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Hakuno F, Fukushima T, Yoneyama Y, Kamei H, Ozoe A, Yoshihara H, Yamanaka D, Shibano T, Sone-Yonezawa M, Yu BC, Chida K, Takahashi SI. The Novel Functions of High-Molecular-Mass Complexes Containing Insulin Receptor Substrates in Mediation and Modulation of Insulin-Like Activities: Emerging Concept of Diverse Functions by IRS-Associated Proteins. Front Endocrinol (Lausanne) 2015; 6:73. [PMID: 26074875 PMCID: PMC4443775 DOI: 10.3389/fendo.2015.00073] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Accepted: 04/25/2015] [Indexed: 12/25/2022] Open
Abstract
Insulin-like peptides, such as insulin-like growth factors (IGFs) and insulin, induce a variety of bioactivities, such as growth, differentiation, survival, increased anabolism, and decreased catabolism in many cell types and in vivo. In general, IGFs or insulin bind to IGF-I receptor (IGF-IR) or insulin receptor (IR), activating the receptor tyrosine kinase. Insulin receptor substrates (IRSs) are known to be major substrates of receptor kinases, mediating IGF/insulin signals to direct bioactivities. Recently, we discovered that IRSs form high-molecular-mass complexes (referred to here as IRSomes) even without IGF/insulin stimulation. These complexes contain proteins (referred to here as IRSAPs; IRS-associated proteins), which modulate tyrosine phosphorylation of IRSs by receptor kinases, control IRS stability, and determine intracellular localization of IRSs. In addition, in these complexes, we found not only proteins that are involved in RNA metabolism but also RNAs themselves. Thus, IRSAPs possibly contribute to modulation of IGF/insulin bioactivities. Since it is established that disorder of modulation of insulin-like activities causes various age-related diseases including cancer, we could propose that the IRSome is an important target for treatment of these diseases.
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Affiliation(s)
- Fumihiko Hakuno
- Department of Animal Sciences, Graduate School of Agriculture and Life Sciences, The University of Tokyo, Tokyo, Japan
- Department of Applied Biological Chemistry, Graduate School of Agriculture and Life Sciences, The University of Tokyo, Tokyo, Japan
| | - Toshiaki Fukushima
- Laboratory of Biomedical Chemistry, Basic Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
- Department of Biological Sciences, Faculty of Bioscience and Biotechnology, Tokyo Institute of Technology, Kanagawa, Japan
| | - Yosuke Yoneyama
- Department of Animal Sciences, Graduate School of Agriculture and Life Sciences, The University of Tokyo, Tokyo, Japan
- Department of Applied Biological Chemistry, Graduate School of Agriculture and Life Sciences, The University of Tokyo, Tokyo, Japan
| | - Hiroyasu Kamei
- Department of Animal Sciences, Graduate School of Agriculture and Life Sciences, The University of Tokyo, Tokyo, Japan
- Department of Applied Biological Chemistry, Graduate School of Agriculture and Life Sciences, The University of Tokyo, Tokyo, Japan
| | - Atsufumi Ozoe
- Department of Animal Sciences, Graduate School of Agriculture and Life Sciences, The University of Tokyo, Tokyo, Japan
- Department of Applied Biological Chemistry, Graduate School of Agriculture and Life Sciences, The University of Tokyo, Tokyo, Japan
| | - Hidehito Yoshihara
- Laboratory of Protein Metabolism, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Daisuke Yamanaka
- Department of Animal Sciences, Graduate School of Agriculture and Life Sciences, The University of Tokyo, Tokyo, Japan
- Department of Applied Biological Chemistry, Graduate School of Agriculture and Life Sciences, The University of Tokyo, Tokyo, Japan
| | - Takashi Shibano
- Department of Animal Sciences, Graduate School of Agriculture and Life Sciences, The University of Tokyo, Tokyo, Japan
- Department of Applied Biological Chemistry, Graduate School of Agriculture and Life Sciences, The University of Tokyo, Tokyo, Japan
| | - Meri Sone-Yonezawa
- Department of Animal Sciences, Graduate School of Agriculture and Life Sciences, The University of Tokyo, Tokyo, Japan
- Department of Applied Biological Chemistry, Graduate School of Agriculture and Life Sciences, The University of Tokyo, Tokyo, Japan
| | - Bu-Chin Yu
- Department of Animal Sciences, Graduate School of Agriculture and Life Sciences, The University of Tokyo, Tokyo, Japan
- Department of Applied Biological Chemistry, Graduate School of Agriculture and Life Sciences, The University of Tokyo, Tokyo, Japan
| | - Kazuhiro Chida
- Department of Animal Sciences, Graduate School of Agriculture and Life Sciences, The University of Tokyo, Tokyo, Japan
