Research Papers:

Functional intratumoral lymphatics in patient-derived xenograft models of squamous cell carcinoma of the uterine cervix: implications for lymph node metastasis

Einar K. Rofstad _, Ruixia Huang, Kanthi Galappathi, Lise Mari K. Andersen, Catherine S. Wegner, Anette Hauge, Jon-Vidar Gaustad and Trude G. Simonsen

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Oncotarget. 2016; 7:56986-56997. https://doi.org/10.18632/oncotarget.10931

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Einar K. Rofstad1, Ruixia Huang1, Kanthi Galappathi1, Lise Mari K. Andersen1, Catherine S. Wegner1, Anette Hauge1, Jon-Vidar Gaustad1, Trude G. Simonsen1

1Group of Radiation Biology and Tumor Physiology, Department of Radiation Biology, Institute for Cancer Research, Oslo University Hospital, Oslo, Norway

Correspondence to:

Einar K. Rofstad, email: einar.k.rofstad@rr-research.no

Keywords: cervix carcinoma, patient-derived xenografts, lymphangiogenesis, metastasis, interstitial fluid pressure

Received: April 19, 2016    Accepted: July 19, 2016    Published: July 29, 2016


Studies of cell line-derived human tumor xenografts have suggested that the lymphatics seen in immunohistochemical preparations from non-peripheral regions of tumors are nonfunctional. In this investigation, lymphangiogenesis, hemangiogenesis, and lymph node metastasis were studied in patient-derived xenograft (PDX) models of carcinoma of the uterine cervix. Lymph vessel density (LVD) and blood vessel density (BVD) were measured in immunohistochemical preparations. The expression of angiogenesis-related genes was investigated by quantitative PCR. Lymphatic functionality was assessed with the ferritin assay, and tumor interstitial fluid pressure (IFP) was measured with a Millar catheter. The PDX models mirrored the angiogenesis and aggressiveness of the donor patients’ tumors, and two highly aggressive models developed functional lymphatics within the tumor mass. Tumors with functional intratumoral lymphatics showed low IFP, high LVD, high BVD, high expression of a large number of angiogenesis-related genes, and high incidence of lymph node metastases. LVD correlated with BVD, and lymph node metastasis was associated with high LVD and high BVD. Nine angiogenesis-related genes associated with the development of functional intratumoral lymhatics were identified. High expression of these genes, high LVD, and high BVD may be important biomarkers for poor outcome in cervix carcinoma.

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