Secondary Logo

Journal Logo

Original article

Enhanced invasionin vitro and the distribution patternsin vivo of CD133+ glioma stem cells

YU, Sheng-ping; YANG, Xue-jun; ZHANG, Bin; MING, Hao-lang; CHEN, Cong; REN, Bing-cheng; LIU, Zhi-feng; LIU, Bin

Author Information
doi: 10.3760/cma.j.issn.0366-6999.2011.17.007


Malignant glioma is the major brain tumor in adults and has a poor prognosis. The failure to control invasive cell subpopulations may be the key reason for local recurrence of glioma after radical tumor resection and may contribute substantially to the failure of adjuvant modalities such as radiotherapy and chemotherapy. Local invasion is the hallmark of malignant glioma. The glioma cells seem to invade following the distinct anatomic structures within the central nervous system. Tumor cell dissemination may occur along structures, such as the basement membranes of blood vessels or the glial limitans externa, which contain extracellular matrix (ECM) proteins. Frequently, invasive glioma cells are also found to migrate along myelinated fiber tracts of white matter.1 Implantation of C6 glioma cells into the rat brain mimics many of the growth and pathological characteristics of human gliomas.2 The invasion study using C6 cells labeled with bromodeoxyuridine (BrdUrd) showed migration of the tumor cells toward the perivascular space that was distant from the primary site of injection after 4 days of the injection.3

Numerous studies indicate that the growth of gliomas is initiated and driven by a subpopulation of cancer cells with stem-like characteristics, including self-renewal capacity and the ability to differentiate. These cells were called glioma stem cells (GSCs), displaying greater tumorigenic potential than matched non-stem tumor cells when xenotransplanted into the brains of immuno-compromised rodents.4 It has been hypothesized that GSCs are more invasive than matched non-stem tumor cells. Do GSCs invade also along the perivascular space or white tracts matter? The direct experimental evidence addressing this issue has been less so far. Here we show experimental data to demonstrate that GSCs display greater invasive potential in vitro than matched non-stem tumor cells derived from C6 cells and the distribution patterns in perivascular niche of tumor-brain interface and along white matter tracts in xenografts.


Reagents and animals

The following reagents and animals were used: rabbit monoclonal to CD133 (Abcam, USA); rabbit polyclonal to nestin (Santa Cruz, USA); epidermal growth factor (EGF), basic fibroblast growth factor (bFGF), 1% luxol fast blue solution (Sigma, USA); B-27 minus vitamin A, DMEM, DMEM/F12 (Gibco, USA); rat glioma line C6 (China Academia Sinica cell repository, Shanghai, China); Sprague-Dawley (SD) rats (Animal Center of PLA General Hospital, Beijing, China); Alexa Fluor-488 F(ab′)2 fragment of goat anti-rabbit IgG, Alexa Fluor-555 F(ab′)2 fragment of goat anti-rabbit IgG (Cell signaling, USA).

Cell culture

C6 cells were cultured in serum-containing medium (SCM) supplemented with 10% fetal bovine serum (FBS), 100 U/ml penicillin G, and 100 U/ml streptomycin. C6 cells formed round cell aggregates or spheres when the cells were cultured in serum-free medium (SFM) containing of DMEM-F12 medium, 10 μg/ml bovine insulin, 100 μg/ml bovine serum albumin (BSA), 50 U/ml penicillin, 50 μg/ml streptomycin, as well as 20 ng/ml bFGF, 20 ng/ml EGF, B-27 (1:50). Spheres were centrifuged, triturated with a fire-narrowed pasteur pipette, and resuspended in phosphate buffered saline (PBS) with 0.5% BSA and 2 mmol/L ethylenediaminetetraacetic acid (EDTA). Magnetic isolation of GSCs was carried out using the Miltenyi Biotec CD133 Cell Isolation kit (Miltenyi Biotec GmbH, Germany). CD133+ and CD133 sorted cell populations were resuspended in SFM. In all experiments, cells were maintained in 100-mm culture dishes (Corning, USA) at 37°C in a humidified 5% CO2/95% air atmosphere.

In vitro matrigel invasion assay

The in vitro cell invasion assay was performed using Matrigel-coated invasion chamber (Millipore, USA) as previously described.5 CD133+ and CD133 cells (1×105) were added to the upper chamber of the Matrigel-coated prehydrate polycarbonate membrane filter. After incubation for 24 hours, the non-invaded cells from the upper side of the filter were scraped using moist cotton swab. The invaded cells in the reverse side of the filter were fixed and stained with crystal violet, and then counted under an inverted microscope.

