肺癌是严重威胁人类生存和发展的恶性疾病之一,已成为肿瘤疾病中的头号杀手。2006年,美国确诊肺癌新病例约174 470人,约占全部肿瘤的13%(男性)和12%(女性),发病率仅次于皮肤癌;死于肺癌者约162 460人,约占全部肿瘤的31%(男性)和26%(女性),死亡率位居第一[1,2]。日本每年肺癌新发病例超过50 000人,死亡率近90%[3]。上海市近年的恶性肿瘤发病调查显示,肺癌(21.56%)高居上海男性恶性肿瘤发病率榜首,在女性则仅次于乳腺癌[4]。肺癌死亡率长期居高不下的主要原因在于难以早期诊断及其高转移性,许多患者首诊时即发现有多器官转移[5]。由于肺癌的发病和转移的生物学机制至今尚不明确,临床缺乏有效的治疗方法,因此,研究肺癌发病机制并探索有效的诊疗方法是国内外学者长期以来的努力方向。
由于肺癌转移的发生大多见于晚期的手术禁忌患者,临床标本取材受限,这在很大程度上迟滞了肺癌转移诊疗研究的进展。因此,如能建立有效的国人肺癌转移细胞及其动物模型,不仅能打破取材困难的瓶颈,而且所建模型可以通过多代筛选富集,更有效地发现转移相关功能基因,进而利用所建模型直接进行干预性治疗研究,其优越性是临床标本所难以企及的。
2007年4月,作者取自一名女性肺腺癌IV期患者腹水建成体外培养的肺腺癌细胞系,命名为CPA-Yang2。现报道如下。
1 材料与方法
1.1 资料
患者,女,56岁,一年半前因咳嗽1月伴左胸痛且胸闷气急来我院就诊并收住入院。胸片和胸部CT示左肺下叶块影伴胸水,胸水细胞学检测为腺癌。化疗10次、放疗1次临床评价均为NR。后体检发现双锁骨上淋巴结肿大;B超示胸水和腹水。体液引流送检细胞学再次诊断为肺腺癌。腹水肿瘤标志物放射免疫检测:CA125、CYFRA21-1、CEA和NSE严重超标。
1.2 CPA-Yang2建立过程
采集新鲜腹水50 mL分别放入3个细胞培养瓶,每瓶加入少许含10%胎牛血清的RPMI-1640培养液和双抗后摇匀,放入培养温度为37 oC、CO2浓度为5%的德国贺利氏BB16型二氧化碳孵养箱内培养。5天后光镜下观察时发现细胞培养瓶底约有70%的面积已长满细胞。早期细胞形态以圆形和椭圆形为主,很少量为梭形,细胞核明显,呈贴壁状生长;各代细胞始终保持旺盛代谢;细胞形态稳定,即使传至第45代,细胞形态和生长速度不变。冻存后复苏良好。
1.3 CPA-Yang2染色体核型分析
按常规方法制备中期染色体标本,自然干燥。选择分散好的分裂中期染色体进行染色体计数和显微照相、配对以及核型分析。
1.4 绘制CPA-Yang2的细胞生长曲线
取第6代、第26代和第46代3组细胞,分别制成2×105个/mL的细胞悬液,吸1 mL加入35 mL细胞培养皿;再加入19 mL含10%胎牛血清的DMEM培养液做细胞培养。每组每天3个培养皿,连续8天细胞计数并绘制生长曲线。
1.5 定量RT-PCR法测定CPA-Yang2的ESM1[6]、VEGF-C[7]、IL-6[8]、IL-8[9]和AR[10]基因表达水平
以SPC-A-1国人肺腺癌细胞为基准,GAPDH为内参,CPA-Yang2为待测细胞样本。细胞总RNA经Trizol试剂(GibcoBRL, Carlsbad, USA)抽提后,行RNA逆转录(Promega, San Luis Obispo, CA, USA)。按ESM1、VEGF-C、IL-6、IL-8、AR序列设计引物(表1)。 定量RT- PCR仪(ABI Prism 7900 Sequence Detection System(Applied Biosystems, Foster City, CA, USA))使用SYBR Green Mastermix药盒(TaKaRa, Kyoto, Japan),检测所得到CT值输出到Microsoft Excel 中去。通过GAPDH均一化处理,我们对目标基因的表达变化进行计算。每一样本进行了三复孔的定量PCR,取平均值后,数据分析采用公式如下:
ΔCt= Ctsample-Ctcon;ΔΔCt=ΔCt(geneX)-ΔCt (GAPDH)
Power值是通过计算后取结果的平均值[11]。
1.6 裸鼠心内注射CPA-Yang2造模
实验动物均采用BALB/c裸鼠,8周龄–10周龄, 体重18 g–20 g,雄性。由上海市肿瘤研究所提供,并在SPF环境下饲养。
1.7 放射性核素荷瘤小鼠活体成像[12,13]
