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Erschienen in: Annals of Surgical Oncology 3/2017

17.11.2015 | Translational Research and Biomarkers

CXCR4 Expression is Associated with Poor Prognosis in Patients with Esophageal Squamous Cell Carcinoma

verfasst von: Masakazu Goto, MD, Takahiro Yoshida, MD, PhD, Yota Yamamoto, MD, PhD, Yoshihito Furukita, MD, Seiya Inoue, MD, Satoshi Fujiwara, MD, Naoya Kawakita, MD, Takeshi Nishino, MD, Takuya Minato, MD, PhD, Yasuhiro Yuasa, MD, PhD, Hiromichi Yamai, MD, PhD, Hirokazu Takechi, MD, PhD, Junichi Seike, MD, PhD, Yoshimi Bando, MD, PhD, Akira Tangoku, MD, PhD

Erschienen in: Annals of Surgical Oncology | Ausgabe 3/2017

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Abstract

Background

Chemokines and their receptors are known to play important roles in the tumorigenesis of many malignancies. The chemokine CXCL12 and its receptors CXCR4 and CXCR7 were suggested to be involved in cancer invasion and metastasis. The aim of this retrospective study was to evaluate the prognostic impact of the expressions of CXCL12, CXCR4 and CXCR7 in patients with esophageal squamous cell carcinoma (ESCC).

Methods

We used immunohistochemistry (IHC) and reverse transcriptase-polymerase chain reaction (RT-PCR) to evaluate the expressions of CXCL12, CXCR4, and CXCR7 in ESCC patients’ tumor biopsy specimens obtained during preoperative endoscopy or surgery. These results were compared with the patients’ clinicopathological parameters and survival.

Results

IHC was conducted for 172 patients. High expression of CXCR4 in the cytoplasm and nuclei and that of CXCR7 were associated with poor cause-specific survival (CSS) (P= .002 and .010, respectively). The specimens from 52 of the 172 patients were examined by RT-PCR and quantitative real-time PCR. The expression levels of messenger RNA (mRNA) of CXCR4 and CXCR7 were significantly increased in the tumors compared with normal esophageal mucosae (P < .0001). The expression level of mRNA of CXCR4 was associated with poor recurrence-free survival and CSS (P = .012 and .038, respectively).

