Molecular Characterization of Perineural Invasion in Pancreatic Ductal Adenocarcinoma: Proteomic Analysis and In Vitro Modelling.

Abstract

Pancreatic ductal adenocarcinoma (PDAC) is the most common type of pancreatic cancer, and the 5th most common cause of cancer death in the UK. One of the peculiarities of this malignancy is its ability to invade nerves, a process called perineural invasion (PNI). PNI is found in almost 100% of PDAC, and is associated with poor prognosis, tumour recurrence and generation of pain. However, the molecular bases of PNI remain largely unknown. We investigated the molecular alterations underlying the neuro-epithelial interactions in PNI using one and two dimensional liquid chromatography – mass spectrometry (1D and 2D LC-MS) of laser microdissected PNI and non-PNI cancer from formalin fixed, paraffin embedded PDAC tissues. We also performed 1D LC-MS analysis of invaded and non-invaded nerves from the same cases. In addition, we developed an in vitro model of PNI using a co-culture system comprising PC12 cells, a rat pheochromocytoma cell line, as the neuronal element and PDAC cell lines. The overall proteomic profiles of PNI and non-PNI cancer appeared largely similar; of very few deregulated proteins, we have validated the up-regulation of antiapoptotic protein Olfactomedin 4 in PNI cancer using immunohistochemistry. In contrast, nerve samples demonstrated widespread molecular alterations characteristic of neuronal plasticity upon invasion by cancer cells. Immunohistochemistry confirmed the up-regulation of VGF in nerves from PDAC and chronic pancreatitis (CP) specimens compared to normal pancreas, as well as in invaded compared to non-invaded nerves in PDAC tissues. Furthermore, VGF expression strongly correlated with pain in CP; similar analysis in PDAC cases is still pending. Using the in vitro co-culture model, several PDAC cell lines were able to induce PC12 cells neuronal plasticity including survival, neurite extension as well as VGF expression, recapitulating thus the changes observed in human tissues. PDAC-induced PC12 plasticity was not mediated via NGF, a neurotrophin acting upstream of VGF and thought to be involved in the neuro-epithelial interactions. The induction of VGF expression was shown not to be necessary for PC12 cell survival, however, it contributed to the neurite extension induced by PDAC cell lines. In summary, based on proteomics analysis and in vitro modelling, we show the complex and intricate involvement and crosstalk of both tumoral and neural elements that are activated during perineural invasion in pancreatic cancer