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Jiang K, Centeno BA. Primary Liver Cancers, Part 2: Progression Pathways and Carcinogenesis. Cancer Control 2018; 25:1073274817744658. [PMID: 29353494 PMCID: PMC5933573 DOI: 10.1177/1073274817744658] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Hepatocellular carcinoma (HCC) and primary intrahepatic cholangiocarcinoma (ICC) have been increasing in incidence worldwide and are leading causes of cancer death. Studies of the molecular alterations leading to these carcinomas provide insights into the key mechanisms involved. A literature review was conducted to identify articles with information relevant to current understanding of the etiologies and molecular pathogenesis of HCC and ICC. Chronic inflammatory diseases are the key etiological risk factors for both HCC and ICC, although other diseases play a role, and for many ICCs, an underlying risk factor is not identified. Mutations in catenin beta 1 ( CTNBB1) and tumor protein 53 (P53) are the main genetic alterations in HCC. Isocitrate dehydrogenases 1 and 2 (IDH1/2), KRAS protooncogene GTPase (KRAS), a RAS Viral Oncogene Homolog in neoroblastoma (NRAS) and P53 are primary genetic alterations in ICC. In both diseases, the mutational landscape is dependent on the underlying etiology. The most significant etiologies and genetic processes involved in the carcinogenesis of HCC and ICC are reviewed.
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Affiliation(s)
- Kun Jiang
- 1 Department of Anatomic Pathology, Moffitt Cancer Center, Tampa, FL, USA.,2 Department of Oncologic Sciences, Morsani College of Medicine at University of South Florida, Tampa, FL, USA
| | - Barbara A Centeno
- 1 Department of Anatomic Pathology, Moffitt Cancer Center, Tampa, FL, USA.,2 Department of Oncologic Sciences, Morsani College of Medicine at University of South Florida, Tampa, FL, USA
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2
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Chávez-López MDG, Zúñiga-García V, Pérez-Carreón JI, Avalos-Fuentes A, Escobar Y, Camacho J. Eag1 channels as potential early-stage biomarkers of hepatocellular carcinoma. Biologics 2016; 10:139-148. [PMID: 27703327 PMCID: PMC5036561 DOI: 10.2147/btt.s87402] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Hepatocellular carcinoma (HCC) is a major cause of cancer death worldwide. HCC is usually asymptomatic at potential curative stages, and it has very poor prognosis if detected later. Thus, the identification of early biomarkers and novel therapies is essential to improve HCC patient survival. Ion channels have been proposed as potential tumor markers and therapeutic targets for several cancers including HCC. Especially, the ether à-go-go-1 (Eag1) voltage-gated potassium channel has been suggested as an early marker for HCC. Eag1 is overexpressed during HCC development from the cirrhotic and the preneoplastic lesions preceding HCC in a rat model. The channel is also overexpressed in human HCC. Astemizole has gained great interest as a potential anticancer drug because it targets several proteins involved in cancer including Eag1. Actually, in vivo studies have shown that astemizole may have clinical utility for HCC prevention and treatment. Here, we will review first some general aspects of HCC including the current biomarkers and therapies, and then we will focus on Eag1 channels as promising tools in the early diagnosis of HCC.
