Formation of Polyploid Giant Cancer Cells Involves in the Prognostic Value of Neoadjuvant Chemoradiation in Locally Advanced Rectal Cancer
Formation of Polyploid Giant Cancer Cells Involves in the Prognostic Value of Neoadjuvant Chemoradiation in Locally Advanced Rectal Cancer
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多倍体巨癌细胞的形成涉及局部晚期直肠癌新辅助放化疗的预后价值
DOI：
10.1155/2019/2316436
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发表时间：
2019-08-29
影响因子：
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通讯作者：
Zhang, Shiwu
中科院分区：
文献类型：
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作者：
Fei, Fei;Zhang, Mingqing;Zhang, Shiwu
我们之前报道过，多倍体巨型癌细胞（PGCC）表现出癌症干细胞特性，并且可以产生具有上皮-间质转化表型的子细胞。本研究调查了 PGCC 形成在局部晚期直肠癌 (LARC) 新辅助放化疗 (nCRT) 预后价值中的作用。观察nCRT后LARC患者的形态学特征。用放射或化疗药物处理结直肠癌细胞系，并检测转移相关蛋白。收集了 304 例 nCRT 病例和 301 例配对的非 nCRT 病例进行分析。 nCRT后肿瘤组织中出现更多的PGCC和与侵袭转移相关的形态特征。辐射或化学物质可以诱导 PGCC 的形成，其子细胞表现出很强的迁移、侵袭和增殖能力。在 nCRT 后的患者中，病理完全缓解、部分缓解、疾病稳定和疾病进展分别为 29 例（9.54%）、125 例（41.12%）、138 例（45.39%）和 12 例（3.95%）。粘液腺癌（MC）在nCRT患者中的发生率高于非nCRT患者（χ2 = 29.352，P=0.001），并且MC患者的预后比非MC患者差（χ2 = 24.617，P=0.001）。 60天（χ2 = 5.357，P=0.021）和70天（χ2 = 18.830，P=0.001）休息间隔时间的生存时间差异有统计学意义。在多变量分析中，60 天休息间隔、Duke 分期以及复发和/或远处转移仍然是生存的重要预测因素。总之，辐射或化学物质诱导PGCCs的形成，并且PGCCs在长时间培养后产生具有较强迁移和侵袭能力的子细胞。适当的休息间隔（潜伏期）对于接受 nCRT 的 LARC 患者非常重要。
We previously reported that polyploid giant cancer cells (PGCCs) exhibit cancer stem cell properties and can generate daughter cells with the epithelial-mesenchymal transition phenotype. This study investigated the role of PGCC formation in the prognostic value of neoadjuvant chemoradiation therapy (nCRT) in locally advanced rectal cancer (LARC). The morphological characteristics were observed in patients with LARC after nCRT. Colorectal cancer cell lines were treated with irradiation or chemotherapeutic drugs, and the metastasis-related proteins were detected. 304 nCRT cases and 301 paired non-nCRT cases were collected for analysis. More PGCCs and morphologic characteristics related to invasion and metastasis appeared in tumor tissue after nCRT. Irradiation or chemicals could induce the formation of PGCCs with daughter cells exhibiting strong migratory, invasive, and proliferation abilities. In patients after nCRT, pathologic complete remission, partial remission, stable disease, and progressive disease were observed in 29 (9.54%), 125 (41.12%), 138 (45.39%), and 12 (3.95%) patients, respectively. Mucinous adenocarcinomas (MCs) occurred more frequently in nCRT than in non-nCRT patients (χ2 = 29.352, P=0.001), and the prognosis in MC patients was worse than that in non-MC patients (χ2 = 24.617, P=0.001). The difference in survival time had statistical significance for 60 days (χ2 = 5.357, P=0.021) and 70 days (χ2 = 18.830, P=0.001) rest interval time. On multivariable analysis, 60 days rest interval, Duke's stage, and recurrence and/or distant metastasis remained significant predictors of survival. In conclusion, irradiation or chemicals induce the formation of PGCCs and PGCCs produce daughter cells with strong migration and invasion abilities after a long incubation period. Appropriate rest interval (incubation period) is very important for patients with LARC who will receive nCRT.