ras Oncogene p21 expression is increased in premalignant lesions and high grade bladder carcinoma

ras p21 expression in the progression of breast cancer

The differential expression of the ras oncogene product p21 in the primary tumor, regional nodes, and distant metastatic sites in patients with disseminated breast cancer was examined to define the biologic and clinical significance of the ras oncogene in the progression of breast cancer. The avidin-biotin peroxidase complex method was used on formalin-fixed, paraffin-embedded tissues from 16 patients with metastatic disease. The primary antibody used in this protocol was RAP-5, an anti-p21 murine monoclonal IgG2a. p21 antigen staining was similar in the primary tumor and regional nodes from the same patient (P less than 0.05), but the staining of distant metastases was more variable. Expression of ras p21 was consistently increased in invasive components of the primary tumor as compared with intraductal tumor. In addition, a high level of p21 expression was seen in tumor emboli in lymphatics and blood vessels as compared with contiguous tumor in parenchymal tissue. Although p21 staining is present in aggressive primary breast cancers and most metastatic sites, our findings indicate that markedly enhanced p21 expression is associated with the earlier stages (invasion and dissemination) of aggressive breast cancers.

ras oncogene p21 as a tumor marker in the cytodiagnosis of gastric and colonic carcinomas

This study was undertaken to determine whether the expression of ras oncogene product p21 can be used as a tumor cell marker of gastric and colonic carcinoma in brush smears. To detect p21 an immunocytochemical assay with RAP-5 monoclonal antibody was used. Benign epithelial gastric cells obtained from normal gastric mucosa or benign gastric lesions reacted negatively in 12 out of 13 cases. Similarly, benign epithelial colonic cells from normal colon or benign colonic lesions were negative for p21 in nine out of ten cases. Weakly positive reaction, confined to a few cell clusters only, was observed in one smear of a benign gastric ulcer and one smear of chronic ulcerative colitis. All 20 smears from colonic carcinoma and all 20 smears of gastric carcinoma contained cells that stained positively for p21, and the degree of tumor differentiation had no impact on the staining pattern. The results recorded in this study show that the immunocytochemical assay for the ras oncogene product may prove to represent a new tool for the cytodiagnosis of gastric and colonic carcinomas.

Transferrin receptor expression by human bladder transitional cell carcinomas

The expression of transferrin receptors (TFR) by normal and neoplastic urothelial cells was studied in "control" patients and in patients with transitional cell carcinoma of the bladder. These tumours were graded independently and consisted of 19 grade I, 30 grade II and 19 grade III lesions. TFRs were identified using a monoclonal antibody specific for TFR (OKT9) in an immunofluorescent or avidin/biotin-immunoperoxidase technique on fresh frozen sections. TFRs were not detected on normal urothelium. However, positive staining was found to increase with increasing pathological grade and stage of the tumours, ranging from 31.6% of grade I to 78.9% of grade III tumours and 51.2% of pTa (mucosa only lesions) to 87.5% of pT2/pT2+ (muscle invasion +/- deeper) primary urothelial malignancies.

Lack of correlation between rare Ha-ras alleles and urothelial cancer in Japan

Restriction fragment length polymorphism (RFLP) of Ha-ras gene was surveyed by Southern blot analysis in leukocyte DNA from 55 normal individuals and 58 urothelial cancer patients in Japan. Three common alleles and 4 rare alleles were classified. The frequency of common alleles in normal Japanese individuals differed from that in Caucasians previously reported; a 7.2-7.5-kb BamHI fragment of common allele was not observed in Japanese individuals. No significant increase in frequency of the rare Ha-ras allele was observed in the group of cancer patients. Moreover, no significant difference in frequency was observed for the 3 common alleles. Tumor DNA was compared with leukocyte DNA in 30 urothelial cancer patients: in 3 of 8 cases with heterozygous Ha-ras locus, decreased intensity of one band, indicating partial loss of one allele in tumor DNA, was observed. In 3 tumors with either deletion of one Ha-ras allele or a rare Ha-ras allele, expression of Ha-ras gene was examined by Northern blot analysis. Such genetic alterations did not always result in a marked increase in Ha-ras expression. These data suggest that these genetic alterations are not directly related to Ha-ras expression, and that RFLP of Ha-ras gene is not a useful genetic marker for urothelial cancer. On the other hand, deletion of one Ha-ras allele was observed in 1 of 5 cases of bladder cancer and in 2 of 3 cases of renal pelvic cancer, suggesting that that deletion may be important in the development of urothelial cancer.

