We thank all residents and attending physicians, notably Dr. A.F. Haney (the University of Chicago, Department of Obstetrics and Gynecology) for collecting omental biopsies. Also, we thank Stacey Tobin and Gail Isenberg for carefully editing this manuscript. This work was supported by Bears Care, the charitable beneficiary of the Chicago Bears Football Club, the National Institute of Neurological Disorders and Stroke (NINDS) R21 NS075702, and the National Cancer Institute grant R01 CA111882 to E.L.

All research protocols described have been reviewed by the University of Chicago Institutional Review Board (IRB). Informed consent was obtained from each patient before surgery and the study was approved by the University of Chicago IRB. A biological safety cabinet type 2 and gloves should be used when handling human tissue for protection and to reduce risk of contaminating cells.
1. Isolation and Culture of Primary Untransformed Stromal Cells
<ol>
	<li>Human tissue collection and preparation.
	<ol>
		<li>Obtain specimens of human omentum, 2 cm3, removed during an abdominal surgery, and immediately immerse tissue in RT phosphate-buffered saline (PBS) (Figure 2A). A piece of omentum 3 cm x 2 cm typically yields 1 million primary human mesothelial cells (HPMC) and 200,000 primary human fibroblasts or normal omental fibroblasts (NOF).</li>
		<li>Spin down the PBS the tissue was immersed in at 0.5 x g for 3 min&#160;as soon as possible after collection (&#60; 2 hr in PBS) and transfer the tissue to fresh 20 ml PBS in a 50 ml conical tube. Cut up tissue into 5mm3 pieces by mincing with scalpels in a 15 cm diameter, sterile culture dish (Figure 2B).</li>
	</ol>
	</li>
	<li>Primary human mesothelial cell isolation8
	<ol>
		<li>To isolate HPMC, transfer the minced tissue into 50 ml conical tubes and wait 1 min&#160;for the solid pieces to float to the top (Figure 2C &#38; D). HPMC and red blood cells (RBC) will be present in the liquid on the bottom. Use a pipet to remove the liquid from the bottom of the tube and into a new conical tube. Spin the liquid down at 0.5 x g for 3 min&#160;and aspirate the supernatant from the HPMC/RBC pellet.
		<ol>
			<li>Repeat the process three times: add 20 ml PBS to the minced tissue, allow tissue to rise, remove liquid from the bottom with a pipette and into the HPMC/RBC tube, spin down, and remove the supernatant. After all spins are completed and the supernatant is aspirated, the pellet will contain HPMC and RBC.</li>
		</ol>
		</li>
		<li>Plate all cells from the pellet into a 75 cm2 flask in 15 ml of full growth media (DMEM with 10% fetal bovine serum [FBS],1% MEM vitamins [93 mg/L], 1% MEM nonessential amino acids [81.4 mg/L], 1% penicillin streptomycin [Pen-Strep, 100 U/ml penicillin and 100 &#181;g/ml streptomycin]).</li>
		<li>Perform a secondary PBS wash to isolate additional HPMCs.
		<ol>
			<li>For the secondary PBS wash, shake the remaining solid tissue at 200 rpm, 37 &#176;C for 10 min&#160;in 20 ml of PBS, then wait 1 min&#160;for the tissue to float to the top. Remove the liquid from the bottom of the tube into a new tube, centrifuge at 0.5 x g for 3 min, and aspirate the supernatant.</li>
			<li>Plate all the HPMC/RBC from the secondary PBS wash in a separate 75 cm2 flask in 15 ml of full growth media.</li>
		</ol>
		</li>
		<li>To isolate any remaining HPMC, shake the minced tissue at 200 rpm, 37 &#176;C degrees for 10 min&#160;in 20 ml of a 1:1 0.25% trypsin 25 mM EDTA:PBS solution by volume. Allow the tissue to rise, collect the liquid at the bottom of the tube into a new 50 ml tube, and spin down at 0.5 g x 3 min.
		<ol>
			<li>Aspirate the supernatant and plate all the HPMC/RBC in a separate 75 cm2 flask in 15 ml of full growth media.</li>
		</ol>
		</li>
		<li>Culture the plated cells at 37&#176;C and 5% CO2 in a humidified environment. Feed plated cells by adding 15 ml of full growth media on days 3 and 5 without removing the spent media. HPMC can be cultured for 5-7 days before splitting.
		<ol>
			<li>Use low-passage HPMC (up to passage 2) in all experiments to minimize dedifferentiation and modification of original phenotype. Use a wide-field microscope preferably with a 20x objective with plastic differential interference contrast capabilities or 4-20x objective with phase contrast capabilities (phase contrast filters on microscope) for taking all images of cells, and a 10x objective ()in bright field to analyze immunohistochemical 3,3&#39;-Diaminobenzidine (DAB) staining.</li>
		</ol>
		</li>
		<li>Confirm that the HPMC are cuboidal and express cytokeratin 8 and vimentin by performing immunohistochemistry8 (Figure 3A, C, E).</li>
	</ol>
	</li>
	<li>NOF isolation8
	<ol>
		<li>Prepare 10 ml of a stock of collagenase type III solution (10x) by combining a 1:1:1 mixture of 100x Pen-Strep: 1,500 units activity/ml of collagenase type III: 714 units activity/ml of hyaluronidase in PBS.</li>
		<li>Shake the minced omentum tissue that remains after HPMC isolation at 200 rpm, 37 &#176;C for 6 hr in 10 ml of the 10x collagenase type III solution diluted in serum-free media (DMEM with 1% MEM vitamins [93 mg/L], 1% MEM nonessential amino acids [81.4 mg/L], 1% penicillin streptomycin [Pen-Strep, 100 U/ml penicillin and 100 &#181;g/ml streptomycin]). Digested tissue will look opaque and may have some fibrous debris (Figure 2E).</li>
		<li>Centrifuge the solution containing NOF cells in suspension at 0.5 x g for 3 min&#160;at RT, aspirate the supernatant and plate the pellet in a 75 cm2 flask in 13 ml of full growth media.</li>
		<li>Remove old media and replace with 15 ml of fresh full growth media after 24 hr. NOF can be cultured for 1-3 days before splitting. Note proliferation of the NOF will cease when the cells reach confluency.</li>
		<li>Confirm that the primary human fibroblasts are flat, elongated cells and express vimentin but not cytokeratin 8 by performing immunohistochemistry8 (Figure 3B, D, F). Use low-passage NOF for experiments (ideally before passage 3) to minimize dedifferentiation and modification of original phenotype. Use a wide-field microscope with a 20x objective with plastic DIC capabilities for taking all phase images of cells, and a 10x objective in bright field to analyze immunohistochemical DAB staining.</li>
	</ol>
	</li>
</ol>
2. Plating the Organotypic Culture8
<ol>
	<li>Release NOF from the 75 cm culture flask by rinsing with 10 ml of PBS followed by 3 ml of 0.25% trypsin/25 mM EDTA for no more than 5 min. Neutralize trypsin with at least 3 times the volume of full growth media.</li>