CPA-Yang2第3代、第8代、第15代细胞分别制成浓度为1×107个/mL的细胞悬液种植裸鼠尾静脉或左心室,接种量分别为1.5×106个/只或1×106个/只。3周–4周后每周做同位素骨扫描。每只小鼠尾静脉注射骨显像剂Tc-99m MDP 111MBq,体积0.1 mL,5 h–6 h后分别在SINMENS MULTI-SPECT(Siemens Medical Systems, Inc., Hoffman Estates, II., USA) 行平面显像及在GE Hawkeye4 Infinia Functional Imaging Scanner (GE Medical Systems, Inc., Waukesha, USA) 行微孔针孔显像。平面显像矩阵为256×256,Zoom为2.67。采集计数为300 K/帧–500 K/帧;微孔针孔显像矩阵为1 024×1 024,Zoom为1。采集体位为前后位、后前位、左侧位和右侧位。发现放射性分布异常的骨组织后做好记录,以便无痛处死小鼠后将可疑骨转移灶取出做病理和转移细胞的体外培养。
1.8 病理检测
通过影像学检测发现肿瘤骨转移灶后处死裸鼠,无菌条件下取可疑的肿瘤转移灶如骨、心、肺、肝、脑、肾、肾上腺、淋巴结等。各组织10%甲醛固定,石蜡包埋,切片,HE染色,光镜下观察裸鼠肿瘤转移情况。
2 结果
2.1 CPA-Yang2细胞形态
在相差倒置显微镜下观察CPAYang2细胞生长情况。胰酶消化后计数2×105个细胞加入一细胞培养瓶按常规细胞培养,在第2代和第8代的细胞相差显微镜图中可见细胞呈贴壁生长(图 1)。
2.2 致瘤率
自采集新鲜腹水做细胞培养的第3天已发现所有细胞培养瓶底都有部分细胞长出;至第8天,对3瓶长满培养瓶底的细胞用胰酶消化,取细胞数约为6×106个,用生理盐水洗2遍后制成细胞悬液,浓度调整为1×107个/mL。分别接种在3只免疫缺陷小鼠两侧皮下。接种60天未见瘤体生长。传代直至第8代给5只裸鼠左右两侧皮下种植30天后仅见2只鼠长3只瘤。传代至第11代给5只裸鼠单侧皮下种植1×106 个CPA-Yang2细胞/只,2周后可见裸鼠100%致瘤。
2.3 CPA-Yang2细胞生长曲线
取第6代、第26代和第46代细胞分别制成2×105个/mL细胞悬液,吸入35 mL细胞培养皿培养;每2天计数,连续8天,可见第2天–第4天为指数增殖期。第6代、第26代和第46代细胞的群体倍增时间分别为26.3 h、26.05 h和24 h(图2)。
2.4 染色体分析
取第11代CPA-Yang2的50个中期分裂相细胞的染色体进行分析,各细胞内染色体数目分布在54–66之间。主流数为60–64。染色体条数增加的前三位是:第20(3.6)号、16(3.4)号和并列第三的17号、21(3)号,无缺失。CPA-Yang2细胞的染色体核型分析图(图3)。
2.5 ESM1、VEGF-C、IL-6、IL-8和AR基因表达水平
RTPCR法对国人肺腺癌细胞CPA-Yang2及其脑、肝、肾上腺和骨转移细胞和SPC-A-1进行ESM1、VEGF-C、IL-6、IL-8和AR基因表达水平的比较(图4)。
2.6
CPA-Yang2是除骨转移以外具有多脏器转移的细胞株第11代后的亲代细胞经裸小鼠体内诱导后给每只裸鼠左心室或尾静脉分别接种1×106个(0.1 mL)、1.5×106个细胞(0.15 mL),3周–4周后经自创微孔针孔活体成像方法能检出100%骨转移[11];解剖肉眼发现有30%脑转移、50%肺转移、60%肝和80%肾上腺转移;90%的鼠在核素骨显像检出时不能被X线检出骨转移灶。检出的骨转移灶主要集中在:下颌骨、脊柱、膝关节、肱骨、肋骨、肩胛骨(图5)。
2.7 病理
荷瘤CPA-Yang2小鼠的多脏器转移(图6)。
图 1 CPA-Yang2第2代(A)、第8代(B)细胞相差显微镜照片(×100) Fig 1 The CPA-Yang2 cells under the contrast phase microscope (×100) A shows the CPA-Yang2 cells in second passage; B shows in eighth passage.
图 3 染色体G分带图(A)和染色体核型分析图(B) Fig 3 Chromosomal instability in human lung adenocarcinoma cell line CPA-Yang2 A shows G-banding of chromosome; B shows chromosomal karyotype analysis.