Intracranial transplantation into SD rats

Intracranial transplantation of C6 cells into SD rats was performed as described.6 Briefly, C6 cells were suspended in PBS (1×105/μl). Twenty-six-week-old SD rats were anesthetized with 10% chloral hydrate (3 ml/kg) and placed in the stereotactic frame using ear bars. A hole was made in the skull 3.0 mm lateral to the bregma, 1 mm anterior to the coronal suture. Cell suspension (10 μl) was transplanted into the right caudate 5.0 mm below the surface of the brain using a Hamilton syringe. When rats developed neurological deficits, they were sacrificed, brains of bearing tumor were quickly dissected out and fixed with 4% paraformaldehyde (PFA). After cutting 5-μm-thick sections from coronal dissected brain and placing them on lysine-coated slides, mirror sections, comprising a pair of consecutive slices, were prepared to examine whether GSCs invasion along with white fiber tracts. The sections were placed on the slides so that their adjacent surfaces faced upwards, and appeared as reversed images of each other, the same as an object and its image in a mirror.7 One of mirror sections was prepared for immunohistochemistry (IHC) staining, another for luxol fast blue (LFB) staining. Brain sections were then subjected to hematoxylin and eosin (H&E) staining. All animal experiments were accordance with the guidelines of the Tianjin Medical University Committee for Ethics of Animal Experimentation.

Immunofluorescent and IHC staining

Immunofluorescence was performed on spheres and serum-cultured cells as described.8 Previously, for immunostaining of undifferentiated tumor spheres, cells were plated onto poly-L-lysine-coated glass coverslips in SCM for 4 hours. Cells were then fixed with 4% PFA and incubated with the following antibodies: CD133 (1:1000), nestin (1:200). Secondary antibodies (anti-rabbit IgG conjugated with Alexa 488 555) were used. For immunostaining of serum-cultured cells, serum-cultured cells C6 were plated onto glass coverslips for 24 hours. Cells were counterstained with anti-fade sealant containing 4′6-diamidino-2-phenylindole (DAPI) (Vectashield, USA). IHC staining of mirror sections and paraffin slips were performed as described7 using following primary antibodies: CD133 (1:100), nestin (1:100). Images were examined under fluorescence microscope DP70 (Olympus, Japan). Pictures were captured with DP70 CCD digital camera (Olympus).

LFB staining

LFB staining was performed as described.9 Mirror sections were immersed in 1% LFB solution overnight at 57°C in tightly sealed staining jars. Removal of excess LFB with 95% ethanol rinses was followed by distilled H2O rinses and an initial differentiation for a few seconds in 0.05% LiCO3. Differentiation of the sections was continued in several changes of 70% ethanol until the grey and white matter were clearly distinguished. Thereafter, the sections were washed thoroughly by distilled H2O and stained for three minutes at 57°C in a preheated 1% solution of cresyl violet acetate (Sigma) containing 0.1% acetic acid (pH 3.7) that had been made up 16 to 20 hours prior to use. After differentiation in 95% ethanol, the sections were dehydrated, cleared in xylene and mounted.

Western blotting

The rat brains of bearing tumor were quickly removed after anesthesia with 10% chloral hydrate (3 ml/kg) and placed on ice. Tissues were taken from tumor core, the junctional zone between the tumor and the normal brain tissue, the surrounding area of the tumor margin (2-3 mm), and the corpus callosum of contralateral hemisphere with microinstrument. They were kept at -80°C. A big piece of frozen tissue was broken into small pieces and transferred into a 1.5-ml microcentrifuge tube; 500-μl cell lysis buffer was added to the tube. The tissue was homogenized with 10 to 15 strokes (3-4 s/stroke) using a mini-homogenizer and plastic pestle on ice. The protein was concentrifuged at 12 000 × g for 15 minutes at 4°C. The supernatant was transferred to a fresh tube; 50-μg protein and an equal volume of 2× sample buffer were heated at 94°C for 5 minutes. Proteins were separated on an 8% sodium dodecyl sulfate-polyacrylamide gel and transblotted onto a polyvinylidene difluoride (PVDF) transfer membrane (Millipore). The blot was blocked in PBS-T and 5% skim milk at 37°C for 1 hour. The membrane was then incubated in primary antibody (CD133, 1:500) at 4°C overnight, followed by treatment with secondary antibody conjugated with horseradish peroxidase (1:1000). Blots were developed using the enhanced chemiluminescence (ECL) reagents (Amersham Pharmacia, UK) and visualized using the GeneGenius Imaging System (Frederick, USA).

