Abstract. The aim of this study was to investigate the roles of the cathepsin B cysteine protease and its endogenous inhibitor stefin A in laryngeal cancer. Immunohistochemistry was employed to detect the expression of cathepsin B and stefin A in 84 patients with laryngeal cancer, respectively. The protein expression of stefin A was negatively associated with lymphatic metastasis, recurrence of laryngeal cancer and the survival rate, which was not observed with cathepsin B protein expression. Both down-regulation of cathepsin B and up-regulation of stefin A in vitro significantly inhibited the migration, invasion and proliferation of laryngeal cancer cells, respectively. Our results strongly suggest that stefin A may be a potential predictor of laryngeal cancer and may be used in the molecular diagnosis and gene therapy of laryngeal cancer. Cathepsin B may be used as a promising therapeutic target in the treatment of laryngeal cancer.
IntroductionLaryngeal cancer is a common head and neck malignancy and accounts for 7% of all malignancies, and the incidence of laryngeal cancer has been increasing over the years. Laryngeal cancer is associated with a high prevalence of local invasion and cervical lymph node metastasis, and a majority of patients die of cervical recurrence and metastasis. Investigations concerning the invasion and metastasis of laryngeal cancer may clarify the exact mechanisms underlying these processes and may identify novel therapeutic targets. The invasion and metastasis of cancers are complex, multistep, multifactor interacting, and dynamic biological processes involving cancer cells, host cells and the extracellular matrix (1). Invasion is a prerequisite of metastasis that depends on adherence and degradation of the extracellular matrix by degradative enzymes (2). Liotta et al proposed that the invasion and metastasis of cancers involve three steps: i) adherence between cancer cells and the extracellular matrix; ii) the release of proteolytic enzymes causing the degradation of the extracellular matrix; and iii) migration of cancer cells under the action of chemokines. This theory suggests that adherence, degradation and migration act sequentially and repetitively, ultimately resulting in sustained invasion and distal metastasis of cancer cells (3). The impairment of the basement membrane has been considered an important marker of cancer invasion, and the degradation of the extracellular matrix by proteolytic enzymes is a critical step of invasion and metastasis of cancer cells. Based on the substrates and pH values for enzyme catalysis, proteolytic enzymes can be classified into four types: serine proteases, matrix metalloproteinases, cysteine proteases, and aspartic proteases. These proteases have different biological functions related to cancer and play an important role in the occurrence, invasion, angiogenesis, and metastasis of cancers. Cancer invasion depends on the local concentration of proteases and the balance between proteases and their inhibitors. Under normal conditions, protease...