	<li>Transfer trypsinized cells into a 50 ml conical tube and spin down at 0.5 g x 3 min. Remove supernatant and bring cells back up in 5 ml of full growth media. Use a cell counter to count the cells recovered from the culture flask.</li>
	<li>Dilute cells in the appropriate volume of full growth media to plate 2,000-4,000 NOF per 100 &#181;l onto a black, clear-bottomed, 96-well plate. Add 0.5 &#181;g/100 &#181;l of rat-tail collagen I to the cell mixture before plating. Let cells sit at 37 &#176;C in 5% CO2 in a humidified environment for at least 4 hr, or until the cells to adhere to the plate surface.</li>
	<li>Release HPMC from the culture flask using the same methods described in steps 2.1 and 2.2. Dilute cells in the appropriate amount of full growth media to plate 10,000-20,000 HPMC per 50 &#181;l on top of the NOF already plated with collagen I in 96-well plates. Let the cells sit at 37 &#176;C in 5% CO2 in a humidified environment for at least 18 hr before beginning experiments.</li>
	<li>Culture green fluorescent protein (GFP)-expressing HeyA8 ovarian cancer cells in full growth media. HeyA8 ovarian cancer cells are fluorescently labeled by expression of a lentiviral vector expressing copepod cGFP (pCDH-CMV-MCS-EF1). HeyA8 ovarian cancer cells should be 80-90% confluent on the day of use (logarithmic growth phase). Release cells from the culture plate and count using the same methods described in steps 2.1-2.2 for primary cells.</li>
	<li>Allow ovarian cancer cells to recover in full growth media for 15-20 min&#160;at 37&#176;C in a conical tube with the lid loosely sealed.</li>
</ol>
3. Adhesion Assay8
<ol>
	<li>After recovery, pellet the ovarian cancer cells by spinning for 3 min&#160;at 0.5 x g and then remove the supernatant and dilute the cells in the appropriate volume of serum-free media to achieve a concentration of 50,000 cells/100 &#181;l.</li>
	<li>Invert the 96-well plates with the HPMC/NOF organotypic cultures to remove spent media, and add 100 &#181;l of the cancer cell suspension in serum-free media to each well. Incubate the plate at 37 &#176;C in 5% CO2 in a humidified environment for 30 min&#160;to 4 hr.</li>
	<li>Invert the 96-well plate to remove media and non-adherent cells. Use a multichannel pipet at low power to carefully and gently pipet 100 &#181;l of PBS into each well, and invert plate again. Repeat the PBS wash once more.</li>
	<li>Invert to remove PBS and add 100 &#181;l 4% paraformaldehyde to each well. Allow the plate to sit for 20 min&#160;to fix the cells. After 20 min, invert the plate and add 100 &#181;l PBS.</li>
	<li>Note that the total fluorescence of wells can be reported or the number of cells can be quantified. For quantification, first plate a standard curve in duplicate using HeyA8 cells at a concentration of 1 million cells/ml.
	<ol>
		<li>Make the standard curve by spinning down 1 million cells, removing media, and allowing them to sit in 1 ml 4% paraformaldehyde for 20 min.</li>
		<li>Spin cells again and bring up in 1 ml PBS (recount cells to confirm 1 million/ml concentration). Plate 50,000, 40,000, 30,000, 20,000, 10,000, 5000, 1,000, and 0 cells into each well in duplicate, and add PBS for a final total volume of 50 &#181;l in each well.</li>
	</ol>
	</li>
	<li>Bottom read the culture plate on a fluorescent plate reader (excitation = 488 nm, emission = 528 nm), scaling high wells (50,000 on standard curve). Use the standard curve to calculate how many ovarian cancer cells adhered to the organotypic culture in each well (Figure 4A-C).</li>
</ol>
4. Proliferation Assay10
<ol>
	<li>After the ovarian cancer cells recover (see steps 2.5 and 2.6 above), pellet the cells by spinning for 3 min&#160;at 0.5 x g and then dilute the cells in the appropriate volume of 1% FBS media (DMEM with 1% FBS, 1% MEM vitamins [93 mg/L], 1% MEM nonessential amino acids [81.4 mg/L], 1% penicillin streptomycin [Pen-Strep, 100 U/ml penicillin and 100 &#181;g/ml streptomycin]) to achieve a concentration of 4,000 cells/150 &#181;l.</li>
	<li>Invert the 96-well plate with the HPMC/NOF organotypic cultures to remove spent media, and add 150 &#181;l of the cancer cell suspension in 1% FBS media to each well. Incubate the plate at 37&#176;C in 5% CO2 in a humidified environment for 72 hr.</li>
	<li>Bottom read the culture plate on a fluorescent plate reader once a day (excitation = 488 nm, emission = 528 nm) to evaluate the relative proliferation of cells. Continue the assay for 96 hr, changing the media at 48 hr (Figure 5A-C). Be careful not to disturb the culture when changing media (inverting the plate is preferable).</li>
</ol>
5. Invasion Assay8
<ol>
	<li>Before plating the 3D culture, add 7.5 &#181;g rat-tail collagen I in 200 &#181;l PBS to a 24-well culture plate insert (8 &#181;m pore size). Let the plate incubate O/N, then carefully remove the PBS with a pipet immediately before plating the HPMC/NOF organotypic culture onto the collagen-coated inserts (step 2, above).</li>
	<li>Prepare the ovarian cancer cells as in step 3.1. To plate the ovarian cancer cells onto the organotypic cultures on the inserts, carefully use a pipet to remove excess media from the top of the inserts. Add 100 &#181;l of the ovarian cancer cell suspension in serum-free media to each well.</li>
	<li>Add 750 &#181;l of full growth media into the well below the insert to induce cancer cell invasion into the organotypic cultures. Incubate the plate at 37 &#176;C in 5% CO2 in a humidified environment for 24 hr. 
	Note: Ovarian cancer cells that invade the organotypic culture will cross the insert and remain on the bottom side of the insert.</li>
	<li>After 24 hr, grasp the insert with tongs and briefly rinse it in a beaker of PBS, then move the insert into an empty well. Scrub the top of each insert with both sides of a cotton swab for a total of 1 min. Quickly place the insert into a plate containing 750 &#181;l 4% paraformaldehyde in each well. Allow each insert to sit in paraformaldehyde for 10 min&#160;before transferring the inserts into wells filled with 750 &#181;l PBS.</li>
	<li>View the invaded cells (adhered and fixed to the bottom of inserts) with a microscope at 2.5x magnification. When the entire well is within the field of view, adjust the magnification to 10x and take 5 pictures, one near the center and 1 in each quadrant of the well, avoiding taking images that are too close to the edges. Follow the same pattern for each well.</li>
	<li>Use the manufacturer&#39;s program to count the number of cells in each image to get an average number of cells invaded per field in each well (Figure 6A-C) according to their protocol.</li>
</ol>