- Department of Applied Biological Chemistry, Graduate School of Agriculture and Life Sciences, The University of Tokyo, Tokyo, Japan
| | - Shin-Ichiro Takahashi
- Department of Animal Sciences, Graduate School of Agriculture and Life Sciences, The University of Tokyo, Tokyo, Japan
- Department of Applied Biological Chemistry, Graduate School of Agriculture and Life Sciences, The University of Tokyo, Tokyo, Japan
- *Correspondence: Shin-Ichiro Takahashi, Laboratory of Cell Regulation, Departments of Animal Sciences and Applied Biological Chemistry, Graduate School of Agriculture and Life Science, The University of Tokyo, 1-1-1 Yayoi, Bunkyo-ku, Tokyo 113-8657, Japan,
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Long Q, Xu J, Osunkoya AO, Sannigrahi S, Johnson BA, Zhou W, Gillespie T, Park JY, Nam RK, Sugar L, Stanimirovic A, Seth AK, Petros JA, Moreno CS. Global transcriptome analysis of formalin-fixed prostate cancer specimens identifies biomarkers of disease recurrence. Cancer Res 2014; 74:3228-37. [PMID: 24713434 DOI: 10.1158/0008-5472.can-13-2699] [Citation(s) in RCA: 94] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Prostate cancer remains the second leading cause of cancer death in American men and there is an unmet need for biomarkers to identify patients with aggressive disease. In an effort to identify biomarkers of recurrence, we performed global RNA sequencing on 106 formalin-fixed, paraffin-embedded prostatectomy samples from 100 patients at three independent sites, defining a 24-gene signature panel. The 24 genes in this panel function in cell-cycle progression, angiogenesis, hypoxia, apoptosis, PI3K signaling, steroid metabolism, translation, chromatin modification, and transcription. Sixteen genes have been associated with cancer, with five specifically associated with prostate cancer (BTG2, IGFBP3, SIRT1, MXI1, and FDPS). Validation was performed on an independent publicly available dataset of 140 patients, where the new signature panel outperformed markers published previously in terms of predicting biochemical recurrence. Our work also identified differences in gene expression between Gleason pattern 4 + 3 and 3 + 4 tumors, including several genes involved in the epithelial-to-mesenchymal transition and developmental pathways. Overall, this study defines a novel biomarker panel that has the potential to improve the clinical management of prostate cancer.
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Affiliation(s)
- Qi Long
- Authors' Affiliations: Departments of Biomedical Informatics, Biostatistics and Bioinformatics, Pathology and Laboratory Medicine, Urology, Hematology and Medical Oncology, Human Genetics, and Surgery; Winship Cancer Institute, Emory University, Atlanta; Atlanta VA Medical Center, Decatur, Georgia; Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida; Department of Laboratory Medicine and Pathobiology, University of Toronto; and Department of Anatomic Pathology, Sunnybrook Health Sciences Centre, Toronto, OntarioAuthors' Affiliations: Departments of Biomedical Informatics, Biostatistics and Bioinformatics, Pathology and Laboratory Medicine, Urology, Hematology and Medical Oncology, Human Genetics, and Surgery; Winship Cancer Institute, Emory University, Atlanta; Atlanta VA Medical Center, Decatur, Georgia; Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida; Department of Laboratory Medicine and Pathobiology, University of Toronto; and Department of Anatomic Pathology, Sunnybrook Health Sciences Centre, Toronto, Ontario
| | - Jianpeng Xu
- Authors' Affiliations: Departments of Biomedical Informatics, Biostatistics and Bioinformatics, Pathology and Laboratory Medicine, Urology, Hematology and Medical Oncology, Human Genetics, and Surgery; Winship Cancer Institute, Emory University, Atlanta; Atlanta VA Medical Center, Decatur, Georgia; Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida; Department of Laboratory Medicine and Pathobiology, University of Toronto; and Department of Anatomic Pathology, Sunnybrook Health Sciences Centre, Toronto, Ontario
| | - Adeboye O Osunkoya
