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Gadducci A, Guerrieri ME, Cosio S. Adenocarcinoma of the uterine cervix: Pathologic features, treatment options, clinical outcome and prognostic variables. Crit Rev Oncol Hematol 2019; 135:103-114. [PMID: 30819439 DOI: 10.1016/j.critrevonc.2019.01.006] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Accepted: 01/16/2019] [Indexed: 12/11/2022] Open
Abstract
Adenocarcinoma accounts for 10-25% of all cervical cancers, and its relative and absolute rate has raised over the past decades. Most, but not all the authors, reported that adenocarcinoma has a greater propensity to lymph node, ovarian and distant metastases and a worse prognosis compared with squamous cell carcinoma. However, whether histologic type is an independent prognostic factor is still a debated issue. Moreover, adenocarcinoma is a very heterogenous disease, including different histological subtypes. Whereas radical hysterectomy and definitive radiotherapy achieve the same clinical outcome in early stage squamous cell carcinoma, surgery seems to obtain better survival compared with definitive radiotherapy in early stage adenocarcinoma. Chemoradiation is the standard treatment for locally advanced cervical cancer regardless of histologic type, although several retrospective studies showed that patients with adenocarcinoma were more likely to die than those with squamous cell carcinoma both before and after concurrent chemoradiation era. The prognostic relevance of biological variables, such as cyclin-dependent kinase inhibitors, p53, cyclooxygenase-2 [COX-2], cell surface tyrosine-kinases and programmed death-ligand [PD-L1], is still under investigation. Palliative chemotherapy is the only treatment option for persistent or recurrent cervical adenocarcinoma not amenable with surgery and radiotherapy. The use of immune checkpoint inhibitors as well as a therapeutic strategy targeting cell surface tyrosine kinases should be adequately explored in this clinical setting.
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Affiliation(s)
- Angiolo Gadducci
- Department of Clinical and Experimental Medicine, Division of Gynecology and Obstetrics, University of Pisa, Italy.
| | - Maria Elena Guerrieri
- Department of Clinical and Experimental Medicine, Division of Gynecology and Obstetrics, University of Pisa, Italy
| | - Stefania Cosio
- Department of Clinical and Experimental Medicine, Division of Gynecology and Obstetrics, University of Pisa, Italy
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Liu L, Li M, Zhang C, Zhang J, Li G, Zhang Z, He X, Fan M. Prognostic value and clinicopathologic significance of nm23 in various cancers: A systematic review and meta-analysis. Int J Surg 2018; 60:257-265. [PMID: 30389538 DOI: 10.1016/j.ijsu.2018.10.035] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2018] [Revised: 09/10/2018] [Accepted: 10/23/2018] [Indexed: 01/30/2023]
Abstract
OBJECTIVE Extensive studies have been carried out to investigate the association between nm23 expression and the prognosis and clinicopathologic significance of various tumors. METHODS AND MATERIALS Eligible studies were searched from Embase, China National Knowledge Infrastructure (CNKI), PubMed and Web of Science up to May 2017. In this study, we calculated the pooled hazard ratios (HRs) with 95% confidence intervals (95%CIs) to determine the association between nm23 expression and the prognosis of various tumors. RESULTS A total of 49 studies were finally included in the meta-analysis. The pooled HRs were 2.00 (95% CIs: 1.44-2.78) for overall survival (OS), 1.23 (95% CIs: 1.04-1.46) for disease-specific survival or progression-free survival (DFS/PFS), and 2.21 (95% CIs: 1.38-3.57) for survival of recurrence-free survival or metastasis-free survival (RFS/MFS). Moreover, the results indicated that low nm23 expression was significantly correlated with the lymph node metastasis (P = 0.002). For the subgroup analysis, the expression of nm23 in patients at N0 stage was obviously higher than the patients with breast carcinoma at N1-N3 stage [Odds ratio (OR) = 2.07, 95%CI (1.31, 3.26), P = 0.002]. Moreover, the expression of nm23 in the patients at N0 stage was remarkably higher than those at N1-N3 stages in the Chinese patients with breast carcinoma and those with nasopharyngeal carcinoma (P < 0.05). Whereas, no statistical difference was noticed in the expression of nm23 in patients of various age, gender, T stage, histological degree, TNM stage, respectively (P > 0.05). CONCLUSION Our study suggests that down-regulation of nm23 is related to poor prognosis in many cancers. The expression of nm23 in cancer tissues may serve as an important factor for evaluating the presence of lymph node metastasis.
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Affiliation(s)
- Liang Liu
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, 200032, PR China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, PR China
| | - Man Li
- Department of Otolaryngology-Head and Neck Surgery, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, 442000, PR China
| | - Chengdong Zhang
- School of Life Sciences, Fudan University, Shanghai, 200082, PR China
| | - Junhua Zhang
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, 200032, PR China
| | - Guoyi Li
- Department of Otolaryngology-Head and Neck Surgery, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, 442000, PR China
| | - Zhimin Zhang
- Department of Otolaryngology-Head and Neck Surgery, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, 442000, PR China
| | - Xinhong He
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, PR China; Department of Interventional Radiology, Shanghai Cancer Center, Fudan University, 200032, PR China.
| | - Min Fan
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, 200032, PR China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, PR China.
