Tumor Biology

, Volume 35, Issue 1, pp 379–385 | Cite as

Notch and TGF-β/Smad3 pathways are involved in the interaction between cancer cells and cancer-associated fibroblasts in papillary thyroid carcinoma

  • Jie Zhang
  • Yuan Wang
  • Dan Li
  • Shanghua Jing
Research Article


Accumulating evidence suggests that cancer-associated stromal fibroblasts (CAFs) contribute to tumor growth by actively communicating with cancer cells. Our aim was to identify the signaling pathways that are involved in tumor–stromal cell interactions in human papillary thyroid carcinoma (PTC). Immunohistochemical analyses were performed with 127 archived formalin-fixed and paraffin-embedded thyroid tissue samples that included 70 cases of PTC, 35 cases of nodular goiter (NG), and 22 cases of normal thyroid tissues. The results showed that the expression levels of Notch1, transforming growth factor β (TGF-β1), and p-Smad3 in PTC cells and α-smooth muscle actin (α-SMA) in the stroma of PTC were all significantly higher than in NG and normal thyroid tissues. Further analysis showed that in PTC, higher expression levels of Notch1 and TGF-β1 were closely related with lymph node metastasis (P < 0.05), whereas for α-SMA and p-Smad3, the percent expression increased significantly with advanced tumor stages (P < 0.05). Correlation analysis revealed that TGF-β1 expression increased with increased Notch1 and p-Smad3 levels in PTC cells (P < 0.05). Moreover, a significant correlation was found between higher TGF-β1 expression in PTC cells and increased α-SMA levels in the fibroblasts surrounding the cancer cells (P < 0.05). We identified TGF-β1 as an important factor from PTC cells that act in a paracrine manner to influence the activation of stromal fibroblasts. These data suggest that the activation of Notch and TGF-β/Smad3 pathways in cancer cells influence tumor growth. Moreover, cancer cell-derived-TGF-β ligands also affect stromal cells in a paracrine fashion and enhance tumor growth.


Papillary thyroid carcinoma Cancer-associated fibroblasts Notch TGF-β/Smad3 α-SMA 