- Authors' Affiliations: Departments of Biomedical Informatics, Biostatistics and Bioinformatics, Pathology and Laboratory Medicine, Urology, Hematology and Medical Oncology, Human Genetics, and Surgery; Winship Cancer Institute, Emory University, Atlanta; Atlanta VA Medical Center, Decatur, Georgia; Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida; Department of Laboratory Medicine and Pathobiology, University of Toronto; and Department of Anatomic Pathology, Sunnybrook Health Sciences Centre, Toronto, OntarioAuthors' Affiliations: Departments of Biomedical Informatics, Biostatistics and Bioinformatics, Pathology and Laboratory Medicine, Urology, Hematology and Medical Oncology, Human Genetics, and Surgery; Winship Cancer Institute, Emory University, Atlanta; Atlanta VA Medical Center, Decatur, Georgia; Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida; Department of Laboratory Medicine and Pathobiology, University of Toronto; and Department of Anatomic Pathology, Sunnybrook Health Sciences Centre, Toronto, OntarioAuthors' Affiliations: Departments of Biomedical Informatics, Biostatistics and Bioinformatics, Pathology and Laboratory Medicine, Urology, Hematology and Medical Oncology, Human Genetics, and Surgery; Winship Cancer Institute, Emory University, Atlanta; Atlanta VA Medical Center, Decatur, Georgia; Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida; Department of Laboratory Medicine and Pathobiology, University of Toronto; and Department of Anatomic Pathology, Sunnybrook Health Sciences Centre, Toronto, OntarioAuthors' Affiliations: Departments of Biomedical Informatics, Biostatistics and Bioinformatics, Pathology and Laboratory Medicine, Urology, Hematology and Medical Oncology, Human Genetics, and Surgery; Winship Cancer Institute, Emory University, Atlanta; Atlanta VA Medical Center, Decatur, Georgia; Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida; Department o
| | - Soma Sannigrahi
- Authors' Affiliations: Departments of Biomedical Informatics, Biostatistics and Bioinformatics, Pathology and Laboratory Medicine, Urology, Hematology and Medical Oncology, Human Genetics, and Surgery; Winship Cancer Institute, Emory University, Atlanta; Atlanta VA Medical Center, Decatur, Georgia; Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida; Department of Laboratory Medicine and Pathobiology, University of Toronto; and Department of Anatomic Pathology, Sunnybrook Health Sciences Centre, Toronto, Ontario
| | - Brent A Johnson
- Authors' Affiliations: Departments of Biomedical Informatics, Biostatistics and Bioinformatics, Pathology and Laboratory Medicine, Urology, Hematology and Medical Oncology, Human Genetics, and Surgery; Winship Cancer Institute, Emory University, Atlanta; Atlanta VA Medical Center, Decatur, Georgia; Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida; Department of Laboratory Medicine and Pathobiology, University of Toronto; and Department of Anatomic Pathology, Sunnybrook Health Sciences Centre, Toronto, Ontario
| | - Wei Zhou
- Authors' Affiliations: Departments of Biomedical Informatics, Biostatistics and Bioinformatics, Pathology and Laboratory Medicine, Urology, Hematology and Medical Oncology, Human Genetics, and Surgery; Winship Cancer Institute, Emory University, Atlanta; Atlanta VA Medical Center, Decatur, Georgia; Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida; Department of Laboratory Medicine and Pathobiology, University of Toronto; and Department of Anatomic Pathology, Sunnybrook Health Sciences Centre, Toronto, OntarioAuthors' Affiliations: Departments of Biomedical Informatics, Biostatistics and Bioinformatics, Pathology and Laboratory Medicine, Urology, Hematology and Medical Oncology, Human Genetics, and Surgery; Winship Cancer Institute, Emory University, Atlanta; Atlanta VA Medical Center, Decatur, Georgia; Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida; Department of Laboratory Medicine and Pathobiology, University of Toronto; and Department of Anatomic Pathology, Sunnybrook Health Sciences Centre, Toronto, OntarioAuthors' Affiliations: Departments of Biomedical Informatics, Biostatistics and Bioinformatics, Pathology and Laboratory Medicine, Urology, Hematology and Medical Oncology, Human Genetics, and Surgery; Winship Cancer Institute, Emory University, Atlanta; Atlanta VA Medical Center, Decatur, Georgia; Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida; Department of Laboratory Medicine and Pathobiology, University of Toronto; and Department of Anatomic Pathology, Sunnybrook Health Sciences Centre, Toronto, OntarioAuthors' Affiliations: Departments of Biomedical Informatics, Biostatistics and Bioinformatics, Pathology and Laboratory Medicine, Urology, Hematology and Medical Oncology, Human Genetics, and Surgery; Winship Cancer Institute, Emory University, Atlanta; Atlanta VA Medical Center, Decatur, Georgia; Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida; Department o
| | - Theresa Gillespie
