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Harini P, Neralla M, Preethi A, Selvakumar SC. Impact of Interleukin-6 on Oral Squamous Cell Carcinoma Among the South Indian Population. Cureus 2024; 16:e63789. [PMID: 39099925 PMCID: PMC11297842 DOI: 10.7759/cureus.63789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Accepted: 07/02/2024] [Indexed: 08/06/2024] Open
Abstract
Introduction Oral squamous cell carcinoma (OSCC) is associated with high rates of morbidity and mortality. Despite advances in research and treatment, the survival rate of OSCC patients has not changed considerably in recent years. Interleukin-6 (IL-6) is a proinflammatory cytokine that is involved in the development of various cancers including OSCC. The role of IL-6 is being studied in various cancers; however, its exact mechanism of action in OSCC among the South Indian population has not yet been studied. Thus, the current study aims to evaluate and assess the impact of IL-6 on OSCC among the South Indian population. Materials and methods Twenty tissues from OSCC patients and 20 normal tissues surrounding the same area from normal people were gathered from the Department of Oral and Maxillofacial Surgery, Saveetha Dental College and Hospital. The tissues were prepared for expression investigations and hematoxylin and eosin staining. The data was presented as mean ± standard deviation, with statistical significance at p<0.05. Results Our results indicate that, in comparison to normal tissues, OSCC samples had increased IL-6 expression levels (p<0.05). Conclusion We conclude that IL-6 has been identified as a key oncogene in the development of tumors and their spread in several types of cancers, including OSCC. Therefore, IL-6 can be used as a potential diagnostic or prognostic biomarker and the use of IL-6 inhibitors can be formulated as a potential treatment for OSCC.
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Affiliation(s)
- P Harini
- Oral and Maxillofacial Surgery, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
| | - Mahathi Neralla
- Oral and Maxillofacial Surgery, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
| | - Auxzilia Preethi
- RNA Biology Lab, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
| | - Sushmaa Chandralekha Selvakumar
- RNA Biology Lab, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
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Liu Z, Hu Y, Xie H, Chen K, Wen L, Fu W, Zhou X, Tang F. Single-Cell Chromatin Accessibility Analysis Reveals the Epigenetic Basis and Signature Transcription Factors for the Molecular Subtypes of Colorectal Cancers. Cancer Discov 2024; 14:1082-1105. [PMID: 38445965 DOI: 10.1158/2159-8290.cd-23-1445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 02/06/2024] [Accepted: 03/04/2024] [Indexed: 03/07/2024]
Abstract
Colorectal cancer is a highly heterogeneous disease, with well-characterized subtypes based on genome, DNA methylome, and transcriptome signatures. To chart the epigenetic landscape of colorectal cancers, we generated a high-quality single-cell chromatin accessibility atlas of epithelial cells for 29 patients. Abnormal chromatin states acquired in adenomas were largely retained in colorectal cancers, which were tightly accompanied by opposite changes of DNA methylation. Unsupervised analysis on malignant cells revealed two epigenetic subtypes, exactly matching the iCMS classification, and key iCMS-specific transcription factors (TFs) were identified, including HNF4A and PPARA for iCMS2 tumors and FOXA3 and MAFK for iCMS3 tumors. Notably, subtype-specific TFs bind to distinct target gene sets and contribute to both interpatient similarities and diversities for both chromatin accessibilities and RNA expressions. Moreover, we identified CpG-island methylator phenotypes and pinpointed chromatin state signatures and TF regulators for the CIMP-high subtype. Our work systematically revealed the epigenetic basis of the well-known iCMS and CIMP classifications of colorectal cancers. SIGNIFICANCE Our work revealed the epigenetic basis of the well-known iCMS and CIMP classifications of colorectal cancers. Moreover, interpatient minor similarities and major diversities of chromatin accessibility signatures of TF target genes can faithfully explain the corresponding interpatient minor similarities and major diversities of RNA expression signatures of colorectal cancers, respectively. This article is featured in Selected Articles from This Issue, p. 897.
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Affiliation(s)
- Zhenyu Liu
- School of Life Sciences, Biomedical Pioneering Innovation Center, Department of General Surgery, Third Hospital, Peking University, Beijing, China
- Beijing Advanced Innovation Center for Genomics (ICG), Ministry of Education Key Laboratory of Cell Proliferation and Differentiation, Beijing, China
| | - Yuqiong Hu
- School of Life Sciences, Biomedical Pioneering Innovation Center, Department of General Surgery, Third Hospital, Peking University, Beijing, China
- Beijing Advanced Innovation Center for Genomics (ICG), Ministry of Education Key Laboratory of Cell Proliferation and Differentiation, Beijing, China
- Key Laboratory of Organ Regeneration and Reconstruction, Institute of Zoology, Chinese Academy of Sciences, Beijing, China
- Beijing Institute for Stem Cell and Regenerative Medicine, Beijing, China
| | - Haoling Xie
- School of Life Sciences, Biomedical Pioneering Innovation Center, Department of General Surgery, Third Hospital, Peking University, Beijing, China
- Academy for Advanced Interdisciplinary Studies, Peking University, Beijing, China
| | - Kexuan Chen
- School of Life Sciences, Biomedical Pioneering Innovation Center, Department of General Surgery, Third Hospital, Peking University, Beijing, China
- Beijing Advanced Innovation Center for Genomics (ICG), Ministry of Education Key Laboratory of Cell Proliferation and Differentiation, Beijing, China
| | - Lu Wen
- School of Life Sciences, Biomedical Pioneering Innovation Center, Department of General Surgery, Third Hospital, Peking University, Beijing, China
- Beijing Advanced Innovation Center for Genomics (ICG), Ministry of Education Key Laboratory of Cell Proliferation and Differentiation, Beijing, China
| | - Wei Fu
- School of Life Sciences, Biomedical Pioneering Innovation Center, Department of General Surgery, Third Hospital, Peking University, Beijing, China
- Peking University Third Hospital Cancer Center, Beijing, China
| | - Xin Zhou
- School of Life Sciences, Biomedical Pioneering Innovation Center, Department of General Surgery, Third Hospital, Peking University, Beijing, China
- Peking University Third Hospital Cancer Center, Beijing, China
| | - Fuchou Tang
- School of Life Sciences, Biomedical Pioneering Innovation Center, Department of General Surgery, Third Hospital, Peking University, Beijing, China
- Beijing Advanced Innovation Center for Genomics (ICG), Ministry of Education Key Laboratory of Cell Proliferation and Differentiation, Beijing, China
- Academy for Advanced Interdisciplinary Studies, Peking University, Beijing, China
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Helmy Mohamed A, Noureldin Hassan A, Hussein Abdel Hay N, Fouad Ahmed M, El Sawy MM, Sonbol MM, Hussein Mohamed R. The potential role of SNHG16/ miRNA-146a/ TRAF6 signaling pathway in the protective effect of zoledronate against colorectal cancer and associated osteoporosis in mouse model. Int Immunopharmacol 2024; 133:112125. [PMID: 38657499 DOI: 10.1016/j.intimp.2024.112125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Revised: 04/17/2024] [Accepted: 04/18/2024] [Indexed: 04/26/2024]
Abstract
Bone fracture as a consequence of colorectal cancer (CRC) and associated osteoporosis (OP) is considered a risk factor for increasing the mortality rate among CRC patients. SNHG16/ miRNA-146a/ TRAF6 signaling pathway is a substantial contributor to neoplastic evolution, progression, and metastasis. Here, we investigated the effect of zoledronate (ZOL) on the growth of CRC and associated OP in a mouse model. Thirty Balb/c mice were divided into Naïve, azoxymethane (AOM)/dextran sodium sulfate (DSS), and ZOL groups. Body weight and small nucleolar RNA host gene 16 (SNHG16) expression, microRNA-146a, and TRAF6 in bone, colon, and stool were investigated. Samples of colon and bone were collected and processed for light microscopic, immunohistochemical staining for cytokeratin 20 (CK20), nuclear protein Ki67 (pKi-67), and caudal type homeobox transcription factor 2 (CDx2) in colon and receptor activator of nuclear factor kB (RANK) and osteoprotegerin (OPG) in bone. A computerized tomography (CT) scan of the femur and tibia was studied. ZOL produced a significant decrease in the expression of SNHG16 and TRAF6 and an increase in miRNA-146a in the colon and bone. ZOL administration improved the histopathological changes in the colon, produced a significant decrease in CK20 and Ki-67, and increased CDx2 expressions. In bone, ZOL prevented osteoporotic changes and tumour cell invasion produced a significant decrease in RANK and an increase in OPG expressions, alongside improved bone mineral density in CT scans. ZOL could be a promising preventive therapy against colitis-induced cancer and associated OP via modulation expression of SNHG16, miRNA-146a, and TRAF6.
