Mdm2 gene amplification in gastric cancer correlation with expression of Mdm2 protein and p53 alterations

Epstein-Barr virus and aberrant expression of mdm2 and p53 in pathogenesis and development of gastric carcinoma

AIM: To investigate the role of p53 and mdm2 gene abnormality in oncogenesis and development of Epstein-Barr virus (EBV) -associated gastric carcinoma (EBVaGC) and to explore the relationship between EBV infection and p53 and mdm2 protein expression.

METHODS: p53 gene mutation in exon 5-8 was detected by polymerase chain reaction and single strand conformation polymorphism analysis (PCR-SSCP), and DNA sequencing. p53 and mdm2 protein expression was tested by immunohistochemistry in EBVaGCs (n = 13), EBVnGCs (EBV negative gastric carcinomas, n = 45) with matched clinicopathological parameters and corresponding adjacent tissues of gastric carcinoma (n = 58).

RESULTS: The positive rates of p53 and mdm2 protein in gastric carcinomas were significantly higher than those in corresponding adjacent normal tissues (86.2%, 29.3% vs 0%, 0% respectively; P < 0.01). There were no significant difference between the positive rates of p53 and mdm2 protein in EBVnGCs and EBVaGCs. The overexpression rate of p53 protein was 15.4% (2/13) in EBVaGCs. This was in marked contrast to the rate of 57.8% (26/45) in EBVnGCs (χ² = 7.2593, P = 0.0 085 < 0.01). There was significant positive correlation between mdm2 expression and p53 overexpression (χ² = 11.1 839, P = 0.0 008 < 0.01, r = 0.4 391). p53 gene mutation was found in only 2 cases of EBVnGCs and both occurred at exon 5. No p53 gene mutation was detected in 13 cases of EBVaGCs and 58 corresponding adjacent tissues.

CONCLUSION: Abnormal accumulation of p53 protein might not result from p53 gene mutation. mdm2 protein may play an important role in the pathogenesis of gastric carcinoma through suppressing the function of wild type p53 protein. The infection of EBV relates to the abnomal expression of p53 protein, but not to the abnomal expression of mdm2 protein and p53 gene mutation in gastric carcinoma

MDM2 gene amplification: a new independent factor of adverse prognosis in non-small cell lung cancer (NSCLC)

The prognostic impact of MDM2 amplification in non-small cell lung cancer (NSCLC) remains unknown. In this study, we investigated the occurrence of MDM2 amplification in surgically treated NSCLC patients. Molecular data were correlated with clinicopathological factors and evaluated for their prognostic value. The study group included 116 NSCLC patients who underwent pulmonary resection between 1996 and 1999. MDM2 amplification was assessed by real-time PCR using hybridization probe format on a LightCycler (Roche). The calculated ratio was a MDM2 value normalized to the amplification of the housekeeping gene phenylalaninhydroxylase (PAH). Survival curves were drawn according to the Kaplan-Meier method and compared with the use of the log-rank test. Multivariate analysis was based on Cox regression analysis. MDM2 amplification was found in 24 patients (21%). There was no relationship between MDM2 amplification and clinicopathological factors, such as sex, age and stage of disease, pT, pN, histology and tumor differentiation. Median disease-free survival (DFS) in patients with and without MDM2 amplification was 3 and 31 months, and 5-year DFS 24 and 33%, respectively (log-rank, P = 0.02). Likewise, median overall survival (OS) in patients with and without MDM2 amplification was 9 and 33 months, respectively, and 5-year OS 24 and 39%, respectively (log-rank, P = 0.01). The strong prognostic relevance of MDM2 amplification for both DFS and OS was confirmed in multivariate analysis (P < 0.01 for both comparisons). Our results suggest that MDM2 gene amplification analysis provides additional prognostic information in surgically treated NSCLC patients.

Alterations of chromosomal copy number during progression of diffuse-type gastric carcinomas: metaphase- and array-based comparative genomic hybridization analyses of multiple samples from individual tumours

The application of comparative genomic hybridization (CGH) has led to the rapid accumulation of cytogenetic information on gastric carcinoma (GC), but there is little information on the time sequence of cytogenetic changes. In the present study, degenerate oligonucleotide-primed polymerase chain reaction (DOP-PCR) and CGH were applied to multiple samples microdissected from 19 diffuse-type GCs including eight early cancers. Recurrent gains were detected at 8q, 3q, 7q, and 8p, and loss at 17p (in more than 50% of the cancers), the frequencies of which were fairly similar between the samples with (SIG) and those without (POR) abundant signet ring cells. Earlier stemline changes (8q+, 8p+, 1q+, 17p-, etc), with breakpoints that were common to all the samples, were discriminated from later sideline changes (2q+, 11q+, 17q-, 21q-, etc) in individual tumours. The changes were generally common to early and advanced cancers, except for 7p+, 15q+, 3p-, and 18q-, which were largely sideline changes and more frequently detected in advanced cancers (p<0.05). Because the samples with 7p+ had a greater number of copy-number changes than those without 7p+ (p<0.01), 7p+ may play a role in tumour progression by acceleration of chromosomal instability. Fifteen different chromosomal loci with amplification were detected in ten cases, mostly as sideline changes in advanced cancers. By microarray-based CGH, KRAS, MDM2, and FGFR2 were confirmed in the amplicons at 12p, 12q, and 10q, and FES at 15q26, for the first time in GC. These results support the notion that SIG and POR are of a genetically single lineage in both early and advanced diffuse-type GC and that the majority of advanced cancers derive from early cancers through the accumulation of various sideline changes in addition to stemline changes.