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K., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Ligand-independent+activation+of+c-Met+by+fibronectin+and+&#945;(5)&#946;(1)-integrin+regulates+ovarian+cancer+invasion+and+metastasis.">Ligand-independent activation of c-Met by fibronectin and &#945;(5)&#946;(1)-integrin regulates ovarian cancer invasion and metastasis.</a> Oncogene. 30, 1566-1576 (2011).</li></ol>

The authors have nothing to disclose.

An organotypic model of the peritoneal microenvironment was established to assess the individual and collective function(s) of both the cellular and innate components of the microenvironment in ovarian cancer dissemination. The specific protocols for plating and customizing the 3D organotypic culture to investigate ovarian cancer cell adhesion, proliferation, and invasion are provided. Primary human omental mesothelial cells and fibroblasts were isolated from patients and used at an early passage to preserve normal morph...

Ovarian cancer is the deadliest gynecologic malignancy1. The majority of patients are diagnosed after the cancer has disseminated throughout the peritoneal cavity. Once the cancer has spread throughout the peritoneal cavity, cytoreductive surgery and chemotherapy are often not sufficient treatment to prevent cancer recurrence and chemoresistance, resulting in a less than 30% 5-year survival rate. Ovarian cancer metastasis is predominantly limited to the peritoneal cavity, and several other cancer types, including gastric, pancreatic, and colon cancers, metastasize to the same anatomic sites in the peritoneal cavity. In general, ovarian cancer cells detach from the in situ carcinoma in the fallopian tube or the primary ovarian tumor, travel in peritoneal fluid as single cells or spheroids, and attach to mesothelium-lined surfaces of the omentum, bowel, and abdominal wall2. 
The tumor microenvironment plays an important role in disease progression and chemoresistance in many cancers3-6. The peritoneal cavity is a unique microenvironment, with a mesothelial cell monolayer covering the majority of surfaces (Figure 1A)7. The mesothelial lining acts as a barrier that creates a low-friction surface, which tends to be protective against cancer cell adhesion8. Immediately underneath this mesothelial-lined surface is a layer made predominantly of fibroblasts and extracellular matrix (ECM), which promote cancer cell adhesion and invasion8. Ovarian cancer cells secrete factors that induce changes in the mesothelial cell lining that enhance ovarian cancer cell adhesion, invasion, and metastasis9,10. Ovarian cancer cells adhere to the mesothelial surface via integrin and CD44-mediated mechanisms (Figure 1B)11-16. 
Historically, several 3D models have been developed to investigate ovarian cancer interactions with the microenvironment. Some of the first models studied ovarian cancer-ECM interface17-21, ovarian cancer-mesothelial cell communication13,14,21-24, or both25 (reviewed by us 26). Niedbala et al. discovered that ovarian cancer cells display a quicker and firmer adhesion to ECM than to mesothelial cells or to plastic alone25. However, these models did not histologically resemble the peritoneal microenvironment. Therefore, we established a 3D organotypic model to more thoroughly replicate the ovarian cancer microenvironment. In order to better understand the role of the microenvironment and the interaction between cancer and peritoneal cells in the peritoneal dissemination of ovarian cancer, we have developed a 3D organotypic in vitro culture model of the peritoneal cavity lining (schematic in Figure 1C). The proposed model is composed of primary human fibroblasts and ECM, covered with a layer of primary human mesothelial cells-each cell type is isolated from human omentum. Histologically, this model resembles the normal peritoneal or omental lining, and provides a surface on which we can study the tumor microenvironment, the interaction between cancer cells and normal tissue, and the processes of cancer cell adhesion, invasion, and proliferation8.

