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Werner TA, Forster CM, Dizdar L, Verde PE, Raba K, Schott M, Knoefel WT, Krieg A. CXCR4/CXCR7/CXCL12-Axis in Follicular Thyroid Carcinoma. J Cancer 2018; 9:929-940. [PMID: 29581772 PMCID: PMC5868160 DOI: 10.7150/jca.23042] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Accepted: 02/13/2018] [Indexed: 12/28/2022] Open
Abstract
Background: Follicular thyroid carcinoma's (FTC) often benign course is partially due to adjuvant radioactive iodine (RAI) treatment. However, once the tumour has spread and fails to retain RAI, the therapeutic options are limited and the outcome is poor. In this subset of patients, the identification of novel druggable biomarkers appears invaluable. Here, we investigated the stage dependent expression and functional role of the C-X-C chemokine receptors type 4 and 7 (CXCR4/7) in FTC. Methods: CXCR4/7 expression was examined in 44 FTC and corresponding non-neoplastic thyroid specimens as well as 10 FTC distant metastases and 18 follicular adenomas using tissue microarray technology. Expression levels were correlated with clinicopathological variables as well as overall and recurrence free survival. Changes regarding cell cycle activation, tumour cell invasiveness and mRNA expression of genes related to epithelial-mesenchymal transition (EMT) were investigated after treatment with recombinant human SDF1α/CXCL12 (rh-SDF1α) and CXCR4 antagonists AMD3100 and WZ811. Results: CXCR4/7 expression was associated with large tumour size, advanced UICC stage as well as shorter overall and recurrence free survival. CXCR4 was significantly higher expressed in distant metastases than in primary tumour cores. In addition, rh-SDF1α induced invasive growth, cell cycle activation and EMT, while CXCR4 antagonists significantly reduced FTC invasiveness in vitro. Conclusion: Here we provide first evidence of the biological importance of the CXCR4/CXCR7/CXCL12 axis in FTC. Our findings underscore the therapeutic potential of this chemokine receptor family in advanced FTC and offer new valuable insight into the oncogenesis of metastatic FTC.
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Affiliation(s)
- Thomas Artur Werner
- Department of Surgery (A), Heinrich-Heine-University and University Hospital Duesseldorf, Moorenstr. 5, 40225 Duesseldorf, Germany
| | - Christina Maria Forster
- Department of Surgery (A), Heinrich-Heine-University and University Hospital Duesseldorf, Moorenstr. 5, 40225 Duesseldorf, Germany
| | - Levent Dizdar
- Department of Surgery (A), Heinrich-Heine-University and University Hospital Duesseldorf, Moorenstr. 5, 40225 Duesseldorf, Germany
| | - Pablo Emilio Verde
- Coordination Centre for Clinical Trials, Heinrich-Heine-University and University Hospital Duesseldorf, Moorenstr. 5, 40225 Duesseldorf, Germany
| | - Katharina Raba
- Institute for Transplantation Diagnostics and Cell Therapeutics, Heinrich-Heine-University and University Hospital Duesseldorf, Moorenstr. 5, 40225, Duesseldorf, Germany
| | - Matthias Schott
- Division of Endocrinology, Heinrich-Heine-University and University Hospital Duesseldorf, Moorenstr. 5, 40225 Duesseldorf, Germany
| | - Wolfram Trudo Knoefel
- Department of Surgery (A), Heinrich-Heine-University and University Hospital Duesseldorf, Moorenstr. 5, 40225 Duesseldorf, Germany
| | - Andreas Krieg
- Department of Surgery (A), Heinrich-Heine-University and University Hospital Duesseldorf, Moorenstr. 5, 40225 Duesseldorf, Germany
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Werner TA, Kröpil F, Schoppe MO, Kröpil P, Knoefel WT, Krieg A. Small bowel volvulus as a complication of von Recklinghausen’s disease: A case report. World J Gastroenterol 2014; 20:7979-7983. [PMID: 24976735 PMCID: PMC4069326 DOI: 10.3748/wjg.v20.i24.7979] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2013] [Revised: 02/09/2014] [Accepted: 03/19/2014] [Indexed: 02/06/2023] Open
Abstract
We report the case of a 25-year-old male with Neurofibromatosis type I (NF-1), who presented at the time of admission with clinical findings of an acute abdomen caused by a mechanical obstruction. Computerized tomography showed a volvulus of the terminal ileum with mesenteric swirling as the cause of the patient’s symptoms. Consecutive exploratory laparotomy confirmed the diagnosis and 70 cm of the small intestine was resected due to an affection of the mesentery by multiple neurofibromas. The gastrointestinal tract is affected in approximately 10% of patients with NF-1, however the mesentery is almost always spared. Here we describe the unique case of a patient with a volvulus caused by mesenteric manifestation of von Recklinghausen’s disease, emphasizing the role of surgery in a team of multidisciplinary specialists to treat this multiorganic disease.