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Affiliation(s)
| | - Violeta Zúñiga-García
- Department of Pharmacology, Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional
| | | | - Arturo Avalos-Fuentes
- Department of Physiology, Biophysics and Neuroscience, Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional
| | - Yesenia Escobar
- Centro de Investigación Clínica Acelerada Sc, Mexico City, Mexico
| | - Javier Camacho
- Department of Pharmacology, Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional
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3
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Liu J, Li W, Deng M, Liu D, Ma Q, Feng X. Immunohistochemical Determination of p53 Protein Overexpression for Predicting p53 Gene Mutations in Hepatocellular Carcinoma: A Meta-Analysis. PLoS One 2016; 11:e0159636. [PMID: 27428001 PMCID: PMC4948819 DOI: 10.1371/journal.pone.0159636] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Accepted: 07/06/2016] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Whether increased expression of the tumor suppressor protein p53 indicates a p53 gene mutation in hepatocellular carcinoma (HCC) remains unclear. We conducted a meta-analysis to determine whether p53 protein overexpression detected by immunohistochemistry (IHC) offers a diagnostic prediction for p53 gene mutations in HCC patients. METHODS Systematic literature searches were conducted with an end date of December 2015. A meta-analysis was performed to estimate the diagnostic accuracy of IHC-determined p53 protein overexpression in the prediction of p53 gene mutations in HCC. Sensitivity, subgroup, and publication bias analyses were also conducted. RESULTS Thirty-six studies were included in the meta-analysis. The results showed that the overall sensitivity and specificity for IHC-determined p53 overexpression in the diagnostic prediction of p53 mutations in HCC were 0.83 (95% CI: 0.80-0.86) and 0.74 (95% CI: 0.71-0.76), respectively. The summary positive likelihood ratio (PLR) and negative likelihood ratio (NLR) were 2.65 (95% CI: 2.21-3.18) and 0.36 (95% CI: 0.26-0.50), respectively. The diagnostic odds ratio (DOR) of IHC-determined p53 overexpression in predicting p53 mutations ranged from 0.56 to 105.00 (pooled, 9.77; 95% CI: 6.35-15.02), with significant heterogeneity between the included studies (I2 = 40.7%, P = 0.0067). Moreover, subgroup and sensitivity analyses did not alter the results of the meta-analysis. However, potential publication bias was present in the current meta-analysis. CONCLUSION The upregulation of the tumor suppressor protein p53 was indeed linked to p53 gene mutations. IHC determination of p53 overexpression can predict p53 gene mutations in HCC patients.
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Affiliation(s)
- Jiangbo Liu
- Department of General Surgery, First Affiliated Hospital, College of Clinical Medicine, Henan University of Science and Technology, Luoyang, Henan, PR China
- Department of Hepatobiliary Surgery, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, PR China
- * E-mail: (JL); (XF)
| | - Wei Li
- Department of Hepatobiliary Surgery, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, PR China
| | - Miao Deng
- Department of General Surgery, First Affiliated Hospital, College of Clinical Medicine, Henan University of Science and Technology, Luoyang, Henan, PR China
| | - Dechun Liu
- Department of General Surgery, First Affiliated Hospital, College of Clinical Medicine, Henan University of Science and Technology, Luoyang, Henan, PR China
| | - Qingyong Ma
- Department of Hepatobiliary Surgery, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, PR China
| | - Xiaoshan Feng
- Henan Key Laboratory of Cancer Epigenetics, Cancer Institute, First Affiliated Hospital, College of Clinical Medicine, Henan University of Science and Technology, Luoyang, Henan, PR China
- * E-mail: (JL); (XF)
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Abstract
Studies about the association between oral contraceptives use and liver cancer risk have generated controversial results. Therefore, a meta-analysis of cohort and case-control studies was performed to quantitatively summarize the existing evidence.Eligible studies were identified by a computer search of PubMed and Embase databases and handed-search of reference lists, without any limitations. Study-specific risk estimates (RRs) with 95% confidence intervals (CIs) were combined with random-effects model.A total of 17 articles were included in this meta-analysis. Overall, there was no statistically significant association between oral contraceptives use and liver cancer risk (RR: 1.23, 95% CI: 0.93-1.63). In a dose-analysis of meta-analysis, a linear relationship between oral contraceptives use and liver cancer risk (P for linearity = 0.391) was found, although this correlation was not statistically significant.Oral contraceptives use was not positively associated with the risk of liver cancer.