Carcinoma of the prostate. Hormonal therapy

A selective review of the literature regarding hormonal therapy for patients with carcinoma of the prostate is presented to assess the current status of the following: therapeutic advantages, disadvantages and risks of alternate approaches to hormonal therapy; observations to predict the magnitude and duration of response to therapy; indications for initiating hormone therapy; the short-term and long-term effects of therapy; and role of hormone therapy in patients with recurrent tumor activity after initial hormonal measures.

Immunohistochemical localization of ras p21 and carcinoembryonic antigens (CEA) in cholangiocarcinoma

An expression of ras p21 proteins on cholangiocarcinoma (CC) (intrahepatic bile duct carcinoma) cells was examined by an immunoperoxidase method using an appropriate dilution of mouse monoclonal antibody RAP-5, with which no positive staining was obtained in livers with normal histology. Of 44 CCs examined 39 were positive for the antigens; well-differentiated adenocarcinoma usually showed a diffuse weak, cytoplasmic staining in nearly all tumor cells with the same staining intensity, while in moderately and poorly differentiated adenocarcinoma the expression of p21 varied markedly in intensity from cell to cell in the same cell nest. The number of positive cells decreased with the grade of tumor, and no or little staining was observed in undifferentiated areas. These findings indicate that the expression of ras p21 antigens was lost with increasing dedifferentiation of tumor cells. Carcinoembryonic antigens (CEA) were positive in 42 of 44 CCS. Well-differentiated adenocarcinoma expressed CEA along the apical surfaces of the tumor glands. With the dedifferentiation of tumor cells, the expression of CEA became prominent not only at the apical surfaces but also on the basolateral surfaces and in the cytoplasms, and further in the surrounding stromal tissue. There was no clear-cut correlation between the expression of p21 antigens and the production of CEA in CCs.

Expression of p21ras in normal and malignant human tissues: lack of association with proliferation and malignancy

Proteins encoded by cellular ras oncogenes (p21ras) are expressed in a wide variety of malignant tumors, including carcinomas, lymphomas, and neuroectodermal tumors. The function of p21ras in these tumors and the distribution and role of p21ras in corresponding normal tissues are unclear. This immunohistochemical study examined the relationship between p21ras expression and malignant transformation, cellular differentiation, and proliferative activity in vivo. p21ras was found to be widely expressed in normal tissues, but within those tissues expression was often sharply restricted to cells at specific stages of differentiation; terminally differentiated cells generally showed stronger reactivity with antibodies to p21ras than did rapidly proliferating cells. Fetal and adult tissues had corresponding patterns of p21ras expression, and the distribution of p21ras in neoplasms paralleled the pattern in normal tissue from which they were derived. Thus, p21ras seems to play a role in many fully differentiated cell types, and levels of p21ras expression do not correlate with proliferative activity in normal cell or, in contrast to past reports, with the transformed phenotype.

Expression of ras oncogene p21 antigen in normal and proliferative thyroid tissues

The ras oncogene p21 antigen (p21) has been identified in several epithelial malignancies, including breast, colon, bladder, and prostate. The pattern and intensity of immunoreactivity between normal and neoplastic tissues has been distinctly different. The authors examined thyroid lesions from 73 different cases by immunohistochemistry for the expression of p21 with a monoclonal antibody (RAP-5). Normal thyroid tissues (4) showed the least immunoreactivity, while papillary carcinomas (8), Hurthle cell carcinomas (10), and follicular carcinomas as (3) showed slightly more intense staining than Hurthle cell adenomas (12) or follicular adenomas (9). Anaplastic carcinomas (4) showed much less intense staining than most other carcinomas, while medullary thyroid carcinomas (5) showed only slight immunoreactivity. Inflammatory thyroid lesions associated with goiters, including Hashimoto's thyroiditis (6) and Graves' disease (8), showed moderate to intense expression of p21 as did multinodular goiters (4). Semiquantitative analysis of staining intensity by serial dilution of the primary antibody showed significant differences in staining between normal thyroid and some carcinomas (P less than 0.05), but not between carcinomas and adenomas. These results show that while antibody RAP-5 detects an antigen that is only weakly expressed in normal thyroids, this antigen is more strongly expressed in benign and malignant thyroid tumors, as well as in inflammatory and nonneoplastic proliferative thyroid lesions. It is thus not helpful in identifying differences between neoplastic and non-neoplastic thyroid lesions.