Statistical analysis

Statistical evaluations were carried out using SPSS 15.0 software (SPSS Inc., USA). Values were expressed as mean ± standard deviation (SD). Student's t test and one-way analysis of variance (ANOVA) test were used. Statistical significance was set at P <0.05.


Characterization of GSCs

The C6 glioma cell line contained a small subpopulation of cancer stem-like cells.10 GSCs of C6 cells grew into neurosphere-like glioma spheres when cultured in SFM (Figure 1B); but in SCM, C6 cells showed adherent growing (Figure 1A). CD133+ GSCs could also be found in an adhere monolayer (Figure 1C). Immunofluorescence staining showed highly expressed CD133 marker in gliomasphere (Figure 1D).

Figure 1.
Figure 1.:
Characterization of GSCs. A: Monolayer C6 cells in serum-containing medium. B: Representative images of GSC tumorspheres. GSCs derived from C6 rat glioma cell line were cultured in surum-free stem cell medium for 5 days to form tumorspheres. C: Some of adherent cells also expressing stem cell marker CD133 (red) cells were immunostained by anti-rabbit alexa 555. D: Tumorspheres of stem cells were immunostained for CD133 followed by anti-rabbit alexa 488 (green). Cell nucleus (blue) was counterstained by DAPI.

In vitro matrigel invasion assay

CD133+ GSCs and CD133 cells were assessed for their invasive potential by examining cell migration through a matrigel invasion assay. GSCs populations showed more cells migrated through the matrigel than matched non-stem tumor cell populations (Figure 2A and 2B). A total of 85.3±4.0 GSCs passed the matrigel, meanwhile the number of the passed non-stem cells was 25.9±3.1. Quantified data confirmed that GSCs had more (3-4 folds) cells migrated through the matrigel than matched non-stem tumor cells (Figure 2C). These data suggested that GSCs were significantly more invasive in vitro than matched non-stem tumor cells (t=14.5, P <0.05).

Figure 2.
Figure 2.:
In vitro matrigel invasion assay of GSCs and matched non-stem tumor cells from C6 cells. The relative invasive capacity of GSCs (A) and matched non-stem tumor cells (B) in the Millipore Matrigel-coated invasion chamber. Cells migrated through the matrigel were stained by crystal violet and photographed. Quantified data shows that GSCs had significantly more cells migrated through the matrigel than matched non-stem tumor cells in vitro (C). Data are mean ± SD (n=3). *P <0.05.

Distribution of GSCs in the brain tumor

Aggressive invasion of cancer cells into brain tissue is one of the most significant characteristics of malignant glioma. To further compare the invasive potential of GSCs and non-tem tumor cells in vivo, the distribution of GSCs in the brain tumor was studied. GSCs invaded into the brain diffusely and the border line was unclear. In the tumor, CD133+ GSCs located around a blood vessel as a single cell and as cell clusters as well. The junction of tumor and brain tissues maintained numerous CD133+ GSCs which distributed around vascular even the long axis of blood vessels. The sites distant from tumor also had this phenomenon of perivascular satellitosis (Figure 3).

Figure 3.
Figure 3.:
Migration of GSCs along the perivascular. Paraffin-embedded, formalin-fixed sections were immunostained with antibodies against CD133 and counterstained with hematoxylin. 3A: Hematoxylin and eosin (H&E) staining of glioma xenografts derived from C6. 3B: Cancer cells invading into normal tissue and numerous CD133+ GSCs in junction of tumor and brain tissue. 3C: CD133 expression was seen in niches which were often perivascular. CD133+ GSCs located around the long axis of vascular. 3D: Glioma cells migrating into the normal brain around blood vessels, some of them express CD133 protein. 3E: The image is the magnification of 3D. 3F: Perivascular satellitosis distant from the xenografts. T: tumor.Figure 4. Mirror sections stained for IHC of nestin and LFB. Specimens (4B and 4C) were stained for nestin, and the corresponding mirror sections (4E and 4F) were stained for LFB. 4A: Normal brain tissues without nestin staining. 4B: Nestin expression of glioma xenografts, lots of nestin+ cells were in the margin of the tumor, white matter tracts was mature barrier to the invasion of GSCs. Glioma cells containing GSCs resided around vascular in another side of white matter tracts. Nestin+ cells are shown in brown. 4C: It is the magnification of 4B. 4D: LFB staining of white matter tracts shown in blue. 4E: The axis of glioma cells is parallel to the white matter tracts, it is a easy way for glioma cells to invasion. 4F: It is the magnification of 4E. Sections were counterstained with hematoxylin to show nuclei.