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Affiliation(s)
- Ning An
- From the Department of Hepatopancreatobiliary Surgery, Sichuan Provincial People's Hospital, Chengdu, Sichuan, China
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Yang D, Hanna DL, Usher J, LoCoco J, Chaudhari P, Lenz HJ, Setiawan VW, El-Khoueiry A. Impact of sex on the survival of patients with hepatocellular carcinoma: a Surveillance, Epidemiology, and End Results analysis. Cancer 2014; 120:3707-16. [PMID: 25081299 DOI: 10.1002/cncr.28912] [Citation(s) in RCA: 97] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2014] [Revised: 04/07/2014] [Accepted: 04/23/2014] [Indexed: 11/10/2022]
Abstract
BACKGROUND Men are 4 to 8 times more likely to develop hepatocellular carcinoma (HCC) than women. Preclinical models have suggested a role for sex hormones in the development of HCC. In the current study, the authors investigated the impact of age, sex, race, and ethnicity on the survival of patients with HCC using the Surveillance, Epidemiology, and End Results (SEER) database. METHODS Patients diagnosed with HCC from 1988 through 2010 were identified from the SEER registry. Hazard ratios (HR) for overall survival (OS) were derived using the Cox regression model adjusted for race, year of diagnosis, marital status, treatment, birthplace, tumor differentiation, and tumor size. RESULTS A total of 39,345 patients were identified; 76% were men and 34% were women (50% white, 12% African American, 21% Asian, 16% Hispanic, and 1% Native American). The median age at the time of diagnosis was 61 years for men and 67 years for women. Approximately 84% of patients had liver-limited disease and 16% had metastatic disease. Treatment information was available for patients diagnosed after 1998 (34,674 patients): 11% received liver-directed therapy, 11% underwent surgical resection, and 7% underwent liver transplantation. The HR for the OS of women versus men was 0.83 (95% confidence interval [95% CI], 0.77-0.88) for patients aged <55 years. The protective effect of sex on OS was found to be greatest in patients aged 18 to 44 years (HR, 0.75; 95% CI, 0.65-0.86 [P<.001]), especially those with surgically resected tumors (HR, 0.68; 95% CI, 0.54-0.86 [P = .001]) and those who were African American (HR, 0.85; 95% CI, 0.78-0.92 [P<.001]). There was no survival difference between sexes noted among Hispanics or patients aged >65 years. CONCLUSIONS Sex appears to be associated with survival in patients with HCC. The role of androgens and estrogens in the development and progression of HCC warrants further investigation.
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Affiliation(s)
- Dongyun Yang
- Department of Preventive Medicine, Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, California
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Vacca M, Degirolamo C, Massafra V, Polimeno L, Mariani-Costantini R, Palasciano G, Moschetta A. Nuclear receptors in regenerating liver and hepatocellular carcinoma. Mol Cell Endocrinol 2013; 368:108-19. [PMID: 22789748 DOI: 10.1016/j.mce.2012.06.025] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2012] [Revised: 06/28/2012] [Accepted: 06/29/2012] [Indexed: 12/22/2022]
Abstract
A comprehensive understanding of the pathways underlying hepatocyte turnover and liver regeneration is essential for the development of innovative and effective therapies in the management of chronic liver disease, and the prevention of hepatocellular carcinoma (HCC) in cirrhosis. Nuclear receptors (NRs) are master transcriptional regulators of liver development, differentiation and function. NRs have been implicated in the modulation of hepatocyte priming and proliferation in regenerating liver, chronic hepatitis and HCC development. In this review, we focus on NRs and their pathways regulating hepatocyte proliferation and liver regeneration, with a perspective view on NRs as candidate biomarkers and novel pharmacological targets in the management of liver disease and HCC.
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Affiliation(s)
- Michele Vacca
- Laboratory of Lipid Metabolism and Cancer, Consorzio Mario Negri Sud, Santa Maria Imbaro, Chieti, Italy
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The role of oestrogen in the pathogenesis of obesity, type 2 diabetes, breast cancer and prostate disease. Eur J Cancer Prev 2011; 19:256-71. [PMID: 20535861 DOI: 10.1097/cej.0b013e328338f7d2] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
A detailed review of the literature was performed in a bid to identify the presence of a common link between specific hormone interactions and the increasing prevalence of global disease. The synergistic action of unopposed oestrogen and leptin, compounded by increasing insulin, cortisol and xeno-oestrogen exposure directly initiate, promote and exacerbate obesity, type 2 diabetes, uterine overgrowth, prostatic enlargement, prostate cancer and breast cancer. Furthermore these hormones significantly contribute to the incidence and intensity of anxiety and depression, Alzheimer's disease, heart disease and stroke. This review, in collaboration with hundreds of evidence-based clinical researchers, correlates the significant interactions these hormones exert upon the upregulation of p450 aromatase, oestrogen, leptin and insulin receptor function; the normal status quo of their binding globulins; and how adduct formation alters DNA sequencing to ultimately produce an array of metabolic conditions ranging from menopausal symptoms and obesity to Alzheimer's disease and breast and prostate cancer. It reveals the way that poor diet, increased stress, unopposed endogenous oestrogens, exogenous oestrogens, pesticides, xeno-oestrogens and leptin are associated with increased aromatase activity, and how its products, increased endogenous oestrogen and lowered testosterone, are associated with obesity, type 2 diabetes, Alzheimer's disease and oestrogenic disease. This controversial break-through represents a paradigm shift in medical thinking, which can prevent the raging pandemic of diabetes, obesity and cancer currently sweeping the world, and as such, it will reshape health initiatives, reduce suffering, prevent waste of government expenditure and effectively transform preventative medicine and global health care for decades.