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Affiliation(s)
- Amany Helmy Mohamed
- Department of Clinical Pharmacology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Ahmed Noureldin Hassan
- Department of Pharmacology, Faculty of Medicine, Galala University, Al Galala, Egypt; Department of Clinical Pharmacology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Nesma Hussein Abdel Hay
- Department of Medical Biochemistry and Molecular Biology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Manar Fouad Ahmed
- Department of Medical Biochemistry and Molecular Biology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Marwa M El Sawy
- Department of Anatomy and Embryology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Mohamed M Sonbol
- Department of Anatomy and Embryology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Reham Hussein Mohamed
- Department of Clinical Pharmacology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
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Ilie-Petrov AC, Cristian DA, Grama FA, Chitul A, Blajin A, Popa A, Mandi DM, Welt L, Bara MA, Vrîncianu R, Ardeleanu CM. Evaluation of the Immunohistochemical Scoring System of CDX2 Expression as a Prognostic Biomarker in Colon Cancer. Diagnostics (Basel) 2024; 14:1023. [PMID: 38786321 PMCID: PMC11119288 DOI: 10.3390/diagnostics14101023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Revised: 05/10/2024] [Accepted: 05/14/2024] [Indexed: 05/25/2024] Open
Abstract
Encoded by the CDX2 homeobox gene, the CDX2 protein assumes the role of a pivotal transcription factor localized within the nucleus of intestinal epithelial cells, orchestrating the delicate equilibrium of intestinal physiology while intricately guiding the precise development and differentiation of epithelial tissue. Emerging research has unveiled that positive immunohistochemical expression of this protein shows that the CDX2 gene exerts a potent suppressive impact on tumor advancement in colorectal cancer, impeding the proliferation and distant dissemination of tumor cells, while the inhibition or suppression of CDX2 frequently correlates with aggressive behavior in colorectal cancer. In this study, we conducted an immunohistochemical assessment of CDX2 expression on a cohort of 43 intraoperatively obtained tumor specimens from patients diagnosed with colon cancer at Colțea Clinical Hospital in Bucharest, between April 2019 and December 2023. Additionally, we shed light on the morphological diversity within colon tumors, uncovering varying differentiation grades within the same tumor, reflecting the variations in CDX2 expression as well as the genetic complexity underlying these tumors. Based on the findings, we developed an innovative immunohistochemical scoring system that addresses the heterogeneous nature of colon tumors. Comprehensive statistical analysis of CDX2 immunohistochemical expression unveiled significant correlations with known histopathological parameters such as tumor differentiation grades (p-value = 0.011) and tumor budding score (p-value = 0.002), providing intriguing insights into the complex involvement of the CDX2 gene in orchestrating tumor progression through modulation of differentiation processes, and highlighting its role in metastatic predisposition. The compelling correlation identified between CDX2 expression and conventional histopathological parameters emphasizes the prognostic significance of the CDX2 biomarker in colon cancer. Moreover, our novel immunohistochemical scoring system reveals a distinct subset of colon tumors exhibiting reserved prognostic outcomes, distinguished by their "mosaic" CDX2 expression pattern.
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Affiliation(s)
- Andreea-Corina Ilie-Petrov
- Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (A.-C.I.-P.); (D.-A.C.); (D.-M.M.); (C.M.A.)
- Clinical General Surgery Department, Colțea Clinical Hospital, 030171 Bucharest, Romania; (A.B.); (A.P.)
| | - Daniel-Alin Cristian
- Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (A.-C.I.-P.); (D.-A.C.); (D.-M.M.); (C.M.A.)
- Clinical General Surgery Department, Colțea Clinical Hospital, 030171 Bucharest, Romania; (A.B.); (A.P.)
| | - Florin Andrei Grama
- Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (A.-C.I.-P.); (D.-A.C.); (D.-M.M.); (C.M.A.)
- Clinical General Surgery Department, Colțea Clinical Hospital, 030171 Bucharest, Romania; (A.B.); (A.P.)
| | - Andrei Chitul
- Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (A.-C.I.-P.); (D.-A.C.); (D.-M.M.); (C.M.A.)
- Clinical General Surgery Department, Colțea Clinical Hospital, 030171 Bucharest, Romania; (A.B.); (A.P.)
| | - Angela Blajin
- Clinical General Surgery Department, Colțea Clinical Hospital, 030171 Bucharest, Romania; (A.B.); (A.P.)
| | - Andrei Popa
- Clinical General Surgery Department, Colțea Clinical Hospital, 030171 Bucharest, Romania; (A.B.); (A.P.)
| | - Draga-Maria Mandi
- Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (A.-C.I.-P.); (D.-A.C.); (D.-M.M.); (C.M.A.)
- Clinical General Surgery Department, Colțea Clinical Hospital, 030171 Bucharest, Romania; (A.B.); (A.P.)
| | - Luminița Welt
- Pathology Department, Colțea Clinical Hospital, 030171 Bucharest, Romania; (L.W.); (M.A.B.)
| | - Marina Alina Bara
- Pathology Department, Colțea Clinical Hospital, 030171 Bucharest, Romania; (L.W.); (M.A.B.)
| | - Rareș Vrîncianu
- Medical Oncology Department, Colțea Clinical Hospital, 030171 Bucharest, Romania;
| | - Carmen Maria Ardeleanu
- Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (A.-C.I.-P.); (D.-A.C.); (D.-M.M.); (C.M.A.)