Conflicts of interest



  1. 1.
    Bhowmick NA, Neilson EG, Moses HL. Stromal fibroblasts in cancer initiation and progression. Nature. 2004;432:332–7.PubMedCentralPubMedCrossRefGoogle Scholar
  2. 2.
    Hu M, Polyak K. Microenvironmental regulation of cancer development. Curr Opin Genet Dev. 2008;18:27–34.PubMedCentralPubMedCrossRefGoogle Scholar
  3. 3.
    Aldred MA, Huang Y, Liyanarachchi S, Pellegata NS, Gimm O, Jhiang S, et al. Papillary and follicular thyroid carcinomas show distinctly different microarray expression profiles and can be distinguished by a minimum of five genes. J Clin Oncol. 2004;22:3531–9.PubMedCrossRefGoogle Scholar
  4. 4.
    Frattini M, Ferrario C, Bressan P, Balestra D, De Cecco L, Mon-dellini P, et al. Alternative mutations of BRAF, RET and NTRK1 are associated with similar but distinct gene expression patterns in papillary thyroid cancer. Oncogene. 2004;23:7436–40.PubMedCrossRefGoogle Scholar
  5. 5.
    Jarzab B, Wiench M, Fujarewicz K, Simek K, Jarzab M, Oczko-Wojciechowska M, et al. Gene expression profile of papillary thyroid cancer: sources of variability and diagnostic implications. Cancer Res. 2005;65:1587–97.PubMedCrossRefGoogle Scholar
  6. 6.
    Yano Y, Uematsu N, Yashiro T, Hara H, Ueno E, Miwa M, et al. Gene expression profiling identifies platelet-derived growth factor as a diagnostic molecular marker for papillary thyroid carcinoma. Clin Cancer Res. 2004;10:2035–43.PubMedCrossRefGoogle Scholar
  7. 7.
    Giordano TJ, Kuick R, Thomas DG, Misek DE, Vinco M, Sanders D, et al. Molecular classification of papillary thyroid carcinoma: distinct BRAF, RAS, and RET/PTC mutation-specific gene expression profiles discovered by DNA microarray analysis. Oncogene. 2005;24:6646–56.PubMedCrossRefGoogle Scholar
  8. 8.
    Melillo RM, Castellone MD, Guarino V, De Falco V, Cirafici AM, Salvatore G, et al. The RET/PTC-RAS-BRAF linear signaling cascade mediates the motile and mitogenic phenotype of thyroid cancer cells. J Clin Invest. 2005;115:1068–81.PubMedCentralPubMedGoogle Scholar
  9. 9.
    Semba S, Kodama Y, Ohnuma K, Mizuuchi E, Masuda R, Yashiro M, et al. Direct cancer–stromal interaction increases fibroblast proliferation and enhances invasive properties of scirrhous-type gastric carcinoma cells. Br J Cancer. 2009;101:1365–73.PubMedCentralPubMedCrossRefGoogle Scholar
  10. 10.
    Guo X, Oshima H, Kitmura T, Taketo MM, Oshima M. Stromal fibroblasts activated by tumor cells promote angiogenesis in mouse gastric cancer. J Biol Chem. 2008;283:19864–71.PubMedCrossRefGoogle Scholar
  11. 11.
    Noma K, Smalley KS, Lioni M, Naomoto Y, Tanaka N, El-Deiry W, et al. The essential role of fibroblasts in esophageal squamous cell carcinoma-induced angiogenesis. Gastroenterology. 2008;134:1981–93.PubMedCentralPubMedCrossRefGoogle Scholar
  12. 12.
    Shimoda M, Mellody KT, Orimo A. Carcinoma-associated fibroblasts are a rate-limiting determinant for tumour progression. Semin Cell Dev Biol. 2010;21:19–25.PubMedCentralPubMedCrossRefGoogle Scholar
  13. 13.
    Yashiro M, Hirakawa K. Cancer–stromal interactions in scirrhous gastric carcinoma. Cancer Microenviron. 2010;3:127–35.PubMedCentralPubMedCrossRefGoogle Scholar
  14. 14.
    Olumi AF, Grossfeld GD, Hayward SW, Carroll PR, Tlsty TD, Cunha GR. Carcinoma-associated fibroblasts direct tumor progression of initiated human prostatic epithelium. Cancer Res. 1999;59:5002–11.PubMedGoogle Scholar
  15. 15.
    Hasebe T, Sasaki S, Imoto S, Ochiai A. Proliferative activity of intratumoral fibroblasts is closely correlated with lymph node and distant organ metastases of invasive ductal carcinoma of the breast. Am J Pathol. 2000;156:1701–10.PubMedCrossRefGoogle Scholar
