases in benign endometrium showed a high staining with MMP-9 (p < 0.01). Proliferative and hyperplastic endometrium together with grade 1 endometrioid cancer expressed MMP-9 better than the atrophic endometrium (p < 0.05). The immunoreactivity with MMP-9 increased gradually from secretory to hyperplastic endometrium and serous carcinoma (p < 0.05). MMP-9 expression in all types of cancers except grade 1 endometrioid and clear cell compared to proliferative endometrium was significantly higher (p < 0.05) and increased from proliferative to grade 2 endometrioid, grade 3 endometrioid, serous and undifferentiated endometrial carcinoma.

DISCUSSION

Gradual increments in MMP-9 expression and basement membrane laminin-1 discontinuity may indicate progression from normal to hyperplastic and to low- and high-grade cancerous endometrium.

Tumour basement membrane laminin expression predicts outcome following curative resection of pancreatic head cancer

Background:

Although widely fragmented BMs have been associated with adverse outcome in several cancer types, comparatively little is known with respect to its effect on the prognosis of pancreatic cancer. The aim of the current study was therefore to determine the prognostic value of tumour basement membrane (BM) continuity in two anatomically closely related, however, prognostically different tumours, pancreatic head- and periampullary cancer.

Methods:

Tumour BM continuity was determined by immunohistochemical staining of its two major components, laminin and collagen type IV. Associations were made with recurrence free survival (RFS), cancer-specific survival (CSS), overall survival (OS) and conventional prognostic factors.

Results:

Fifty-nine and 61% of pancreatic head and periampullary tumours, respectively, showed limited BM laminin expression. Whereas 43% and 41% of pancreatic head and periampullary cancers, respectively, showed limited BM collagen type IV expression. Limited BM laminin was associated with poor outcome following curative resection of pancreatic head cancer (P=0.034, 0.013 and 0.017 for RFS, CSS and OS, respectively). Two and a half times as many patients with ⩾25% BM laminin were recurrence free and alive 5 years following resection compared with those with limited BM laminin. Although staining patterns of both BM components were weakly correlated with each other, BM collagen type IV expression was not significantly associated with outcome in either tumour type.

Conclusion:

Discontinuous BMs, determined by laminin expression, are associated with poor outcome following curative resection of pancreatic head cancer.

Evaluation of basement membrane status in aggressive skin carcinomas with skull base invasion: a case-control study

Some skin carcinomas may be very aggressive. Breached of basement membrane (BM) has been in some situations associated with tumor aggressiveness. In this study, the status of BM in invasion was evaluated in basal cell carcinomas (BCCs) and squamous cell carcinomas (SCCs) with skull base invasion, and it was compared with tumor's good outcome. Integrity or breached of BM was visualized using immunohistochemistry technique with anti-type IV collagen antibody. The pattern of BM was classified as intact, breached, or absent in 24 BCCs and 11 SCCs with skull base invasion. Control group (good outcome) included 23 BCCs and 10 SCCs. Breached BM and absence of BM were respectively noted in 33.33% and 45.83% of BCCs with skull base invasion, compared with 8.33% and 17.395% in the control group ( P < .001). Regarding SCCs, ruptured and absent BMs were, respectively, noted in 36.36% and 63.64% of BCCs with skull base invasion, compared with 30% and 30% in the control group ( P = .075). In this study, destruction of BM was significantly more common in BCCs with skull base invasion, in comparison with those with good outcome. In SCC, this difference was not statistically significant.

Immunohistochemical studies concerning cathepsin D in endometrial carcinomas

OBJECTIVES

To study the prognostic value of immunohistochemical detection of cathepsin D and laminin in endometrial carcinomas.

METHODS

Immunohistochemical staining of cathepsin D was performed on paraffin sections of 111 endometrial carcinomas, and laminin deposition was studied in 65 endometrial carcinomas.

RESULTS

Of 111 tissue specimens, 55 showed a positive reaction for cathepsin D. The incidence of cathepsin D-positive staining increased with the extension of the primary tumor (p < 0.01). Patients with vessel invasion and pelvic lymph-node metastasis had a higher incidence of cathepsin D-positive staining than patients without these findings (p < 0.05). A favorable prognosis was obtained in a negative case of cathepsin D in comparison with a positive case (p < 0.01). Of 9 patients in whom laminin was detected in the cytoplasm of cancer cells, 5 showed poor prognoses and died from a primary disease.

CONCLUSION

Cathepsin D and laminin status might represent possible prognostic factors.