- Pathology Department, OncoTeam Diagnostic Laboratory, 010719 Bucharest, Romania
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Nair D, Neralla M, Selvakumar SC, Preethi A. Effect of the Protein Kinase B (PKB) Gene on the Carcinogenesis of Oral Squamous Cell Carcinoma in the South Indian Population. Cureus 2024; 16:e60099. [PMID: 38860090 PMCID: PMC11164297 DOI: 10.7759/cureus.60099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Accepted: 05/11/2024] [Indexed: 06/12/2024] Open
Abstract
INTRODUCTION The most common head and neck cancer is oral squamous cell carcinoma (OSCC). It is also one of the most prevalent forms of cancer globally. The current pharmacological treatment strategy for oral cancer lacks specificity and is capable of causing various side effects. This fact highlights the increasing need for targeted therapy. Interestingly, protein kinase B (PKB), commonly referred to as the AKT serine/threonine kinase, is an oncogenic protein that controls cell development, proliferation, apoptosis, and glycogen metabolism. Thus, the present study analyzed the AKT gene expression in OSCC patient samples. MATERIALS AND METHODS A total of 25 OSCC tissue samples and normal tissue samples were collected from the patients who reported to the Department of Oral and Maxillofacial Surgery, Saveetha Dental College and Hospitals in Chennai, India. The tissues were processed for H&E staining for histopathological confirmation, and expression studies of the AKT gene were done on both healthy and proven OSCC tissue samples. The data were shown as mean ± standard deviation, and p<0.05* was considered to be statistically significant. RESULTS The quantitative reverse transcription polymerase chain reaction (qRT-PCR) analysis revealed that the AKT gene had been significantly upregulated in the OSCC tissue samples when compared to normal tissues (p<0.05). Moreover, upregulated AKT is postulated to be involved in increased cell proliferation and reduced apoptosis in OSCC. CONCLUSION The gene expression analysis was done in the samples of histologically confirmed OSCC, and it revealed that the AKT gene was significantly upregulated in OSCC tissues. Thus, AKT could be postulated as a potential therapeutic target for OSCC.
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Affiliation(s)
- Devika Nair
- Oral and Maxillofacial Surgery, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences (SIMATS) Saveetha University, Chennai, IND
| | - Mahathi Neralla
- Oral and Maxillofacial Surgery, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences (SIMATS) Saveetha University, Chennai, IND
| | - Sushmaa Chandralekha Selvakumar
- RNA Biology Lab, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences (SIMATS) Saveetha University, Chennai, IND
| | - Auxzilia Preethi
- RNA Biology Lab, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences (SIMATS) Saveetha University, Chennai, IND
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Grass A, Kasajima A, Foersch S, Kriegsmann M, Brobeil A, Schmitt M, Wagner D, Poppinga J, Wiese D, Maurer E, Kirschbaum A, Muley T, Winter H, Rinke A, Gress TM, Kremer M, Evert M, Märkl B, Quaas A, Eckstein M, Tschurtschenthaler M, Klöppel G, Denkert C, Bartsch DK, Jesinghaus M. PITX2 as a Sensitive and Specific Marker of Midgut Neuroendocrine Tumors: Results from a Cohort of 1157 Primary Neuroendocrine Neoplasms. Mod Pathol 2024; 37:100442. [PMID: 38309431 DOI: 10.1016/j.modpat.2024.100442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Revised: 01/12/2024] [Accepted: 01/25/2024] [Indexed: 02/05/2024]
Abstract
As neuroendocrine tumors (NETs) often present as metastatic lesions, immunohistochemical assignment to a site of origin is one of the most important tasks in their pathologic assessment. Because a fraction of NETs eludes the typical expression profiles of their primary localization, additional sensitive and specific markers are required to improve diagnostic certainty. We investigated the expression of the transcription factor Pituitary Homeobox 2 (PITX2) in a large-scale cohort of 909 NET and 248 neuroendocrine carcinomas (NEC) according to the immunoreactive score (IRS) and correlated PITX2 expression groups with general tumor groups and primary localization. PITX2 expression (all expression groups) was highly sensitive (98.1%) for midgut-derived NET, but not perfectly specific, as non-midgut NET (especially pulmonary/duodenal) were quite frequently weak or moderately positive. The specificity rose to 99.5% for a midgut origin of NET if only a strong PITX2 expression was considered, which was found in only 0.5% (one pancreatic/one pulmonary) of non-midgut NET. In metastases of midgut-derived NET, PITX2 was expressed in all cases (87.5% strong, 12.5% moderate), whereas CDX2 was negative or only weakly expressed in 31.3% of the metastases. In NEC, a fraction of cases (14%) showed a weak or moderate PITX2 expression, which was not associated with a specific tumor localization. Our study independently validates PITX2 as a very sensitive and specific immunohistochemical marker of midgut-derived NET in a very large collective of neuroendocrine neoplasms. Therefore, our data argue toward implementation into diagnostic panels applied for NET as a firstline midgut marker.
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Affiliation(s)
- Albert Grass
- Department of Pathology, Phillips University Marburg und University Hospital Marburg, Marburg, Germany
| | - Atsuko Kasajima
- Department of Pathology, Technical University of Munich, Munich, Germany
| | | | - Mark Kriegsmann
- Department of Pathology, University Hospital Heidelberg, Heidelberg, Germany
| | - Alexander Brobeil
- Department of Pathology, University Hospital Heidelberg, Heidelberg, Germany
| | - Maxime Schmitt
- Department of Pathology, Phillips University Marburg und University Hospital Marburg, Marburg, Germany
| | - Daniel Wagner
- Department of Pathology, University Hospital Mainz, Mainz, Germany
| | - Jelte Poppinga
- Department of Surgery, Phillips University Marburg and University Hospital Marburg, Marburg, Germany
| | - Dominik Wiese
- Department of Surgery, Phillips University Marburg and University Hospital Marburg, Marburg, Germany
| | - Elisabeth Maurer
- Department of Surgery, Phillips University Marburg and University Hospital Marburg, Marburg, Germany
| | - Andreas Kirschbaum
- Department of Surgery, Phillips University Marburg and University Hospital Marburg, Marburg, Germany
| | - Thomas Muley
- Translational Lung Research Center Heidelberg (TLRC-H), Heidelberg, Germany; Translational Research Unit, Thoraxklinik at Heidelberg University Hospital, Heidelberg, Germany
| | - Hauke Winter
- Translational Lung Research Center Heidelberg (TLRC-H), Heidelberg, Germany; Translational Research Unit, Thoraxklinik at Heidelberg University Hospital, Heidelberg, Germany; Department of Thoracic Surgery, Thoraxklinik at Heidelberg University Hospital, Heidelberg, Germany
| | - Anja Rinke
- Department of Gastroenterology, Endocrinology and Infectious Diseases, Phillips University Marburg and University Hospital Marburg, Marburg, Germany
| | - Thomas M Gress
- Department of Gastroenterology, Endocrinology and Infectious Diseases, Phillips University Marburg and University Hospital Marburg, Marburg, Germany
| | - Markus Kremer
- Institute of Pathology, Städtisches Klinikum München, Munich, Germany
| | - Matthias Evert
- Department of Pathology, University Hospital Regensburg, Regensburg, Germany
| | - Bruno Märkl
- Institute of Pathology, University Hospital Augsburg, Augsburg, Germany
| | - Alexander Quaas
- Institute of Pathology, University Hospital Cologne, Cologne, Germany
| | - Markus Eckstein
- Department of Pathology, University Hospital Erlangen, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Markus Tschurtschenthaler
- Institute for Translational Cancer Research, German Cancer Consortium (DKTK), Partner Site Munich, Munich, Germany
| | - Günter Klöppel
- Department of Pathology, Technical University of Munich, Munich, Germany
| | - Carsten Denkert
- Department of Pathology, Phillips University Marburg und University Hospital Marburg, Marburg, Germany
| | - Detlef K Bartsch
- Department of Surgery, Phillips University Marburg and University Hospital Marburg, Marburg, Germany
| | - Moritz Jesinghaus
- Department of Pathology, Phillips University Marburg und University Hospital Marburg, Marburg, Germany.