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NDPKA is not just a metastasis suppressor - be aware of its metastasis-promoting role in neuroblastoma. J Transl Med 2018; 98:219-227. [PMID: 28991262 DOI: 10.1038/labinvest.2017.105] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Revised: 07/22/2017] [Accepted: 07/24/2017] [Indexed: 12/20/2022] Open
Abstract
NDPK-A, encoded by nm23-H1 (also known as NME1) was the first metastasis suppressor discovered. Much of the attention has been focused on the metastasis-suppressing role of NDPK-A in human tumors, including breast carcinoma and melanoma. However, compelling evidence points to a metastasis-promoting role of NDPK-A in certain tumors such as neuroblastoma and lymphoma. To balance attention on this contrariety of NDPK-A in different cancer types, this review addresses the metastasis-promoting role of NDPK-A in neuroblastoma. Neuroblastoma is an embryonic tumor, arising from neural crest cells that fail to differentiate into the sympathetic nervous system. We summarize and discuss nm23-H1 genetics and the prognosis of neuroblastoma, structural and functional changes associated with the S120G mutation of NDPK-A, as well as the evidence supporting the role of NDPK-A as a metastasis promoter. Also discussed are the NDPK-A relevant molecular determinants of neuroblastoma metastasis, and metastasis-relevant neural crest development. Because of NDPK-A's dichotomous role in tumor metastasis as both a suppressor and a promoter, tumor genome/exome profiles are necessary to identify the molecular drivers of metastasis in the NDPK-A network for developing tumor-specific therapies.
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Li Y, Tong Y, Wong YH. Regulatory functions of Nm23-H2 in tumorigenesis: insights from biochemical to clinical perspectives. Naunyn Schmiedebergs Arch Pharmacol 2014; 388:243-56. [PMID: 25413836 DOI: 10.1007/s00210-014-1066-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2014] [Accepted: 11/07/2014] [Indexed: 12/12/2022]
Abstract
Substantial effort has been directed at elucidating the functions of the products of the Nm23 tumor metastasis suppressor genes over the past two decades, with the ultimate goal of exploring their translational potentials in changing cancer patients' outcomes. Much attention has been focused on the better-known Nm23-H1, but despite having high sequence similarity, Nm23-H2 functions differently in many aspects. Besides acting as a metastasis suppressor, compelling data suggest that Nm23-H2 may modulate various tumor-associated biological events to enhance tumorigenesis in human solid tumors and hematological malignancies. Linkage to tumorigenesis may occur through the ability of Nm23-H2 to regulate transcription, cell proliferation, apoptosis, differentiation, and telomerase activity. In this review, we examine the linkages of Nm23-H2 to tumorigenesis in terms of its biochemical and structural properties and discuss its potential role in various tumor-associated events.
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Affiliation(s)
- Yuanjun Li
- Division of Life Science and the Biotechnology Research Institute, Hong Kong University of Science and Technology, Clear Water Bay, Kowloon, Hong Kong, China
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Wang PH, Yi YC, Tsai HT, Tee YT, Ko JL, Han CP, Liu YF, Lin LY, Yang SF. Significant association of genetic polymorphism of human nonmetastatic clone 23 type 1 gene with an increased risk of endometrial cancer. Gynecol Oncol 2010; 119:70-5. [DOI: 10.1016/j.ygyno.2010.06.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2010] [Revised: 06/08/2010] [Accepted: 06/13/2010] [Indexed: 11/28/2022]
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Feng CY, Wang PH, Tsai HT, Tee YT, Ko JL, Chen SC, Lin CY, Han CP, Yang JS, Liu YF, Lin LY, Yang SF. Polymorphisms of Human Nonmetastatic Clone 23 Type 1 Gene and Neoplastic Lesions of Uterine Cervix. Reprod Sci 2010; 17:886-93. [DOI: 10.1177/1933719110373661] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- Chi-Yen Feng
- Department of Surgery, Da Chien General Hospital, Miao-Li County, Taiwan
| | - Po-Hui Wang
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan, Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung, Taiwan, School of Medicine, Chung Shan Medical University, Taichung, Taiwan,
| | - Hsiu-Ting Tsai
- School of Nursing, Chung Shan Medical University, Taichung, Taiwan, Department of Nursing, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Yi-Torng Tee
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan, Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung, Taiwan, School of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Jiunn-Liang Ko
- Institute of Medical and Molecular Toxicology, Chung Shan Medical University, Taichung, Taiwan
| | - Shiuan-Chih Chen
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan, Department of Family and Community Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Ching-Yi Lin
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan, Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung, Taiwan, School of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Chih-Ping Han