Ras related oncogene protein as a tumor marker in transitional cell carcinoma of the bladder

An oncogene related protein has been detected in the urine of patients with transitional cell carcinoma (TCC). This is a 55 kilodalton protein (p55) which is immunologically related to the ras oncogene product p21. Sixteen patients with TCC (55%) and none of the controls exhibited high level of p55 expression (greater than or equal to 3X the level of background). There were ten cancer patients (35%) who had 2X the level of background and three patients (10%) who had the level of background. In contrast, there were two non-cancer patients with 2X level of expression (9%) and the remainder (91%) had the background level of p55 expression. The expression of the marker (p55) tends to correlate with tumor grade and stage and is elevated in patients with a history of multiple recurrences. The ras oncogene has been identified in the tissues of a wide variety of cancers and is not a marker which is specific for any single cancer. The identification of its related gene product in the urine may be useful as a marker for TCC.

Pancreatic neoplasia induced by ras expression in acinar cells of transgenic mice

Expression of an activated human c-H-ras oncogene under control of rat elastase I regulating elements leads to neoplasia of the fetal exocrine pancreas. In most transgenic mice bearing this gene construct, massive tumors involving all the pancreatic acinar cells develop within a few days of pancreatic differentiation. Expression of the normal c-H-ras proto-oncogene in acinar cells leads to more subtle anomalies, but no tumors develop. Thus modest amounts of the mutant ras proteins are sufficient, in an otherwise normal genetic background, to lead to neoplastic transformation of differentiating pancreatic acinar cells. In contrast, a comparable elastase-myc construct produces no pancreatic tumors in transgenic mice.

Expression of Ha-ras oncogene p21 protein in relation to the cell cycle of cultured human tumor cells

It has been postulated that the expression of the product (p21) encoded by the ras genes may have a role in cell cycle events. Simultaneous multiparameter flow cytometry was used to measure the p21 content in relation to the cell cycle of several cancer cell lines of human origin. These studies revealed that p21 levels rise during the G1 phase of the cycle and remain approximately constant as cells traverse the S and G2 + M phases. The threshold level of p21 expression of S phase cells was used to divide the G1 cell population into cells with low (G1A) and high (G1B) p21 content. The p21 levels of G1B cells were approximately ten times higher than those of G1A cells. The validity of this subdivision was confirmed by synchronous measurements of RNA content and p21. Cells with low RNA content, hence in early part of G1 phase of the cell cycle, expressed low levels of p21, and cells with higher RNA content expressed higher levels of p21. These observations suggest that the levels of p21 are much lower at the onset of the cell cycle than at its end; hence a drop in p21 expression is likely to occur during or immediately after mitotic division.

Expression of oncogenes in human tumours with special reference to the head and neck region

A major recent advance in cancer research has been in the field of oncogenes. Oncogenes are genes with a proven cancer association and which appear to be particularly implicated in cellular regulation and proliferation. The oncogenic potential of specific cellular genes has now been recognised and this has influenced current thinking concerning the initiation of carcinogenesis. The specific role of an oncogene is still incompletely understood but research with one particular oncogene (ras) has demonstrated that it can be involved in more than one stage of multi-step carcinogenesis. New techniques are being developed and evaluated to determine the expression of specific oncogenes in normal and neoplastic tissues, with a view to using them in future diagnostic immuno-histopathological methods. This review describes the concept of oncogenes and discusses their role in the development of neoplasia. The results of the expression of various oncogenes in human malignancies with special reference to the head and neck regions are discussed. Finally, the future prospects of this research field are examined their and its possible implications in cancer therapy.

Hurthle cell thyroid tumors. An immunohistochemical study

Twenty-three Hurthle cell neoplasms of the thyroid were analyzed immunohistochemically for thyroglobulin, carcinoembryonic antigen (CEA), and for immunoreactivity with a monoclonal antibody to p21 ras oncogene product. Both benign and malignant tumors defined by the presence or absence of invasion and metastasis stained positively for thyroglobulin. Most tumors expressed both CEA and p21 ras oncogene product. Clinicopathologic analysis showed that malignant tumors were larger, occurred in slightly older patients (mean age, 52.8 years), and had an almost equal sex distribution, whereas benign tumors were more common in women and occurred in younger patients (mean age, 44.7 years). These results indicate that both benign and malignant Hurthle cell thyroid tumors produce thyroglobulin and express both CEA and p21 ras oncogene product, whereas adjacent normal thyroid tissues showed weak to absent immunoreactivity for p21 ras oncogene product. Because there are no specific immunohistochemical markers to distinguish between benign and malignant Hurthle cell tumors, one needs to rely on traditional histologic features such as invasion and metastasis to distinguish between benign and malignant Hurthle cell neoplasms.