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Aydin SG, Olmez OF, Selvi O, Geredeli C, Ozden F, Bilici A, Acikgoz O, Karci E, Kutlu Y, Hamdard J, Aydin A. The Prognostic Role of Mismatch Repair Status and CDX-2 Expression with Inflammatory Markers and Pathological Risk Factors in Stage II and III Colon Cancer: Multicenter Real-Life Data. J Gastrointest Cancer 2024; 55:227-236. [PMID: 37347353 DOI: 10.1007/s12029-023-00953-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/09/2023] [Indexed: 06/23/2023]
Abstract
OBJECTIVE Colorectal cancer is common worldwide, and adjuvant treatment's benefit is still controversial. We designed this study to determine the role of MSI and CDX-2 status determined by immunohistochemistry (IHC) combined with the inflammatory markers and pathological parameters in predicting disease recurrence in stage II and III colon cancer. METHODS A total of 226 stage II/III colon cancer patients with a median age of 59 years who underwent initial surgery were included in this retrospective study. The pathologic assessment of MSI and CDX-2 was performed twice by immunohistochemistry (IHC) and two different pathologists. No staining/weak staining below 10% of the tumor was accepted as CDX-2 negative, and any MSI clones with weak staining below 10% were accepted as MSI-H. The laboratory parameters were noted at the initial diagnosis. RESULTS One hundred twenty-one and 105 patients were diagnosed with stage III and II colon cancer. 58.0% of patients were male, 46 (20.4%) of tumor tissue were MSS, and 17 (7.5%) were CDX-2 negative. One hundred twenty-nine tumors were localized in the right colon. Disease recurrence was significantly correlated with tumor localization, CDX-2 status, stage at diagnosis, and preoperatively median CRP and CEA levels. DFS rates for MSS patients with CDX-2 negative and positive were 36.7% and 98.1%, respectively [p < 0.001]. There was no significant correlation between MSI status and CDX-2 status. MSI status, the presence of adjuvant treatment, and systemic inflammatory markers were not significant prognostic factors for DFS. CDX-2 status [HR:0.08, CI 95% 0.03-0.17, p < 0.001 HR: 1.7, CI 95% 1.1-3.0, p = 0.03], disease stage [HR:2.6, CI 95% 1.43-4.74], and preoperatively CEA levels [HR:4.1 CI 95% 2.18-785, p < 0.001 were independent significant prognostic factors for DFS. CONCLUSION CDX-2 loss was an independent prognostic factor for DFS and disease recurrence in early-stage colon cancer. MSS patients with CDX-2 loss had significantly worse survival outcomes, and this might be the reason for deciding on adjuvant chemotherapy.
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Affiliation(s)
- Sabin Goktas Aydin
- Department of Medical Oncology, Medical Faculty, Istanbul Medipol University, TEM Avrupa Otoyolu Goztepe, Cikisi, No:1, Bagcilar, 34214, Istanbul, Turkey.
| | - Omer Fatih Olmez
- Department of Medical Oncology, Medical Faculty, Istanbul Medipol University, TEM Avrupa Otoyolu Goztepe, Cikisi, No:1, Bagcilar, 34214, Istanbul, Turkey
| | - Oguzhan Selvi
- Department of Medical Oncology, Okmeydani Training and Research Hospital, Kaptan Paşa Mahallesi, Darülaceze Cad. No:25, 34384, Okmeydani, Istanbul, Turkey
| | - Caglayan Geredeli
- Department of Medical Oncology, Okmeydani Training and Research Hospital, Kaptan Paşa Mahallesi, Darülaceze Cad. No:25, 34384, Okmeydani, Istanbul, Turkey
| | - Ferhat Ozden
- Department of Pathology, Medical Faculty, Istanbul Medipol University, TEM Avrupa Otoyolu Goztepe, Cikisi, No:1, Bagcilar, 34214, Istanbul, Turkey
| | - Ahmet Bilici
- Department of Medical Oncology, Medical Faculty, Istanbul Medipol University, TEM Avrupa Otoyolu Goztepe, Cikisi, No:1, Bagcilar, 34214, Istanbul, Turkey
| | - Ozgur Acikgoz
- Department of Medical Oncology, Medical Faculty, Istanbul Medipol University, TEM Avrupa Otoyolu Goztepe, Cikisi, No:1, Bagcilar, 34214, Istanbul, Turkey
| | - Ebru Karci
- Department of Medical Oncology, Medical Faculty, Istanbul Medipol University, TEM Avrupa Otoyolu Goztepe, Cikisi, No:1, Bagcilar, 34214, Istanbul, Turkey
| | - Yasin Kutlu
- Department of Medical Oncology, Medical Faculty, Istanbul Medipol University, TEM Avrupa Otoyolu Goztepe, Cikisi, No:1, Bagcilar, 34214, Istanbul, Turkey
| | - Jamshid Hamdard
- Department of Medical Oncology, Medical Faculty, Istanbul Medipol University, TEM Avrupa Otoyolu Goztepe, Cikisi, No:1, Bagcilar, 34214, Istanbul, Turkey
| | - Ahmet Aydin
- Department of Internal Medicine, Medical Faculty, Istanbul Medipol University, TEM Avrupa Otoyolu Goztepe, Cikisi, No:1, Bagcilar, 34214, Istanbul, Turkey
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Durán-Díaz I, Sarmiento A, Fondón I, Bodineau C, Tomé M, Durán RV. A Robust Method for the Unsupervised Scoring of Immunohistochemical Staining. ENTROPY (BASEL, SWITZERLAND) 2024; 26:165. [PMID: 38392420 PMCID: PMC10888407 DOI: 10.3390/e26020165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Revised: 02/02/2024] [Accepted: 02/07/2024] [Indexed: 02/24/2024]
Abstract
Immunohistochemistry is a powerful technique that is widely used in biomedical research and clinics; it allows one to determine the expression levels of some proteins of interest in tissue samples using color intensity due to the expression of biomarkers with specific antibodies. As such, immunohistochemical images are complex and their features are difficult to quantify. Recently, we proposed a novel method, including a first separation stage based on non-negative matrix factorization (NMF), that achieved good results. However, this method was highly dependent on the parameters that control sparseness and non-negativity, as well as on algorithm initialization. Furthermore, the previously proposed method required a reference image as a starting point for the NMF algorithm. In the present work, we propose a new, simpler and more robust method for the automated, unsupervised scoring of immunohistochemical images based on bright field. Our work is focused on images from tumor tissues marked with blue (nuclei) and brown (protein of interest) stains. The new proposed method represents a simpler approach that, on the one hand, avoids the use of NMF in the separation stage and, on the other hand, circumvents the need for a control image. This new approach determines the subspace spanned by the two colors of interest using principal component analysis (PCA) with dimension reduction. This subspace is a two-dimensional space, allowing for color vector determination by considering the point density peaks. A new scoring stage is also developed in our method that, again, avoids reference images, making the procedure more robust and less dependent on parameters. Semi-quantitative image scoring experiments using five categories exhibit promising and consistent results when compared to manual scoring carried out by experts.
