癌干细胞研究进展

关于肿瘤发生及发展的机制人们已探索多年,但由于肿瘤病因本身的复杂性、研究技术和知识积累不足等各种原因,研究进展缓慢。近些年来,癌干细胞的发现、确认和特性研究为肿瘤发病机制的揭示,乃至新型高效治疗策略的制定提出了新线索。许多研究成果显示,癌干细胞因具有自我更新和潜在的强增殖能力,在肿瘤发生发展、复发转移中均发挥着很重要的作用;肿瘤化疗的失败与肿瘤组织中癌干细胞的耐药性可能存在密切关系。本文就癌干细胞在这方面的研究进展及存在的问题作一综述。     

肿瘤干细胞研究进展

肿瘤干细胞（cancer stem cell, CSC）假说是近年来提出的关于肿瘤发生的新理论,在所有的肿瘤细胞中,可能只有一小部分细胞具有产生肿瘤并维持肿瘤生长和异质性的能力,目前已经在白血病、乳腺癌、脑癌等肿瘤组织中成功分离出了肿瘤干细胞,深入了解肿瘤干细胞的生物学特性、发展相应的鉴别方法以及特殊的治疗手段对癌症的临床治疗有着重要的意义。主要从肿瘤干细胞的概念、起源、鉴定分离方法、与正常干细胞的比较、比率以及与肿瘤转移的关系等方面进行了综述。     

抑癌基因OVCA1的研究进展

随着肿瘤分子生物学技术及学科的发展,人们认识到癌症是一种基因疾病,肿瘤的发生发展是多种基因参与的复杂过程,包括癌基因的异常激活和肿瘤抑制基因失活。新近分离鉴定的重要的肿瘤抑制基因——卵巢癌基因1(OVCA1)在多种肿瘤中存在高频率的缺失和突变,对多种癌细胞增殖有明显的抑制作用,可能作用于肿瘤发生的早期阶段,在哺乳动物中高度保守,提示在细胞中具有重要作用;OVCA1可能具有调控细胞周期、翻译、DNA损伤及胚胎发育等生物功能,具体作用机制尚不明确;体外研究显示,OVCA1的缺失表达导致肿瘤发生可能与周期蛋白D1上调表达、P16下调表达相关,与p53基因突变可能存在相互作用;OVCA1的缺失表达与卵巢癌发生发展及预后密切相关,与宫颈癌及人乳头瘤病毒感染、乳腺癌等恶性肿瘤的关系尚在研究中。我们简要综述了OVCA1基因的国内外研究进展,为卵巢癌等恶性肿瘤进行基因水平的诊治提供理论依据。     

Oct4在晚期浆液性卵巢癌中的表达及意义

目的:卵巢癌是女性生殖器官常见的恶性肿瘤,肿瘤干细胞理论认为卵巢癌中存在肿瘤干细胞,并且肿瘤干细胞是肿瘤复发、转移、耐药的罪魁祸首.Oct4是细胞干细胞特性的重要标志之一.本文旨在探讨Oct4蛋白在晚期浆液性卵巢癌的表达情况,并分析其表达水平与患者临床病理特征之间的关系.方法:采用免疫组化法检测101例晚期浆液性卵巢癌中Oct4蛋白的表达情况,并结合临床资料分析Oct4蛋白的表达水平在晚期浆液性卵巢癌患者中的意义.结果:晚期浆液性卵巢癌患者中Oct4阳性表达率为87.1％ (88/101),其表达水平和患者的年龄、病理分化程度、淋巴结转移情况及临床分期无明显相关性(P＞0.05),但是其高表达与化疗耐药明显相关(P=0.023).结论:我们的研究证明Oct4在晚期浆液性卵巢癌中有较高表达,并且Oct4的表达与卵巢癌化疗后复发有关;理论上支持在晚期浆液性卵巢癌中可能存在肿瘤干细胞,且比例较高,肿瘤干细胞的比率和卵巢癌化疗耐药相关.Oct4可能是晚期浆液性卵巢癌治疗的新靶点.     