GSCs and white fiber tracts

The infiltrative path of gliomas into the normal brain presents as a non-random process, often following white matter tracts.11 These preferred anatomical routes for invasion suggest the importance of interactions between migrating cells and their microenvironment. Mirror sections staining showed that GSCs around vascular located at the edge of white matter tracts. The polarity of glioma cells in fiber was parallel to the white matter tracts. GSCs were observed migrating along vessels and reaching the white matter tracts, and then GSCs migrating into other sites transited through the white matter tracts (Figure 4).

Western blotting

The expressions of CD133 in different regions of brain tumor were identified by Western blotting. Data were presented as the mean of triplicate experiments, differences between the mean of each group were tested using the one-way ANOVA test (F=2488, P <0.05) (Figure 5). Significantly higher amounts of protein were observed in the center (0.0378±0.0007) and edge of brain tumor (0.0464±0.0010) than in the surrounding of the tumor (0.0295±0.0004). CD133 protein expressed also in corpus callosum between hemispheres but the level of expression was very low (0.0115±0.0002), which might imply that GSCs was migrating into the contralateral hemisphere along corpus callosum.

Figure 5.
Figure 5.:
Western blotting analysis for expression of CD133 in different regions of brain tumor. a: Normal brain tissue. b: Tumor core. c: The junctional zone between the tumor and the normal brain tissue. d: The surrounding of brain tumor (2-3 mm to the border of brain tumor). e: The corpus callosum of contralateral hemisphere. The pictures were analyzed by Quantity One Software. GAPDH was used as a loading control.


Treatment of adult glioma, in particular glioblastoma, remains a significant clinical challenge, despite modest advances in surgical technique, radiation, and chemotherapeutics. Two major aspects of glioma biology that contributes to this recalcitrance are the formation of new blood vessels through the process of angiogenesis and the invasion of glioma cells through white matter tracts, which are hallmarks of glioblastoma. Recent insight into the relationship between GSCs with invasion provide a renewed hope for development of novel strategies aimed at reducing the morbidity of this uniformly fatal disease. Singh and colleagues12 successfully isolated cancer stem cells (CSCs) from different types of brain tumors, GSCs make up a small fraction of the glioma that have been shown to be capable of giving rise to the entire tumor and which are believed to represent a source of treatment resistance. Although malignant glioma cells rarely spread outside the central nervous system, glioma cells often infiltrate into normal brain tissue preventing curative surgical resection.

Cell surface molecules differentially expressed in GSCs and functionally associated with the maintenance of GSCs may be ideal markers for sorting or identifying GSC population. Several molecules, including CD133, CD15, A2B5, L1CAM have been identified on cell surface of GSCs. CD15 (SSEA-1) originally identified as a surface marker of mouse embryonic stem cells has been recently used as an alternative marker to enrich GSCs from some glioblastoma multiforme (GBM) tumors in which CD133 is not an informative maker for GSCs population.13 CD15 in normal stem cells and CSCs remains poorly understood. A2B5 have been used for the enrichment of GSC population.14 L1CAM is a differentially expressed surface glycoprotein that plays critical roles in the maintenance, survival and cellular functions of GSCs.15 Some important stem cell transcription factors (SCTFs) involved in regulating normal stem cells are also required for the maintenance of a GSC phenotype. These stem cell transcription factors such as Sox2, Oct4, Nanog, c-Myc, Olig2 and Bmil are critical for maintaining the self-renewal, proliferation, survival, and multi-lineage differentiation potential of GSCs.16 Some of above glioma stem cell markers could only identify the particular stage of a certain type of CSCs ascribed to a some degree of GSCs' heterogeneity. Among these stem cell markers, CD133 and Nestin are currently the most accredited markers for the identification of GSCs. The C6 rat glioma cell line is known to contain a subpopulation of GSCs. In this study, we isolated and characterized CSCs from the C6 cells, and assessed their invasive potential. GSCs deprived from C6 cells had greater invasive potential than matched non-stem tumor cells in vitro cell invasion assay. On the basis of this, we speculate that GSCs are likely to be primary tumor cells invading into brain tissue.