图 4 RT-PCR法比较CPA-Yang2及其脑、肝、肾上腺、骨转移亚系与SPC-A-1部分基因ESM1、VEGF-c、IL-6、IL-8、AR的表达水平 Fig 4 Real-time PCR was performed on CPA-Yang2 and its sublines compare with SPC-A-1 to evaluate the expression changes of genes
图 5 微孔针孔核素骨显像检测小鼠骨转移(后前位) A:箭头所指左右下颌骨和左肱骨转移;B:上箭头示左右下颌骨转移,下两箭头示左右肩胛骨转移;C:箭头所指左肋骨转移。 Fig 5 The pinhole bone scintigraphy detected bone metastasis in vivo mice. A: Arrows show jaw bones and left humerus metastases; B: Arrows show jaw bones and shoulder blades metastases; C: Arrows show left rib metastasis.
图 6 CPA-Yang2经血道接种后引发小鼠多脏器转移病理(HE, ×40) A:视网膜转移;B:脑转移;C:肝转移;D:肋骨转移;E:肺转移;F:肾上腺转移。 Fig 6 Histological features of multi-organ metastases in the mouse with CPA-Yang2 (HE, ×40) A shows eye metastasis from; B brain metastasis; C shows liver metastasis; D shows rib metastasis; E shows lung metastasis; F shows adrenal metastasis.
3 讨论
肺癌的转移、复发和耐药是肺癌治疗的难题。然而,肺癌转移尤其是靶向转移(肿瘤细胞向特定器官进行转移)和耐药的分子机理还不清楚。肺腺癌的发病率呈逐年上升趋势,而且非常容易发生骨、脑、肝脏等脏器的转移,这样的病人大都耐药,由于对化疗药物不敏感,因此预后很差。肿瘤转移相关分子的研究一直在开展,也发现了各种各样的分子如降解细胞基质的分子、细胞黏附分子、转移和耐药相关糖蛋白等等,但都没有对肿瘤向特定器官进行转移的机制进行说明。
建立肺癌转移细胞及其动物模型的理论基础在于肿瘤细胞内自发转移大多具有相对固定的靶组织。经研究发现,这一特性是由肿瘤组织中少量亚群细胞所决定的,而大部分的肿瘤细胞并不具备转移致瘤能力[14,15]。Luzzi等[15]通过动态成像技术追踪体内肿瘤细胞发现,在进入循环系统的肿瘤细胞中只有约0.02%的细胞能最终锚定于转移靶点并形成肿瘤转移灶。而当转移灶形成后,其中的转移性肿瘤细胞因筛选后的优势生长比例较原发灶显著提高。在一定的条件下,该类细胞会按相对固定的模式在特定靶组织形成肿瘤转移灶。因此,肿瘤细胞株经反复多代接种免疫缺陷动物筛选后,此类亚群细胞得到有效的富集,靶组织转移率渐进升高。因而从某种程度来讲,以肿瘤转移模型筛选肿瘤转移相关基因的效率甚至优于临床标本。同时,转移细胞及其动物模型本身也为今后抗肿瘤转移药物的研发提供了高效的研究工具。
AR是一种配体依赖的转录因子,除脾和骨髓外,广泛表达于其它器官。 闫明等[10]采用免疫组化法检测105例肺癌手术标本中雌激素受体(ER)和雄激素受体(AR)的表达,实验的结论为:ER阳性表达与肺癌生物学行为无关。AR阳性表达与肺癌进展和淋巴结转移程度相关。 Stabile等[16]发现肺癌的发生可能与性激素及其受体的作用有关。但总体来看,国内外有关性激素与肿瘤的研究报道不少,各自研究的方法和结论也不尽相同,甚至截然相反。有关性激素受体与肺癌的研究不多,尤其是雄激素受体和肺癌的报道更少;雄激素受体与肺腺癌骨转移的研究至今未见有报道。在本研究中虽然骨转移细胞比亲代细胞AR表达上调,但要证明它的普遍意义还有待于进一步研究。
本研究开发了具有自主知识产权的国人多器官转移的专利细胞系,旨在通过分离纯化出来的向特定器官进行转移的骨转移、脑转移、肝脏转移、肺转移细胞系进行系统地全基因组芯片和microRNA芯片分析,将基因或microRNA的表达变化与基因组的扩增或缺失相联系,并结合microRNA的靶标数据库(miRBase),筛选位于基因组上缺失或扩增区域的同时有表达变化的microRNA,将这些microRNA的调控靶标(即受这些microRNA调控的基因)与在各转移细胞中表达发生变化的且位于基因组缺失或扩增区域的基因进行比较,挑选重叠的基因进行研究,这样有利于发现关键的或起决定作用的与靶向转移相关的基因或microRNA,可以深入揭示肺腺癌靶向转移的分子机理,为阻断转移提供候选的分子靶标,可服务于肺腺癌病人的检测,评估其发生转移以及转移部位的风险,从而为有针对性地治疗提供依据,分子靶标功能的明确也为今后分子靶向治疗奠定基础。
4 结论
国人新颖肺腺癌细胞CPA-Yang2是个高潜能多器官转移细胞系,由于它的背景材料也可能是个耐药细胞系。总之,要真正了解其本质还得进行合理的实验构思和艰苦的劳动,不过该细胞在今后的肺癌分子生物学的研究中必将发挥重要的作用。
鸣谢
衷心感谢叶剑定、冯久贤、包国良、江一峰、郑志春等专家、同道和放射科技术组的同志们长期以来对本研究给予热情的支持和大力协助,以及中科院生命科学院健康研究所胡斌在RT-PCR检测中的精益求精。
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1Department of Nuclear Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai 200030, China; 2Department of Pathology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai 200030, China; 3Department of Pathology, Shanghai First Maternity and Infant Health Hospital, Tongji University, Shanghai 200040, China; 4Shanghai Prenatal Diagnosis Center, Shanghai First Maternity and Infant Health Hospital, Tongji University, Shanghai 200040, China