<table><tbody><tr><td>&lt;strong&gt;1. Isolation and culture of primary cells&lt;/strong&gt;</td><td></td><td></td><td></td></tr><tr><td>PBS</td><td>Fisher Scientific</td><td>SH3001304</td><td></td></tr><tr><td>Single-edged razor blades</td><td>Fisher Scientific</td><td>12-640</td><td></td></tr><tr><td>15 cm culture dishes</td><td>BD Biosciences</td><td>353025</td><td></td></tr><tr><td>Glass flask</td><td>?</td><td>?</td><td></td></tr><tr><td>Fetal Bovine Serum (FBS)</td><td>Life Technologies</td><td>16000044_3616914956</td><td></td></tr><tr><td>DMEM with L-Glutamine</td><td>Corning</td><td>10-013-CV</td><td></td></tr><tr><td>MEM Vitamins</td><td>Corning</td><td>25-020-Cl</td><td></td></tr><tr><td>MEM Nonessential amino acids</td><td>Corning</td><td>25-025-CI</td><td></td></tr><tr><td>Penicillin-Streptomycin</td><td>Corning</td><td>30-002-CI</td><td></td></tr><tr><td>Shaker&amp;nbsp;</td><td>Thermo-Fisher</td><td>MaxQ 4450</td><td></td></tr><tr><td>Centrifuge</td><td>Eppendorf</td><td>5702</td><td></td></tr><tr><td>Incubator</td><td>Thermo-Fisher</td><td>Forma Series II Water Jacketed CO2 Incubator Model 3100</td><td></td></tr><tr><td>Trypsin EDTA, 1x (0.25%)</td><td>Corning</td><td>25-053-CI</td><td></td></tr><tr><td>Hyaluronidase</td><td>Worthington Biochemical</td><td>LS002592</td><td></td></tr><tr><td>T-75 Flasks</td><td>BD Biosciences</td><td>353136</td><td></td></tr><tr><td>T-175 Flasks</td><td>BD Biosciences</td><td>353112</td><td></td></tr><tr><td>Pipet tips</td><td>Rainin</td><td>P2, P10, P20, P200 and P1000</td><td></td></tr><tr><td>Pipet tips</td><td>Corning</td><td>Filtered tips P2, P10, P20, P200 and P1000</td><td></td></tr><tr><td>&lt;strong&gt;Name of Reagent/ Equipment&lt;/strong&gt;</td><td>&lt;strong&gt;Company&lt;/strong&gt;</td><td>&lt;strong&gt;Catalog Number&lt;/strong&gt;</td><td>&lt;strong&gt;Comments/Description&lt;/strong&gt;</td></tr><tr><td>&lt;strong&gt;2. Plating 3D culture&lt;/strong&gt;</td><td></td><td></td><td></td></tr><tr><td>Cell Counter</td><td>Invitrogen</td><td>Countess</td><td></td></tr><tr><td>Countess Cell Counting Chamber Slides</td><td>Invitrogen</td><td>C10313</td><td></td></tr><tr><td>Trypan Blue Stain (0.4%)</td><td>Gibco</td><td>15250-061</td><td></td></tr><tr><td>Collagen Type I (Rat Tail)</td><td>BD Biosciences</td><td>354236</td><td></td></tr><tr><td>96 well plate, clear bottom, black</td><td>BD Biosciences</td><td>353219</td><td></td></tr><tr><td>&lt;strong&gt;Name of Reagent/ Equipment&lt;/strong&gt;</td><td>&lt;strong&gt;Company&lt;/strong&gt;</td><td>&lt;strong&gt;Catalog Number&lt;/strong&gt;</td><td>&lt;strong&gt;Comments/Description&lt;/strong&gt;</td></tr><tr><td>&lt;strong&gt;3. Adhesion assay&lt;/strong&gt;</td><td></td><td></td><td></td></tr><tr><td>Multichannel pipet</td><td>Eppendorf</td><td>Xplorer 300</td><td></td></tr><tr><td>Paraformaldehyde solution 4% in PBS</td><td>Santa Cruz Biotechnology</td><td>sc-281692</td><td></td></tr><tr><td>Plate reader</td><td>Molecular Devices</td><td>Minimax</td><td></td></tr><tr><td>&lt;strong&gt;Name of Reagent/ Equipment&lt;/strong&gt;</td><td>&lt;strong&gt;Company&lt;/strong&gt;</td><td>&lt;strong&gt;Catalog Number&lt;/strong&gt;</td><td>&lt;strong&gt;Comments/Description&lt;/strong&gt;</td></tr><tr><td>&lt;strong&gt;5. Invasion assay&lt;/strong&gt;</td><td></td><td></td><td></td></tr><tr><td>Cell Culture Inserts (8um, 24-well)</td><td>BD Biosciences</td><td>353097</td><td></td></tr><tr><td>Cotton swabs</td><td>Q-tips</td><td>cotton swabs</td><td></td></tr><tr><td>Microscope</td><td>Zeiss</td><td>Axiovert 200m</td><td></td></tr><tr><td>Cell Profiler</td><td>public domain</td><td></td><td></td></tr><tr><td>24 well plate</td><td>BD Biosciences</td><td>353047</td><td></td></tr><tr><td>&lt;strong&gt;Name of Reagent/ Equipment&lt;/strong&gt;</td><td>&lt;strong&gt;Company&lt;/strong&gt;</td><td>&lt;strong&gt;Catalog Number&lt;/strong&gt;</td><td>&lt;strong&gt;Comments/Description&lt;/strong&gt;</td></tr><tr><td>&lt;strong&gt;6. Antibodies&lt;/strong&gt;</td><td></td><td></td><td></td></tr><tr><td>Anti-Integrin &amp;alpha;V&amp;beta;3 Antibody, clone LM609</td><td>EMD Millipore</td><td>MAB1976</td><td></td></tr><tr><td>Beta 1&amp;nbsp;</td><td>Oncosynergy</td><td>OS2966</td><td></td></tr><tr><td>Alpha 5 [CD49e]</td><td>ID Pharmingen</td><td>555615</td><td></td></tr><tr><td>Beta 4 [CD104]</td><td>EMD Millipore</td><td>MAB 2058</td><td></td></tr></tbody></table>