Conclusions

CXCR4 expression is associated with poor prognosis in patients with ESCC.
Literatur
1.
Zurück zum Zitat Pisani P, Parkin DM, Bray F, Ferlay J. Estimates of the worldwide mortality from 25 cancers in 1990. Int J Cancer. 1999;83:18–29.CrossRefPubMed Pisani P, Parkin DM, Bray F, Ferlay J. Estimates of the worldwide mortality from 25 cancers in 1990. Int J Cancer. 1999;83:18–29.CrossRefPubMed
2.
Zurück zum Zitat Ando N, Iizuka T, Ide H, et al. Surgery plus chemotherapy compared with surgery alone for localized squamous cell carcinoma of the thoracic esophagus: a Japan Clinical Oncology Group Study-JCOG9204. J Clin Oncol. 2003;21:4592–6.CrossRefPubMed Ando N, Iizuka T, Ide H, et al. Surgery plus chemotherapy compared with surgery alone for localized squamous cell carcinoma of the thoracic esophagus: a Japan Clinical Oncology Group Study-JCOG9204. J Clin Oncol. 2003;21:4592–6.CrossRefPubMed
3.
Zurück zum Zitat Ando N, Kato H, Igaki H, et al. A randomized trial comparing postoperative adjuvant chemotherapy with cisplatin and 5-fluorouracil versus preoperative chemotherapy for localized squamous cell carcinoma of the thoracic esophagus (JCOG 9907). Ann Surg Oncol. 2012;19:68–74.CrossRefPubMed Ando N, Kato H, Igaki H, et al. A randomized trial comparing postoperative adjuvant chemotherapy with cisplatin and 5-fluorouracil versus preoperative chemotherapy for localized squamous cell carcinoma of the thoracic esophagus (JCOG 9907). Ann Surg Oncol. 2012;19:68–74.CrossRefPubMed
4.
Zurück zum Zitat Yamasaki M, Miyata H, Miyazaki Y, et al. Perioperative therapy for esophageal cancer. Gen Thorac Cardiovasc Surg. 2014;62:531–40.CrossRefPubMed Yamasaki M, Miyata H, Miyazaki Y, et al. Perioperative therapy for esophageal cancer. Gen Thorac Cardiovasc Surg. 2014;62:531–40.CrossRefPubMed
5.
Zurück zum Zitat Yoshimura T, Matsushima K, Tanaka S, Robinson EA, Appella E, Oppenheim JJ, Leonard EJ. Purification of a human monocyte-derived neutrophil chemotactic factor that has peptide sequence similarity to other host defense cytokines. Proc Natl Acad Sci U S A. 1987;84:9233–7.CrossRefPubMedPubMedCentral Yoshimura T, Matsushima K, Tanaka S, Robinson EA, Appella E, Oppenheim JJ, Leonard EJ. Purification of a human monocyte-derived neutrophil chemotactic factor that has peptide sequence similarity to other host defense cytokines. Proc Natl Acad Sci U S A. 1987;84:9233–7.CrossRefPubMedPubMedCentral
6.
Zurück zum Zitat Muller A, Homey B, Soto H, et al. Involvement of chemokine receptors in breast cancer metastasis. Nature. 2001;410:50–6.CrossRefPubMed Muller A, Homey B, Soto H, et al. Involvement of chemokine receptors in breast cancer metastasis. Nature. 2001;410:50–6.CrossRefPubMed
7.
8.
Zurück zum Zitat Murphy PM, Baggiolini M, Charo IF, et al. International union of pharmacology. XXII. Nomenclature for chemokine receptors. Pharmacol Rev. 2000;52:145–76.PubMed Murphy PM, Baggiolini M, Charo IF, et al. International union of pharmacology. XXII. Nomenclature for chemokine receptors. Pharmacol Rev. 2000;52:145–76.PubMed
9.
Zurück zum Zitat Matsusue R, Kubo H, Hisamori S, et al. Hepatic stellate cells promote liver metastasis of colon cancer cells by the action of SDF-1/CXCR4 axis. Ann Surg Oncol. 2009;16:2645–53.CrossRefPubMed Matsusue R, Kubo H, Hisamori S, et al. Hepatic stellate cells promote liver metastasis of colon cancer cells by the action of SDF-1/CXCR4 axis. Ann Surg Oncol. 2009;16:2645–53.CrossRefPubMed
10.
Zurück zum Zitat Hu J, Deng X, Bian X, et al. The expression of functional chemokine receptor CXCR4 is associated with the metastatic potential of human nasopharyngeal carcinoma. Clin Cancer Res. 2005;11:4658–65.CrossRefPubMed Hu J, Deng X, Bian X, et al. The expression of functional chemokine receptor CXCR4 is associated with the metastatic potential of human nasopharyngeal carcinoma. Clin Cancer Res. 2005;11:4658–65.CrossRefPubMed