干细胞、肿瘤干细胞与肿瘤

干细胞是一种具有自我更新、无限增殖和多向分化能力的细胞.而多数肿瘤是由不同增殖潜能的不均一性细胞构成.随着对干细胞的研究不断深入,使人们对肿瘤的发生机制重新进行了审视,并在造血系统、脑、肺、乳腺等部位肿瘤中发现极少量的具有与干细胞非常类似生物学特性的细胞,称之为肿瘤干细胞,它们很可能是肿瘤细胞的起源.肿瘤干细胞的提出.使得靶向性杀伤肿瘤干细胞从而使根治肿瘤和防止肿瘤复发和转移成为可能.所以研究肿瘤干细胞的起源及其与肿瘤的发生关系,成为当前研究和治疗肿瘤领域的新热点.本文就肿瘤干细胞的存在证据、干细胞与肿瘤干细胞的异同点及它们与肿瘤发生之间的关系作简要的综述.     

Nanog 基因在卵巢癌和卵巢肿瘤干细胞中的表达及意义

目的:探讨胚胎干细胞关键因子Nanog基因mRNA及其蛋白在卵巢癌和卵巢癌肿瘤干细胞中的表达及意义。方法:选取10例正常卵巢上皮组织、10例卵巢良性肿瘤及60例卵巢癌组织,采用逆转录酶-聚合酶链反应(RT-PCR)方法和免疫组织化学PV-6000两步法检测Nanog mRNA和蛋白表达水平;采用无血清悬浮培养法从SKOV-3卵巢癌细胞株中分离培养肿瘤干细胞,流式细胞术鉴定肿瘤干细胞CD117表达,采用RT-PCR和Western Blot方法检测SKOV-3卵巢癌细胞及肿瘤干细胞中NanogmRNA及其蛋白的表达水平。结果:Nanog mRNA在卵巢癌组织中的表达水平均高于正常卵巢组织和卵巢良性肿瘤组织(P<0.05);Nanog mRNA在不同分化程度及临床分期的卵巢癌组织中表达水平不同,低分化组高于高分化组(P<0.05);III-IV期高于I-II期(P<0.05);免疫组化结果同RT-PCR。从SKOV-3卵巢癌细胞株中成功分离出肿瘤干细胞,SKOV-3卵巢癌细胞和肿瘤干细胞Nanog mRNA相对含量分别为0.6044±0.0368,0.8736±0.0537,差异具有统计学意义(P<0.05),两种细胞Nanog蛋白相对含量分别为0.6364±0.0169 1.2788±0.0314,差别具有统计学意义(P<0.05)。结论:Nanog基因在卵巢癌组织和SKOV-3细胞系中均高表达,其在组织中的表达强度与临床分期及病理分级关系密切,且在肿瘤干细胞中表达高于一般卵巢癌细胞,其与卵巢癌的发生发展关系密切,可能是卵巢癌干细胞的表面标志物,有望成为新的标志物。     

肿瘤干细胞的代谢

肿瘤干细胞(cancer stem cells, CSCs)又称为肿瘤起始细胞(tumor initiating cells, TICs),是一类具有干细胞样特性的细胞群,能够起始肿瘤发生并具有自我更新和分化能力,是导致肿瘤异质性的主要原因之一,且呈现高度的化疗不敏感性和化疗耐药性,对于肿瘤的发生发展以及肿瘤复发至关重要。近年来,肿瘤代谢在肿瘤发生发展中的重要地位日益凸显,虽然分化的肿瘤细胞与肿瘤干细胞都呈现出适应性的代谢重编程(metabolic reprogramming),但是目前观点认为,肿瘤干细胞的代谢特征具有其特异性,从而满足其生存需求,并维持其干性和自我更新。关于肿瘤干细胞的特异性代谢特征至今并未达成共识。一些研究发现,肿瘤干细胞主要依赖有氧糖酵解供能。但也有研究指出,线粒体代谢是其主要能量来源。肿瘤干细胞似乎表现出更好的代谢适应性,能够转变其代谢偏好以更好的适应其生存环境的改变。关注肿瘤干细胞代谢异常和通路的改变,将有望为肿瘤治疗寻找代谢弱点(vulnerability)和作用靶标。基于现有的肿瘤干细胞相关研究,本文综述了有关肿瘤干细胞鉴别和分离培养的方法,着重介绍了肿瘤干细胞的糖代谢、脂肪酸代谢和氨基酸代谢特征,也讨论了肿瘤微环境对肿瘤干细胞代谢的影响,强调了靶向肿瘤干细胞代谢结合化疗药物的治疗策略,从而有助于临床寻找更为有效的肿瘤治疗手段。     

