Presence of cancer-associated fibroblasts inversely correlates with Schwannian stroma in neuroblastoma tumors

Rana Zeine, Helen R. Salwen, Radhika Peddinti, Yufeng Tian, Lisa Guerrero, Qiwei Yang, Alexandre Chlenski, Susan L. Cohn

Research output: Contribution to journalArticlepeer-review

35 Scopus citations

Abstract

Stromal cells have a central function in the regulation of tumor angiogenesis. Recent studies have shown that stromal myofibroblasts (cancer-associated fibroblasts) actively promote tumor growth and enhance tumor angiogenesis in many types of adult carcinomas. To evaluate the function cancer-associated fibroblasts have in neuroblastoma angiogenesis and investigate their relationship to stromal Schwann cells, we quantified cancer-associated fibroblasts in 60 primary neuroblastoma tumors and in a novel neuroblastoma xenograft model in which murine Schwann cells were induced to infiltrate into the tumor stroma. Tumor sections were examined for presence of microvascular proliferation, a hallmark of tumor angiogenesis. Cancer-associated fibroblasts were characterized by positive immunostaining for α-smooth muscle actin (α-SMA) and were distinguished from pericytes by staining negatively for high-molecular-weight caldesmon. α-SMA-positive cells were quantified and their number was defined as high when 1.0% of the area was positive. Associations between high cancer-associated fibroblast number, microvascular proliferation and established prognosticators were analyzed. High numbers of cancer-associated fibroblasts were associated with Schwannian stroma-poor histopathology and microvascular proliferation. Thirty-seven (80%) of the 46 Schwannian stroma-poor tumors had high numbers of cancer-associated fibroblasts in the tumor stroma compared to only 2 (14%) of the 14 Schwannian stroma-rich/dominant tumors (P0.001). Thirty-three (89%) of 37 tumors with microvascular proliferation had high numbers of cancer-associated fibroblasts compared to 9 (40%) of 22 tumors without microvascular proliferation (P0.001). In the xenografts with infiltrating Schwann cells (n10), the number of cancer-associated fibroblasts per mm 2 was approximately sevenfold less than in the control xenografts without stromal Schwann cells (n9) (mean of 5130 vs 368105, respectively; P0.001). Thus, cancer-associated fibroblasts were inversely associated with presence of Schwann cells, suggesting that Schwann cells may prevent the activation of fibroblasts. A deeper understanding of the function cancer-associated fibroblasts have in neuroblastoma angiogenesis may guide future development of stroma-directed therapeutic strategies.

Original languageEnglish (US)
Pages (from-to)950-958
Number of pages9
JournalModern Pathology
Volume22
Issue number7
DOIs
StatePublished - Jul 2009
Externally publishedYes

Keywords

  • Cancer-associated fibroblast
  • Neuroblastoma
  • Schwannian stroma

ASJC Scopus subject areas

  • General Medicine

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