modeling the early steps of ovarian cancer dissemination in an organotypic culture of the human peritoneal cavity

The pattern of ovarian cancer metastasis is markedly different from that of most other epithelial tumors, because it rarely spreads hematogenously. Instead, ovarian cancer cells exfoliated from the primary tumor are carried by peritoneal fluid to metastatic sites within the peritoneal cavity. These sites, most notably the abdominal peritoneum and omentum, are organs covered by a mesothelium-lined surface. To investigate the processes of ovarian cancer dissemination, we assembled a complex three-dimensional culture system that reconstructs the lining of the peritoneal cavity in vitro. Primary human fibroblasts and mesothelial cells were isolated from human omentum. The fibroblasts were then mixed with extracellular matrix and covered with a layer of the primary human mesothelial cells to mimic the peritoneal and omental surfaces encountered by metastasizing ovarian cancer cells. The resulting organotypic model is, as shown, used to examine the early steps of ovarian cancer dissemination, including cancer cell adhesion, invasion, and proliferation. This model has been used in a number of studies to investigate the role of the microenvironment (cellular and acellular) in early ovarian cancer dissemination. It has also been successfully adapted to high throughput screening and used to identify and test inhibitors of ovarian cancer metastasis.

The organotypic culture was assembled by first mixing primary human fibroblasts with collagen type I and then overlaying this culture with 5 times the number of mesothelial cells. The culture was incubated for at least 18 hr&#160;before ovarian cancer cells were added to study adhesion, invasion or proliferation. Each assay was repeated with multiple (n=3-5) 3D cultures obtained from different patients and numerous wells were tested in each condition for the adhesion (n=5), proliferation (n=5) and invasion assays (n=3). ...

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Modeling the Early Steps of Ovarian Cancer Dissemination in an Organotypic Culture of the Human Peritoneal Cavity

Here, we present a protocol to construct a three-dimensional in vitro model of the lining of the peritoneal cavity, composed of primary human mesothelial cells and fibroblasts layered with extracellular matrix, as a tool to investigate ovarian cancer cell adhesion, invasion, and proliferation.

The pattern of ovarian cancer metastasis is markedly different from that of most other epithelial tumors, because it rarely spreads hematogenously. ...

modeling-early-steps-ovarian-cancer-dissemination-an-organotypic

Research

JoVE Journal

Medicine

26.6K Views.  University of Chicago. Here, we present a protocol to construct a three-dimensional in vitro model of the lining of the peritoneal cavity, composed of primary human mesothelial cells and fibroblasts layered with extracellular matrix, as a tool to investigate ovarian cancer cell adhesion, invasion, and proliferation. 