间充质干细胞融合在肿瘤转移中的研究进展

侵袭转移是恶性肿瘤的基本特征和重要标志,也是导致肿瘤患者死亡的主要原因。上皮-间质转化(epithelial-mesenchymal transition,EMT)是肿瘤侵袭转移的首要步骤。研究表明,细胞融合是肿瘤发生转移过程中的常见现象之一。间充质干细胞(mesenchymal stem cell,MSC)是细胞融合中广泛涉及的一种重要细胞,并通过细胞融合在肿瘤发生转移过程中发挥重要作用。本文主要综述了间充质干细胞与肿瘤细胞融合在肿瘤转移中的最新研究进展,其机制的阐明有可能为肿瘤治疗提供新的策略。     

肿瘤干细胞与肿瘤转移

近年来,肿瘤干细胞(cancer stem cell,CSC)学说研究认为CSC与肿瘤发生、发展、转移和复发关系极为密切。研究还发现CSC具有明显的异质性,即CSC可分为增生、耐药、侵袭和转移等行为不同的亚群细胞,其中具有转移生物学特性的CSC亚群细胞称为肿瘤转移干细胞(migrating cancer stem cell,MCSC)。目前认为,上皮-间质转变、趋化因子和靶器官微环境可能在肿瘤转移过程中起着重要作用。针对MCSC及其相关机制的靶向治疗有望能更有效地遏制肿瘤的转移。     

肿瘤干细胞鉴定方法

肿瘤干细胞假说是近年来提出的关于肿瘤发生的新理论,该理论认为肿瘤组织中仅有一小部分细胞可以产生肿瘤并且维持肿瘤生长。在体内外如何鉴定这种具有启动以及保持肿瘤生长的细胞类型,成为肿瘤基础及应用研究的关键问题。目前已经在白血病、乳腺癌、神经胶质瘤等肿瘤中成功鉴定并分离出肿瘤干细胞,这对于肿瘤的临床治疗具有重要意义。本文主要从肿瘤干细胞的鉴定及其在临床研究中的应用等方面进行综述。     

Stem Cell-Like Gene Expression in Ovarian Cancer Predicts Type II Subtype and Prognosis

Although ovarian cancer is often initially chemotherapy-sensitive, the vast majority of tumors eventually relapse and patients die of increasingly aggressive disease. Cancer stem cells are believed to have properties that allow them to survive therapy and may drive recurrent tumor growth. Cancer stem cells or cancer-initiating cells are a rare cell population and difficult to isolate experimentally. Genes that are expressed by stem cells may characterize a subset of less differentiated tumors and aid in prognostic classification of ovarian cancer. The purpose of this study was the genomic identification and characterization of a subtype of ovarian cancer that has stem cell-like gene expression. Using human and mouse gene signatures of embryonic, adult, or cancer stem cells, we performed an unsupervised bipartition class discovery on expression profiles from 145 serous ovarian tumors to identify a stem-like and more differentiated subgroup. Subtypes were reproducible and were further characterized in four independent, heterogeneous ovarian cancer datasets. We identified a stem-like subtype characterized by a 51-gene signature, which is significantly enriched in tumors with properties of Type II ovarian cancer; high grade, serous tumors, and poor survival. Conversely, the differentiated tumors share properties with Type I, including lower grade and mixed histological subtypes. The stem cell-like signature was prognostic within high-stage serous ovarian cancer, classifying a small subset of high-stage tumors with better prognosis, in the differentiated subtype. In multivariate models that adjusted for common clinical factors (including grade, stage, age), the subtype classification was still a significant predictor of relapse. The prognostic stem-like gene signature yields new insights into prognostic differences in ovarian cancer, provides a genomic context for defining Type I/II subtypes, and potential gene targets which following further validation may be valuable in the clinical management or treatment of ovarian cancer.     

Enrichment for Chemoresistant Ovarian Cancer Stem Cells from Human Cell Lines

Cancer stem cells (CSCs) are defined as a subset of slow cycling and undifferentiated cells that divide asymmetrically to generate highly proliferative, invasive, and chemoresistant tumor cells. Therefore, CSCs are an attractive population of cells to target therapeutically. CSCs are predicted to contribute to a number of types of malignancies including those in the blood, brain, lung, gastrointestinal tract, prostate, and ovary. Isolating and enriching a tumor cell population for CSCs will enable researchers to study the properties, genetics, and therapeutic response of CSCs. We generated a protocol that reproducibly enriches for ovarian cancer CSCs from ovarian cancer cell lines (SKOV3 and OVCA429). Cell lines are treated with 20 µM cisplatin for 3 days. Surviving cells are isolated and cultured in a serum-free stem cell media containing cytokines and growth factors. We demonstrate an enrichment of these purified CSCs by analyzing the isolated cells for known stem cell markers Oct4, Nanog, and Prom1 (CD133) and cell surface expression of CD177 and CD133. The CSCs exhibit increased chemoresistance. This method for isolation of CSCs is a useful tool for studying the role of CSCs in chemoresistance and tumor relapse.     