Immunohistochemical studies on matrix metalloproteinase-9 (MMP-9) and type-IV collagen in endometrial carcinoma

Immunohistochemical staining of MMP-9 and the type-IV collagen was performed on paraffin sections of endometrial carcinoma. Immunostaining in 129 cases of endometrial cancer detected MMP-9 in 19.0% of the cases. MMP-9 positive was shown in 30% of the cases with vessel invasion, and in 12.7% of the cases without vessel invasion (p < 0.05). MMP-9 showed positive in many cases with poor differentiation and lymph node metastasis, but still failed to achieve statistical significance. MMP-9 staining did not correlate with disease outcomes. We can not clarify that MMP-9 is associated with tumor-cell invasion and metastasis. Type-IV collagen deposition at the tumor-stromal border was studied in 58 cases of endometrial carcinoma in which disruptions were seen in varying degrees. The type-IV collagen in the primary lesion decreased as the differentiation decreased. Even in the lymph node metastasis lesions, the type-IV collagen was stained and was almost in agreement with the primary lesions. In the primary lesions, there was no relationship between MMP-9 staining and the type-IV collagen. It was suggested that the type-IV collagen observed in endometrial carcinoma was more concerned with the differentiation of the tumor than with the degradation by MMP-9.

Immunohistologic distribution of basement membrane in oral squamous cell carcinoma

The distribution pattern of the basement membrane (BM) around tumor cells was determined in 72 oral squamous cell carcinomas by immunohistochemical staining with antibodies against human type IV collagen, laminin, and heparan sulfate proteoglycan. An intact continuous BM was found in 29 cases, whereas partial or widespread loss of the BM was detected in the other 43 cases (59.7%). Statistical analysis showed that the degree of BM loss was correlated with the degree of differentiation of tumor cells, but not with tumor size, and, most significantly, with the mode of cancer invasion and the incidence of lymph node metastasis. Carcinoma with a well-defined tumor-stromal boundary generally expressed an intact continuous BM. In contrast, the majority of diffusely invasive carcinomas lacked a continuous BM. Carcinomas with a widespread loss of BM structures showed a high frequency of regional lymph node metastasis (16 of 18 cases, 88.9%).

The expression of invasive behavior of differentiated squamous carcinoma cell line evaluated by an in vitro invasion model

In order to elucidate the factors contributory to the expression of invasiveness of oral squamous cell carcinoma, we conducted biochemical and morphological comparisons of well differentiated squamous carcinoma cell line OSC-19 (oral squamous cell carcinoma) and undifferentiated carcinoma cell line KB, both cultured on 3T3 cell-embedded collagen gel (in vitro invasion model). OSC-19 cells invaded 3T3 cell-embedded collagen gel, while KB cells and OSC-19 cells on 3T3 cell-free gel matrix were less invasive. Cultured OSC-19 cells were characterized by lower proliferating activity, lower secretion of laminin and higher secretion of fibronectin than those of KB cells. Although the basement membrane with deposition of laminin and type IV collagen was formed, it was discontinuous at the invasion front. Gelatin zymography and western blotting showed matrix metalloproteinases (MMP), i.e., 72 kDa gelatinase (MMP-2) and 92 kDa gelatinase (MMP-9). Gelatinolytic activity was assayed, and was higher in OSC-19 cells than in KB cells or OSC-19 cells of the 3T3 cell-free model. By immunohistochemical analysis, MMP-2-positive cells were found scattered in both cell lines without any preferential localization, and the positivity for MMP-9 was localized in the invasion front of OSC-19 cells. These results strongly suggest that the invasiveness of squamous cell carcinoma is well correlated with cell-matrix adhesion by fibronectin and with focal elaboration of metalloproteinases, especially MMP-9, which play a major role in degrading the extracellular matrix components.

Clinical significance of laminin deposition and T-cell infiltration in oral cancer

Biopsied specimens from 55 patients with squamous cell carcinoma (SCC) of the oral cavity were examined immunohistopathologically as to the clinical significance of basement membrane (BM) deposition and T-cell infiltration at the tumor-stromal border using monoclonal anti-laminin and anti-CD3 antibodies. According to the immunoreactivity, all specimens could be divided into three groups: group A, a continuous linear pattern of positive staining for BM around tumor nests; group B, an alteration of BM deposition around tumor nests with T cell infiltration into those tumor nests; and group C, an alteration of BM deposition around tumor nests without T cell infiltration into those tumor nests. These groups were correlated with clinical manifestations, such as tumor size, tumor regression rate with induction chemotherapy, and regional lymph node metastatic rate. In these groups, tumors classified as group C showed a trend toward resistance to chemotherapy and high metastatic characteristics. Tumors classified as group B, which showed the same alteration of BM deposition as a result of T cell infiltration into the tumor nests, showed a sufficient tumor regression rate with chemotherapy. The visualization of the staining for BM laminin and T cells in oral SCC appeared not only to increase our understanding of the biologic and clinical behavior of individual tumors, but could be a prognostic indicator.