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Tornai I. [Role of environmental factors in the etiology of hepatocellular carcinoma]. Orv Hetil 2010; 151:1132-6. [PMID: 20570793 DOI: 10.1556/oh.2010.28913] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Chronic B and C virus hepatitis (HBV and HCV) are the most important risk factors in the development of hepatocellular carcinoma (HCC). About 40-50% of HCC is induced by these two chronic viral infections. Prevalence of HCC is slowly increasing in the United States and in Western-Europe, whereas alcohol consumption is gradually decreasing in the majority of these countries. However, the most important environmental risk factor for HCC is still the heavy long-term alcohol use. The risk of cirrhosis and HCC increases linearly, wherever ethanol intake is greater than 60 g/day for men and women. Aflatoxin, which contaminates grains, mostly in China and Africa, is a well-known mycotoxin. Since geographical distribution of aflatoxin as well as HBV overlaps with each other, they have a synergistic effect on inducing HCC. Cigarette smoking has also hepatocarcinogenic effect, which is significantly enhanced by the concomitant alcohol use or chronic viral hepatitis. Obesity, non-alcoholic fatty liver and steatohepatitis as well as diabetes mellitus together also form a significant risk for HCC, due to the gradually increasing number of patients. Insulin resistance and oxidative stress are the major pathogenetic mechanisms leading to hepatic cell injury in these patients. Oral contraceptive drugs may also play a role in the development of HCC. The long-term exposure to organic solvents is also a risk factor for HCC. Dietary antioxidants, selenium, statins and coffee drinking have protective effect against HCC.
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Affiliation(s)
- István Tornai
- Debreceni Egyetem, Orvos- és Egészségtudományi Centrum Belgyógyászati Intézet, Gasztroenterológiai Tanszék Debrecen.
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Maheshwari S, Sarraj A, Kramer J, El-Serag HB. Oral contraception and the risk of hepatocellular carcinoma. J Hepatol 2007; 47:506-13. [PMID: 17462781 DOI: 10.1016/j.jhep.2007.03.015] [Citation(s) in RCA: 94] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2006] [Revised: 02/22/2007] [Accepted: 03/13/2007] [Indexed: 01/02/2023]
Abstract
BACKGROUNDS/AIMS We performed a meta-analysis of observational epidemiological studies to examine the association between oral contraceptives (OC) and hepatocellular carcinoma (HCC). METHODS Two independent researchers conducted PubMed searches followed by systematic abstraction of studies that compared OC use between patients with HCC and a group of controls. Pooling of ORs was conducted using a random effects model. Heterogeneity and publication bias among studies were examined. RESULTS Twelve case-control studies that included 739 cases and 5223 controls met the inclusion and exclusion criteria. The pooled estimate of ORs (age- and sex-matched only) from all 12 studies was 1.57 (95% CI=0.96-2.54, p=0.07) with a heterogeneity of I(2)=39.9. Exclusion of one large multi-national European study decreased the heterogeneity to I(2)=16.9 and increased the pooled OR to 1.70 (95% CI=1.12-2.59, p=0.01). Eight studies reported adjusted ORs (in addition to age and sex); the pooled estimate was 1.45 (95% CI=0.93-2.27, p=0.11) with a heterogeneity of I(2)=20.4. Only few studies identified or adjusted for other HCC risk factors. Six studies showed a significant 2- to 20-fold increase in HCC risk with longer durations of OC use; however, the reporting was too inconsistent to allow meta-analysis. CONCLUSIONS The evidence is inconclusive to establish a relation between oral contraceptives and the risk of hepatocellular carcinoma. Future studies should focus on the duration, intermittency, and recency of OC use.