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Affiliation(s)
- Iván Durán-Díaz
- Signal Theory and Communications Department, University of Seville, Avda. Descubrimientos S/N, 41092 Seville, Spain
| | - Auxiliadora Sarmiento
- Signal Theory and Communications Department, University of Seville, Avda. Descubrimientos S/N, 41092 Seville, Spain
| | - Irene Fondón
- Signal Theory and Communications Department, University of Seville, Avda. Descubrimientos S/N, 41092 Seville, Spain
| | - Clément Bodineau
- Department of Pathology, Brigham and Women's Hospital, Boston, MA 02115, USA
- Department of Genetics, Harvard Medical School, Boston, MA 02115, USA
| | - Mercedes Tomé
- Centro Andaluz de Biología Molecular y Medicina Regenerativa-CABIMER, Consejo Superior de Investigaciones Científicas, Universidad de Sevilla, Universidad Pablo de Olavide, 41092 Seville, Spain
| | - Raúl V Durán
- Centro Andaluz de Biología Molecular y Medicina Regenerativa-CABIMER, Consejo Superior de Investigaciones Científicas, Universidad de Sevilla, Universidad Pablo de Olavide, 41092 Seville, Spain
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Omiya M, Murata T, Sawaki A, Teshima S, Kawachi J. Cutaneous Metastasis of Transverse Colon Cancer with an Aberrant Pattern of CK7/CK20/CDX2 and High Microsatellite Instability. Intern Med 2023; 62:3625-3630. [PMID: 37164671 PMCID: PMC10781542 DOI: 10.2169/internalmedicine.1629-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 03/27/2023] [Indexed: 05/12/2023] Open
Abstract
A 79-year-old woman was diagnosed with transverse colon cancer, moderately differentiated adenocarcinoma. She underwent surgery and postoperative adjuvant chemotherapy. At 80 years old, the patient exhibited changes in skin tone at the chest and abdomen with CK7+/CK20-/CDX2- immunostaining that was later identified as poorly differentiated adenocarcinoma. The diagnosis was cancer of unknown primary origin. The patient passed away three months after the detection of the skin lesion. Autopsy revealed recurrence at the transverse colon, multiple organ metastases, a similar postmortem immunostaining pattern, and high-frequency microsatellite instability (MSI-high). We herein report this case of CK7+/CK20-/CDX2- and MSI-high transverse colon cancer showing cutaneous metastasis.
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Affiliation(s)
- Moeko Omiya
- Department of General Internal Medicine, Shonan Kamakura General Hospital, Japan
| | - Takaaki Murata
- Department of Surgery, Shonan Kamakura General Hospital, Japan
| | - Akira Sawaki
- Department of Medical Oncology, Shonan Kamakura General Hospital, Japan
| | - Shinichi Teshima
- Department of Pathology, Shonan Kamakura General Hospital, Japan
| | - Jun Kawachi
- Department of Surgery, Shonan Kamakura General Hospital, Japan
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10
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Fernandez-De-Los-Reyes I, Gomez-Dorronsoro M, Monreal-Santesteban I, Fernandez-Fernandez A, Fraga M, Azcue P, Alonso L, Fernandez-Marlasca B, Suarez J, Cordoba-Iturriagagoitia A, Guerrero-Setas D. ZEB1 hypermethylation is associated with better prognosis in patients with colon cancer. Clin Epigenetics 2023; 15:193. [PMID: 38093305 PMCID: PMC10720242 DOI: 10.1186/s13148-023-01605-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Accepted: 11/19/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND Colon cancer (CC) is a heterogeneous disease that is categorized into four Consensus Molecular Subtypes (CMS) according to gene expression. Patients with loco-regional CC (stages II/III) lack prognostic factors, making it essential to analyze new molecular markers that can delineate more aggressive tumors. Aberrant methylation of genes that are essential in crucial mechanisms such as epithelial mesenchymal transition (EMT) contributes to tumor progression in CC. We evaluate the presence of hyper- and hypomethylation in subrogate IHC markers used for CMS classification (CDX2, FRMD6, HTR2B, ZEB1) of 144 stage II/III patients and CC cell lines by pyrosequencing. ZEB1 expression was also studied in control and shRNA-silenced CC cell lines and in paired normal tissue/tumors by quantitative PCR. The pattern of ZEB1 staining was also analyzed in methylated/unmethylated tumors by immunohistochemistry. RESULTS We describe for the first time the hypermethylation of ZEB1 gene and the hypomethylation of the FRMD6 gene in 32.6% and 50.9% of tumors, respectively. Additionally, we confirm the ZEB1 re-expression by epigenetic drugs in methylated cell lines. ZEB1 hypermethylation was more frequent in CMS1 patients and, more importantly, was a good prognostic factor related to disease-free survival (p = 0.015) and overall survival (p = 0.006) in our patient series, independently of other significant clinical parameters such as patient age, stage, lymph node involvement, and blood vessel and perineural invasion. CONCLUSIONS Aberrant methylation is present in the subrogate genes used for CMS classification. Our results are the first evidence that ZEB1 is hypermethylated in CC and that this alteration is an independent factor of good prognosis.