11.
Zurück zum Zitat Scala S, Ottaiano A, Ascierto PA, et al. Expression of CXCR4 predicts poor prognosis in patients with malignant melanoma. Clin Cancer Res. 2005;11:1835–41.CrossRefPubMed Scala S, Ottaiano A, Ascierto PA, et al. Expression of CXCR4 predicts poor prognosis in patients with malignant melanoma. Clin Cancer Res. 2005;11:1835–41.CrossRefPubMed
12.
Zurück zum Zitat Zhao H, Guo L, Zhao H, Zhao J, Weng H, Zhao B. CXCR4 over-expression and survival in cancer: a system review and meta-analysis. Oncotarget. 2015;6:5022–40.CrossRefPubMed Zhao H, Guo L, Zhao H, Zhao J, Weng H, Zhao B. CXCR4 over-expression and survival in cancer: a system review and meta-analysis. Oncotarget. 2015;6:5022–40.CrossRefPubMed
13.
Zurück zum Zitat Burns JM, Summers BC, Wang Y, et al. A novel chemokine receptor for SDF-1 and I-TAC involved in cell survival, cell adhesion, and tumor development. J Exp Med. 2006;203:2201–13.CrossRefPubMedPubMedCentral Burns JM, Summers BC, Wang Y, et al. A novel chemokine receptor for SDF-1 and I-TAC involved in cell survival, cell adhesion, and tumor development. J Exp Med. 2006;203:2201–13.CrossRefPubMedPubMedCentral
14.
Zurück zum Zitat Balabanian K, Lagane B, Infantino S, et al. The chemokine SDF-1/CXCL12 binds to and signals through the orphan receptor RDC1 in T lymphocytes. J Biol Chem. 2005;280:35760–6.CrossRefPubMed Balabanian K, Lagane B, Infantino S, et al. The chemokine SDF-1/CXCL12 binds to and signals through the orphan receptor RDC1 in T lymphocytes. J Biol Chem. 2005;280:35760–6.CrossRefPubMed
16.
Zurück zum Zitat Libert F, Parmentier M, Lefort A, Dumont JE, Vassart G. Complete nucleotide sequence of a putative G protein coupled receptor: RDC1. Nucleic Acids Res. 1990;18:1917.CrossRefPubMedPubMedCentral Libert F, Parmentier M, Lefort A, Dumont JE, Vassart G. Complete nucleotide sequence of a putative G protein coupled receptor: RDC1. Nucleic Acids Res. 1990;18:1917.CrossRefPubMedPubMedCentral
17.
Zurück zum Zitat Miao Z, Luker KE, Summers BC, et al. CXCR7(RDC1) promotes breast and lung tumor growth in vivo and is expressed on tumor-associated vasculature. Proc Natl Acad Sci USA. 2007;104:15735–40.CrossRefPubMedPubMedCentral Miao Z, Luker KE, Summers BC, et al. CXCR7(RDC1) promotes breast and lung tumor growth in vivo and is expressed on tumor-associated vasculature. Proc Natl Acad Sci USA. 2007;104:15735–40.CrossRefPubMedPubMedCentral
18.
Zurück zum Zitat Hattermann K, Held-Feindt J, Lucius R, Muerkoster SS, Penfold ME, Schall TJ, Mentlein R. The chemokine receptor CXCR7 is highly expressed in human glioma cells and mediates antiapoptotic effects. Cancer Res. 2010;70:3299–308.CrossRefPubMed Hattermann K, Held-Feindt J, Lucius R, Muerkoster SS, Penfold ME, Schall TJ, Mentlein R. The chemokine receptor CXCR7 is highly expressed in human glioma cells and mediates antiapoptotic effects. Cancer Res. 2010;70:3299–308.CrossRefPubMed
19.
Zurück zum Zitat Wang J, Shiozawa Y, Wang J, et al. The role of CXCR7/RDC1 as a chemokine receptor for CXCL12/SDF-1 in prostate cancer. J Biol Chem. 2008;283:4283–94.CrossRefPubMed Wang J, Shiozawa Y, Wang J, et al. The role of CXCR7/RDC1 as a chemokine receptor for CXCL12/SDF-1 in prostate cancer. J Biol Chem. 2008;283:4283–94.CrossRefPubMed
20.
Zurück zum Zitat Lu CL, Guo J, Gu J, Ge D, Hou YY, Lin ZW, Ding JY. CXCR4 heterogeneous expression in esophageal squamous cell cancer and stronger metastatic potential with CXCR4-positive cancer cells. Dis Esophagus. 2014;27:294–302.CrossRefPubMed Lu CL, Guo J, Gu J, Ge D, Hou YY, Lin ZW, Ding JY. CXCR4 heterogeneous expression in esophageal squamous cell cancer and stronger metastatic potential with CXCR4-positive cancer cells. Dis Esophagus. 2014;27:294–302.CrossRefPubMed
21.