Video: Modeling the Early Steps of Ovarian Cancer Dissemination in an Organotypic Culture of the Human Peritoneal Cavity

Murine Experimental Model of Original Tumor Development and Peritoneal Metastasis via Orthotopic Inoculation with Ovarian Carcinoma Cells

Epithelial ovarian carcinoma (EOC) is associated with a poor prognosis because it shows peritoneal dissemination. To improve the prognosis, it is important to control peritoneal dissemination. However, it is still unclear how tumor cells detach from primary lesions and attach to the mesothelium. The establishment of an appropriate animal model is needed to gain an understanding of the mechanism of peritoneal dissemination in vivo. In the current study, we introduce the process from the local injection of EOC cells into the murine ovarian surface to the development of metastasis, including the peritoneum and distant organs. Female nude mice (BALB/c nu/nu) at 8 weeks of age were used. Under a microscopic field of view, EOC cells (1 x 105 cells/&#181;l of medium-extracellular matrix (ECM)-based hydrogel/unilateral ovary/mouse) were injected into murine ovaries through a retroperitoneal approach from the dorsal flank. This proposed method is a less invasive procedure for the mouse and minimizes damage to the ovary. Here, we describe the methodological steps in the development of the original and metastatic tumor formation of EOC.

Murine Experimental Model of Original Tumor Development and Peritoneal Metastasis via Orthotopic Inoculation with Ovarian Carcinoma Cells

To clarify the multistep process of peritoneal dissemination of ovarian carcinoma, the current study presents a murine experimental model of original tumor development and peritoneal metastasis via orthotopic inoculation with these tumor cells.

Epithelial ovarian carcinoma (EOC) is associated with a poor prognosis because it shows peritoneal dissemination. To improve the prognosis, it is ...

Cancer Research

In vitro Mesothelial Clearance Assay that Models the Early Steps of Ovarian Cancer Metastasis

Ovarian cancer is the fifth leading cause of cancer related deaths in the United States1. Despite a positive initial response to therapies, 70 to 90 percent of women with ovarian cancer develop new metastases, and the recurrence is often fatal2. It is, therefore, necessary to understand how secondary metastases arise in order to develop better treatments for intermediate and late stage ovarian cancer. Ovarian cancer metastasis occurs when malignant cells detach from the primary tumor site and disseminate throughout the peritoneal cavity. The disseminated cells can form multicellular clusters, or spheroids, that will either remain unattached, or implant onto organs within the peritoneal cavity3 (Figure 1, Movie 1). 
All of the organs within the peritoneal cavity are lined with a single, continuous, layer of mesothelial cells4-6 (Figure 2). However, mesothelial cells are absent from underneath peritoneal tumor masses, as revealed by electron micrograph studies of excised human tumor tissue sections3,5-7 (Figure 2). This suggests that mesothelial cells are excluded from underneath the tumor mass by an unknown process. 
Previous in vitro experiments demonstrated that primary ovarian cancer cells attach more efficiently to extracellular matrix than to mesothelial cells8, and more recent studies showed that primary peritoneal mesothelial cells actually provide a barrier to ovarian cancer cell adhesion and invasion (as compared to adhesion and invasion on substrates that were not covered with mesothelial cells)9,10. This would suggest that mesothelial cells act as a barrier against ovarian cancer metastasis. The cellular and molecular mechanisms by which ovarian cancer cells breach this barrier, and exclude the mesothelium have, until recently, remained unknown. 
Here we describe the methodology for an in vitro assay that models the interaction between ovarian cancer cell spheroids and mesothelial cells in vivo (Figure 3, Movie 2). Our protocol was adapted from previously described methods for analyzing ovarian tumor cell interactions with mesothelial monolayers8-16, and was first described in a report showing that ovarian tumor cells utilize an integrin &#x2013;dependent activation of myosin and traction force to promote the exclusion of the mesothelial cells from under a tumor spheroid17. This model takes advantage of time-lapse fluorescence microscopy to monitor the two cell populations in real time, providing spatial and temporal information on the interaction. The ovarian cancer cells express red fluorescent protein (RFP) while the mesothelial cells express green fluorescent protein (GFP). RFP-expressing ovarian cancer cell spheroids attach to the GFP-expressing mesothelial monolayer. The spheroids spread, invade, and force the mesothelial cells aside creating a hole in the monolayer. This hole is visualized as the negative space (black) in the GFP image. The area of the hole can then be measured to quantitatively analyze differences in clearance activity between control and experimental populations of ovarian cancer and/ or mesothelial cells. This assay requires only a small number of ovarian cancer cells (100 cells per spheroid X 20-30 spheroids per condition), so it is feasible to perform this assay using precious primary tumor cell samples. Furthermore, this assay can be easily adapted for high throughput screening.

In vitro Mesothelial Clearance Assay that Models the Early Steps of Ovarian Cancer Metastasis

The mesothelial clearance assay described here takes advantage of fluorescently labeled cells and time-lapse video microscopy to visualize and quantitatively measure the interactions of ovarian cancer multicellular spheroids and mesothelial cell monolayers. This assay models the early steps of ovarian cancer metastasis.

Ovarian cancer is the fifth leading cause of cancer related deaths in the United States1. Despite a positive initial response to therapies, 70 to 90 ...