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Affiliation(s)
- Irene Fernandez-De-Los-Reyes
- Department of Pathology, Hospital Universitario de Navarra (HUN), Irunlarrea 3, 31008, Pamplona, Spain
- Molecular Pathology of Cancer Group, Navarrabiomed, Universidad Pública de Navarra (UPNA), Instituto de Investigación Sanitaria de Navarra (IdiSNA), Irunlarrea 3, 31008, Pamplona, Spain
| | - Marisa Gomez-Dorronsoro
- Department of Pathology, Hospital Universitario de Navarra (HUN), Irunlarrea 3, 31008, Pamplona, Spain
- Oncogenetic and Hereditary Cancer Group, Universidad Pública de Navarra (UPNA), Instituto de Investigación Sanitaria de Navarra (IdiSNA), Irunlarrea 3, 31008, Pamplona, Spain
| | - Iñaki Monreal-Santesteban
- Molecular Pathology of Cancer Group, Navarrabiomed, Universidad Pública de Navarra (UPNA), Instituto de Investigación Sanitaria de Navarra (IdiSNA), Irunlarrea 3, 31008, Pamplona, Spain
| | - Agustín Fernandez-Fernandez
- Nanomaterials and Nanotechnology Research Center (CINN-CSIC), 33940, El Entrego, Spain
- Health Research Institute of Asturias (ISPA), 33011, Oviedo, Spain
- University Institute of Oncology (IUOPA), University of Oviedo, 33006, Oviedo, Spain
- Center for Biomedical Network Research on Rare Diseases (CIBERER), 28029, Madrid, Spain
| | - Mario Fraga
- Nanomaterials and Nanotechnology Research Center (CINN-CSIC), 33940, El Entrego, Spain
- Health Research Institute of Asturias (ISPA), 33011, Oviedo, Spain
- University Institute of Oncology (IUOPA), University of Oviedo, 33006, Oviedo, Spain
- Center for Biomedical Network Research on Rare Diseases (CIBERER), 28029, Madrid, Spain
| | - Pablo Azcue
- Department of Health Science, Public University of Navarra, Irunlarrea 3, 31008, Pamplona, Spain
| | - Laura Alonso
- Department of Pathology, Hospital Universitario de Navarra (HUN), Irunlarrea 3, 31008, Pamplona, Spain
| | | | - Javier Suarez
- Department of Surgery, Hospital Universitario de Navarra (HUN), Irunlarrea 3, 31008, Pamplona, Spain
| | - Alicia Cordoba-Iturriagagoitia
- Department of Pathology, Hospital Universitario de Navarra (HUN), Irunlarrea 3, 31008, Pamplona, Spain
- Molecular Pathology of Cancer Group, Navarrabiomed, Universidad Pública de Navarra (UPNA), Instituto de Investigación Sanitaria de Navarra (IdiSNA), Irunlarrea 3, 31008, Pamplona, Spain
| | - David Guerrero-Setas
- Department of Pathology, Hospital Universitario de Navarra (HUN), Irunlarrea 3, 31008, Pamplona, Spain.
- Molecular Pathology of Cancer Group, Navarrabiomed, Universidad Pública de Navarra (UPNA), Instituto de Investigación Sanitaria de Navarra (IdiSNA), Irunlarrea 3, 31008, Pamplona, Spain.
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Anees FF, Preethi KA, Selvakumar SC, Murthykumar K, Ganapathy D, Sekar D. Prospective study: expression levels of microRNA-7-3p and its target STAT3 in head and neck cancer. Minerva Dent Oral Sci 2023; 72:326-331. [PMID: 37326506 DOI: 10.23736/s2724-6329.23.04824-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
BACKGROUND Head and neck cancer (HNC) is the seventh most prevalent type of cancer in the globe, and it encompasses a wide range of tumors that affect the oral, facial and neck region. Despite breakthroughs in treatment strategies, patients survival has not increased substantially in the last few decades. Therefore, there is need for quick and reliable biomarkers and therapeutic targets for the treatment of HNC. Interestingly, microRNAs (miRNAs) are a small non-coding RNAs (ncRNAs) that have a role in the post-transcriptional regulation of gene expression. Thus, the aim of the study is to evaluate the role of miR-7-3p in the HNC and normal tissues. METHODS A total of 25 HNC and normal tissues were collected from the Department of Oral and Maxillofacial Surgery, Saveetha Dental College and Hospitals. Bioinformatic tool (TargetScan) was used to predict the target for miR-7-3p. The tissue samples were processed for Hematoxylin and Eosin staining and following that total RNA was extracted and analyzed for expression studies using RT-qPCR. RESULTS The bioinformatic analysis of the current study have revealed that STAT3 is a direct target for miR-7-3p. The histopathological examination showed damaged epithelial cells and keratin pool formation was observed in HNC tissue. Our results have also revealed that the miR-7-3p levels were significantly reduced and STAT3 levels were significantly higher in the HNC tissues when compared to the normal tissues. CONCLUSIONS MiR-7-3p can be used as a prognostic, diagnostic biomarker and therapeutic target for the treatment of HNC.
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Affiliation(s)
- Fharreeha F Anees
- Department of Prosthodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences (SIMATS), Saveetha University, Chennai, India
| | - K Auxzilia Preethi
- RNA Biology Lab, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences (SIMATS), Saveetha University, Chennai, India
| | - Sushmaa C Selvakumar
- RNA Biology Lab, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences (SIMATS), Saveetha University, Chennai, India
| | - Karthikeyan Murthykumar
- Department of Periodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences (SIMATS), Saveetha University, Chennai, India
| | - Dhanraj Ganapathy
- Department of Prosthodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences (SIMATS), Saveetha University, Chennai, India
| | - Durairaj Sekar
- RNA Biology Lab, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences (SIMATS), Saveetha University, Chennai, India
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12
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Badia-Ramentol J, Gimeno-Valiente F, Duréndez E, Martínez-Ciarpaglini C, Linares J, Iglesias M, Cervantes A, Calon A, Tarazona N. The prognostic potential of CDX2 in colorectal cancer: Harmonizing biology and clinical practice. Cancer Treat Rev 2023; 121:102643. [PMID: 37871463 DOI: 10.1016/j.ctrv.2023.102643] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 10/10/2023] [Accepted: 10/11/2023] [Indexed: 10/25/2023]
Abstract
Adjuvant chemotherapy following surgical intervention remains the primary treatment option for patients with localized colorectal cancer (CRC). However, a significant proportion of patients will have an unfavorable outcome after current forms of chemotherapy. While reflecting the increasing complexity of CRC, the clinical application of molecular biomarkers provides information that can be utilized to guide therapeutic strategies. Among these, caudal-related homeobox transcription factor 2 (CDX2) emerges as a biomarker of both prognosis and relapse after therapy. CDX2 is a key transcription factor that controls intestinal fate. Although rarely mutated in CRC, loss of CDX2 expression has been reported mostly in right-sided, microsatellite-unstable tumors and is associated with aggressive carcinomas. The pathological assessment of CDX2 by immunohistochemistry can thus identify patients with high-risk CRC, but the evaluation of CDX2 expression remains challenging in a substantial proportion of patients. In this review, we discuss the roles of CDX2 in homeostasis and CRC and the alterations that lead to protein expression loss. Furthermore, we review the clinical significance of CDX2 assessment, with a particular focus on its current use as a biomarker for pathological evaluation and clinical decision-making. Finally, we attempt to clarify the molecular implications of CDX2 deficiency, ultimately providing insights for a more precise evaluation of CDX2 protein expression.
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Affiliation(s)
- Jordi Badia-Ramentol
- Cancer Research Program, Hospital del Mar Research Institute (IMIM), Barcelona, Spain
| | - Francisco Gimeno-Valiente
- Cancer Evolution and Genome Instability Laboratory, University College London Cancer Institute, London, UK
| | - Elena Duréndez
- Department of Medical Oncology, INCLIVA Biomedical Research Institute, University of Valencia, CIBERONC, Spain
| | | | - Jenniffer Linares
- Cancer Research Program, Hospital del Mar Research Institute (IMIM), Barcelona, Spain
| | - Mar Iglesias
- Cancer Research Program, Hospital del Mar Research Institute (IMIM), Barcelona, Spain; Department of Pathology, Hospital del Mar, Barcelona, CIBERONC, Spain
| | - Andrés Cervantes
- Department of Medical Oncology, INCLIVA Biomedical Research Institute, University of Valencia, CIBERONC, Spain
| | - Alexandre Calon
- Cancer Research Program, Hospital del Mar Research Institute (IMIM), Barcelona, Spain.
| | - Noelia Tarazona
- Department of Medical Oncology, INCLIVA Biomedical Research Institute, University of Valencia, CIBERONC, Spain.