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Affiliation(s)
- Shail Maheshwari
- Sections of Gastroenterology and Health Services Research at the Michael E. DeBakey Veterans Affairs Medical Center and Baylor College of Medicine, 2002 Holcombe Blvd., Houston, TX 77030, USA
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El-Serag HB, Rudolph KL. Hepatocellular carcinoma: epidemiology and molecular carcinogenesis. Gastroenterology 2007; 132:2557-76. [PMID: 17570226 DOI: 10.1053/j.gastro.2007.04.061] [Citation(s) in RCA: 4162] [Impact Index Per Article: 244.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2007] [Accepted: 04/18/2007] [Indexed: 02/06/2023]
Abstract
Primary liver cancer, which consists predominantly of hepatocellular carcinoma (HCC), is the fifth most common cancer worldwide and the third most common cause of cancer mortality. HCC has several interesting epidemiologic features including dynamic temporal trends; marked variations among geographic regions, racial and ethnic groups, and between men and women; and the presence of several well-documented environmental potentially preventable risk factors. Moreover, there is a growing understanding on the molecular mechanisms inducing hepatocarcinogenesis, which almost never occurs in healthy liver, but the cancer risk increases sharply in response to chronic liver injury at the cirrhosis stage. A detailed understanding of epidemiologic factors and molecular mechanisms associated with HCC ultimately could improve our current concepts for screening and treatment of this disease.
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Affiliation(s)
- Hashem B El-Serag
- Michael E. DeBakey Veterans Administration Medical Center and Baylor College of Medicine, Houston Center for Quality of Care and Utilization Studies, Houston, Texas, USA.
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Baltaci V, Zeyneloglu HB. Increased frequency of sister-chromatid exchange and altered alkaline comet assay scores in superovulation cycles for unexplained infertility. Eur J Obstet Gynecol Reprod Biol 2004; 113:73-7. [PMID: 15036715 DOI: 10.1016/j.ejogrb.2003.05.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2002] [Revised: 05/20/2003] [Accepted: 05/23/2003] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Sister-chromatid exchange analysis (SCE) and alkaline comet assay measure and analyze DNA damage in mammalian cells. This study assesses whether ovulation induction agents increase DNA damage in the lymphocytes of infertile women undergoing superovulation. STUDY DESIGN Prospective case control study in a university based hospital. Baseline and hCG day peripheral blood samples were withdrawn from 20 women with undergoing superovulation for unexplained infertility and baseline and luteinizing hormone (LH) peak day samples were also withdrawn from another 20 infertile women with unexplained infertility. RESULTS There was increased SCE frequency and DNA damage determined by comet assay on the hCG day compared to the basal state. The SCE increase was correlated with the hCG day estradiol (E2) but not with ampoules of follicular stimulating hormone (FSH). The SCE frequency was also increased naturally ovulating women; however this was significantly less than that in FSH receiving women. CONCLUSION Increased DNA damage may indicate for increased potential for malignancies after superovulation.
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Affiliation(s)
- Volkan Baltaci
- Department of Medical Genetics, Baskent University, Ankara, Turkey
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Davis CR, Okihiro MS, Hinton DE. Effects of husbandry practices, gender, and normal physiological variation on growth and reproduction of Japanese medaka, Oryzias latipes. AQUATIC TOXICOLOGY (AMSTERDAM, NETHERLANDS) 2002; 60:185-201. [PMID: 12200085 DOI: 10.1016/s0166-445x(02)00004-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Japanese medaka, Oryzias latipes, are currently used in a variety of research applications for toxicological and carcinogenesis research, yet the impact of certain husbandry factors on study outcome has received limited attention. In this study, we demonstrated significant effects of stocking density (SD), dietary restriction (DR) and photoperiod on somatic growth in medaka. Higher stocking densities significantly inhibited somatic and hepatic growth in females, while having no similar effects on males. Daily egg production declined in a step-wise manner in groups of fish stocked at densities ranging from 0.38 to 2.6 fish per l. Significantly slower somatic growth was observed in fish fed on a mildly restrictive dietary protocol compared with those fish fed to excess. Further significant declines were observed in somatic growth of fish fed at a rate comparable to that used in research studies (3-4% body weight (BW) per day). Fish reared at an 8-h light:16-h dark (8L/16D) photoperiod were significantly smaller than cohorts reared at a 16-h light:8-h dark (16L/8D) photoperiod and female sexual maturity was delayed in the short photoperiod cohort. In normal female medaka, a high degree of individual variation was observed in daily egg production, as well as diurnal fluctuations in ovarian weight, gonadosomatic index (GSI) and hepatosomatic index (HSI). These results indicate some husbandry factors affect growth, sexual maturation and egg production in medaka and should be taken into consideration in studies evaluating endpoints that may be impacted by growth and reproductive performance, i.e. carcinogenesis and endocrine disruption studies. The high degree of individual variation among normal females and daily fluctuations in organ weights should also be considered in study design.