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Cupisti K, Lehwald N, Anlauf M, Riemer J, Werner TA, Krieg A, Witte J, Chanab A, Baldus SE, Krausch M, Raffel A, Herdter C, Schott M, Knoefel WT. Encapsulation status of papillary thyroid microcarcinomas is associated with the risk of lymph node metastases and tumor multifocality. Horm Metab Res 2014; 46:138-44. [PMID: 24356791 DOI: 10.1055/s-0033-1361158] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The management of papillary microcarcinoma (PMC) of the thyroid is controversial, especially after partial thyroid resection for benign thyroid disease. In order to detect prognostic factors for PMC, we analyzed 116 patients with PMC for encapsulation status and lymph node metastases. Between 10/1992 and 12/2010, 116 patients with PMC have been operated in our department (87 females, 29 males, median age 49 years). Eighty per cent of PMCs were diagnosed postoperatively. Seventy-six patients (66%) received a more extended resection with either thyroidectomy, near total thyroidectomy, or Dunhill operation either primarily or after completion operation, whereas 40 patients (34%) had only partial resection. Fifty patients (43%) received radioiodine (RIA) ablation. Lymph node metastases were found in 21 patients (18%). Univariate analysis showed four risk factors to be significantly associated with the risk of lymph node metastasis (p<0.05): male gender, younger age, age group<50 years and nonencapsulation of the tumor. Multivariate analysis demonstrated statistical significance for gender and tumor capsulation status. The tumor capsulation status also correlated with tumor multifocality. Our data show that the risk of lymph node metastases is significantly higher in partially or nonencapsulated PMC than in encapsulated specimens. We therefore suggest that the WHO classification should be extended to a compulsory notification of the encapsulation status in PMC.
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Affiliation(s)
- K Cupisti
- Department of General, Visceral and Pediatric Surgery, Heinrich Heine University and University Hospital Duesseldorf, Duesseldorf, Germany
| | - N Lehwald
- Department of General, Visceral and Pediatric Surgery, Heinrich Heine University and University Hospital Duesseldorf, Duesseldorf, Germany
| | - M Anlauf
- Institute of Pathology, Heinrich Heine University and University Hospital Duesseldorf, Duesseldorf, Germany
| | - J Riemer
- Institute of Pathology, Heinrich Heine University and University Hospital Duesseldorf, Duesseldorf, Germany
| | - T A Werner
- Department of General, Visceral and Pediatric Surgery, Heinrich Heine University and University Hospital Duesseldorf, Duesseldorf, Germany
| | - A Krieg
- Department of General, Visceral and Pediatric Surgery, Heinrich Heine University and University Hospital Duesseldorf, Duesseldorf, Germany
| | - J Witte
- Department of General, Visceral and Pediatric Surgery, Heinrich Heine University and University Hospital Duesseldorf, Duesseldorf, Germany
| | - A Chanab
- Department of General, Visceral and Pediatric Surgery, Heinrich Heine University and University Hospital Duesseldorf, Duesseldorf, Germany
| | - S E Baldus
- Institute of Pathology, Heinrich Heine University and University Hospital Duesseldorf, Duesseldorf, Germany
| | - M Krausch
- Department of General, Visceral and Pediatric Surgery, Heinrich Heine University and University Hospital Duesseldorf, Duesseldorf, Germany
| | - A Raffel
- Department of General, Visceral and Pediatric Surgery, Heinrich Heine University and University Hospital Duesseldorf, Duesseldorf, Germany
| | - C Herdter
- Department of General, Visceral and Pediatric Surgery, Heinrich Heine University and University Hospital Duesseldorf, Duesseldorf, Germany
| | - M Schott
- Department of Endocrinology, Rheumatology and Diabetes, Heinrich Heine University and University Hospital Duesseldorf, Duesseldorf, Germany
| | - W T Knoefel
- Department of General, Visceral and Pediatric Surgery, Heinrich Heine University and University Hospital Duesseldorf, Duesseldorf, Germany
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