PNAS:上海交大施奇惠研究组等建立稀有肿瘤细胞鉴定新方法

2017-02-24 佚名 生物帮

2017年1月31日,国际著名学术期刊《美国国家科学院院刊》杂志在线发表了上海交通大学系统生物医学研究院施奇惠教授研究组、上海市胸科医院陆舜主任与加州大学洛杉矶分校医学院魏巍教授研究组合作的最新研究成果。



2017年1月31日,国际著名学术期刊《美国国家科学院院刊》杂志在线发表了上海交通大学系统生物医学研究院施奇惠教授研究组、上海市胸科医院陆舜主任与加州大学洛杉矶分校医学院魏巍教授研究组合作的最新研究成果,研究论文题为High-throughput screening of rare metabolically active tumor cells in pleural effusion and peripheral blood of lung cancer patients。研究发展了一种在胸水、血液等液体样本中检测具有高代谢活性的稀有肿瘤细胞的高通量检测新方法,并为临床提供了一种快速鉴定恶性胸水的新方法。上海交通大学系统生物医学研究院博士研究生汤寅、王卓以及上海市胸科医院的李子明医生为共同第一作者,施奇惠教授、陆舜主任以及魏巍教授为共同通讯作者。

恶性肿瘤在播散、侵袭、转移的过程中常伴有肿瘤细胞进入体液,如血液、胸腹水、脑脊液等。因此,在这些体液样本中找到肿瘤细胞是判定肿瘤存在、甚至转移的可视化高级别证据,具有明确的临床意义。但是,这些体液样本中包含多种细胞且肿瘤细胞的数目常常较少,给临床检测带来挑战。目前在体液样本中鉴定脱落肿瘤细胞主要依赖于细胞学检查,基于肿瘤细胞的形态学特征进行鉴定,并进一步结合免疫组化明确其器官来源和病理分型,费时费力且有较高的专业要求。

该研究的目的是希望在传统的形态学检查之外探索快速、简便的稀有恶性细胞鉴定新方法。美国麻省理工学院的Robert A. Weinberg教授在2011年总结了肿瘤细胞的十大基本特征("Hallmarks of Cancer: The Next Generation",Cell, 2011, 144, 646),包括维持增殖信号,逃避生长抑制,抑制细胞死亡,无限自我复制,诱导血管生成,激活浸润转移,避免免疫损伤,促进肿瘤炎症,能量代谢异常以及基因组不稳定等。这些基本特征能够有效地鉴别恶性细胞,但其中除了能量代谢异常外,其他特征均难以方便地在单细胞尺度上进行鉴定。肿瘤细胞具有不同于正常细胞的能量代谢途径,这一现象首先被Otto Warburg观察到。即使在氧气存在的情况下,肿瘤细胞仍主要以糖酵解的方式进行能量代谢,其摄取的葡萄糖大大高于正常细胞,这一效应被称为Warburg效应,Warburg也因此获得1931年的诺贝尔奖。

Warburg效应在临床上已有广泛应用,通过将带有放射性标记的葡萄糖类似物(18F- FDG)作为示踪剂,应用正电子发射断层摄影术(PET/CT)可以非侵袭性、可视化灵敏检测体内高葡萄糖摄取的恶性组织,从而发现肿瘤原位及转移病灶。由于放射性标记的葡萄糖类似物的空间分辨率较低,该研究采用荧光标记的葡萄糖类似物在体外对大量细胞的葡萄糖摄取能力进行高通量检测。其基本假设是在胸水样本中高葡萄糖摄取且不表达白细胞共同抗原(CD45)的细胞有较大可能是肿瘤细胞,具有这类细胞的胸水可被鉴定为恶性胸水。

具体实验方法是将少量胸水样本(1-5 mL)在除去红细胞后与荧光标记的葡萄糖类似物以及荧光标记的CD45抗体孵育,然后将所有细胞铺在一个包含20万微孔的芯片上,通过高内涵设备进行多通道快速成像,并进一步通过程序分析确定所有高葡萄糖摄取且CD45阴性的疑似肿瘤细胞。为了验证这些细胞是否的确为肿瘤细胞,使用显微操作设备将这些疑似肿瘤细胞一一取出进行单细胞测序。实验结果表明,对于肺腺癌患者的胸水样本,超过60%的疑似肿瘤细胞均检测到了与原位肿瘤细胞一致的驱动基因突变(EGFR、KRAS等)。同时,在部分传统细胞学检查阴性或无法确诊的样本中,该方法能够有效找到肿瘤细胞并通过测序加以确认。

以上结果充分说明了在胸水样本中检测高代谢活性的细胞是一种快速鉴定恶性胸水的有效方法,有望成为现有细胞学检查的有益补充。该方法筛选到的高代谢活性细胞均具有高度活性,因此能方便地进行单细胞测序与体外培养。进一步的实验表明,该方法可被应用于血液样本中循环肿瘤细胞的检测,但由于血液中的细胞数目远多于胸水,检测时间也需相应延长。

研究通过肿瘤细胞的能量代谢异常这一基本特征在体液样本中高通量、快速鉴定肿瘤细胞,并通过大量的单细胞测序确认其可靠性,提供了一种在复杂体液样本中鉴定恶性细胞的新思路和新方法。

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    2017-08-27 drwjr
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