Heterotypic Three-dimensional In Vitro Modeling of Stromal-Epithelial Interactions During Ovarian Cancer Initiation and Progression

Epithelial ovarian cancers (EOCs) are the leading cause of death from gynecological malignancy in Western societies. Despite advances in surgical treatments and improved platinum-based chemotherapies, there has been little improvement in EOC survival rates for more than four decades 1,2. Whilst stage I tumors have 5-year survival rates &gt;85%, survival rates for stage III/IV disease are &lt;40%. Thus, the high rates of mortality for EOC could be significantly decreased if tumors were detected at earlier, more treatable, stages 3-5. At present, the molecular genetic and biological basis of early stage disease development is poorly understood. More specifically, little is known about the role of the microenvironment during tumor initiation; but known risk factors for EOCs (e.g. age and parity) suggest that the microenvironment plays a key role in the early genesis of EOCs. We therefore developed three-dimensional heterotypic models of both the normal ovary and of early stage ovarian cancers. For the normal ovary, we co-cultured normal ovarian surface epithelial (IOSE) and normal stromal fibroblast (INOF)&nbsp;cells, immortalized by retrovrial transduction of the catalytic subunit of human telomerase holoenzyme (hTERT) to extend the lifespan of these cells in culture. To model the earliest stages of ovarian epithelial cell transformation, overexpression of the CMYC oncogene in IOSE cells, again co-cultured with INOF cells. These heterotypic models were used to investigate the effects of aging and senescence on the transformation and invasion of epithelial cells. Here we describe the methodological steps in development of these three-dimensional model; these methodologies aren't specific to the development of normal ovary and ovarian cancer tissues, and could be used to study other tissue types where stromal and epithelial cell interactions are a fundamental aspect of the tissue maintenance and disease development.

Heterotypic Three-dimensional In Vitro Modeling of Stromal-Epithelial Interactions During Ovarian Cancer Initiation and Progression

We describe methodologies for establishing in vitro heterotypic three-dimensional models comprising ovarian fibroblasts and normal ovarian surface or ovarian cancer epithelial cells. We discuss the use of these models to study stromal-epithelial interactions that occur during ovarian cancer development.

Epithelial ovarian cancers (EOCs) are the leading cause of death from gynecological malignancy in Western societies. Despite advances in surgical ...

Assessment of Ovarian Cancer Spheroid Attachment and Invasion of Mesothelial Cells in Real Time

Ovarian cancers metastasize by shedding into the peritoneal fluid and dispersing to distal sites within the peritoneum. Monolayer cultures do not accurately model the behaviors of cancer cells within a nonadherent environment, as cancer cells inherently aggregate into multicellular structures which contribute to the metastatic process by attaching to and invading the peritoneal lining to form secondary tumors. To model this important stage of ovarian cancer metastasis, multicellular aggregates, or spheroids, can be generated from established ovarian cancer cell lines maintained under nonadherent conditions. To mimic the peritoneal microenvironment encountered by tumor cells in vivo, a spheroid-mesothelial co-culture model was established in which preformed spheroids are plated on top of a human mesothelial cell monolayer, formed over an extracellular matrix barrier. Methods were then developed using a real-time cell analyzer to conduct quantitative real time measurements of the invasive capacity of different ovarian cancer cell lines grown as spheroids. This approach allows for the continuous measurement of invasion over long periods of time, which has several advantages over traditional endpoint assays and more laborious real time microscopy image analyses. In short, this method enables a rapid, determination of factors which regulate the interactions between ovarian cancer spheroid cells invading through mesothelial and matrix barriers over time.

Ovarian cancer cell invasion into the mesothelial lining of the peritoneum is a dynamic process over time. Utilizing a real time analyzer, the invasive capacity of ovarian cancer cells in a spheroid-mesothelial cell co-culture model can be quantified over prolonged time periods, providing insights into factors regulating the metastatic process.

Ovarian cancers metastasize by shedding into the peritoneal fluid and dispersing to distal sites within the peritoneum. Monolayer cultures do not ...

Establishing a 3D Ex Vivo Model for Ovarian Cancer-Omentum Interaction

An Ex Vivo Model of Ovarian Cancer Peritoneal Metastasis Using Human Omentum

Ovarian cancer is the deadliest gynecologic malignancy. The omentum plays a key role in providing a supportive microenvironment to metastatic ovarian cancer cells as well as immune modulatory signals that allow tumor tolerance. However, we have limited models that closely mimic the interaction between ovarian cancer cells and adipose-rich tissues. To further understand the cellular and molecular mechanisms by which the omentum provides a pro-tumoral microenvironment, we developed a unique 3D ex vivo model of cancer cell-omentum interaction. Using human omentum, we are able to grow ovarian cancer cells within this adipose-rich microenvironment and monitor the factors responsible for tumor growth and immune regulation. In addition to providing a platform for the study of this adipose-rich tumor microenvironment, the model provides an excellent platform for the development and evaluation of novel therapeutic approaches to target metastatic cancer cells in this niche. The proposed model is easy to generate, inexpensive, and applicable to translational investigations.

Author Spotlight: Advanced Ex Vivo Model for Investigating Cancer-Adipose Microenvironment Interaction 

This protocol describes the establishment of a three-dimensional (3D) ex vivo model of cancer cell-omentum interaction. The model provides a platform for elucidating pro-tumor mechanisms within the adipose niche and for testing novel therapies.