Descriptions in the 1940s of tumor cells migrating into the normal brain around blood vessels (perivascular satellitosis), first suggested that malignant glioma cells might have a special relationship with the surrounding vasculature.17 Nestin+/CD133+ cancer cells locate next to capillaries in brain tumors, the brain tumor microvasculature forms a niche that is critical for the maintenance of GSCs.18,19 IHC study using C6 orthotopic tumor models show that CD133+ glioma cells locate and distribute in the tumor-brain interface and the space being distant from the site of tumor, meanwhile these GSCs reside perivascular niche, even around the long vessel axis. Perivascular niche exhibit restricted oxygen availability and distinct ECM profiles. In parallel, GSCs are enriched in perivascular niches, and possibly also within regions of hypoxia and at the invasive edge of the tumor.20 Why is GSCs performing “vasoinvasion”? In malignant glioma, there exists an imbalance between the supply and consumption of oxygen as a result of limited O2 delivery to the cancer cells.21 Hypoxic can be caused by abnormal vascular structure, increased diffusion distance, a temporary disruption in blood flow and/or low haemoglobin level. Hypoxic stress is a key important factor of niche.22 Unlike normal cells, tumor cells are much better equipped to cope with hypoxia, in hypoxic conditions, hypoxia-tolerant tumor cell clones are selected, while tumor stem cells in hypoxic niches escape anti-angiogenic treatment.23 The core relationship between a tumor and its host niche is the nutritional and signal interactions between CSCs and endothelial cells, the nutritional interaction between the cancer and the host triggers the invasion and metastasis of cancers.24 For more nutrition and O2, GSCs may reach “fertile soil” alongside “oxygen pipes”.25

The infiltrating GSCs probably reached white matter tracts by through perivascular space, white matter tracts under certain circumstances, acted as barriers to invasion of gliomas cells. The polarity of glioma cells which show intrafascicular, perifascicular, and interfibrillary migration is parallel to the white matter tracts. Herein, cells migrating follow the path of white matter tracts maybe a forced process, it is an easy way for glioma cells to invade along white matter tracts, because of minimal resistance. Most of tumor cells are polarized in the tumor-brain interface and white matter tracts, but in the tumor center, there are only a few. Soluble motility factors (such as CXCL12/CXCR4) function as autocrine or paracrine signaling, leading to changes in cell morphology: the cell becomes polarized and membrane protrusions including pseudopodia, lamellipodia, filopodia and invadopodia are extended from the leading edge of the cells.26,27 The polarized cells are easy to invasion and migration. Corpus callosum of contralateral hemisphere express CD133 protein show that GSCs probably migrated into contralateral hemisphere across the corpus callosum.

In short, the GSCs under the influence of hypoxic pressure, prone to migrate to more fertile areas along blood vessels and white matter tracts, guided by chemokine factor. Targeting GSCs through anti-invasive therapies in combination with traditional GBM therapeutic paradigms may inhibit cancer invasion, overcome therapeutic resistance and reduce tumor recurrence, which may lead to a significant improvement of GBM treatment.