  16. 16.
    Tomasek JJ, Gabbiani G, Hinz B, Chaponnier C, Brown RA. Myofibroblasts and mechano-regulation of connective tissue remodelling. Nat Rev Mol Cell Biol. 2002;3:349–63.PubMedCrossRefGoogle Scholar
  17. 17.
    Tsujino T, Seshimo I, Yamamoto H, Ngan CY, Ezumi K, Takemasa I, et al. Stromal myofibroblasts predict disease recurrence for colorectal cancer. Clin Cancer Res. 2007;13:2082–90.PubMedCrossRefGoogle Scholar
  18. 18.
    Matsubara D, Morikawa T, Goto A, Nakajima J, Fukayama M, Niki T. Subepithelial myofibroblast in lung adenocarcinoma: a histological indicator of excellent prognosis. Mod Pathol. 2009;22:776–85.PubMedGoogle Scholar
  19. 19.
    Brenmoehl J, Miller SN, Hofmann C, Vogl D, Falk W, Scholmerich J, et al. Transforming growth factor-beta 1 induces intestinal myofibroblast differentiation and modulates their migration. World J Gastroenterol. 2009;15:1431–42.PubMedCrossRefGoogle Scholar
  20. 20.
    Zhang Y, Tang H, Cai J, Zhang T, Guo J, Feng D, et al. Ovarian cancer-associated fibroblasts contribute to epithelial ovarian carcinoma metastasis by promoting angiogenesis, lymphangiogenesis and tumor cell invasion. Cancer Lett. 2011;303:47–55.PubMedCrossRefGoogle Scholar
  21. 21.
    Inaba M, Umemura S, Satoh H, Ichikawa Y, Abe Y, Kirokawa K, et al. Papillary thyroid carcinoma with fibromatosis-like stroma: a report of two cases. Endocr Pathol. 2002;13:219–25.PubMedCrossRefGoogle Scholar
  22. 22.
    Isarangkul W. Dense fibrosis. Another diagnostic criterion for papillary thyroid carcinoma. Arch Pathol Lab Med. 1993;117:645–6.PubMedGoogle Scholar
  23. 23.
    Massagué J, Seoane J, Wotton D. Smad transcription factors. Genes Dev. 2005;19:2783–810.PubMedCrossRefGoogle Scholar
  24. 24.
    Webber J, Steadman R, Mason MD, Tabi Z, Clayton A. Cancer exosomes trigger fibroblast to myofibroblast differentiation. Cancer Res. 2010;70:9621–30.PubMedCrossRefGoogle Scholar
  25. 25.
    De Wever O, Nguyen QD, Van Hoorde L, Bracke M, Bruyneel E, Gespach C, et al. Tenascin-C and SF/HGF produced by myofibroblasts in vitro provide convergent pro-invasive signals to human colon cancer cells through RhoA and Rac. FASEB J. 2004;18:1016–8.PubMedGoogle Scholar
  26. 26.
    Casey TM, Eneman J, Crocker A, White J, Tessitore J, Stanley M, et al. Cancer associated fibroblasts stimulated by transforming growth factor beta1 (TGF-beta 1) increase invasion rate of tumor cells: a population study. Breast Cancer Res Treat. 2008;110:39–49.PubMedCrossRefGoogle Scholar
  27. 27.
    Lewis MP, Lygoe KA, Nystrom ML, Anderson WP, Speight PM, Marshall JF, et al. Tumour-derived TGF-beta1 modulates myofibroblast differentiation and promotes HGF/SF-dependent invasion of squamous carcinoma cells. Br J Cancer. 2004;90:822–32.PubMedCentralPubMedCrossRefGoogle Scholar
  28. 28.
    Shangguan L, Ti X, Krause U, Hai B, Zhao Y, Yang Z, et al. Inhibition of TGF-β/Smad signaling by BAMBI blocks differentiation of human mesenchymal stem cells to carcinoma-associated fibroblasts and abolishes their protumor effects. Stem Cells. 2012;30:2810–9.PubMedCrossRefGoogle Scholar
  29. 29.
    Aoyagi-Ikeda K, Maeno T, Matsui H, Ueno M, Hara K, Aoki Y, et al. Notch induces myofibroblast differentiation of alveolar epithelial cells via transforming growth factor-{beta}-Smad3 pathway. Am J Respir Cell Mol Biol. 2011;45:136–44.PubMedGoogle Scholar
  30. 30.
    Artavanis-Tsakonas S, Rand MD, Lake RJ. Notch signaling: cell fate control and signal integration in development. Science. 1999;284:770–6.PubMedCrossRefGoogle Scholar
  31. 31.
