METHODS
In the present study, after developing a metastatic animal model of TNBC, metastatic and primary tumor
cells were extracted from the lung and primary tumor of cancerous mice, respectively. In the next
step, the sphere formation ability as a reliable in vitro assay to assess the presence and self-renewal ability
of CSCs, in metastatic and primary tumor cells was evaluated separately.
RESULTS
The results showed that sphere formation ability, and consequently the population of cancer stem cells
among metastatic tumor cells was significantly higher.
CONCLUSION
A higher percent of CSCs in lung metastatic site, compared with the primary tumor site, can partly explain
the reasons for the chemoresistance and relapse in metastatic TNBC.
Keywords: Cancer stem cells; metastasis; sphere formation; triple-negative breast cancer
Metastases account for 90% of human cancer
deaths. In cancer, metastasis and resistance to chemotherapy
are linked phenomena.[
Extensive cancer research has clarified the existence
of a rare subpopulation of stem cells between heterogeneous
populations of cancer cells in recent decades. These
cells are known as the cancer stem cells or cancerinitiating
cells characterized by the presence of surface
biomarkers, multi-drug resistance pumps and deregulated
self-renewal pathway. They have a decisive role in
stimulating cancer cells leading to tumorigenesis and
its advanced metastasis.[
It has been demonstrated that CSCs have the ability
to form spheres in vitro when grown in special culture
conditions.[
Several authors have emphasized on the pivotal role
of the CSCs as the active source of metastatic spread;
however, analysis of the role of CSCs in metastasis has
been mainly conceptual and speculative.[
Induction of Syngeneic Animal Model of Breast
Cancer
Female BALB/c mice weighing 20 to 25 gram obtained
from Royan Institute (Iran). The animals were housed
in cages at 12-h photoperiod while they had free access
to food and water. All animal experiments were
in compliance with the relevant laws, and this study
was approved by the Ethics Committee of Tehran University of Medical Sciences (registration number:
IR.TUMS. REC.1394.1439). 4T1 cells were subcutaneously
injected to the flank (or the right hind limb)
of the mice (105 cells suspended in 100 µL PBS) using
an insulin syringe with a 32G needle. The mice were
monitored daily for appearance and behavior characteristics.
Lung Metastatic and Primary Breast Tumor Cell Extraction
Sphere Formation Ability
Statistical Analysis
TPrimary and metastatic tumor cells were extracted as
previously described.[
Heterogeneous population of primary and lung
metastatic tumor cells was separately cultured in
DMEM containing 10% FBS, 100 U/ml Penicillin, and
100 ug/ml Streptomycin (all from Gibco, USA) at 37°C
in 5% CO2. For Sphere formation, cells were seeded at
2.5 × 104 cells in a petri dish in DMEM supplemented
with 10% FBS. After 24 h, cell culture media replaced
with fresh medium comprised of DMEM supplemented
with 2% FBS. Again, after 72 h, cell culture media replaced
with fresh medium comprised of DMEM supplemented
with 1% FBS. Primary/1° and secondary/2°
mammosphere formation was achieved after eight
days. The sphere formation index was determined by
two independent investigators by counting the sphere
formed in 10 high power fields per petri dish.
Results are expressed as the mean ± standard deviation.
Data were analyzed with GraphPad Prism statistical
software 6.0 (GraphPad Software, La Jolla, CA, USA)
using Paired Samples t-test. P<0.05 was considered statistically
significant.
Higher Capacity of Metastatic Tumor Cells in Sphere
Formation
After eight days of culturing primary and metastatic
tumor cells in sphere forming media, results indicated
that metastatic tumor cell have greater ability in sphere
formation. As shown in Figure
In the present study, after extraction of primary and metastatic tumor cells from mouse model of TNBC, we analyzed sphere formation ability in these cells. We determined that sphere formation ability as a key cancer stem cells property in metastatic tumor cells is significantly higher than primary tumor cells. Accordingly, we concluded that percent of CSCs population in metastatic loci is higher than primary tumor. Then, these CSCs can be responsible for chemoresistance and relapse in TNBC.
Hierarchical potential of CSCs to sustain self-renewal
along with constructing daughter cells that result
in the establishment of bulk tumor cells, while keeping
a self-replicating potential.[
Survey of researches indicated that CSCs make
up a small minority of most tumors, while in a small
number of tumors (for example, melanoma), they
may comprise up to 25% of the total mass.[
In conclusion, our study, to our knowledge, for the
first time, shows that in comparison with the primary tumor,
a higher percentage of cancer stem cell is present in
the metastatic site, which could be one of the main causes
of resistance to chemotherapy observed in metastatic
breast cancer. By targeting these cancer stem cells, we can
overcome these resistance and preventing recurrences of
the disease in patients with metastatic breast cancer.
Acknowledgments: We want to especially thank Dr. Mohammad
Vasei for his practical advising and helpful information
about metastatic breast cancer.
Peer-review: Externally peer-reviewed.
Conflict of Interest: The author declares that they have no
competing interests.
Ethics Committee Approval: This study was approved by the Ethics Committee of Shahroud University of Medical
Sciences (registration number: IR.SHMU.REC.1398.109).
Financial Support: This work was supported by a grant
from the Shahroud University of Medical Sciences (SHMU)
Grant No 9886.