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Litmeyer A, Konukiewitz B, Kasajima A, Foersch S, Schicktanz F, Schmitt M, Kellers F, Grass A, Jank P, Lehman B, Gress TM, Rinke A, Bartsch DK, Denkert C, Weichert W, Klöppel G, Jesinghaus M. High expression of insulinoma-associated protein 1 (INSM1) distinguishes colorectal mixed and pure neuroendocrine carcinomas from conventional adenocarcinomas with diffuse expression of synaptophysin. J Pathol Clin Res 2023; 9:498-509. [PMID: 37608427 PMCID: PMC10556265 DOI: 10.1002/cjp2.339] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 07/06/2023] [Accepted: 07/27/2023] [Indexed: 08/24/2023]
Abstract
Complementary to synaptophysin and chromogranin A, insulinoma-associated protein 1 (INSM1) has emerged as a sensitive marker for the diagnosis of neuroendocrine neoplasms. Since there are no comparative data regarding INSM1 expression in conventional colorectal adenocarcinomas (CRCs) and colorectal mixed adenoneuroendocrine carcinomas/neuroendocrine carcinomas (MANECs/NECs), we examined INSM1 in a large cohort of conventional CRCs and MANECs/NECs. In conventional CRC, we put a special focus on conventional CRC with diffuse expression of synaptophysin, which carry the risk of being misinterpreted as a MANEC or a NEC. We investigated INSM1 according to the immunoreactive score in our main cohort of 1,033 conventional CRCs and 21 MANECs/NECs in comparison to the expression of synaptophysin and chromogranin A and correlated the results with clinicopathological parameters and patient survival. All MANECs/NECs expressed INSM1, usually showing high or moderate expression (57% high, 34% moderate, and 9% low), which distinguished them from conventional CRCs, which were usually INSM1 negative or low, even if they diffusely expressed synaptophysin. High expression of INSM1 was not observed in conventional CRCs. Chromogranin A was negative/low in most conventional CRCs (99%), but also in most MANECs/NECs (66%). Comparable results were observed in our independent validation cohorts of conventional CRC (n = 274) and MANEC/NEC (n = 19). Similar to synaptophysin, INSM1 expression had no prognostic relevance in conventional CRCs, while true MANEC/NEC showed a highly impaired survival in univariate and multivariate analyses (e.g. disease-specific survival: p < 0.001). MANECs/NECs are a highly aggressive variant of colorectal cancer, which must be reliably identified. High expression of INSM1 distinguishes MANEC/NEC from conventional CRCs with diffuse expression of the standard neuroendocrine marker synaptophysin, which do not share the same dismal prognosis. Therefore, high INSM1 expression is a highly specific/sensitive marker that is supportive for the diagnosis of true colorectal MANEC/NEC.
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Affiliation(s)
- Anne‐Sophie Litmeyer
- Institute of PathologyPhillips University Marburg and University Hospital MarburgMarburgGermany
| | - Björn Konukiewitz
- Department of PathologyUniversity Hospital Schleswig‐Holstein, Campus Kiel, Christian‐Albrechts‐Universität zu KielKielGermany
- Institute of PathologyTechnical University of MunichMunichGermany
| | - Atsuko Kasajima
- Institute of PathologyTechnical University of MunichMunichGermany
| | | | - Felix Schicktanz
- Institute of PathologyTechnical University of MunichMunichGermany
| | - Maxime Schmitt
- Institute of PathologyTechnical University of MunichMunichGermany
| | - Franziska Kellers
- Department of PathologyUniversity Hospital Schleswig‐Holstein, Campus Kiel, Christian‐Albrechts‐Universität zu KielKielGermany
| | - Albert Grass
- Institute of PathologyPhillips University Marburg and University Hospital MarburgMarburgGermany
| | - Paul Jank
- Institute of PathologyPhillips University Marburg and University Hospital MarburgMarburgGermany
| | - Bettina Lehman
- Department of SurgeryPhillips University Marburg and University Hospital MarburgMarburgGermany
| | - Thomas M Gress
- Department of Gastroenterology, Endocrinology and Infectious DiseasesPhillips University Marburg and University Hospital MarburgMarburgGermany
| | - Anja Rinke
- Department of Gastroenterology, Endocrinology and Infectious DiseasesPhillips University Marburg and University Hospital MarburgMarburgGermany
| | - Detlef K Bartsch
- Department of SurgeryPhillips University Marburg and University Hospital MarburgMarburgGermany
| | - Carsten Denkert
- Institute of PathologyPhillips University Marburg and University Hospital MarburgMarburgGermany
| | - Wilko Weichert
- Institute of PathologyTechnical University of MunichMunichGermany
| | - Günter Klöppel
- Institute of PathologyTechnical University of MunichMunichGermany
| | - Moritz Jesinghaus
- Institute of PathologyPhillips University Marburg and University Hospital MarburgMarburgGermany
- Institute of PathologyTechnical University of MunichMunichGermany
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Devall MA, Eaton S, Hu G, Sun X, Jakum E, Venkatesh S, Powell SM, Yoshida C, Weisenberger DJ, Cooper GS, Willis J, Ebrahim S, Zoellner J, Casey G, Li L. Potential role of fructose on human colon DNA methylation in racial disparities observed for colorectal cancer risk. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.05.31.23290777. [PMID: 37398462 PMCID: PMC10312841 DOI: 10.1101/2023.05.31.23290777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/04/2023]
Abstract
Background and aims An increasing body of observational studies has linked fructose intake to colorectal cancer (CRC). African Americans (AAs) are significantly more likely than European Americans to consume greater quantities of fructose and to develop right-side colon cancer. Yet, a mechanistic link between these two associations remains poorly defined. We aimed to identify differentially methylated regions (DMRs) associated with dietary fructose consumption measures obtained from food frequency questionnaires in a cohort of normal colon biopsies derived from AA men and women (n=79). Methods DNA methylation data from this study was obtained using the Illumina Infinium MethylationEPIC kit and is housed under accession GSE151732. DMR analysis was carried out using DMRcate in right and matched left colon, separately. Secondary analysis of CRC tumors was carried out using data derived from TCGA-COAD, GSE101764 and GSE193535. Differential expression analysis was carried out on CRC tumors from TCGA-COAD using DESeq2 . Results We identified 4,263 right-side fructose-DMRs. In contrast, only 24 DMRs survived multiple testing corrections (FDR<0.05) in matched, left colon. To identify targets by which dietary fructose drives CRC risk, we overlaid these findings with data from three CRC tumor datasets. Remarkably, almost 50% of right-side fructose-DMRs overlapped regions associated with CRC in at least one of three datasets. TNXB and CDX2 ranked among the most significant fructose risk DMRs in right and left colon respectively that also displayed altered gene expression in CRC tumors. Conclusions Our mechanistic data support the notion that fructose has a greater CRC-related effect in right than left AA colon, alluding to a potential role for fructose in contributing to racial disparities in CRC.