    Gridley T. Notch signaling in vascular development and physiology. Development. 2007;134:2709–18.PubMedCrossRefGoogle Scholar
  32. 32.
    Tschaharganeh DF, Chen X, Latzko P, Malz M, Gaida MM, Felix K, et al. Yes-associated protein upregulates jagged-1 and activates the NOTCH pathway in human hepatocellular carcinoma. Gastroenterology. 2013;144:1530–42.PubMedCrossRefGoogle Scholar
  33. 33.
    Ercan C, Vermeulen JF, Hoefnagel L, Bult P, van der Groep P, van der Wall E, et al. HIF-1α and NOTCH signaling in ductal and lobular carcinomas of the breast. Cell Oncol. 2012;35:435–42.CrossRefGoogle Scholar
  34. 34.
    Doi H, Iso T, Sato H, Yamazaki M, Matsui H, Tanaka T, et al. Jagged1-selective notch signaling induces smooth muscle differentiation via a RBP–Jkappa-dependent pathway. J Biol Chem. 2006;281:28555–64.PubMedCrossRefGoogle Scholar
  35. 35.
    Noseda M, Fu Y, Niessen K, Wong F, Chang L, McLean G, et al. Smooth muscle alpha-actin is a direct target of Notch/CSL. Circ Res. 2006;98:1468–70.PubMedCrossRefGoogle Scholar
  36. 36.
    Liu T, Hu B, Choi YY, Chung M, Ullenbruch M, Yu H, et al. Notch1 signaling in FIZZ1 induction of myofibroblast differentiation. Am J Pathol. 2009;174:1745–55.PubMedCrossRefGoogle Scholar
  37. 37.
    Timmerman LA, Grego-Bessa J, Raya A, Bertrán E, Pérez-Pomares JM, Díez J, et al. Notch promotes epithelial–mesenchymal transition during cardiac development and oncogenic transformation. Genes Dev. 2004;18:99–115.PubMedCrossRefGoogle Scholar
  38. 38.
    Leong KG, Karsan A. Recent insights into the role of Notch signaling in tumorigenesis. Blood. 2006;107:2223–33.PubMedCrossRefGoogle Scholar
  39. 39.
    Geers C, Colin IM, Gérard AC. Delta-like4/Notch pathway is differentially regulated in benign and malignant thyroid tissues. Thyroid. 2011;21:1323–30.PubMedCrossRefGoogle Scholar
  40. 40.
    Vasko V, Espinosa AV, Scouten W, He H, Auer H, Liyanarachchi S, et al. Gene expression and functional evidence of epithelial-to-mesenchymal transition in papillary thyroid carcinoma invasion. Proc Natl Acad Sci U S A. 2007;104:2803–8.PubMedCentralPubMedCrossRefGoogle Scholar
  41. 41.
    Chu D, Zhou Y, Zhang Z, Li Y, Li J, Zheng J, et al. Notch1 expression, which is related to p65 status, is an independent predictor of prognosis in colorectal cancer. Clin Cancer Res. 2011;17:5686–94.PubMedCrossRefGoogle Scholar
  42. 42.
    Koumoundourou D, Kassimatis T, Zolota V, Tzorakoeleftherakis E, Ravazoula P, Vassiliou V, et al. Prognostic significance of TGFbeta-1 and pSmad2/3 in breast cancer patients with T1–2, N0 tumours. Anticancer Res. 2007;27:2613–20.PubMedGoogle Scholar
  43. 43.
    Graham RP, Dry S, Li X, Binder S, Bahrami A, Raimondi SC, et al. Ossifying fibromyxoid tumor of soft part: a clinicopathologic, proteomic, and genomic study. Am J Surg Pathol. 2011;35:1615–25.PubMedCentralPubMedCrossRefGoogle Scholar
  44. 44.
    Ferretti E, Tosi E, Po A, Scipioni A, Morisi R, Espinola MS, et al. Notch signaling is involved in expression of thyrocyte differentiation markers and is down-regulated in thyroid tumors. J Clin Endocrinol Metab. 2008;93:4080–7.PubMedCrossRefGoogle Scholar
  45. 45.
    Mumm JB, Oft M. Cytokine-based transformation of immune surveillance into tumor-promoting inflammation. Oncogene. 2008;27:5913–9.PubMedCrossRefGoogle Scholar
  46. 46.
    Siegel PM, Shu W, Cardiff RD, Muller WJ, Massagué J. Transforming growth factor beta signaling impairs Neu-induced mammary tumorigenesis while promoting pulmonary metastasis. Proc Natl Acad Sci USA. 2003;100:8430–5.PubMedCrossRefGoogle Scholar
  47. 47.