Ovarian cancer is the deadliest gynecologic malignancy. The omentum plays a key role in providing a supportive microenvironment to metastatic ovarian ...

Modeling Ovarian Cancer Multicellular Spheroid Behavior in a Dynamic 3D Peritoneal Microdevice

Ovarian cancer is characterized by extensive peritoneal metastasis, with tumor spheres commonly found in the malignant ascites. This is associated with poor clinical outcomes and currently lacks effective treatment. Both the three-dimensional (3D) environment and the dynamic mechanical forces are very important factors in this metastatic cascade. However, traditional cell cultures fail to recapitulate this natural tumor microenvironment. Thus, in vivo-like models that can emulate the intraperitoneal environment are of obvious importance. In this study, a new microfluidic platform of the peritoneum was set up to mimic the situation of ovarian cancer spheroids in the peritoneal cavity during metastasis. Ovarian cancer spheroids generated under a non-adherent condition were cultured in microfluidic channels coated with peritoneal mesothelial cells subjected to physiologically relevant shear stress. In summary, this dynamic 3D ovarian cancer-mesothelium microfluidic platform can provide new knowledge on basic cancer biology and serve as a platform for potential drug screening and development.

To study ovarian tumor progression in a physiologically relevant model, multicellular spheroids were cultured in a microdevice under simulated fluid flow. This dynamic 3D model emulates the intraperitoneal environment with the cellular and mechanical components where ovarian cancer metastasis occurs.

Ovarian cancer is characterized by extensive peritoneal metastasis, with tumor spheres commonly found in the malignant ascites. This is associated with ...

Bioengineering

Modeling Ovarian Cancer Communication for Imaging Mass Spectrometry Analysis: A Method to Identify Small Molecule Chemical Communicators in Metastatic Ovarian Tumor Development

Source: Zink, K. E. et. al. <a href="https://www.jove.com/t/59490">Capturing Small Molecule Communication Between Tissues and Cells Using Imaging Mass Spectrometry.</a> J. Vis. Exp. (2019)
This protocol describes a technique for sample preparation by co-culturing ovarian explants with the fallopian tube cancer cells. These samples are visualized using imaging mass spectroscopy, or IMS,&#160; to detect small molecule exchange between the cells and tissues leading to tumor development.

Source: Zink, K. E. et. al. Capturing Small Molecule Communication Between Tissues and Cells Using Imaging Mass Spectrometry. J. Vis. Exp. (2019)
This ...

JoVE Encyclopedia of Experiments

Gynecologic Cancer

Assays & techniques

Modeling Ovarian Cancer Metastasis in Peritoneal Cavity Lining: A Method To Establish an In Vitro 3D Model of the Peritoneal Lining

Source: Peters, P. N. et al. <a href="https://www.jove.com/t/53541">Modeling the Early Steps of Ovarian Cancer Dissemination in an Organotypic Culture of the Human Peritoneal Cavity.</a> J. Vis. Exp. (2015)
In this video, we demonstrate the development of&#160; an in vitro &#160;three-dimensional model of the lining of the peritoneal cavity. This organotypic culture can help to investigate ovarian cancer cell adhesion, invasion, and proliferation.

Source: Peters, P. N. et al. Modeling the Early Steps of Ovarian Cancer Dissemination in an Organotypic Culture of the Human Peritoneal Cavity. J. Vis. ...

Orthotopic Inoculation of Ovarian Cancer Cells into Murine Ovary: A Procedure to Establish an Ovarian Cancer Mouse Model to Study Peritoneal Dissemination of Cells

Source: Koya, Y. et al. <a href="https://www.jove.com/t/54353">Murine Experimental Model of Original Tumor Development and Peritoneal Metastasis via Orthotopic Inoculation with Ovarian Carcinoma Cells.</a> J. Vis. Exp. (2016)
This video describes the protocol for creating a murine experimental model to study tumor development and peritoneal metastasis. This ovarian cancer model is generated by the orthotopic inoculation of human epithelial ovarian cancer cells into the ovaries of a female mouse.

Source: Koya, Y. et al. Murine Experimental Model of Original Tumor Development and Peritoneal Metastasis via Orthotopic Inoculation with Ovarian ...

Animal model studies

Modeling Ovarian Cancer Cell Colonization of Omentum: An Ex Vivo Method to Establish Milky Spot Colonization of Fluorescently Labeled Ovarian Cancer Cells in Murine Omentum Explants

Source: Krishnan, V. et al. <a href="https://www.jove.com/t/52721">In Vivo and Ex Vivo Approaches to Study Ovarian Cancer Metastatic Colonization of Milky Spot Structures in Peritoneal Adipose.</a> J. Vis. Exp. (2015)
In this video, we establish an ex vivo omental organ culture overlaid with GFP-expressing ovarian cancer cells to study ovarian cancer colonization within the omental explant. This protocol analyzes immune cell structures within the omentum known as milky spots that promote metastases.

Source: Krishnan, V. et al. In Vivo and Ex Vivo Approaches to Study Ovarian Cancer Metastatic Colonization of Milky Spot Structures in Peritoneal Adipose. ...

Modeling the Early Steps of Ovarian Cancer Dissemination in an Organotypic Culture of the Human Peritoneal Cavity

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