Yang Zhang

Pathological lymphatic diseases mostly affect vessels in specific tissues, yet little is known about organ-specific regulation of the lymphatic vasculature. Here, we show that the vascular endothelial growth factor receptor 3 (VEGFR-3)/p110α PI3-kinase signaling pathway is selectively required for the formation of mesenteric lymphatic vasculature. Using genetic lineage tracing, we demonstrate that part of the mesenteric lymphatic vasculature develops from cKit lineage cells of hemogenic endothelial origin through a process we define as lymphvasculogenesis. This is contrary to the current dogma that all mammalian lymphatic vessels form by sprouting from veins. Our results reveal vascular-bed-specific differences in the origin and mechanisms of vessel formation, which may critically underlie organ-specific manifestation of lymphatic dysfunction in disease. The progenitor cells identified in this study may be exploited to restore lymphatic function following cancer surgery, lymphedema, or tissue trauma.

BACKGROUND: Studies have shown that manual lymphatic drainage (MLD) has a beneficial effect on lymphedema related to breast cancer surgery. However, whether MLD reduces the risk of lymphedema is still debated. The purpose of this systematic review and meta-analysis was to summarize the current evidence to assess the effectiveness of MLD in preventing and treating lymphedema in patients after breast cancer surgery. METHODS: From inception to May 2019, PubMed, EMBASE, and Cochrane Library databases were systematically searched without language restriction. We included randomized controlled trials (RCTs) that compared the treatment and prevention effect of MLD with a control group on lymphedema in breast cancer patients. A random-effects model was used for all analyses. RESULTS: A total of 17 RCTs involving 1911 patients were included. A meta-analysis of 8 RCTs, including 338 patients, revealed that MLD did not significantly reduce lymphedema compared with the control group (standardized mean difference (SMD): -0.09, 95% confidence interval (CI): [-0.85 to 0.67]). Subgroup analysis was basically consistent with the main analysis according to the research region, the publication year, the sample size, the type of surgery, the statistical analysis method, the mean age, and the intervention time. However, we found that MLD could significantly reduce lymphedema in patients under the age of 60 years (SMD: -1.77, 95% CI: [-2.23 to -1.31]) and an intervention time of 1 month (SMD: -1.77, 95% CI: [-2.23 to -1.30]). Meanwhile, 4 RCTs including, 1364 patients, revealed that MLD could not significantly prevent the risk of lymphedema (risk ratio (RR): 0.61, 95% CI: [0.29-1.26]) for patients having breast cancer surgery. CONCLUSIONS: Overall, this meta-analysis of 12 RCTs showed that MLD cannot significantly reduce or prevent lymphedema in patients after breast cancer surgery. However, well-designed RCTs with a larger sample size are required, especially in patients under the age of 60 years or an intervention time of 1 month.

The protective role of fibrinogen‑like‑protein 1 (FGL1) in liver injury has been reported previously. However, there are few studies on FGL1 expression in gastric cancer (GC) tissues, and the role of FGL1 in GC remains unclear. The aim of the present study was to investigate the correlation between FGL1 expression and prognosis in GC patients. Data was downloaded from The Cancer Genome Atlas database, and 50 pairs of GC tissues and the corresponding non‑tumor tissues were collected between 2008 to 2011. Furthermore, FGL1 expression was silenced in order to explore its role in SGC‑7901 cell proliferation, invasion and migration using Cell Counting Kit‑8, wound healing, Transwell invasion and migration assays, respectively. Finally, whether FGL1 is involved in epithelial‑mesenchymal transition (EMT) regulation in SGC‑7901 cells was determined by western blotting. The results revealed that FGL1 expression was upregulated in GC tissues, and the overall survival time of GC patients with high FGL1 expression levels was markedly shorter than that of GC patients with low FGL1 expression levels (P=0.005). In addition, silencing FGL1 significantly inhibited SGC‑7901 cell proliferation, invasion and migration in vitro. Finally, western blot analyses indicated that knockdown of FGL1 markedly increased E‑cadherin expression levels (P<0.01), and significantly decreased N‑cadherin (P<0.01) and vimentin expression levels (P<0.01), thereby suggesting that FGL1 may promote EMT. These results indicated that FGL1 has the potential to be a predictor in GC patients as well as a target for the treatment of GC.