Zurück zum Zitat Sasaki K, Natsugoe S, Ishigami S, et al. Expression of CXCL12 and its receptor CXCR4 correlates with lymph node metastasis in submucosal esophageal cancer. J Surg Oncol. 2008;97:433–8.CrossRefPubMed Sasaki K, Natsugoe S, Ishigami S, et al. Expression of CXCL12 and its receptor CXCR4 correlates with lymph node metastasis in submucosal esophageal cancer. J Surg Oncol. 2008;97:433–8.CrossRefPubMed
22.
Zurück zum Zitat Sasaki K, Nastugoe S, Ishigami S, et al. Expression of CXCL12 and its receptor CXCR4 in esophageal squamous cell carcinoma. Oncol Rep. 2009;21:65–71.PubMed Sasaki K, Nastugoe S, Ishigami S, et al. Expression of CXCL12 and its receptor CXCR4 in esophageal squamous cell carcinoma. Oncol Rep. 2009;21:65–71.PubMed
23.
Zurück zum Zitat Yoshida T, Seike J, Miyoshi T, et al. A preoperative chemotherapy with weekly docetaxel plus low-dose cisplatin and 5-fluorouracil for stage II/III squamous cell carcinoma of the esophagus. Esophagus. 2010;7:95–100.CrossRef Yoshida T, Seike J, Miyoshi T, et al. A preoperative chemotherapy with weekly docetaxel plus low-dose cisplatin and 5-fluorouracil for stage II/III squamous cell carcinoma of the esophagus. Esophagus. 2010;7:95–100.CrossRef
24.
Zurück zum Zitat The Japan Esophageal Society. Guidelines for the Clinical and Pathologic Studies on Carcinoma of the Esophagus. 10th ed. Tokyo: Kanehara; 2008. The Japan Esophageal Society. Guidelines for the Clinical and Pathologic Studies on Carcinoma of the Esophagus. 10th ed. Tokyo: Kanehara; 2008.
25.
26.
Zurück zum Zitat Masuda T, Nakashima Y, Ando K, et al. Nuclear expression of chemokine receptor CXCR4 indicate poorer prognosis in gastric cancer. Anticancer Res. 2014;34:6397–403.PubMed Masuda T, Nakashima Y, Ando K, et al. Nuclear expression of chemokine receptor CXCR4 indicate poorer prognosis in gastric cancer. Anticancer Res. 2014;34:6397–403.PubMed
27.
Zurück zum Zitat Wang L, Wang Z, Yang B, Yang Q, Wang L, Sun Y. CXCR4 nuclear localization follows binding of its ligand SDF-1 and occurs in metastatic but not primary renal cell carcinoma. Oncol Rep. 2009;22:1333–9.PubMed Wang L, Wang Z, Yang B, Yang Q, Wang L, Sun Y. CXCR4 nuclear localization follows binding of its ligand SDF-1 and occurs in metastatic but not primary renal cell carcinoma. Oncol Rep. 2009;22:1333–9.PubMed
28.
Zurück zum Zitat Kato M, Kitayama J, Kazama S and Nagawa H. Expression pattern of CXC chemokine receptor-4 is correlated with lymph node metastasis in human invasive ductal carcinoma. Breast Cancer Res. 2003;5:R144–50.CrossRefPubMedPubMedCentral Kato M, Kitayama J, Kazama S and Nagawa H. Expression pattern of CXC chemokine receptor-4 is correlated with lymph node metastasis in human invasive ductal carcinoma. Breast Cancer Res. 2003;5:R144–50.CrossRefPubMedPubMedCentral
29.
Zurück zum Zitat Yoshitake N, Fukui H, Yamagishi H, et al. Expression of SDF-1 alpha and nuclear CXCR4 predicts lymph node metastasis in colorectal cancer. Br J Cancer. 2008;98:1682–9.CrossRefPubMedPubMedCentral Yoshitake N, Fukui H, Yamagishi H, et al. Expression of SDF-1 alpha and nuclear CXCR4 predicts lymph node metastasis in colorectal cancer. Br J Cancer. 2008;98:1682–9.CrossRefPubMedPubMedCentral
30.
Zurück zum Zitat Wang N, Wu QL, Fang Y, et al. Expression of chemokine receptor CXCR4 in nasopharyngeal carcinoma: pattern of expression and correlation with clinical outcome. J Transl Med. 2005;3:26.CrossRefPubMedPubMedCentral Wang N, Wu QL, Fang Y, et al. Expression of chemokine receptor CXCR4 in nasopharyngeal carcinoma: pattern of expression and correlation with clinical outcome. J Transl Med. 2005;3:26.CrossRefPubMedPubMedCentral
31.
Zurück zum Zitat Na IK, Scheibenbogen C, Adam C, et al. Nuclear expression of CXCR4 in tumor cells of non-small cell lung cancer is correlated with lymph node metastasis. Hum Pathol. 2008;39:1751–5.CrossRefPubMed Na IK, Scheibenbogen C, Adam C, et al. Nuclear expression of CXCR4 in tumor cells of non-small cell lung cancer is correlated with lymph node metastasis. Hum Pathol. 2008;39:1751–5.CrossRefPubMed
