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Steps involved in the progression of non-small cell lung cancer (NSCLC) to metastasis are poorly understood. Expression of oncogenic C-RAF in lung epithelial cells has yielded a model for non-small cell lung cancer (NSCLC). The induced adenomas are characterised by high genomic stability, a lack of tumor progression and pronounced cell-cell contacts raising the question whether disruption of E-cadherin complexes would promote progression to metastasis. Two genetic approaches were used to evaluate the role of adherens junctions in a C-RAF driven mouse model for NSCLC: conditional ablation of the Cdh1 gene and expression of dominant negative (dn) E-cadherin. Disruption of E-cadherin function caused massive formation of intratumoral vessels that was reversible in the early phase of induction. Vascularized tumors grew more rapidly, developed invasive fronts and gave rise to micrometastasis. ß-catenin was identified as a critical effector of E-cadherin disruption leading to up-regulation of angiogenic inducers (VEGF-A and VEGF-C) in mouse and human lung tumor cell lines. In vivo, lung tumor cells with disrupted E-cadherin expressed ß-catenin target genes of endodermal and other lineages suggesting that reprogramming may be involved in metastatic progression.
Background
Hematogenous tumor spread of malignant meningiomas occurs very rarely but is associated with very poor prognosis.
Case presentation
We report an unusual case of a patient with a malignant meningioma who developed multiple metastases in bones, lungs and liver after initial complete resection of the primary tumor. After partial hepatic resection, specimens were histologically analyzed, and a complete loss of E-cadherin adhesion molecules was found. No oncogenic target mutations were found. The patient received a combination of conventional radiotherapy and peptide receptor radionuclide therapy (PRRT). Due to aggressive tumor behavior and rapid spread of metastases, the patient deceased after initiation of treatment.
Conclusions
E-cadherin downregulation is associated with a higher probability of tumor invasion and distant metastasis formation in malignant meningioma. Up to now, the efficacy of systemic therapy, including PRRT, is very limited in malignant meningioma patients.
In der vorliegenden Arbeit wurden die Expressionshäufigkeiten von MAGE-A-Antigenen, E -Cadherin, Laminin-5-gamma-2, MMP2 und MMP9 in Plattenepithelkarzinomen im Kopf- und Halsbereich untersuchen. Hierbei findet der Vergleich zwischen Primärtumoren und korrespondierenden Lymphknotenmetastasen besondere Beachtung. Um die Hypothese zu verifizieren, dass die o.g. Parameter einen signifikanten Einfluss auf die Progression und Metastasierung haben, wird der Zusammenhang zwischen den in der vorliegenden Arbeit gewonnenen Ergebnissen und diversen klinischen Parametern mittels Korrelationsanalyse untersucht.