1. Giese A, Westphal M. Glioma invasion in the central nervous system. Neurosurgery 1996; 39: 235-252.
2. Grobben B, De Deyn PP, Slegers H. Rat C6 glioma as experimental model system for the study of glioblastoma growth and invasion. Cell Tissue Res 2002; 310: 257-270.
3. Nagano N, Sasaki H, Aoyagi M, Hirakawa K. Invasion of experimental rat brain tumor: early morphological changes following microinjection of C6 glioma cells. Acta Neuropathol 1993; 86: 117-125.
4. Sanai N, Alvarez-Buylla A, Berger MS. Neural stem cells and the origin of gliomas. N Engl J Med 2005; 353: 811-822.
5. Bao S, Wu Q, Sathornsumetee S, Hao Y, Li Z, Hjelmeland AB, et al. Stem cell-like glioma cells promote tumor angiogenesis through vascular endothelial growth factor. Cancer Res 2006; 66: 7843-7848.
6. Li Z, Bao S, Wu Q, Wang H, Eyler C, Sathornsumetee S, et al. Hypoxia-inducible factors regulate tumorigenic capacity of glioma stem cells. Cancer Cell 2009; 15: 501-513.
7. Semba S, Iwaya K, Matsubayashi J, Serizawa H, Kataba H, Hirano T, et al. Coexpression of actin-related protein 2 and Wiskott-Aldrich syndrome family verproline-homologous protein 2 in adenocarcinoma of the lung. Clin Cancer Res 2006; 12: 2449-2454.
8. Cheng L, Wu Q, Huang Z, Guryanova OA, Huang Q, Shou W, et al. L1CAM regulates DNA damage checkpoint response of glioblastoma stem cells through NBS1. EMBO J 2011; 30: 800-813.
9. Yao DL, Komoly S, Zhang QL, Webster HD. Myelinated axons demonstrated in the CNS and PNS by anti-neurofilament immunoreactivity and Luxol fast blue counterstaining. Brain Pathol 1994; 4: 97-100.
10. Kondo T, Setoguchi T, Taga T. Persistence of a small subpopulation of cancer stem-like cells in the C6 glioma cell line. Proc Natl Acad Sci U S A 2004; 101: 781-786.
11. Zagzag D, Esencay M, Mendez O, Yee H, Smirnova I, Huang Y, et al. Hypoxia- and vascular endothelial growth factor-induced stromal cell-derived factor-lalpha/CXCR4 expression in glioblastomas: one plausible explanation of Scherer's structures. Am J Pathol 2008; 173: 545-560.
12. Singh SK, Clarke ID, Terasaki M, Bonn VE, Hawkins C, Squire J, et al. Identification of a cancer stem cell in human brain tumors. Cancer Res 2003; 63: 5821-5828.
13. Son MJ, Woolard K, Nam DH, Lee J, Fine HA. SSEA-1 is an enrichment marker for tumor-initiating cells in human glioblastoma. Cell Stem Cell 2009; 4: 440-452.
14. Tchoghandjian A, Baeza N, Colin C, Cayre M, Metellus P, Beclin C, et al. A2B5 cells from human glioblastoma have cancer stem cell properties. Brain Pathol 2010; 20: 211-221.
15. Bao S, Wu Q, Li Z, Sathornsumette S, Wang H, Mclendon RE, et al. Targeting cancer stem cells through L1CAM suppresses glioma growth. Cancer Res 2008; 68: 6043-6048.
16. Huang Z, Cheng L, Guryanova OA, Wu Q, Bao S. Cancer stem cells in glioblastoma — molecular signaling and therapeutic targeting. Protein Cell 2010; 1: 638-655.
17. Gilbertson RJ, Rich JN. Making a tumour's bed: glioblastoma stem cells and the vascular niche. Nat Rev Cancer 2007; 7: 733-736.
18. Calabrese C, Poppleton H, Kocak M, Hogg TL, Fuller C, Hamner B, et al. A perivascular niche for brain tumor stem cells. Cancer Cell 2007; 11: 69-82.
19. Christensen K, Schroder HD, Kristensen BW. CD133 identifies perivascular niches in grade II-IV astrocytomas. J Neurooncol 2008; 90: 157-170.
20. Lathia JD, Heddleston JM, Venere M, Rich JN. Deadly teamwork: neural cancer stem cells and the tumor microenvironment. Cell Stem Cell 2011; 8: 482-485.
21. Rademakers SE, Span PN, Kaanders JH, Sweep FC, van der Kogel AJ, Bussink J. Molecular aspects of tumour hypoxia. Mol Oncol 2008; 2: 41-53.
22. Mohyeldin A, Garzon-Muvdi T, Quinones-Hinojosa A. Oxygen in stem cell biology: a critical component of the stem cell niche. Cell Stem Cell 2010; 7: 150-161.
23. Brahimi-Horn MC, Chiche J, Pouyssegur J. Hypoxia and cancer. J Mol Med 2007; 85: 1301-1307.
24. Lin ZX. Patterns in the occurrence and development of tumors. Chin Med J 2011; 124: 1097-1104.
25. Bergers G, Hanahan D. Modes of resistance to anti-angiogenic therapy. Nat Rev Cancer 2008; 8: 592-603.
26. Azab AK, Azab F, Blotta S, Pitsillides CM, Thompson B, Runnel JM, et al. RhoA and Racl GTPases play major and differential roles in stromal cell-derived factor-1-induced cell adhesion and chemotaxis in multiple myeloma. Blood 2009; 114: 619-629.
27. Kucia M, Reca R, Miekus K, Wanzeck J, Wojakowski W, Janowska-Wieczorek A, et al. Trafficking of normal stem cells and metastasis of cancer stem cells involve similar mechanisms: pivotal role of the SDF-1-CXCR4 axis. Stem Cells 2005; 23: 879-894.

glioma; glioma stem cell; invasion; white matter tracts

© 2011 Chinese Medical Association