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Vlahović I, Rajc J, Švagelj I, Šolić K, Švagelj D. Potential predictors for CDX2 expression loss and mismatch repair deficiency in colorectal cancer. Pathol Oncol Res 2023; 29:1610908. [PMID: 37325467 PMCID: PMC10266418 DOI: 10.3389/pore.2023.1610908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Accepted: 05/16/2023] [Indexed: 06/17/2023]
Abstract
CDX2 expression loss is commonly associated with mismatch repair deficiency (dMMR) in colorectal cancer (CRC). However, there are only a few studies that have attempted to correlate CDX2 expression loss with specific MMR genes (MLH1, MSH2, MSH6, PMS2). This is a retrospective study of 327 patients who underwent surgery due to CRC. Nine patients (2.9%) had two synchronous CRCs, making the total sample 336 CRC. Histopathological data such as tumor type, tumor grade, perineural, lymphatic, and vascular invasion, pT stage, pN stage, peritumoral and intratumoral lymphocytic infiltration were collected and recorded in the database. After immunohistochemical analysis, CDX2 expression, MLH1, MSH2, MSH6, and PMS2 deficiency were also recorded. CDX2 expression loss was detected in 19 out of 336 CRCs (5.9%) and was associated with ascending colon CRC, partially mucinous adenocarcinoma, poorly differentiated carcinoma, and dMMR. Forty-four (13.1%) of CRCs were dMMR. We found a statistically significant association between CDX2 expression loss and MLH1 and PMS2 deficiency. Considering that most expression phenotypes include pairs of MMR genes, we analyzed MLH1/PMS2 and MSH2/MSH6 as heterodimers. Analysis of heterodimers showed a similar result, namely, that MLH1/PMS2 heterodimer deficiency was significantly associated with CDX2 expression loss. We also constructed a regression model for CDX2 expression loss and for dMMR. Poor tumor differentiation and MLH1/PMS2 heterodimer deficiency have been identified as potential predictors for CDX2 expression loss. CRC in the ascending colon and CDX2 expression loss have been identified as positive potential predictors of dMMR with rectal cancer as negative potential predictor of dMMR. Our study showed a significant association between CDX2 expression loss and MLH1 and PMS2 deficiency in CRC. We also managed to produce a regression model for CDX2 expression and showed that poor tumor differentiation and MLH1/PMS2 heterodimer deficiency are independent factors for CDX2 expression loss. We were the first to include CDX2 expression in a regression model for dMMR and showed that CDX2 expression loss can be used as a predictive factor for dMMR, which should be confirmed by further studies.
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Affiliation(s)
- Ivan Vlahović
- Department of Abdominal Surgery, Clinical Hospital Center Osijek, Faculty of Medicine, University of Osijek, Osijek, Croatia
| | - Jasmina Rajc
- Department of Pathology and Forensic Medicine, Clinical Hospital Center Osijek, Faculty of Medicine, University of Osijek, Osijek, Croatia
| | - Ivan Švagelj
- Department of Pathology and Cytology, General County Hospital Vinkovci, Vinkovci, Croatia
| | - Krešimir Šolić
- Department of Medical Statistics and Medical Informatics, Faculty of Medicine, University of Osijek, Osijek, Croatia
| | - Dražen Švagelj
- Department of Pathology and Cytology, General County Hospital Vinkovci, Vinkovci, Croatia
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Li HS, Chu CL. Intestinal metaplasia in progression of Barrett's esophagus to esophageal adenocarcinoma. Shijie Huaren Xiaohua Zazhi 2023; 31:41-47. [DOI: 10.11569/wcjd.v31.i2.41] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
The incidence of esophageal adenocarcinoma (EAC) has been increasing year by year. The prognosis of EAC is poor, and the 5-year survival rate is less than 20%. Barrett's esophagus (BE) is the only known precancerous lesion of EAC. BE with intestinal metaplasia (IM) has a higher risk of progressing to EAC. Exploring the mechanism of IM and finding targeted therapeutic targets for BE has become an important measure for tumor prevention. Bile acid reflux is considered an important factor in the occurrence of IM and promotes the progression of BE to EAC. However, the molecular regulatory mechanism of bile reflux induced IM and carcinogenesis remains unclear. This article reviews the environment, significance, and cell origin theory of IM, toxic effects of bile reflux, and molecular changes of IM progression to tumor, aiming to improve clinicians' understanding of IM in BE and provide evidence for early intervention of BE and prevention and treatment of EAC.
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Affiliation(s)
- Hai-Su Li
- Jinan Central Hospital, Jinan Key Translational Gastroenterology Laboratory, Jinan Digestive Diseases Clinical Research Center, Jinan 250013, Shandong Province, China
| | - Chuan-Lian Chu
- Jinan Central Hospital, Jinan Key Translational Gastroenterology Laboratory, Jinan Digestive Diseases Clinical Research Center, Jinan 250013, Shandong Province, China
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Loss of SATB2 Occurs More Frequently Than CDX2 Loss in Colorectal Carcinoma and Identifies Particularly Aggressive Cancers in High-Risk Subgroups. Cancers (Basel) 2021; 13:cancers13246177. [PMID: 34944797 PMCID: PMC8699173 DOI: 10.3390/cancers13246177] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 12/03/2021] [Accepted: 12/05/2021] [Indexed: 12/12/2022] Open
Abstract
Simple Summary The immunohistochemical analysis of Special AT-rich sequence-binding protein 2 (SATB2) is increasingly being used to detect colorectal differentiation. Our study aimed to investigate SATB2 expression levels and the prognostic relevance of SATB2 loss in colorectal carcinoma (CRC), especially in comparison with CDX2, the standard marker of colorectal differentiation. We tested SATB2 expression in 1039 CRCs and identified SATB2 as a strong prognosticator in the overall cohort as well as in specific subcohorts, including high-risk subgroups. Compared to CDX2, SATB2 showed a higher prognostic power but was lost at a much higher frequency, generally rendering SATB2 as the less sensitive marker for colorectal differentiation compared to CDX2. Abstract Background: Special AT-rich sequence-binding protein 2 (SATB2) has emerged as an alternative immunohistochemical marker to CDX2 for colorectal differentiation. However, the distribution and prognostic relevance of SATB2 expression in colorectal carcinoma (CRC) have to be further elucidated. Methods: SATB2 expression was analysed in 1039 CRCs and correlated with clinicopathological and morphological factors, CDX2 expression as well as survival parameters within the overall cohort and in clinicopathological subgroups. Results: SATB2 loss was a strong prognosticator in univariate analyses of the overall cohort (p < 0.001 for all survival comparisons) and in numerous subcohorts including high-risk scenarios (UICC stage III/high tumour budding). SATB2 retained its prognostic relevance in multivariate analyses of these high-risk scenarios (e.g., UICC stage III: DSS: p = 0.007, HR: 1.95), but not in the overall cohort (DSS: p = 0.1, HR: 1.25). SATB2 loss was more frequent than CDX2 loss (22.2% vs. 10.2%, p < 0.001) and of higher prognostic relevance with only moderate overlap between SATB2/CDX2 expression groups. Conclusions: SATB2 loss is able to identify especially aggressive CRCs in high-risk subgroups. While SATB2 is the prognostically superior immunohistochemical parameter compared to CDX2 in univariate analyses, it appears to be the less sensitive marker for colorectal differentiation as it is lost more frequently.
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