Cancer-associated fibroblast heterogeneity in axillary lymph nodes drives metastases in breast cancer through complementary mechanisms

Nat Commun. 2020 Jan 21;11(1):404. doi: 10.1038/s41467-019-14134-w.

Abstract

Although fibroblast heterogeneity is recognized in primary tumors, both its characterization in and its impact on metastases remain unknown. Here, combining flow cytometry, immunohistochemistry and RNA-sequencing on breast cancer samples, we identify four Cancer-Associated Fibroblast (CAF) subpopulations in metastatic lymph nodes (LN). Two myofibroblastic subsets, CAF-S1 and CAF-S4, accumulate in LN and correlate with cancer cell invasion. By developing functional assays on primary cultures, we demonstrate that these subsets promote metastasis through distinct functions. While CAF-S1 stimulate cancer cell migration and initiate an epithelial-to-mesenchymal transition through CXCL12 and TGFβ pathways, highly contractile CAF-S4 induce cancer cell invasion in 3-dimensions via NOTCH signaling. Patients with high levels of CAFs, particularly CAF-S4, in LN at diagnosis are prone to develop late distant metastases. Our findings suggest that CAF subset accumulation in LN is a prognostic marker, suggesting that CAF subsets could be examined in axillary LN at diagnosis.

Publication types

  • Research Support, Non-U.S. Gov't
  • Video-Audio Media

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Axilla
  • Breast Neoplasms / mortality
  • Breast Neoplasms / pathology*
  • Breast Neoplasms / therapy
  • Cancer-Associated Fibroblasts / metabolism*
  • Cancer-Associated Fibroblasts / pathology
  • Cell Proliferation
  • Cell Separation
  • Chemokine CXCL12 / metabolism
  • Epithelial-Mesenchymal Transition
  • Female
  • Flow Cytometry
  • Follow-Up Studies
  • Humans
  • Kaplan-Meier Estimate
  • Lymph Nodes / cytology
  • Lymph Nodes / pathology
  • Lymphatic Metastasis / pathology*
  • Middle Aged
  • Myofibroblasts / metabolism*
  • Myofibroblasts / pathology
  • Neoplasm Invasiveness / pathology
  • Primary Cell Culture
  • Prognosis
  • Progression-Free Survival
  • Receptors, Notch / metabolism
  • Signal Transduction
  • Transforming Growth Factor beta / metabolism
  • Tumor Cells, Cultured
  • Tumor Microenvironment

Substances

  • CXCL12 protein, human
  • Chemokine CXCL12
  • Receptors, Notch
  • Transforming Growth Factor beta