Expression of Nerve Growth Factors in Pancreatic Neural Tissue and Pancreatic CancerMatthias B. Schneidera,b, Jens Standopa, Alexis Ulricha, Uwe Wittela, Helmut Friessb, Åke Andrén-Sandbergc, and Parviz M. Pouraa Eppley Institute for Research in Cancer and Allied Diseases, University of Nebraska Medical Center, Omaha, Nebraska b Klinik für Viszeral- und Transplantationschirurgie, Inselspital, University of Bern, Bern, Switzerland c Department of Surgery, University of Lund, Lund, Sweden Correspondence to: Parviz M. Pour, The Eppley Institute for Research in Cancer and Allied Diseases, U. of Nebraska Medical Center, 986805 Nebraska Medical Center, Omaha, NE 68198-6805. E-mail: ppour@unmc.edu
One of the characteristics of pancreatic cancer is its tendency to invade neural tissue. We hypothesized that the affinity of cancer cells for nerve tissue is related to the presence of growth factors in neural tissue and their receptors in cancer cells. Sections of pancreatic cancer and normal pancreatic tissue were examined by immunohistochemistry for the expression of the neurotrophins NGF, BDNF, NT-3, NT-4, and their receptors TrkA, TrkB, and TrkC, as well as the low-affinity receptor, p75NTR. TrkA expression was found in duct, islet, and cancer cells; TrkB was found in the (J Histochem Cytochem 49:12051210, 2001) Key Words: nerve growth factor, pancreas, carcinoma, invasion, nerves, immunohistochemistry
PANCREATIC CANCER is a lethal disease. Less than 10% of patients survive for more than a year from the time of diagnosis (
The grave prognosis of the disease is related to its invasive and metastatic nature. Perineural invasion is one of the most common features of pancreatic cancer. Up to 90% of patients show the involvement of intrapancreatic nerves and 69% of extrapancreatic nerves (
NGF and its relatives, brain-derived neurotrophic factor (BDNF), NT-3, and NT-4, are a family of polypeptides that promote the outgrowth and differentiation of peripheral and central neurons. Thus far, two classes of corresponding receptors have been identified. The high-affinity tyrosine kinase receptors TrkA, TrkB, and TrkC (kD The purpose of the present study was to examine whether these growth factors and their receptors play a role in the affinity of pancreatic cancer cells for neural tissue.
Nineteen surgically removed pancreatic cancer specimens were examined. The cancers were classified according to the International Histological Classification of Tumors published by the World Health Organization (WHO) (
Antibodies
Immunohistochemical Examinations
Hyaluronidase (Sigma; St Louis, MO) 1 mg/ml in 100 mmol/liter sodium acetate and 0.85% NaCl or saponin (Sigma) 0.05% in deionized water was used for antigen retrieval for anti-TrkA, anti-TrkB, and anti-TrkC antibodies. After preincubation with Tris-buffered saline containing 0.1% (v/v) Triton X-100 for 15 min, the sections were incubated at 37C for 30 min. Formalin-fixed, paraffin-embedded sections of human prostate cancer served as control for the immunostaining of TrkA as reported (
Table 1 summarizes the expression of the growth factors and their receptors in normal and malignant pancreatic cells.
The immunoreactivity of anti-TrkA differed depending on the pretreatment with saponin or hyaluronidase. The latter treatment resulted in staining of the tunica muscularis of blood vessels, the neural tissue, duct and ductule cells, scattered islet cells, and cancer cells. Duct, ductule, and cancer cells showed moderate to strong granular and membranous staining. Acinar cells were unstained. Pretreatment of the same sections with saponin showed weak staining of smooth muscle tissue of blood vessels only.