- Authors' Affiliations: Departments of Biomedical Informatics, Biostatistics and Bioinformatics, Pathology and Laboratory Medicine, Urology, Hematology and Medical Oncology, Human Genetics, and Surgery; Winship Cancer Institute, Emory University, Atlanta; Atlanta VA Medical Center, Decatur, Georgia; Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida; Department of Laboratory Medicine and Pathobiology, University of Toronto; and Department of Anatomic Pathology, Sunnybrook Health Sciences Centre, Toronto, OntarioAuthors' Affiliations: Departments of Biomedical Informatics, Biostatistics and Bioinformatics, Pathology and Laboratory Medicine, Urology, Hematology and Medical Oncology, Human Genetics, and Surgery; Winship Cancer Institute, Emory University, Atlanta; Atlanta VA Medical Center, Decatur, Georgia; Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida; Department of Laboratory Medicine and Pathobiology, University of Toronto; and Department of Anatomic Pathology, Sunnybrook Health Sciences Centre, Toronto, Ontario
| | - Jong Y Park
- Authors' Affiliations: Departments of Biomedical Informatics, Biostatistics and Bioinformatics, Pathology and Laboratory Medicine, Urology, Hematology and Medical Oncology, Human Genetics, and Surgery; Winship Cancer Institute, Emory University, Atlanta; Atlanta VA Medical Center, Decatur, Georgia; Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida; Department of Laboratory Medicine and Pathobiology, University of Toronto; and Department of Anatomic Pathology, Sunnybrook Health Sciences Centre, Toronto, Ontario
| | - Robert K Nam
- Authors' Affiliations: Departments of Biomedical Informatics, Biostatistics and Bioinformatics, Pathology and Laboratory Medicine, Urology, Hematology and Medical Oncology, Human Genetics, and Surgery; Winship Cancer Institute, Emory University, Atlanta; Atlanta VA Medical Center, Decatur, Georgia; Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida; Department of Laboratory Medicine and Pathobiology, University of Toronto; and Department of Anatomic Pathology, Sunnybrook Health Sciences Centre, Toronto, OntarioAuthors' Affiliations: Departments of Biomedical Informatics, Biostatistics and Bioinformatics, Pathology and Laboratory Medicine, Urology, Hematology and Medical Oncology, Human Genetics, and Surgery; Winship Cancer Institute, Emory University, Atlanta; Atlanta VA Medical Center, Decatur, Georgia; Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida; Department of Laboratory Medicine and Pathobiology, University of Toronto; and Department of Anatomic Pathology, Sunnybrook Health Sciences Centre, Toronto, Ontario
| | - Linda Sugar
- Authors' Affiliations: Departments of Biomedical Informatics, Biostatistics and Bioinformatics, Pathology and Laboratory Medicine, Urology, Hematology and Medical Oncology, Human Genetics, and Surgery; Winship Cancer Institute, Emory University, Atlanta; Atlanta VA Medical Center, Decatur, Georgia; Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida; Department of Laboratory Medicine and Pathobiology, University of Toronto; and Department of Anatomic Pathology, Sunnybrook Health Sciences Centre, Toronto, OntarioAuthors' Affiliations: Departments of Biomedical Informatics, Biostatistics and Bioinformatics, Pathology and Laboratory Medicine, Urology, Hematology and Medical Oncology, Human Genetics, and Surgery; Winship Cancer Institute, Emory University, Atlanta; Atlanta VA Medical Center, Decatur, Georgia; Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida; Department of Laboratory Medicine and Pathobiology, University of Toronto; and Department of Anatomic Pathology, Sunnybrook Health Sciences Centre, Toronto, Ontario
| | - Aleksandra Stanimirovic
- Authors' Affiliations: Departments of Biomedical Informatics, Biostatistics and Bioinformatics, Pathology and Laboratory Medicine, Urology, Hematology and Medical Oncology, Human Genetics, and Surgery; Winship Cancer Institute, Emory University, Atlanta; Atlanta VA Medical Center, Decatur, Georgia; Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida; Department of Laboratory Medicine and Pathobiology, University of Toronto; and Department of Anatomic Pathology, Sunnybrook Health Sciences Centre, Toronto, OntarioAuthors' Affiliations: Departments of Biomedical Informatics, Biostatistics and Bioinformatics, Pathology and Laboratory Medicine, Urology, Hematology and Medical Oncology, Human Genetics, and Surgery; Winship Cancer Institute, Emory University, Atlanta; Atlanta VA Medical Center, Decatur, Georgia; Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida; Department of Laboratory Medicine and Pathobiology, University of Toronto; and Department of Anatomic Pathology, Sunnybrook Health Sciences Centre, Toronto, Ontario