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Affiliation(s)
- Corrine R Davis
- Department of Anatomy, Physiology and Cell Biology, School of Veterinary Medicine, University of California, One Shields Ave, Davis, CA 95616, USA.
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Mucci LA, Kuper HE, Tamimi R, Lagiou P, Spanos E, Trichopoulos D. Age at menarche and age at menopause in relation to hepatocellular carcinoma in women. BJOG 2001; 108:291-4. [PMID: 11281471 DOI: 10.1111/j.1471-0528.2001.00032.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To assess whether age at menarche, age at menopause, parity, and selected blood hormones are associated with risk of hepatocellular carcinoma among women. DESIGN Case-control. SAMPLE and setting Data collected from 50 cases of hepatocellular carcinoma among women and 62 female controls with minor trauma or surgical conditions who attended one of three hospitals in Athens, Greece between 1995 and 1998. METHODS Researchers collected information on Reproductive variables and assayed sera samples for blood hormone levels and for chronic infection with Hepatitis B and C viruses. RESULTS Individuals with hepatocellular carcinoma had a lower mean age at menarche and a significantly higher mean age at menopause. After adjusting for potential confounding, age at menopause remained an important and significant predictor, increasing the risk of hepatocellular carcinoma 24% for each later year of menopause (P < 0.001). For each year that menarche was delayed, risk of hepatocellular carcinoma declined 21% (P = 0.100). Mean levels of insulin-like growth factor-1 and its binding protein were significantly reduced in cases compared with controls, while levels of oestradiol, testosterone and sex hormone binding globulin were somewhat higher among the cases. CONCLUSIONS This study provides indirect, but converging evidence that steroid hormones in general, and oestrogens in particular, play an important role in the aetiology of hepatocellular carcinoma among women.
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Affiliation(s)
- L A Mucci
- Department of Hygiene and Epidemiology, University of Athens Medical School, Greece
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15
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Cavalieri E, Frenkel K, Liehr JG, Rogan E, Roy D. Estrogens as endogenous genotoxic agents--DNA adducts and mutations. J Natl Cancer Inst Monogr 2001:75-93. [PMID: 10963621 DOI: 10.1093/oxfordjournals.jncimonographs.a024247] [Citation(s) in RCA: 358] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Estrogens induce tumors in laboratory animals and have been associated with breast and uterine cancers in humans. In relation to the role of estrogens in the induction of cancer, we examine formation of DNA adducts by reactive electrophilic estrogen metabolites, formation of reactive oxygen species by estrogens and the resulting indirect DNA damage by these oxidants, and, finally, genomic and gene mutations induced by estrogens. Quinone intermediates derived by oxidation of the catechol estrogens 4-hydroxyestradiol or 4-hydroxyestrone may react with purine bases of DNA to form depurinating adducts that generate highly mutagenic apurinic sites. In contrast, quinones of 2-hydroxylated estrogens produce less harmful, stable DNA adducts. The catechol estrogen metabolites may also generate potentially mutagenic oxygen radicals by metabolic redox cycling or other mechanisms. Several types of indirect DNA damage are caused by estrogen-induced oxidants, such as oxidized DNA bases, DNA strand breakage, and adduct formation by reactive aldehydes derived from lipid hydroperoxides. Estradiol and the synthetic estrogen diethylstilbestrol also induce numerical and structural chromosomal aberrations and several types of gene mutations in cells in culture and in vivo. In conclusion, estrogens, including the natural hormones estradiol and estrone, must be considered genotoxic carcinogens on the basis of the evidence outlined in this chapter.