The pattern of staining with anti-TrkB did not differ between sections pretreated with saponin or hyaluronidase. Cancer cells did not express TrkB in any specimen. Strong cytoplasmic staining of up to 20% of islet cells within each islet was detected with this antibody in both normal and cancer tissues. Double immunostaining with the TrkB antibody and islet hormone antibodies showed strict co-localization of TrkB in
Similar to the findings with anti-TrkA, the immunoreactivity of anti-TrkC differed according to the method of pretreatment. Although the slides pretreated with saponin did not show staining in any cells, in the specimens pretreated with hyaluronidase the anti-TrkC antibody showed strong membranous staining of ducts and ductules in both normal and cancerous tissues. Acinar and endocrine cells were not stained. Although cancer cells, in general, revealed a fine membranous staining, in well-differentiated tumors a few cells also showed very strong cytoplasmic staining. Neural and smooth muscle tissues of intra- and peripancreatic blood vessels showed similar but weaker staining than with the anti-TrkA antibody. In normal tissue and in the tumor-free pancreatic tissues of five pancreatic cancer specimens, the pan Trk (TrkB3) antibody showed a cytoplasmic granular staining of duct and acinar cells. Scattered polygonal cells, grouped in small clusters, also showed strong cytoplasmic granular staining in the normal tissue and in tumor-free tissue adjacent to the cancer (Fig 2). Cancer cells presented a granular cytoplasmic staining, with stronger reactivity in the supranuclear regions. This finding was consistent throughout the tumors with various grades of differentiation (Fig 3). No staining was found in the neural structures. There were no differences in the staining patterns and intensity between the specimens pretreated with saponin and those pretreated with hyaluronidase. The low-affinity receptor p75NTR was expressed in nerve fibers, perineurium, and ganglia in both normal and cancer tissues. In all specimens the perineurium showed the strongest staining (Fig 4). Ductules and ducts showed strong membranous staining only in atrophic areas close to the cancer cells and only in specimens pretreated with saponin. Pancreatic cancer cells did not show any immunoreactivity with the antibody regardless of the pretreatment. Acinar, duct, ductule, and centroacinar cells, particularly in atrophic pancreatic areas, showed diffuse cytoplasmic staining with the anti-NGF antibody. Neural fibers were also stained. Strong nuclear staining of a few Schwann cells was noted in neural tissue. Cancer cells showed weak and diffuse cytoplasmic staining in glandular or anaplastic areas but not in cystic areas of the two cystadenocarcinoma specimens (Fig 5). Nuclear staining of a few cancer cells was also present within the malignant glands. NT-3 antibody showed immunoreactivity with erythrocytes and capillary endothelia in both normal and cancerous tissues. No immunoreactivity was found in any pancreatic cells, cancer cells, or nerves. NT-4 antibody, on the other hand, showed strong cytoplasmic staining of duct and ductule cells (Fig 6) and heterogeneous staining of cancer cells. Although acinar cells were negative for NT-4, about 13% of islets showed weak granular staining. No significant differences in the immunoreactivity of anti-NGF, anti-NT-3, and NT-4 antibodies were found between the tissues pretreated with saponin and those treated with hyaluronidase. Immunoreactivity with the anti-BDNF antibody was not detected in any tissues, regardless of the method of pretreatment.
Perineural invasion is one of the most common characteristics of pancreatic cancer and appears to occur more often than in cancer of the prostate, biliary tree, or other gastrointestinal tumors. Characteristically, cancer cells appear to migrate along the nerve fibers for a long distance to reach the celiac plexus, where they apparently provide a nidus for cancer recurrence after surgery (
It is suggested that the abundant expression of EGFR by cancer cells and the overexpression of TGF-
Our study could, in part, confirm the reported immunoreactivity of pancreatic cancer cells with TrkA and TrkC ( Remarkably, only in hyaluronidase-pretreated slides the immunoreactivity of the pan Trk (TrkB3) antibody which, according to the manufacturer, recognizes all three Trk epitopes, corresponded to the immunoreactivity of TrkA, TrkB, and TrkC. This finding suggests that the epitope is masked by a complex carbohydrate structure in formalin-fixed tissues. This also may explain, in part, the differences in the reported cellular expression of these growth factors and their receptors.
The striking selective expression of TrkA and TrkB by
The strong cytoplasmic expression of NT-4 in duct cells in all specimens is noteworthy. It appears that expression of this growth factor represents a duct cell marker. In that case, the presence of a few cells within the islets could be considered to represent the tendency of some islet cells towards duct cell differentiation as has been shown to invariably occur in vitro ( In summary, strong expression of pan Trk (TrkB3), TrkA and TrkC on cancer cells and NGF in neural tissue may be, at least in part, the reason for the affinity of cancer cells for neural tissue. However, the existence of other mechanisms, which are of great clinical importance, awaits further studies.
Supported by the National Institute of Health, National Cancer Institute Grant, 5ROICA60479 and Spore Grant P50CA72712, the National Cancer Institute Laboratory Cancer Research Center Support Grant CA367127, and the American Cancer Special Institutional Grant. Alexis Ulrich is a recipient of a scholarship from the Deutsche Forschungsgemeinschaft, Germany. Received for publication August 7, 2000; accepted May 2, 2001.
