Periostin+ cancer-associated fibroblasts promote lymph node metastasis by impairing the lymphatic endothelial barriers in cervical squamous cell carcinoma

Mol Oncol. 2021 Jan;15(1):210-227. doi: 10.1002/1878-0261.12837. Epub 2020 Nov 12.

Abstract

Lymph node metastasis (LNM), a critical prognostic determinant in cancer patients, is critically influenced by the presence of numerous heterogeneous cancer-associated fibroblasts (CAFs) in the tumor microenvironment. However, the phenotypes and characteristics of the various pro-metastatic CAF subsets in cervical squamous cell carcinoma (CSCC) remain unknown. Here, we describe a CAF subpopulation with elevated periostin expression (periostin+ CAFs), located in the primary tumor sites and metastatic lymph nodes, that positively correlated with LNM and poor survival in CSCC patients. Mechanistically, periostin+ CAFs impaired lymphatic endothelial barriers by activating the integrin-FAK/Src-VE-cadherin signaling pathway in lymphatic endothelial cells and consequently enhanced metastatic dissemination. In contrast, inhibition of the FAK/Src signaling pathway alleviated periostin-induced lymphatic endothelial barrier dysfunction and its related effects. Notably, periostin- CAFs were incapable of impairing endothelial barrier integrity, which may explain the occurrence of CAF-enriched cases without LNM. In conclusion, we identified a specific periostin+ CAF subset that promotes LNM in CSCC, mainly by impairing the lymphatic endothelial barriers, thus providing the basis for potential stromal fibroblast-targeted interventions that block CAF-dependent metastasis.

Keywords: cancer-associated fibroblasts; cervical squamous cell carcinoma; lymph node metastasis; lymphatic endothelial barrier; periostin.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antigens, CD / metabolism
  • Cadherins / metabolism
  • Cancer-Associated Fibroblasts / metabolism*
  • Carcinoma, Squamous Cell / metabolism*
  • Carcinoma, Squamous Cell / pathology*
  • Cell Adhesion Molecules / metabolism*
  • Cell Line, Tumor
  • Cell Membrane Permeability
  • Down-Regulation
  • Endothelial Cells / metabolism
  • Endothelial Cells / pathology*
  • Female
  • Focal Adhesion Protein-Tyrosine Kinases / metabolism
  • Humans
  • Integrins / metabolism
  • Lymphatic Metastasis / pathology*
  • Middle Aged
  • Survival Analysis
  • Uterine Cervical Neoplasms / metabolism*
  • Uterine Cervical Neoplasms / pathology*
  • src-Family Kinases / metabolism

Substances

  • Antigens, CD
  • Cadherins
  • Cell Adhesion Molecules
  • Integrins
  • POSTN protein, human
  • cadherin 5
  • Focal Adhesion Protein-Tyrosine Kinases
  • src-Family Kinases