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Affiliation(s)
- E Cavalieri
- Eppley Institute, University of Nebraska Medical Center, Omaha, USA.
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Abstract
Estrogen administration to rodents results in various types of DNA damage and ultimately leads to tumors in estrogen-responsive tissues. Yet these hormones have been classified as nonmutagenic, because they did not induce mutations in classical bacterial and mammalian mutation assays. In this review, we have discussed the induction by estrogens of DNA and chromosomal damage and of gene mutations, because the classical assays were designed to uncover mutations only at one specific locus and could not have detected other types of mutations or changes in other genes. Various types of estrogen-induced DNA damage include: (a) direct covalent binding of estrogen quinone metabolites to DNA; (b) enhancement of endogenous DNA adducts by chronic estrogen exposure of rodents; (c) free radical generation by metabolic redox cycling between quinone and hydroquinone forms of estrogens and free radical damage to DNA such as strand breakage, 8-hydroxylation of purine bases of DNA and lipid hydroperoxide-mediated DNA modification. Two different types of chromosomal damage have also been induced by estrogen in vivo and in cells in culture such as numerical chromosomal changes and also structural chromosomal aberrations. Gene mutations have been induced in several cell types in culture either by the parent estrogen or by reactive estrogen quinone metabolites. Furthermore, in estrogen-induced kidney tumors in hamsters, several mutations have been observed in the DNA polymerase beta gene mRNA. Estradiol also induces microsatellite instability in these kidney tumors and in premalignant kidney exposed to estradiol. Although this work is still ongoing, it can be concluded that estrogens are complete carcinogens capable of tumor initiation by mutation potentially in critical genes. The hormonal effects of estrogens may complete the development of tumors.
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Affiliation(s)
- D Roy
- Department of Environmental Health Science, University of Alabama, Birmingham, AL 35294, USA
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Li Y, Bhuiyan M, Vaitkevicius VK, Sarkar FH. Molecular analysis of the p53 gene in pancreatic adenocarcinoma. DIAGNOSTIC MOLECULAR PATHOLOGY : THE AMERICAN JOURNAL OF SURGICAL PATHOLOGY, PART B 1998; 7:4-9. [PMID: 9646028 DOI: 10.1097/00019606-199802000-00002] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Mutations in the p53 tumor suppressor gene are the most common genetic alterations found in human cancer. Most mutations are accompanied by stabilization of the protein, which renders the mutations detectable through immunohistochemical techniques. The immunoreactivity of p53, however, might not correlate with the result of p53 DNA sequencing. In order to explain the discrepancy, we studied the p53 expressions, mutations, and changes of the three-dimensional protein structure of mutant p53 in a series of 61 pancreatic adenocarcinoma specimens using immunohistochemistry, polymerase chain reaction-single strand conformation polymorphism (PCR-SSCP), DNA sequencing, and computerized protein modeling. PCR-SSCP followed by DNA sequencing of the p53 gene showed mutations in 31.2% (19 of 61) of the pancreatic adenocarcinomas. Eight of 19 cases showed p53 immunopositivity. These mutations were located on the surface of the three-dimensional structure or formed unfolded proteins, which were easily recognized by the antibody. Among other mutations in which p53 was immunonegative, five cases with deletions and insertion caused frameshift and formation of severely truncated p53 protein structures unreactive with the antibody used. In three cases with point mutations, the mutant amino acids were located in the core of the tightly packed beta sandwich inaccessible to the antibody. Three silent mutations were immunonegative, corresponding with the absence of amino acid changes. These results strongly suggest that the analysis of a computer-generated p53 three-dimensional model based on DNA sequencing data can assist in evaluating the significance of p53 immunostaining and mutations for clinical applications.
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Affiliation(s)
- Y Li
- Department of Pathology, Wayne State University School of Medicine, Harper Hospital, Detroit Medical Center, Michigan, USA
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