Immunohistochemical localization of basement membrane type VII collagen and laminin in neoplasms of the head and neck

The distribution pattern of the basement membrane components type VII collagen and laminin, was studied immunohistochemically in normal human head and neck tissues and in a series of benign and malignant tumours from the same site. Using monoclonal antibodies, a basement membrane containing type VII collagen and laminin could be demonstrated beneath the epithelial cell layer in 16 normal head and neck tissues from different localizations. Unlike type VII collagen, laminin was also abundantly present around blood vessels and muscle fibres. With respect to 42 squamous cell carcinomas studied, type VII collagen and laminin were present in basement membranes surrounding small and large tumour fields, independent of the tumour grade. Type VII collagen was demonstrated in the cytoplasm of tumour cells in 36% of the cases, while the antibody to laminin displayed a basement membrane staining pattern mainly. Both antibodies showed a staining gradient in more than half of the cases, with strong staining in the centre of the tumour and weakening of the staining towards the tumour periphery. In a series of 22 salivary gland tumours consisting of 19 pleomorphic adenomas and three adenoid cystic carcinomas, the distribution pattern of type VII collagen and laminin was very heterogeneous. Laminin was present in 17 and type VII collagen in 10 of 19 cases of pleomorphic adenoma, mostly scattered throughout the tumour fields. In the tumours positive for type VII collagen areas with little or no positivity were also found. A correlation between type VII collagen positivity and the presence of basal cell keratin 14 positivity was noticed in the majority of cases.(ABSTRACT TRUNCATED AT 250 WORDS)

Morphological characteristics of tumours formed by Lewis lung carcinoma-derived cloned cell lines with different metastatic potentials: structural differences in their basement membranes formed in vivo

Tumour basement membrane (BM) is an extracellular matrix produced by tumour cells of epithelial origin. We examined the structure and function of the tumour BM of tumour tissues formed by Lewis lung carcinoma-derived cloned cell lines (P29, LM12-3 and LM60-D6 cells) with low, medium and high metastatic potentials, respectively. Immunohistochemical staining of major BM constituents laminin and type IV collagen demonstrated that all the cell lines produced and deposited these materials extracellularly in vivo. However, the continuity of the tumour BM composed of these materials was much greater in the higher metastatic LM12-3 and LM60-D6 tumours than in those with the low metastatic P29 tumour. Electron microscopic examination revealed that in the higher metastatic tumours, especially the LM60-D6 tumour, the tumour BM had a highly organized structure consisting of lamina densa and lamina rara. Parallel bilayers of BM and their fusion were often observed and tumour cells were in direct contact with the BM. In the vicinity of tumour blood vessels, similar interactions between the tumour BM and the vascular BM were observed, and the tumour cells rested on their own BM, the fused BM or the vascular BM. In contrast, in the low metastatic tumour in which the tumour BM was not clearly defined, this close contact between tumour cells and the vascular BM was not observed. In vitro studies showed that the higher metastatic cells adhered more firmly than the LMP cells to a subendothelial matrix. These results suggest that the adhesiveness of tumour cells to the vascular BM in vivo is correlated with their ability to form an integrated BM in vivo, and that this adhesiveness of the tumour cells may be mediated in part by the tumour BM via BM fusion.

Prognostic significance of basement membrane deposition in operable squamous cell carcinomas of the lung

Tumor histology, stage of disease, and performance status are the most important prognostic factors in squamous cell lung cancer (SqCLC). A potentially important descriptor is the pattern of tumor growth as reflected in the dissolution of preexisting or deposition of newly formed basement membrane (BM) around tumor cell nests. The possible correlation between the pattern of BM deposition and patient survival was investigated. Immunohistochemistry testing, using polyclonal antibodies to human type IV collagen, was done on tumor samples of 68 patients with operable Stages I or II SqCLC, and BM staining was scored semiquantitatively. More than 75% immunoreactivity was scored as extensive BM and less than 75% as moderate or limited BM. In six patients, no immunoreactivity could be detected. In 27 of 62 patients, extensive and, in 35 of 62 patients, moderate-limited BM deposition was found. This deposition had a significant effect on survival (P = 0.02). Cox regression analysis, including BM deposition and tumor stage, indicated that BM deposition might also have value as an additional independent prognostic indicator for survival (P = 0.02). Deposition of an appreciable amount of BM in the center of the SqCLC was a prognostically favorable sign, independent of tumor stage.