Cancer stem cells and angiogenesis

Cancer stem cells (CSCs) or tumor initiating cells were identified and characterized as a unique subpopulation with stem cell features in many types of cancer. Current CSC studies provide novel insights regarding tumor initiation, progression, angiogenesis, resistance to therapy and interplay with the tumor micro-environment. A cancer stem cell niche has been proposed based on these findings. The niche provides the soil for CSC self-renewal and maintenance, stimulating essential signaling pathways in CSCs and leading to secretion of factors that promote angiogenesis and long term growth of CSCs. We present evidence which has emerged over the past 5 years indicating interaction of CSCs with angiogenesis in the proposed "vascular niche". Based on these findings, targeting the "cancer stem cell niche" by combining an individualized anti-CSC approach with treatment of their microenvironment may represent a novel therapeutic strategy against solid tumor systems.     

In vitro Enrichment of Ovarian Cancer Tumor-initiating Cells

Evidence suggests that small subpopulations of tumor cells maintain a unique self-renewing and differentiation capacity and may be responsible for tumor initiation and/or relapse. Clarifying the mechanisms by which these tumor-initiating cells (TICs) support tumor formation and progression could lead to the development of clinically favorable therapies. Ovarian cancer is a heterogeneous and highly recurrent disease. Recent studies suggest TICs may play an important role in disease biology. We have identified culture conditions that enrich for TICs from ovarian cancer cell lines. Growing either adherent cells or non-adherent ‘floater’ cells in a low attachment plate with serum free media in the presence of growth factors supports the propagation of ovarian cancer TICs with stem cell markers (CD133 and ALDH activity) and increased tumorigenicity without the need to physically separate the TICs from other cell types within the culture. Although the presence of floater cells is not common for all cell lines, this population of cells with innate low adherence may have high tumorigenic potential.Compared to adherent cells grown in the presence of serum, TICs readily form spheres, are significantly more tumorigenic in mice, and express putative stem cell markers. The conditions are easy to establish in a timely manner and can be used to study signaling pathways important for maintaining stem characteristics, and to identify drugs or combinations of drugs targeting TICs. The culture conditions described herein are applicable for a variety of ovarian cancer cells of epithelial origin and will be critical in providing new information about the role of TICs in tumor initiation, progression, and relapse.     

Presence and role of stem cells in ovarian cancer

Ovarian cancer is the deadliest gynecological malignancy. It is typically diagnosed at advanced stages of the disease, with metastatic sites disseminated widely within the abdominal cavity. Ovarian cancer treatment is challenging due to high disease recurrence and further complicated pursuant to acquired chemoresistance. Cancer stem cell(CSC) theory proposes that both tumor development and progression are driven by undifferentiated stem cells capable of self-renewal and tumor-initiation. The most recent evidence revealed that CSCs in terms of ovarian cancer are not only responsible for primary tumor growth, metastasis and relapse of disease, but also for the development of chemoresistance. As the elimination of this cell population is critical for increasing treatment success, a deeper understanding of ovarian CSCs pathobiology, including epithelial-mesenchymal transition, signaling pathways and tumor microenvironment, is needed. Finally, before introducing new therapeutic agents for ovarian cancer, targeting CSCs, accurate identification of different ovarian stem cell subpopulations, including the very small embryoniclike stem cells suggested as progenitors, is necessary. To these ends, reliable markers of ovarian CSCs should be identified. In this review, we present the current knowledge and a critical discussion concerning ovarian CSCs and their clinical role.     

Cancer stem cells--old concepts, new insights

Cancer has long been viewed as an exclusively genetic disorder. The model of carcinogenesis, postulated by Nowell and Vogelstein, describes the formation of a tumor by the sequential accumulation of mutations in oncogenes and tumor suppressor genes. In this model, tumors are thought to consist of a heterogeneous population of cells that continue to acquire new mutations, resulting in a highly dynamic process, with clones that out compete others due to increased proliferative or survival capacity. However, novel insights in cancer stem cell research suggest another layer of complexity in the process of malignant transformation and preservation. It has been reported that only a small fraction of the cancer cells in a malignancy have the capacity to propagate the tumor upon transplantation into immuno-compromised mice. Those cells are termed 'cancer stem cells' (CSC) and can be selected based on the expression of cell surface markers associated with immature cell types. In this review, we will critically discuss these novel insights in CSC-related research. Where possible we integrate these results within the genetic model of cancer and illustrate that the CSC model can be considered an extension of the classic genetic model rather than a contradictory theory. Finally, we discuss some of the most controversial issues in this field.     

