Analysis of RCAS1 Immunoreactivity within Hydatidiform Mole Cells and Decidual Cells according to the Applied Therapeutic Strategy: Surgery or Surgery Followed by Chemotherapy

Abstract

Introduction: Trophoblast cells cooperate with both maternal immune cells and decidual cells to help develop the suppressive microenvironment of the endometrium. The maternal immune response against hydatidiform mole depends on this suppressive endometrial profile. Since RCAS1 is one of the molecular factors participating in the development of the suppressive profile of the endometrium we decided to examine the immunoreactivity of the RCAS1 within both the trophoblast and decidual cells during the development of hydatidiform mole. Methods: We analyzed the immunoreactivity of RCAS1 on both trophoblast and decidual cells derived from patients who underwent curettage because of hydatidiform mole. These patients were then divided into two subgroups according to whether or not they required chemotherapy after the surgical procedure. Result: We observed significantly lower immunoreactivity levels of both RCAS1 within the complete molar lesions of the patients on whom surgery alone was performed when compared to the levels found in those for whom surgery was followed by chemotherapy. Conclusion: RCAS1 staining may provide information regarding the intensity of the immunosuppressive microenvironment of both the molar lesion and the endometrium. This information can prove significant in determining the clinical course of hydatidiform mole.

The potential predictive value of serum srCaS1 levels for overall survival in endometrial cancer

“…Numerous studies have shown that tumor RCAS1 expression is an indicator of poor prognoses in patients with cancer [16,[24][25][26][27][28][29]. However, there is sparse data on serum sRCAS1 levels as a prognostic factor in human malignancies, and most of the data that does exist relates to the evaluation of short term outcomes [23].…”

Uterine Rupture in Twin Pregnancy with Normal Fetus and Complete Hydatidiform Mole

“…Sixty-five percent of patients with PTD who undergo hysterectomy still require chemotherapy and the operation is an emergency procedure in 48.75% of cases [24]. Significantly lower immunoreactivity levels following RCAS1-staining of complete molar lesions have been observed in patients who underwent hysterectomy without chemotherapy compared with those who underwent hysterectomy followed by chemotherapy, suggesting that staining with RCAS1 may provide information regarding the intensity of the immunosuppressive microenvironment of both molar lesions and the endometrium [25]. This information may prove significant in determining the clinical course of hydatidiform mole.…”

Creation of a suppressive microenvironment by macrophages and cancer-associated fibroblasts

“…The interaction of RCAS1 protein with the tumor and its microenvironment is presented in Figure 1. In our previous studies, RCAS1-expression and RCAS1-positive macrophages have been observed in various types of malignant neoplasms and their microenvironments as well as in conditions of chronic inflammation, such as chronic tonsillitis and nasal polyps (68)(69)(70)(71)(72)(73)(74)(75)). The expression of RCAS1 was identified in both squamous cell carcinoma and adenocarcinoma cells from the tissues of patients with head and neck, cervical, and ovarian cancer; it was also found in hydatidiform mole tissue and in the cancer microenvironments of these patients.…”