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2015 ; 106
(4
): 466-74
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Spread of tumor microenvironment contributes to colonic obstruction through
subperitoneal fibroblast activation in colon cancer
#MMPMID25613547
Yokota M
; Kojima M
; Higuchi Y
; Nishizawa Y
; Kobayashi A
; Ito M
; Saito N
; Ochiai A
Cancer Sci
2015[Apr]; 106
(4
): 466-74
PMID25613547
show ga
We evaluated the influence of the cancer microenvironment formed by peritoneal
invasion (CMPI) on clinical findings in colon cancer patients. In addition to the
association with poor prognosis, we discovered a relationship with bowel
obstruction. Detailed analysis revealed that clinical findings related to bowel
obstruction occurred more frequently in patients with an elevated type tumor,
which had peritoneal elastic laminal elevation to the tumor surface, compared to
those with non-elevated type tumors among those with elastic laminal invasion
(ELI). Lateral tumor spread and increase of tumor annularity rate in ELI-positive
elevated type cases suggested the morphological progression from ELI-positive
non-elevated type to elevated type. In addition, ?-smooth muscle actin expression
was the highest in ELI-positive elevated type, and prominent expressions were
found not only in the deep tumor area but also in the shallow tumor area.
Furthermore, contraction assays revealed the robust contractile ability of
subperitoneal fibroblasts stimulated by cancer cell-conditioned medium. Our
findings suggest that CMPI spread into the luminal side of the colonic wall along
with tumor progression, which caused bowel obstruction through the activation of
subperitoneal fibroblasts. However, although the clinical outcome was not
different between the two types, the clinical findings were affected by the
spread of CMPI. We are the first to explore how the alteration of the
tumor-promoting microenvironment, along with tumor progression, contributes to
the development of clinical findings.