Abstract

Chordomas is rare malignant bone tumors thought to arise from remnants of embryonic notochord along the spine, frequently at the skull base and sacrum. Although chordoma is slow growing tumors, while are extremely recurrent, and aggressive, as well as the rate of prognosis remains poorly. Radical surgery and high-dose radiation are the most used treatments. Currently, there is no effective chemotherapeutic standard for chordomas. The Hedgehog (HH) pathway adjusts various processes included in expansion and differentiation of tissues and organs throughout the fetus’s life, furthermore cell growth and differentiation in the adult organism, of the cell in an adult organism, in which acute anesthesia is involved in multiple cancers. To study the role of signaling the hedgehog in the base of the skull and sacrum chordomas, the expression of SHH and GLI-1 levels were detected immuno histochemically, Additionally, PTCH-1 and GLI-1 expressions were distinguished by in- Situ- hybridization. Based on the findings presented herein, it is likely that the HH signal cascade was revealed even in cranial, where consecoently spinal chordoma and their recurrences play an important role. Our staining exhibited a canonical, ligand- dependent and autocrine Hedgehog signaling in skull base and sacrum chordomas including relapse. Due to the high levels of SHH and GLI-1 expression in all investigated chordoma samples, the study suggests a possible autocrine ligand-dependent activation of the canonical HH signaling cascade. A paracrine or non-canonical pathway cannot be excluded. Our results suggest that Hedgehog-inhibitors, like SHH-, GLI- and SMO- inhibitors, might serve as a potential and effective target for the treatment of chordomas.

Highlights

  • Slow-growing type of bone neoplasm arising from cartilage cells [1]

  • Chordoma is prevalent in the skull base region and in the area of the sacrum [3,4]

  • Since GLI1 stimulates PTCH transcription, both GLI1 and PTCH1 can be regarded as target genes, as well as reliable markers for an active HH/PTCH signaling cascade [20]

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Summary

Introduction

Slow-growing type of bone neoplasm arising from cartilage cells [1]. Since GLI1 stimulates PTCH transcription, both GLI1 and PTCH1 can be regarded as target genes, as well as reliable markers for an active HH/PTCH signaling cascade [20]. Many recent studies have demonstrated that HH signaling cannot be processed through GLI activation, but can act via other signaling pathways, such as the RAS (Rat Sarcoma) and Transforming Growth Factor Beta (TGFb) signaling cascade [30,31]. We investigated whether SHH signal cascade play a role in the formation of chordomas and their recurrences. A chemotherapeutic approach for the treatment of these patients may be conceivable if evidence of an active SHH signaling cascade is available

Patient Collective
Immunohistochemistry
Immunohistochemical Scoring for Shh and Gli1
In Situ Hybridization
Ethics Approval and Consent to Participate
Conclusions
Full Text
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