    Hasegawa Y, Takanashi S, Kanehira Y, Tsushima T, Imai T, Okumura K. Transforming growth factor-beta1 level correlates with angiogenesis, tumor progression, and prognosis in patients with nonsmall cell lung carcinoma. Cancer. 2001;91:964–71.PubMedCrossRefGoogle Scholar
  48. 48.
    Zurawa-Janicka D, Kobiela J, Galczynska N, Stefaniak T, Lipinska B, Lachinski A, et al. Changes in expression of human serine protease HtrA1, HtrA2 and HtrA3 genes in benign and malignant thyroid tumors. Oncol Rep. 2012;28:1838–44.PubMedGoogle Scholar
  49. 49.
    Eloy C, Santos J, Cameselle-Teijeiro J, Soares P, Sobrinho-Simões M. TGF-beta/Smad pathway and BRAF mutation play different roles in circumscribed and infiltrative papillary thyroid carcinoma. Virchows Arch. 2012;460:587–600.PubMedCrossRefGoogle Scholar
  50. 50.
    Abdollah S, Macias-Silva M, Tsukazaki T, Hayashi H, Attisano L, Wrana JL. ThRI phosphorylation of Smad2 on Ser465 and Ser467 is required for Smad2–Smad4 complex formation and signaling. J Biol Chem. 1997;272:27678–85.PubMedCrossRefGoogle Scholar
  51. 51.
    Asano N, Watanabe T, Kitani A, Fuss IJ, Strober W. Notch1 signaling and regulatory T cell function. J Immunol. 2008;180:2796–804.PubMedGoogle Scholar
  52. 52.
    Blokzijl A, Dahlqvist C, Reissmann E, Falk A, Moliner A, Lendahl U, et al. Cross-talk between the Notch and TGF-beta signaling pathways mediated by interaction of the Notch intracellular domain with Smad3. J Cell Biol. 2003;163:723–8.PubMedCrossRefGoogle Scholar
  53. 53.
    Fu Y, Chang A, Chang L, Niessen K, Eapen S, Setiadi A, et al. Differential regulation of transforming growth factor beta signaling pathways by Notch in human endothelial cells. J Biol Chem. 2009;284:19452–62.PubMedCrossRefGoogle Scholar
  54. 54.
    Kennard S, Liu H, Lilly B. Transforming growth factor-beta (TGF- 1) down-regulates Notch3 in fibroblasts to promote smooth muscle gene expression. J Biol Chem. 2008;283:1324–33.PubMedCrossRefGoogle Scholar
  55. 55.
    Sjölund J, Boström AK, Lindgren D, Manna S, Moustakas A, Ljungberg B, et al. The notch and TGF-β signaling pathways contribute to the aggressiveness of clear cell renal cell carcinoma. PLoS One. 2011; e23057.Google Scholar
  56. 56.
    Hanahan D, Weinberg RA. Hallmarks of cancer: the next generation. Cell. 2011;144:646–74.PubMedCrossRefGoogle Scholar
  57. 57.
    Na KY, Kim HS, Sung JY, Park WS, Kim YW. Papillary carcinoma of the thyroid gland with nodular fasciitis-like stroma. Korean J Pathol. 2013;47:167–71.PubMedCentralPubMedCrossRefGoogle Scholar
  58. 58.
    Böttinger EP, Jakubczak JL, Roberts IS, Mumy M, Hemmati P, Bagnall K, et al. Expression of a dominant-negative mutant TGF-beta type II receptor in transgenic mice reveals essential roles for TGF-beta in regulation of growth and differentiation in the exocrine pancreas. EMBO J. 1997;16:2621–33.PubMedCrossRefGoogle Scholar
  59. 59.
    Perrot CY, Javelaud D, Mauviel A. Insights into the transforming growth factor-β signaling pathway in cutaneous melanoma. Ann Dermatol. 2013;25:135–44.PubMedCentralPubMedCrossRefGoogle Scholar
  60. 60.
    Chen H, Yang WW, Wen QT, Xu L, Chen M. TGF-beta induces fibroblast activation protein expression; fibroblast activation protein expression increases the proliferation, adhesion, and migration of HO-8910PM [corrected]. Exp Mol Pathol. 2009;87:189–94.PubMedCrossRefGoogle Scholar

Copyright information

© International Society of Oncology and BioMarkers (ISOBM) 2013

Authors and Affiliations

  1. 1.Department of Head and Neck Surgery, Fourth HospitalHebei Medical UniversityShijiazhuangPeople’s Republic of China
  2. 2.Department of Pathology, Second HospitalHebei Medical UniversityShijiazhuangPeople’s Republic of China

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