CANCER-ASSOCIATED ADIPOCYTES AND PROGNOSTIC VALUE OF PREOPERATIVE NEUTROPHIL-LYMPHOCYTE RATIO IN GASTRIC CANCER.

BACKGROUND: The neutrophil-to-lymphocyte ratio (NLR) turned out to be a routinely available marker capable to reflect the systemic inflammatory response created by a tumor. Gastric cancer (GC) grows in the anatomical vicinity of adipose tissue, which is also associated with low-grade inflammation. AIM: To investigate the usefulness of the combined use of preoperative NLR and density of intratumoral cancer-associated adipocytes (CAAs) for predicting the disease outcome in GC patients. MATERIALS AND METHODS: A total of 151 patients with GC were eligible for retrospective analysis between 2009 and 2015.NLR preoperative values were calculated. Perilipin expression in tumor tissue was examined immunohistochemically. RESULTS: Low preoperative NLR is the most reliable prognostic factor for the favorable outcome for patients with low density of intratumoral CAAs. Patients with a high density of CCAs are at high risk of lethal outcomes independently of the value of preoperative NLR. CONCLUSION: The results have clearly shown an association between preoperative NLR and the density of CAAs in the primary tumor of GC patients. The prognostic value of NLR is essentially modified by means of the individual density of intratumoral CAAs in GC patients.The elevated NLR could be of significant predictive potential for a negative prognosis for patients with tumors characterized by the high density of CAAs independently of BMI.

Structural changes of serum albumin in response to oxidative stress caused by Walker-256 carcinosarcoma growth.

AIM: To assess oxidative stress and structural changes of the serum albumin in rats with transplanted Walker-256 carcinosarcoma (W256) strains with varying sensitivity to doxorubicin (Dox). MATERIALS AND METHODS: The study was performed on female Wistar rats with transplanted W256. On the 9th day after tumor cell transplantation an analysis of peripheral blood, oxidative stress parameters, and structural changes of serum albumin of experimental animals was performed. RESULTS: On the 9th day after W256 transplantation a significant increase in the leukocyte counts was observed in the groups of animals with the Dox-resistant and parental (Dox-sensitive) W256 tumors compared with the group of the intact animals: up to 14.24 ± 1.92 â€¢ 103/µl and 9.78 ± 1.03 â€¢ 103/µl, vs 8.92 ± 1.04 â€¢ 103/µl, respectively, due to the increase of granulocyte and monocyte counts. The number of lymphocytes was within the normal range. The level of hemoglobin and the erythrocyte counts were also within normal limits, but hematocrit in both groups of animals with tumors somewhat increased against the background of 1.2-fold elevation of the mean erythrocyte volume. In the group of rats with Dox-resistant W256, there was observed a decrease in the plateletcrit by almost 22% and thrombocyte counts - by 28%. Analysis of oxidative stress indices revealed a significant increase in the level of reactive oxygen species, 2-fold increase of malonic dialdehyde level and the degree of oxidative damage of blood plasma proteins, as well as a decrease in the activity of catalase in hemolysates (by 12-15%) in both groups of tumor-bearing rats. With the use of differential scanning calorimetry, UV and fluorescence spectroscopy we have revealed anomalous conformational changes of albumin caused by tumor development: structural rearrangements in the region of its first drug binding site located in the IIA domain, separation of globular parts of albumin molecule, and partial "opening" in a protein molecular three-domain structure resulting a loss of its thermal resistance. CONCLUSION: The development of transplanted Walker-256 carcinosarcoma, especially its Dox-resistant variant, results in severe metabolic intoxication reflected in alteration of hematological parameters, and indices of oxidative stress, as well as architectonic changes of serum albumin.

Tumor microenvironment and metabolic factors: contribution to gastric cancer.