Enhanced expression of the c-myc protooncogene in high-grade human prostate cancers

We examined a series of 29 surgical specimens of benign and malignant human prostate tissue for the expression of both the cHa-ras and c-myc protooncogenes. Northern blots were prepared using polyadenylated mRNA extracted from nine prostatic adenocarcinomas, 19 benign hypertrophied prostates (BPH) and one normal prostate. When the Northern blots were hybridized to a probe for cHa-ras, only one specimen of BPH showed an appreciable amount of the 1.2-kb transcript homologous to cHa-ras. Upon reprobing these blots with c-myc, six cancers showed a considerable amount of a 2.4-kb transcript homologous to c-myc. Three other cancers and all the benign tissue showed little or no detectable 2.4-kb c-myc transcript. On retrospective analysis, the cancers with elevated c-myc transcripts were found to have a Gleason score of 5 and above (poorly differentiated tumors), while the cancers with little or no c-myc transcripts were all of Gleason score 4 and lower. Finally, we compared our ability to detect c-myc transcripts in mRNA extracted from a surgically derived prostate tumor with mRNA extracted from the same tumor subject to a sham electrocautery procedure, as would occur during transurethral resection. The electrocautery procedure decreased both the intensity and the integrity of the c-myc signal in mRNA from the tumor. Thus, our exclusive use of surgically derived prostate tumors may be the reason we are able to detect an elevation in the expression of c-myc mRNA in high-grade tumors.

Evaluation of a monoclonal antibody to ras peptide, RAP-5, claimed to bind preferentially to cells of infiltrating carcinomas

RAP-5, a monoclonal antibody raised against a p21ras peptide, has been claimed to show immunohistochemical localisation of cells with infiltrative properties in human tumours. We confirmed that this antibody reveals pronounced cellular heterogeneity in human colonic neoplasms but could find no obvious relationship to infiltrative activity. RAP-5 bound to many different cell types, neoplastic and normal. In order to clarify the specificities of RAP-5 we applied it to two cell lines: nontumorigenic hamster fibroblasts in which ras expression is barely detectable, and a vigorously tumorigenic line derived from these fibroblasts by insertion of the human mutated Ha-ras oncogene in a high expression vector. Another antibody to p21ras, Y13-259, clearly distinguished between these cell lines both on immunoblots and immunocytochemically, but RAP-5 did not. Rather, it bound to proteins of a variety of molecular weights in both cell lines. The results show that RAP-5 is unlikely to be a useful reagent for detection of ras associated proteins in human tissues.

A comparison of tumor-related antigens in male and female breast cancer

A retrospective analysis was undertaken in which 15 female and 15 male breast cancers were matched by age, stage, estrogen receptor status, and histologic type. Our protocol compares male and female breast cancers for reactivity with antibodies against tumor-associated antigens known to be present on female breast cancer cells. Formalin-fixed sections of each primary tumor were reacted in the ABC immunoperoxidase assay against antibodies B72.3 and DF.3 and an antibody to the ras p21 antigen. Reactivity to B72.3 and DF.3 was similar. However, the ras p21 antigen was expressed to a significantly greater extent in female breast cancers (p = .0008). Thus, although there are similarities in antigenic phenotype of male and female breast cancers, some female breast cancers may have a different pathogenesis as demonstrated by increased amounts of a specific oncogene product.

Expression of ras oncogene p21 in prostate cancer

The major neoplastic transformation-inducing genes of human solid tumors are members of the ras oncogene family. We used an immunohistochemical assay to assess expression of both the unaltered and the mutated ras oncogene protein (p21) in normal and neoplastic prostatic cells. With the concentration of monoclonal antibody used in this study, epithelial and stromal cells from subjects with normal prostates and from 19 patients with benign prostatic hyperplasia were negative for p21 antigen. This antigen was detected in 2 of 6 prostates with Grade I carcinoma, 4 of 6 with Grade II, and all of 17 with higher grades. A semiquantitative immunohistochemical method demonstrated that expression of the p21 antigen in a carcinoma strongly correlated with nuclear anaplasia and was inversely related to the degree of glandular differentiation. However, markedly anaplastic tumors were often more heterogeneous in expression of p21 and contained areas of low staining for the antigen. Comparison of p21 antigen with tumor carcinoembryonic antigen and prostate-specific antigen demonstrated that ras p21 was the only phenotypic marker that correlated with histologic tumor grade. Thus, ras oncogene p21 may represent a new class of biologically relevant tumor markers and may be a useful adjunct to histopathologic examination in determining the prognosis of patients with prostate cancer.