Basement membrane type IV collagen in oral squamous cell carcinoma

Biopsied specimens of 82 oral squamous cell carcinomas were immunohistochemically studied for detection of type IV collagen existence in the basement membrane (BM). Immunoreactivity on BM was semiquantitatively evaluated as limited (+/-), moderate (+), or extensive (+ +), and matched against clinical and histopathologic features. No clear difference in BM deposition could be found in the tumor sites. The amount of type IV collagen decreased in advanced T stage (T3 and T4) tumors. BM deposition was significantly correlated with lymph node metastasis. In 54 N-, 32 had extensive deposition, 18 had moderate, and the remaining had limited. Conversely, only 5 of 28 N+ cases showed good type IV collagen immunoreactivity and 14 cases exhibited limited BM deposition. BM existence was also associated with the mode of invasion. BM deposition decreased in order with the grade (i.e., the more limited the BM deposition, the more diffuse the invasion mode). BM deposition was, however, not related with stromal responses, such as cellular infiltrates and fibrosis. We conclude that immunohistochemical examinations of BM deposition on biopsied specimens seem beneficial for cancer treatment.

Distribution of basement membrane antigens in the uterine cervical adenocarcinomas: an immunohistochemical study

The distribution of laminin and collagen type IV in the basement membrane of 45 uterine cervical adenocarcinomas was studied using immunohistochemical techniques. Staining patterns of basement membranes were divided into three types, according to the intensity of staining: thick and discontinuous (type I), thin and discontinuous (type II), and fragmentary (type III). In well-differentiated adenocarcinomas, 17 of 24 cases (71%) showed type I and the remaining 7 showed type II. In contrast, in poorly differentiated adenocarcinomas 4 of 5 cases (80%) showed type III. Five of six cases (83%) of adenoma malignum, even though extremely well differentiated, showed type III. Staining patterns of the basement membranes correlated with histological grade. Five-year survival rate of patients with type I and II staining (74%) was better than that of patients with type III (55%).

Immunocytochemical assays in human endometrial carcinomas: a multiparametric computerized analysis and comparison with nonmalignant changes

Immunocytochemical assay (ICAs) were performed on frozen sections from human endometrial samples (n = 89) including normal endometrium, decidua, hyperplasia with and without atypia, and carcinomas. Monoclonal antiestrogen receptor (ER), anti-laminin (Lam), anti-type IV collagen (Coll IV), and anti-Ki67 were applied with avidin-biotin-peroxidase complex or peroxidase-antiperoxidase complex. The results of the ICAs were evaluated through a computerized system of image analysis referred to as SAMBA. It was shown that this system provided for an accurate reliable and reproducible analysis of ICAs in tissue sections. It is concluded that this multiparametric and standardized method of analysis of ICAs can further be applied in correlations with clinical and biochemical data.

Collagen type III in ovarian tumors. Histological, immunohistochemical and ultrastructural findings

The occurrence and location of interstitial collagen amino-terminal propeptide type III procollagen (PIIIP) and fibronectin was studied in 123 ovarian tumors of different types and related to the histological type and clinical behavior of the neoplasm. The purpose was to further our understanding of the development and classification of these tumors and to determine characteristics of diagnostic and prognostic significance. PIIIP-positive fibers were common in the stroma of all types of neoplasms, condensation of fibres occurred at the epithelial-stromal interface of surface epithelial tumors, and disintegration and discontinuation of fibers around invasive epithelial islets and in stroma of undifferentiated epithelial carcinomas. The PIIIP-positive stromal meshwork surrounded individual cells in thecomas, while it was virtually absent in diffuse granulosa cell tumors and distinctly developed in malignant stromal neoplasms, being seen mainly around epithelial islets in mixed mesodermal tumors.