Malignancy may be characterized as a state formed in the setting of specific tumor-host relationships at the molecular and cellular microenvironment levels. R.E. Kavetsky and his collaborators distinctly outlined the concept of tumor-host interaction. Tumor is a complicated biological system closely connected with the organism, where it arises and develops. Tumor cells are in the environment of different factors that form tumor microenvironment playing an active role in the disease progression. There are two types of tumor microenvironment: the metabolic microenvironment mediated by factors of tumor microphysiology (blood flow, vascular permeability, oxygenation, extracellular рН, interstitial fluid pressure, etc.) and the cellular-molecular microenvironment comprising interactions between tumor cells and non-tumor cells and the factors of the stromal compartment. Factors of tumor microphysio-logy can modify the interaction between tumor cells and surrounding non-tumor cells and molecular components and they form the tumor profile that influences the pressure of tumor on the host. The review presents the data concerning the role of metabolic microenvironment of tumor cells from the point of tumor-host interaction in order to employ these parameters to working out the methods of diagnosis and prognosis of disease outcome in patients with gastric cancer. Special attention has been paid to hypoxia as a key factor of metabolic microenvironment that positively affects tumor progression, stimulating its aggressiveness, metastasis and resistance to therapy and is regarded as a factor of unfavorable prognosis. It was shown that there is possible clinical relevance of tumor classification based on the level of tumor oxygenation that may be advantageous for selection of patients for individualized therapy that may give the hope for enhancement of treatment efficacy.

CD8 and CD45RO T lymphocytes in bone marrow of gastric cancer patients: correlation with disseminated tumor cells and disease outcome.

AIM: To evaluate the association between the presence of CD8 and CD45RO T lymphocytes in bone marrow (BM), disseminated tumor cells (DTCs), tumor hypoxia and their impact on disease outcome. MATERIAL AND METHODS: 91 naïve gastric cancer (GC) patients were enrolled into the study. DTCs, CD8- and CD45RO-positive T lymphocytes in BM were detected using immunocytochemistry. All patients were thoroughly informed about the study that was approved by the local ethics committee. Statistical analyses were done using NCSS2000/PASS2000 and Prism, version 4.03 software packages. RESULTS: It was detected that 80.5 and 81.3% of patients had CD8- and CD45RO-positive T cells in BM, respectively. When DTCs were detected in BM, the number of patients with CD8-and CD45RO-positive T cells in BM were 86.1 and 84.4%, respectively. It was also determined that the number of patients with DTCs in BM with categories M0 and M1 and with CD8- and CD45RO-positive T cells in BM were 86.2 and 85.7%, 85.7 and 80.0%, respectively. The association between DTCs in BM and presence of CD8 and CD45RO T cells lymphocytes in BM was not found. At the same time it was shown the association between presence of CD8 and CD45RO T lymphocytes and survival. The presence of CD8- and CD45RO-positive T cells in BM were accompanied with significantly longer overall survival of patients compared to that of patients without CD8- and CD45RO-positive T cells in BM. CONCLUSION: Patients with the presence of CD8- and CD45RO-positive T cells in BM demonstrated better survival of GC patients than those with the absence of these cells in BM. It may be suggested that tumor cells in BM are controlled in a dormant state by T cells in BM, in particular by CD8-positive T cells.

Premorphological alterations in gastric mucosa in patients with gastric cancer: hypoxia level assessed by 31P NMR spectroscopy.

UNLABELLED: The aim of this study was to detect the hypoxic status in adjacent histologically uninvolved gastric mucosa in gastric cancer (GC) patients. PATIENTS AND METHODS: 50 naïve patients with primary GC, and one patient with stomach ulcer (gastric mucosa was used as control) were enrolled into the study. The tumor and mucosa samples of stomach (without muscularis and serosa layers) in patients with GC were obtained immediately after operation. Assessment of the hypoxia level has been provided using (31)P NMR spectroscopy in tissue perchloric acid extracts. Mucosa was examined by convenient histological method. Obtained results were analyzed statistically. RESULTS: It was shown that gastric mucosa in 52% of patients with GC is under different levels of hypoxia, among them 23% of mucosa is under severe hypoxia (PME/Pi < 1.0) with average mean of PME/Pi 0.89 ± 0.04. It was revealed that there are definite associations between the hypoxia in mucosa tissue and pT as well as pN categories and G grade and stage of disease but not with M category. Overall survival of patients with gastric mucosa characterized by severe and mild hypoxia was significantly poorer as compared to that of patients with gastric mucosa with satisfactory oxygenation (p = 0.0035). CONCLUSION: Gastric mucosa uninvolved in tumor process is characterized by hypoxia in 52% of GC patients; severe hypoxia of mucosa was detected in 23% of patients having hypoxic mucosa. It was suggested that biochemical alterations in tissue surrounding tumor node may precede morphological ones.