YAP/TEAD Co-Activator Regulated Pluripotency and Chemoresistance in Ovarian Cancer Initiated Cells

Recent evidence suggests that some solid tumors, including ovarian cancer, contain distinct populations of stem cells that are responsible for tumor initiation, growth, chemo-resistance, and recurrence. The Hippo pathway has attracted considerable attention and some investigators have focused on YAP functions for maintaining stemness and cell differentiation. In this study, we successfully isolated the ovarian cancer initiating cells (OCICs) and demonstrated YAP promoted self-renewal of ovarian cancer initiated cell (OCIC) through its downstream co-activator TEAD. YAP and TEAD families were required for maintaining the expression of specific genes that may be involved in OCICs'' stemness and chemoresistance. Taken together, our data first indicate that YAP/TEAD co-activator regulated ovarian cancer initiated cell pluripotency and chemo-resistance. It proposed a new mechanism on the drug resistance in cancer stem cell that Hippo-YAP signal pathway might serve as therapeutic targets for ovarian cancer treatment in clinical.     

肿瘤干细胞分离研究进展

癌症是严重威胁人类生命健康的疾病之一,传统治疗方法未能彻底根除癌症。究其原因是癌症的发病机制复杂,至今尚未完全认识。肿瘤干细胞理论的提出为肿瘤的发生、发展乃至术后复发提供了新的研究思路,同时也为癌症的治疗带来了新的曙光。但由于肿瘤干细胞含量极低、分离困难,给肿瘤干细胞的研究带来诸多不便。目前常用的分离方法为无血清培养法与流式分选法,但二者均存在一定的缺陷,因此亟须建立一种新型有效地分离方法。肿瘤干细胞与普通干细胞有许多相似的信号通路,因此可利用干细胞的微环境筛选分离分化程度较低的肿瘤干细胞。水凝胶由于其独特的性质,目前广泛用于细胞的三维培养。有鉴于此,科研工作者利用水凝胶模拟普通干细胞生长的力学环境筛选、富集肿瘤干细胞。本文就肿瘤干细胞目前常用分离及鉴定方法,同时结合国内外最新的肿瘤干细胞分离方法进行综述。     

Establishment of human ovarian serous carcinomas cell lines in serum free media

Ovarian cancers are the fifth leading cause of cancer death among US woman. The majority of ovarian cancers belong to a category of serous adenocarcinomas. This type of cancer is often diagnosed at a late stage of the disease. Surgical debulking, followed by chemotherapy is the current treatment. Half of all patients will die within 5 years of diagnosis of the disease. Poor survival may be due to disease progression as a consequence of development of drug resistance, cancer cell heterogeneity within the tumor, or the persistence of cancer stem cells. Cancer stem cells (CSC) are defined as a minority cell type in the tumor, which retains the capacity, through asymmetric division, for self-renewal as well as differentiation into multiple cell types. Through this process, CSC can regenerate the entire tumor phenotype and subsequent metastases. Initial in vitro work in the area of solid tumor CSC biology has focused on the isolation and propagation of cells with CSC-like properties from breast and colon tumors. Breast and colon cell lines with CSC-like properties have been isolated and maintained in vitro for extended periods of time. The in vitro maintenance of these CSC requires growth in hormone-supplemented serum-free media and the use of matrix or growth as tumor spheres (Roberts, Ricci-Vitiani et al., Cammareri et al.). Based on the pioneering work generating breast and colon CSC, our lab has begun to develop methods for the establishment cell lines with CSC-like properties from additional solid tumors. In this article, we describe methods, using defined medium, which allow for the successful establishment of continuous cell cultures from a minority cell type within serous ovarian cancers. The cell lines established using these methods grow in serum-free hormone-supplemented medium either as a monolayer on a matrix, or as tumor spheres in suspension. These cells express markers previously reported for tumor stem cells, including CD44 and CD133, and form tumors that recreate the morphology of the original patient tumor when implanted in immune deficient mice. The introduction of this method will facilitate the expansion of ovarian cancer cells for investigating cancer stem cell biology as well as providing tools to aid in the development of new treatments for this deadly disease.