Bockman DE, Buchler M, Beger HG (1994) Interaction of pancreatic ductal carcinoma with nerves leads to nerve damage. Gastroenterology 107:219-230[Medline] Friedman WJ, Greene LA (1999) Neurotrophin signaling via Trks and p75. Exp Cell Res 253:131-142[Medline] Gudjonsson B (1987) Cancer of the pancreas. 50 years of surgery. Cancer 60:2284-2303[Medline] Gudjonsson B (1995) Carcinoma of the pancreas: critical analysis of costs, results of resections, and the need for standardized reporting. J Am Coll Surg 181:483-503. [see Comments][Medline] Hoehner JC, Olsen L, Sandstedt B, Kaplan DR, Pahlman S (1995) Association of neurotrophin receptor expression and differentiation in human neuroblastoma. Am J Pathol 147:102-113[Abstract] KerrConte J, Pattou F, LecomteHoucke M, Xia Y, Boilly B, Proye C, Lefebvre J (1996) Ductal cyst formation in collagen-embedded adult human islet preparations. A means to the reproduction of nesidioblastosis in vitro. Diabetes 45:1108-1114[Abstract] Kimura W, Morikane K, Esaki Y, Chan WC, Pour PM (1998) Histologic and biologic patterns of microscopic pancreatic ductal adenocarcinomas detected incidentally at autopsy. Cancer 82:1839-1849[Medline] Klein R (1994) Role of neurotrophins in mouse neuronal development. FASEB J 8:738-744[Abstract] Klein R, Jing SQ, Nanduri V, O'Rourke E, Barbacid M (1991) The trk proto-oncogene encodes a receptor for nerve growth factor. Cell 65:189-197[Medline] Kloeppel G, Solcia E, Longnecker DS, Capella C, Sobin LH (1996) Histological Typing of Tumours of the Exocrine Pancreas. 2nd ed Berlin, Heidelberg, Springer-Verlag Lamballe F, Klein R, Barbacid M (1991) trkC, a new member of the trk family of tyrosine protein kinases, is a receptor for neurotrophin-3. Cell 66:967-979[Medline] LucasClerc C, Massart C, Campion JP, Launois B, Nicol M (1993) Long-term culture of human pancreatic islets in an extracellular matrix: morphological and metabolic effects. Mol Cell Endocrinol 94:9-20[Medline] Maness LM, Kastin AJ, Weber JT, Banks WA, Beckman BS, Zadina JE (1994) The neurotrophins and their receptors: structure, function, and neuropathology. Neurosci Biobehav Rev 18:143-159[Medline] Matsuda M, Nimura Y (1983) [Perineural invasion of pancreas head carcinoma]. Nippon Geka Gakkai Zasshi 84:719728 (in Japanese) Miknyoczki SJ, Lang D, Huang L, KleinSzanto AJ, Dionne CA, Ruggeri BA (1999) Neurotrophins and Trk receptors in human pancreatic ductal adenocarcinoma: expression patterns and effects on in vitro invasive behavior. Int J Cancer 81:417-427[Medline] Nagakawa T, Kayahara M, Ueno K, Ohta T, Konishi I, Miyazaki I (1992a) Clinicopathological study on neural invasion to the extrapancreatic nerve plexus in pancreatic cancer. Hepatogastroenterology 39:51-55[Medline] Nagakawa T, Kayahara M, Ueno K, Ohta T, Konishi I, Ueda N, Miyazaki I (1992b) A clinicopathologic study on neural invasion in cancer of the pancreatic head. Cancer 69:930-935[Medline] Nagakawa T, Konishi I, Higashino Y, Ueno K, Ohta T, Kayahara M, Ueda N, Maeda K, Miyazaki I (1989) The spread and prognosis of carcinoma in the region of the pancreatic head. Jpn J Surg 19:510-518[Medline] Nagakawa T, Mori K, Nakano T, Kadoya M, Kobayashi H, Akiyama T, Kayahara M, Ohta T, Ueno K, Higashino Y, Konishi I, Miyazaki I (1993) Perineural invasion of carcinoma of the pancreas and biliary tract. Br J Surg 80:619-621[Medline] Nakao A, Harada A, Nonami T, Kaneko T, Takagi H (1996) Clinical significance of carcinoma invasion of the extrapancreatic nerve plexus in pancreatic cancer. Pancreas 12:357-361[Medline] Pflug BR, Dionne C, Kaplan DR, Lynch J, Djakiew D (1995) Expression of a Trk high affinity nerve growth factor receptor in the human prostate. Endocrinology 136:262-268[Abstract] Pour PM, Kazakoff K, Dulany K (1994) A new technique for simultaneous demonstration of 4 tumor-associated antigens in pancreatic cancer cells. Zentralbl Pathol 140:397-401[Medline]
Rabizadeh S, Oh J, Zhong LT, Yang J, Bitler CM, Butcher LL, Bredesen DE (1993) Induction of apoptosis by the low-affinity NGF receptor. Science 261:345-348 Schmied BM, Liu G, Matsuzaki H, Ulrich A, Hernberg S, Moyer MP, Weide L, Murphy L, Batra SK, Pour PM (2000a) Differentiation of islet cells in long-term culture. Pancreas 20:337-347[Medline] Schmied BM, Ulrich A, Matsuzaki H, Ding X, Ricordi C, Moyer MP, Batra SK, Adrian TE, Pour PM (2000b) Maintenance of human islets in long-term culture. Differentiation 66:173-180[Medline] Shibayama E, Koizumi H (1996) Cellular localization of the Trk neurotrophin receptor family in human non-neuronal tissues. Am J Pathol 148:1807-1818[Abstract] Takahashi T, Ishikura H, Motohara T, Okushiba S, Dohke M, Katoh H (1997) Perineural invasion by ductal adenocarcinoma of the pancreas. J Surg Oncol 65:164-170[Medline] Weiner HL (1995) The role of growth factor receptors in central nervous system development and neoplasia. Neurosurgery 37:179-193, discussion 193194[Medline] Yuan S, Rosenberg L, Paraskevas S, Agapitos D, Duguid WP (1996) Transdifferentiation of human islets to pancreatic ductal cells in collagen matrix culture. Differentiation 61:67-75[Medline]
This article has been cited by other articles:
|
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||