Reversibility of rat liver cirrhosis by medroxyprogesterone acetate

The possible effects of a synthetic progesterone, medroxyprogesterone acetate (MPA), on carbon tetrachloride/phenobarbital (CCl4/PB)-induced rat liver injury were studied by morphological methods. CCl4/PB-treated rats showed extensive liver fibrosis consisting of procollagen type III aminoterminal propeptide-positive strands and fibres with concomitant extensive basement membrane deposits and fibronectin synthesis. MPA treatment after CCl4/PB-induced liver damage reduced alterations in cytoplasmic organelles, inflammation and hemorrhages and reversed the fibrosis, mostly around individual liver cells, possibly due to the normalization of cellular structure and function with a decrease in fibronectin deposits.

Type IV collagen immunostaining and computerized image analysis (SAMBA) in breast and endometrial disorders

Type IV collagen immunostaining was performed on tissue sections from a large series of non-malignant and malignant disorders of the breast and endometrium. The results were analysed by means of a computerized system of image analysis referred to as SAMBA. It was shown that this system provided an accurate, reliable, reproducible, automated and multiparameteric analysis of collagen IV immunoprecipitates. It was concluded that this standardized method of analyses can be routinely used for the measurement of collagen IV, thus enabling correlations to be sought with histopathological and clinical data.

Type IV collagen immunoreactivity in colorectal cancer. Prognostic value of basement membrane deposition

Using antibodies to type IV collagen, basement membrane (BM) deposition at the tumor-stromal border was studied in 163 cases of colorectal carcinomas. Immunoreactivity was scored semiquantitatively as moderate/extensive versus limited BM deposition and correlated with Dukes' stages and survival data. Cases with limited BM deposition showed an overall significant shorter survival and were overrepresented in Dukes' Stages C/D. Stratification of the cases, for limited versus moderate/extensive BM deposition and Dukes' Stages A/B and C/D, showed that in Dukes' Stages C/D, cases with moderate/extensive BM deposition reached a plateau phase in the survival curve after 2 years. Cases with limited BM deposition showed a continuous downward course on the survival curve. The results suggest that immunostaining of BM in cases in Dukes' C differentiates tumors with relatively high invasive and metastatic capacity from tumors with low invasive and metastatic capacity.

Basement membrane formation by malignant mouse keratinocyte cell lines in organotypic culture and transplants: correlation with degree of morphologic differentiation

Six malignant C3H mouse epidermal cell lines (HEL-30, HEL-37, HELP I, HELP IV, HD II, H3L), with different capacities for epidermal differentiation, were analyzed for their organized growth behavior and basement membrane (BM) formation in organotypical cultures in vitro and after transplantation into syngeneic mice. Expression and deposition of five BM components (type IV collagen, laminin, bullous pemphigoid antigen, fibronectin, heparan sulfate proteoglycan) were determined on frozen sections by indirect immunofluorescence. Additionally, synthesis and secretion of BM components by the line HEL-30 (in submersed cultures) were identified by metabolic labeling and immunoprecipitation. Morphologic differentiation features and formation of a structured BM were studied by electron microscopy. All cell lines were tumorigenic and invasive but nevertheless able to synthesize BM constituents in vitro and in vivo, although pronounced variations in the expression and the polarity and continuity of deposition were found. Irrespective of the amount of BM components synthesized, none of the cell lines formed a structured BM in organotypical cultures in vitro. After transplantation the production of BM components was improved and the newly formed epithelia were separated from the mesenchyme by a structured BM. The formation of BM occurred whether the epithelial cells were in immediate contact with the mesenchyme or separated by a 1 to 2 mm thick native collagen gel. Deposition of BM constituents and formation of BM structures occurred both at the superficial epithelium and around invading cell cords. The studies clearly demonstrated that malignant epidermal cells maintain their capacity to synthesize BM components. The extent of production and the polarity of deposition of the constituents and the quality of BM formation were usually higher in well differentiated cell lines and obviously correlated well with their preserved degree of differentiation. Comparable to normal keratinocytes, formation of structured BM requires interaction with living mesenchyme but occurs independently of direct epidermal-mesenchymal contact.

Occurrence of basement membranes in pigment cell tumors of the skin, relation to cell type and clinical behavior

The occurrence, location and intensity of the basement membrane (BM) components collagen IV and laminin in benign and malignant pigment cell tumors was studied by immunohistochemical methods. The results seemed to establish the following findings: junctional nevi display varying continuity of BM; nevus cells in the dermis display more continuous and thicker BM superficially (associated with epithelial type nevus cells); superficial spreading melanoma displays discontinuity of BM, and nodular melanoma and metastatic melanoma display variable BM around tumor aggregates. The variable expression of BM components in this study showed an apparent relationship to tumor cell type and laminin and collagen IV production, partly related to clinical behaviour.