Real-time PCR based on SYBR-Green I fluorescence: an alternative to the TaqMan assay for a relative quantification of gene rearrangements, gene amplifications and micro gene deletions

Background

Real-time PCR is increasingly being adopted for RNA quantification and genetic analysis. At present the most popular real-time PCR assay is based on the hybridisation of a dual-labelled probe to the PCR product, and the development of a signal by loss of fluorescence quenching as PCR degrades the probe. Though this so-called 'TaqMan' approach has proved easy to optimise in practice, the dual-labelled probes are relatively expensive.

Results

We have designed a new assay based on SYBR-Green I binding that is quick, reliable, easily optimised and compares well with the published assay. Here we demonstrate its general applicability by measuring copy number in three different genetic contexts; the quantification of a gene rearrangement (T-cell receptor excision circles (TREC) in peripheral blood mononuclear cells); the detection and quantification of GLI, MYC-C and MYC-N gene amplification in cell lines and cancer biopsies; and detection of deletions in the OPA1 gene in dominant optic atrophy.

Conclusion

Our assay has important clinical applications, providing accurate diagnostic results in less time, from less biopsy material and at less cost than assays currently employed such as FISH or Southern blotting.

PTEN encoding product: A marker for tumorigenesis and progression of gastric carcinoma

AIM: To detect the expression of PTEN encoding product in normal mucosa, intestinal metaplasia (IM), dysplasia and carcinoma of the stomach, and to investigate its clinical implication in tumorigenesis and progression of gastric carcinoma.

METHODS: Formalin-fixed paraffin embedded specimens from 184 cases of gastric carcinoma, their adjacent normal mucosa, IM and dysplasia were evaluated for PTEN protein expression by SABC immunohistochemistry. PTEN expression was compared with tumor stage, lymph node metastasis, Lauren’s and WHO’s histological classification of gastric carcinoma. Expression of VEGF was also detected in 60 cases of gastric carcinoma and its correlation with PTEN was concerned.

RESULTS: The positive rates of PTEN protein were 100% (102/102), 98.5% (65/66), 66.7% (4/6) and 47.8% (88/184) in normal mucosa, IM, dysplasia and carcinoma of the stomach, respectively. The positive rates in dysplasia and carcinoma were lower than in normal mucosa and IM (P < 0.01). Advanced gastric cancers expressed less frequent PTEN than early gastric cancer (42.9% vs 67.6%, P < 0.01). The positive rate of PTEN protein was lower in gastric cancer with than without lymph node metastasis (40.3% vs 63.3%, P < 0.01). PTEN was less expressed in diffuse-type than in intestinal-type gastric cancer (41.5% vs 57.8%, P < 0.05). Signet ring cell carcinoma showed the expression of PTEN at the lowest level (25.0%, 7/28); less than well and moderately differentiated ones (P < 0.01). Expression of PTEN was not correlated with expression of VEGF (P > 0.05).

CONCLUSION: Loss or reduced expression of PTEN protein occures commonly in tumorigenesis and progression of gastric carcinoma. It is suggested that PTEN can be an objective marker for pathologically biological behaviors of gastric carcinoma.

Morphologic expressions of urothelial carcinoma in situ: a detailed evaluation of its histologic patterns with emphasis on carcinoma in situ with microinvasion

The recently proposed World Health Organization/International Society of Urological Pathology (WHO/ISUP) consensus classification of flat urothelial lesions expands the definition traditionally used for urothelial (transitional cell) carcinoma in situ (CIS), basing its diagnosis predominantly on the severity of cytologic changes. Lesions now encompassed within the diagnosis of CIS exhibit an array of cytologic and architectural features, which have not been documented in detail. In this study, cases were examined with respect to histologic patterns and microinvasion (invasion into the lamina propria to a depth of less than 2 mm). Five major patterns of CIS, often occurring in the same specimen (160 patterns in 77 cases), were noted. Common to each pattern was the presence of high-grade cytologic atypia, the definitional feature. The patterns found include 1) large cell CIS with pleomorphism (57%), in which the cells had abundant cytoplasm and nuclear pleomorphism; 2) large cell CIS without nuclear pleomorphism (48%); 3) small cell CIS (14%), in which the cytoplasm was relatively scant and pleomorphism was usually minimal; 4) clinging CIS (40%), in which the urothelium was denuded with a patchy, usually single layer of atypical cells; and 5) cancerization of urothelium (16%) with either pagetoid spread (clusters or isolated single cells) or undermining or overriding of the normal urothelium. Carcinoma in situ with microinvasion into the lamina propria (13 cases: 3 of 77 CIS cases studied above and 10 additional cases) was evident as invasive cells with retraction artifact mimicking vascular invasion (77%, 10 cases); nests, irregular cords, and strands, or isolated single cells with desmoplasia (8%, 1 case); or absent stromal response (15%, 2 cases). Although the diagnostic terminology for all of these patterns, for the purposes of the surgical pathology report, should be simply urothelial CIS with no specific mention of the morphologic pattern, awareness of the histologic diversity of CIS will facilitate the diagnosis of this therapeutically and biologically critical flat lesion of the urothelium. These lesions may be associated with microinvasion, which may be clinically unsuspected and histologically subtle.