Nanohyperthermia of malignant tumors. II. In vivo tumor heating with manganese perovskite nanoparticles.

OBJECTIVES: To evaluate the ability of manganese perovskite nanoparticles (lanthanum-strontium manganite) to heat the tumor tissue in vivo under action of external alternating magnetic field. MATERIALS AND METHODS: The magnetic fluid on the basis of nanoparticles of perovskite manganite was tested in the heating experiments using of alternating magnetic field of frequency 300 kHz and amplitude 7.7 kA/m. Guerin carcinoma was transplanted into the muscle of rat. Magnetic fluid was injected intramuscularly or intratumorally. Temperature was measured by copper-constantan thermocouple. RESULTS: Temperature of magnetic fluid was increased by 56 °C for 10 min of alternating magnetic field action. Administration of magnetic fluid into the muscle followed by alternating magnetic field resulted in the elevation of muscle temperature by 8 °C after 30 min post injection. Temperature of the tumor injected with magnetic fluid and treated by alternating magnetic field was increased by 13.6 °C on the 30 min of combined influence. CONCLUSION: In vivo study with rat tissue has demonstrated that magnetic fluid of manganite perovskite injected in the tumor increases the tumor temperature under an alternating magnetic field. Obtained results emphasize that magnetic fluid of manganite perovskite can be considered as effective inducer of tumor hyperthermia.

Nanohyperthermia of malignant tumors. I. Lanthanum-strontium manganite magnetic fluid as potential inducer of tumor hyperthermia.

OBJECTIVES: To synthesize magnetic particles of lanthanum-strontium manganite, prepare the magnetic fluid (MF), evaluate the generation of heat by particles and determine their common toxiсity. METHODS: Nanoparticles based on the solid solutions of lanthanum-strontium manganite (La(1-x)Sr(x)MnO(3)) have been synthesized by a sol-gel method. Conventional methods of experimental oncology were used. RESULTS: Nanoparticles of ferromagnetic materials on the basis of solid solutions of lanthanum strontium manganite by sol-gel method were synthesized. It was shown the possibility to regulate the aggregate form of particles that are formed during the synthesis. Magnetic fluid based on the synthesized nanoparticles and water solutions of agarose have been produced. It was shown the possibility to heat this magnetic fluid up to 42-45 °Ð¡ in externally applied alternating magnetic field (AMF) operated at 100-400 kHz. It was determined that under long-term influence of AMF nanofluid is heated up to temperature which is not over that of magnetic phase transition. It was detected that magnetic powder as well as fluid have not displayed acute toxicity or side effects (intraperitoneal or intratumoral administration) in animals either intact or with transplanted tumors. CONCLUSIONS: Possibility of synthesized magnetic fluid to generate heat in externally applied AMF as well as lack of side effects allow to consider its as a potential mean for tumor hyperthermia (HT).

Hypoxia, tumour-associated macrophages, microvessel density, VEGF and matrix metalloproteinases in human gastric cancer: interaction and impact on survival

INTRODUCTION: Hypoxia is a key feature of the microenvironment of cancer cells actively participating in tumour progression. Our study was aimed to evaluate the impact of hypoxia and hypoxia-associated factors on tumour progression and survival of patients with gastric cancer. MATERIAL AND METHODS: One hundred and five resected specimens were used. The level of tumour hypoxia was evaluated using (31)P NMR spectroscopy, CD68 (tumour-associated macrophages), CD34 (microvessel density, MVD) and VEGF expression, immunohistochemistry, MMP-2 and MMP-9 activity, zymography. Statistical analysis was conducted using Pearson's test, Kaplan-Meier survival analysis, log-rank test and Cox proportional hazards model. RESULTS: Intratumoral hypoxia level has been significantly correlated with VEGF expression, TAM number and total protease activity. The overall survival rate of patients with strong tumour hypoxia, high level of MVD, VEGF expression, TAM and MMP activity was significantly lower than that of the patients without the mentioned tumour characteristics. CONCLUSIONS: The hypoxia-associated signalling that is activated in tumours promotes tumour progression through the recruitment of macrophages, remodelling of extracellular matrix and neoangiogenesi (AU)

Bioenergetic status and hypoxia in Lewis lung carcinoma assessed by 31P NMR spectroscopy: correlation with tumor progression.