32.
Zurück zum Zitat Iwakiri S, Mino N, Takahashi T, et al. Higher expression of chemokine receptor CXCR7 is linked to early and metastatic recurrence in pathological stage I nonsmall cell lung cancer. Cancer. 2009;115:2580–93.CrossRefPubMed Iwakiri S, Mino N, Takahashi T, et al. Higher expression of chemokine receptor CXCR7 is linked to early and metastatic recurrence in pathological stage I nonsmall cell lung cancer. Cancer. 2009;115:2580–93.CrossRefPubMed
33.
Zurück zum Zitat Rubin JB, Kung AL, Klein RS, et al. A small-molecule antagonist of CXCR4 inhibits intracranial growth of primary brain tumors. Proc Natl Acad Sci U S A. 2003;100:13513–8.CrossRefPubMedPubMedCentral Rubin JB, Kung AL, Klein RS, et al. A small-molecule antagonist of CXCR4 inhibits intracranial growth of primary brain tumors. Proc Natl Acad Sci U S A. 2003;100:13513–8.CrossRefPubMedPubMedCentral
34.
Zurück zum Zitat Smith MC, Luker KE, Garbow JR, Prior JL, Jackson E, Piwnica-Worms D, Luker GD. CXCR4 regulates growth of both primary and metastatic breast cancer. Cancer Res. 2004;64:8604–12.CrossRefPubMed Smith MC, Luker KE, Garbow JR, Prior JL, Jackson E, Piwnica-Worms D, Luker GD. CXCR4 regulates growth of both primary and metastatic breast cancer. Cancer Res. 2004;64:8604–12.CrossRefPubMed
35.
Zurück zum Zitat Burger JA, Peled A. CXCR4 antagonists: targeting the microenvironment in leukemia and other cancers. Leukemia. 2009;23:43–52.CrossRefPubMed Burger JA, Peled A. CXCR4 antagonists: targeting the microenvironment in leukemia and other cancers. Leukemia. 2009;23:43–52.CrossRefPubMed
36.
Zurück zum Zitat Beider K, Ribakovsky E, Abraham M, et al. Targeting the CD20 and CXCR4 pathways in non-Hodgkin lymphoma with rituximab and high-affinity CXCR4 antagonist BKT140. Clin Cancer Res. 2013;19:3495–507.CrossRefPubMed Beider K, Ribakovsky E, Abraham M, et al. Targeting the CD20 and CXCR4 pathways in non-Hodgkin lymphoma with rituximab and high-affinity CXCR4 antagonist BKT140. Clin Cancer Res. 2013;19:3495–507.CrossRefPubMed
37.
Zurück zum Zitat Devine SM, Flomenberg N, Vesole DH, et al. Rapid mobilization of CD34+ cells following administration of the CXCR4 antagonist AMD3100 to patients with multiple myeloma and non-Hodgkin’s lymphoma. J Clin Oncol. 2004;22:1095–102.CrossRefPubMed Devine SM, Flomenberg N, Vesole DH, et al. Rapid mobilization of CD34+ cells following administration of the CXCR4 antagonist AMD3100 to patients with multiple myeloma and non-Hodgkin’s lymphoma. J Clin Oncol. 2004;22:1095–102.CrossRefPubMed
38.
Zurück zum Zitat Hartmann TN, Grabovsky V, Pasvolsky R, et al. A crosstalk between intracellular CXCR7 and CXCR4 involved in rapid CXCL12-triggered integrin activation but not in chemokine-triggered motility of human T lymphocytes and CD34+ cells. J Leukoc Biol. 2008;84:1130–40.CrossRefPubMed Hartmann TN, Grabovsky V, Pasvolsky R, et al. A crosstalk between intracellular CXCR7 and CXCR4 involved in rapid CXCL12-triggered integrin activation but not in chemokine-triggered motility of human T lymphocytes and CD34+ cells. J Leukoc Biol. 2008;84:1130–40.CrossRefPubMed
Metadaten
Titel
CXCR4 Expression is Associated with Poor Prognosis in Patients with Esophageal Squamous Cell Carcinoma
verfasst von
Masakazu Goto, MD
Takahiro Yoshida, MD, PhD
Yota Yamamoto, MD, PhD
Yoshihito Furukita, MD
Seiya Inoue, MD
Satoshi Fujiwara, MD
Naoya Kawakita, MD
Takeshi Nishino, MD
Takuya Minato, MD, PhD
Yasuhiro Yuasa, MD, PhD
Hiromichi Yamai, MD, PhD
Hirokazu Takechi, MD, PhD
Junichi Seike, MD, PhD
Yoshimi Bando, MD, PhD
Akira Tangoku, MD, PhD
Publikationsdatum
17.11.2015
Verlag
Springer International Publishing
Erschienen in
Annals of Surgical Oncology / Ausgabe 3/2017
Print ISSN: 1068-9265
Elektronische ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-015-4974-5

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