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Abstract
背景与目的 肺癌的复发、转移和耐药是肺癌治疗的难题。本研究旨在建立国人肺腺癌转移细胞株,为肺癌的发生、发展和耐药的研究提供新的实验模型。方法 本细胞取自化疗10次、放疗1次临床认定均无效的56岁女性肺腺癌患者的腹水且放射免疫法肿瘤标志物检测CA125、CYFRA21-1、CEA和NSE均超标,细胞原代培养即获成功。免疫缺陷小鼠致瘤率实验,绘制细胞生长曲线,细胞染色体核型分析,荧光定量PCR检测部分基因表达。结果 传自第8代细胞经裸小鼠皮下种植致瘤率仅30%,传自第11代且以后各代均表现稳定的致瘤率(100%),体外培养细胞在显微镜下显示为贴壁生长,该细胞的染色体核型分析为亚三倍体;经裸鼠左心室或尾静脉分别接种1×106个细胞(0.1 mL)、1.5×106个细胞(0.15 mL),2周后陆续出现小鼠体重下降,第3周经核素骨显像检测和病理确定为骨转移达100%,同时伴有各脏器转移:脑(30%)、肺(50%)、肝(60%)和肾上腺(80%)。 荧光定量PCR检测ESM1、VEGF-C、IL-6、IL-8、AR等基因过表达。结论 新建的CPA-Yang2是取自化疗10次、放疗1次均NR的肺腺癌病人腹水培养成功并经裸鼠血道种植后具有除多发骨转移外同时伴有脑、肝、肾上腺和肺转移特性的国人肺腺癌细胞株,细胞代谢旺盛,性状稳定。该细胞将成为国人肺癌研究的又一个良好细胞实验模型。
Background and objective The recurrence, metastasis and multidrug resistance (MDR) in lung cancer are the tough problems worldwide. This study was to establish a novel chinese lung adenocarcinoma cell line with high metastasis potential for exploring the mechanism of reccurrence, development and MDR in lung cancer. Methods The cell came from the abdominal dropsy of a fifty-six years old female patient with lung adenocarcinoma and the tumor markers CA125, CYFRA21-1, CEA, NSE were detected to be higher secretion by radioimmunoassay in the abdominal dropsy. Tumorigenicity of immunodeficient mice was confirmed in 8th passage. The cell growth curve was mapped. Analysis of chromosome karyotype was tested. The gene expression was measured by real-time quantitative PCR. Results The tumorigenesis rate started at 8th passage in 3/10 immunodeficient mice via subcutaneously and the fully tumorigenicity was at 11th passage as well as later passages. Under the microscope, the cell showed oval-shap and adherence. The chromosome karyotype analysis of the cells was sub-triploid. Approximately 1×106 and 1.5×106 cancerous cells were injected into left cardiac ventricle and tail vein of immunodeficient mice respectively. The results showed multiorgan metastasis in the mice after three-four weeks, including mandible, scapula, humerus, vertebral column, femur, rib and brain, liver, adrenal gland, pulmonary in the mice after inoculation. The bone metastasis rate was 100% in the tumor bearing mice by bone scintigraphy and pathology. Quantitative real-time PCR was used to examined and compared with SPC-A-1 lung adenocarcinoma, ESM1, VEGF-C, IL-6, IL-8, AR genes were overexpressed. The novel cell was named CPA-Yang2. Conclusion The characteristics of novel strain CPA-Yang2 is a highly metastasis cell line of Chinese lung adenocarcinoma. It has stable traits, highly metastasis ability and maybe is a MDR lung cancerous cell line. Of course, it’s a good experimental model for lung cancer research.
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