AIM: To evaluate the hypoxia level and some indices of Lewis lung carcinoma energy metabolism by means of 31P NMR spectroscopy in perchloric acid (PCA) tissue extracts during growth of primary tumor and metastasis. MATERIALS AND METHODS: C57Bl/6 mice-bearing Lewis lung carcinoma were used in this study. Tumor energy metabolism was studied by 31P NMR spectroscopy and the metabolic NMR ratios were used as parameters for metabolic status and hypoxia level. RESULTS: It was shown that growth of primary tumor is accompanied with increase of Pi/PCr, Pi/betaNTP and PME/betaNTP ratios that reflect drop of tumor energy status and oxygenation level in tumor tissue. These changes in relevant metabolic ratios correlate with enlargement of primary tumor volume (r=0.87, p=0.0045; r=0.90, p=0.0012; r=0.764, p=0.05, respectively) as well as with the number of lung metastases (r(s)=0.761, p=0.028; r(s)=0.86, p=0.0049; r(s)=0.77, p=0.040, respectively). CONCLUSION: In present study it was shown that 31P NMR spectroscopy of PCA tumor tissue extracts may be used as reliable method for the assessment of the level of oxygenation as well as changes in energy metabolism in the experimental tumors. It may be helpful to evaluate the energy status of human tumors by investigation both of biopsy and surgical specimens. Hypoxia and hypoxia-associated metabolic events in primary tumor are linked with malignant progression, in particular metastasis.

Hypoxia level and matrix metalloproteinases-2 and -9 activity in Lewis lung carcinoma: correlation with metastasis.

AIM: To investigate the relationship between tumor hypoxia in vivo, activity of matrix metalloproteinases (MMPs), and metastatic potential of tumor. MATERIALS AND METHODS: Lewis lung carcinoma (3LL) was used in this study. Total activity of MMP-2 and -9 in tumor was measured biochemically, tumor hypoxia level was assessed by (31)P NMR spectroscopy in tissue perchloric extracts. RESULTS: It was determined that hypoxia level in primary tumor has been concomitantly increasing along with tumor growth and correlated with metastasis level in lung. The positive correlation between hypoxia level and activities of MMP-2 and MMP-9 in primary tumor was registered. Moreover, the activity of MMP-2 and -9 in 3LL (primary tumor) directly correlates with metastasis level in lung. CONCLUSION: This study demonstrated that the growth of primary tumor is distinctly accompanied by an increase of tumor hypoxia level which positively correlates both with the activity of MMP-2 and -9 in primary tumor and metastatic efficiency.

Modifying effect of organocobalt complexes on the tumour response to anticancer treatments.

A new type of agents are proposed for combined cancer therapy. They are organocobalt (III) chelates containing a sigma-bounded organyl group and a mixed tridentate ligand derived from a Schiff base. These complexes generate free radicals due to the action of protons in physiological ranges of pH and temperature, and hence are conceivably capable of selectively attacking a malignant neoplasm that is slightly acidic and can be made even more so by introducing some means intensifying glycolysis. An in vivo examination was performed using transplanted rat tumours (Guerin and Walker 256 carcinomas, Sarcoma 45). The modifying effect of one of these complexes on the tumour response to cis-DDP, radiation and/or local hyperthermia was tested by means of tumour growth delay assay and local tumour control. The potentiating effect of the complex was maximal when it was administered 60-90 minutes prior to other agents (cisDDP, X-irradiation heat). The enhancement ratio was found to be ca. 2.0-4.0 for cisDDP and 2.0 for radiation. In conclusion, in our tumour models, an increase of the antitumour effect was obtained for conventional antitumour agents when they were supplemented with organocobalt complex. It can be hypothesised that DNA in tumour cells may be considered to be the main target for organocobalt complexes.