| | - Arun K Seth
- Authors' Affiliations: Departments of Biomedical Informatics, Biostatistics and Bioinformatics, Pathology and Laboratory Medicine, Urology, Hematology and Medical Oncology, Human Genetics, and Surgery; Winship Cancer Institute, Emory University, Atlanta; Atlanta VA Medical Center, Decatur, Georgia; Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida; Department of Laboratory Medicine and Pathobiology, University of Toronto; and Department of Anatomic Pathology, Sunnybrook Health Sciences Centre, Toronto, OntarioAuthors' Affiliations: Departments of Biomedical Informatics, Biostatistics and Bioinformatics, Pathology and Laboratory Medicine, Urology, Hematology and Medical Oncology, Human Genetics, and Surgery; Winship Cancer Institute, Emory University, Atlanta; Atlanta VA Medical Center, Decatur, Georgia; Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida; Department of Laboratory Medicine and Pathobiology, University of Toronto; and Department of Anatomic Pathology, Sunnybrook Health Sciences Centre, Toronto, Ontario
| | - John A Petros
- Authors' Affiliations: Departments of Biomedical Informatics, Biostatistics and Bioinformatics, Pathology and Laboratory Medicine, Urology, Hematology and Medical Oncology, Human Genetics, and Surgery; Winship Cancer Institute, Emory University, Atlanta; Atlanta VA Medical Center, Decatur, Georgia; Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida; Department of Laboratory Medicine and Pathobiology, University of Toronto; and Department of Anatomic Pathology, Sunnybrook Health Sciences Centre, Toronto, OntarioAuthors' Affiliations: Departments of Biomedical Informatics, Biostatistics and Bioinformatics, Pathology and Laboratory Medicine, Urology, Hematology and Medical Oncology, Human Genetics, and Surgery; Winship Cancer Institute, Emory University, Atlanta; Atlanta VA Medical Center, Decatur, Georgia; Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida; Department of Laboratory Medicine and Pathobiology, University of Toronto; and Department of Anatomic Pathology, Sunnybrook Health Sciences Centre, Toronto, OntarioAuthors' Affiliations: Departments of Biomedical Informatics, Biostatistics and Bioinformatics, Pathology and Laboratory Medicine, Urology, Hematology and Medical Oncology, Human Genetics, and Surgery; Winship Cancer Institute, Emory University, Atlanta; Atlanta VA Medical Center, Decatur, Georgia; Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida; Department of Laboratory Medicine and Pathobiology, University of Toronto; and Department of Anatomic Pathology, Sunnybrook Health Sciences Centre, Toronto, OntarioAuthors' Affiliations: Departments of Biomedical Informatics, Biostatistics and Bioinformatics, Pathology and Laboratory Medicine, Urology, Hematology and Medical Oncology, Human Genetics, and Surgery; Winship Cancer Institute, Emory University, Atlanta; Atlanta VA Medical Center, Decatur, Georgia; Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida; Department o
| | - Carlos S Moreno
- Authors' Affiliations: Departments of Biomedical Informatics, Biostatistics and Bioinformatics, Pathology and Laboratory Medicine, Urology, Hematology and Medical Oncology, Human Genetics, and Surgery; Winship Cancer Institute, Emory University, Atlanta; Atlanta VA Medical Center, Decatur, Georgia; Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida; Department of Laboratory Medicine and Pathobiology, University of Toronto; and Department of Anatomic Pathology, Sunnybrook Health Sciences Centre, Toronto, OntarioAuthors' Affiliations: Departments of Biomedical Informatics, Biostatistics and Bioinformatics, Pathology and Laboratory Medicine, Urology, Hematology and Medical Oncology, Human Genetics, and Surgery; Winship Cancer Institute, Emory University, Atlanta; Atlanta VA Medical Center, Decatur, Georgia; Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida; Department of Laboratory Medicine and Pathobiology, University of Toronto; and Department of Anatomic Pathology, Sunnybrook Health Sciences Centre, Toronto, OntarioAuthors' Affiliations: Departments of Biomedical Informatics, Biostatistics and Bioinformatics, Pathology and Laboratory Medicine, Urology, Hematology and Medical Oncology, Human Genetics, and Surgery; Winship Cancer Institute, Emory University, Atlanta; Atlanta VA Medical Center, Decatur, Georgia; Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida; Department of Laboratory Medicine and Pathobiology, University of Toronto; and Department of Anatomic Pathology, Sunnybrook Health Sciences Centre, Toronto, Ontario
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