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan, Clinical Trial Center, Chung Shan Medical University Hospital, Taichung, Taiwan 10
| | - Jia-Sin Yang
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Yu-Fan Liu
- Department of Biomedical Sciences, Chung Shan Medical University, Taichung, Taiwan
| | - Long-Yau Lin
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan, Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung, Taiwan, School of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Shun-Fa Yang
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan, Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan,
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Hsu CG, Lin LY, Ko JL, Yang SF, Chang H, Lin CY, Tsai HT, Chen SC, Chen SC, Wang PH. High expression of human nonmetastatic clone 23 type 1 in cancer of uterine cervix and its association with poor cell differentiation and worse overall survival. J Surg Oncol 2008; 98:448-56. [DOI: 10.1002/jso.21127] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Manavi M, Hudelist G, Fink-Retter A, Gschwandtler-Kaulich D, Pischinger K, Czerwenka K. Gene profiling in Pap-cell smears of high-risk human papillomavirus-positive squamous cervical carcinoma. Gynecol Oncol 2007; 105:418-26. [PMID: 17306351 DOI: 10.1016/j.ygyno.2006.12.032] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2006] [Revised: 11/29/2006] [Accepted: 12/22/2006] [Indexed: 10/23/2022]
Abstract
OBJECTIVE The purpose of the study was to investigate benign and malignant squamous cervical cells obtained by cervical swabs with regard to differentially expressed genes and gene expression profiling, in order to evaluate the biological behavior and clinical outcome of cervical malignancies. METHODS Cervical squamous cells from six women with high-risk human papillomavirus positive [HR-HPV(+)] cervical carcinoma and from six HPV-negative women with normal ectocervical cells were analyzed by cDNA array. RESULTS cDNA over-expression of several genes such as MET (c-met), Nm23-H1 (NME1), EGFR, KGFR, Nm23-H2 (NME2), ERBB2 (c-erbB-2), cyclin-dependent kinase inhibitor 4 (CDKN2A, p16INK4A), cytokeratin 8 (KRT8), KRAS (K-ras), FLT1, KGF (FGF7), BCL2-like 2 protein (BCL2L2), ERBB4, MYCN (N-myc), cyclin D1 (CCND1), KIT (c-kit), secreted phosphoprotein 1 (SPP1) and STAT1, was significant in cervical squamous cell carcinoma (CSCC). Gene expression was downregulated for 13 genes in CSCC, such as interleukin 1 alpha (IL1A), the transforming growth factor receptor beta superfamily (TGFbeta; TGFB), some members of the insulin-like growth factor binding proteins (IGFBPs) and the integrin family (ITGA6, ITGB1). CONCLUSION This study was focused on the gene expression profiling of HR-HPV(-) and (+) cervical squamous cells and CSCC obtained by cytobrush. We observed gene expression patterns and signaling pathways that permit the investigator to distinguish between benign squamous cervical cells and CSCC with and without HPV infection.
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Affiliation(s)
- Mahmood Manavi
- Department of Gynecology and Obstetrics, Division of Special Gynecology, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria.
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Abstract
The protein product of nm23-H1 gene has activity of nucleoside diphosphate (NDP) kinase, which catalyzes the phosphorylation of nucleoside diphosphates to the corresponding nucleoside triphosphates. Reductions in nm23 expression have been significantly associated with aggressive behavior in melanoma, breast, colon, and gastric carcinomas. On the contrary, high levels of nm23 gene expression are noted in the advanced stage of thyroid carcinomas and associated with significant reductions in survival for neuroblastoma and osteosarcoma patients. Although expression of nm23/NDP kinase is divergent in various malignant tumors, its reduced expression seems to be related to increased metastatic potential in most carcinoma types. However, it is hypothesized that nm23 may play a tissue-specific role, and that different regulatory mechanisms may act in different tumors. In ovarian carcinoma, nm23-H1/NDP kinase may be correlated with some clinicopathologic characteristics. In cervical cancer, nm23-H1 is probably involved in cervical carcinogenesis and correlated with some aggressive parameters. Overexpression of nm23-H1 protein may indicate poor survival for cervical cancer patients. Other than histidine 118 residue (amino acid sequence 118: histidine) concerned with NDP kinase activity of nm23-H1, serine 120 (amino acid sequence 120: serine) related activity of histidine-dependent protein phosphotransfer was recently reported to be responsible for its biological suppressive effects. To inhibit metastatic potential, nm23-H1 is also demonstrated to co-immunoprecipitate the kinase suppressor of Ras and phosphorylate it, and therefore reduce activation of the extracellular signal-regulated kinase mitogen-activated protein kinase pathway in response to signaling.
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Affiliation(s)
- Yi-Torng Tee
- Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung, Taiwan
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Branca M, Giorgi C, Ciotti M, Santini D, Di Bonito L, Costa S, Benedetto A, Bonifacio D, Di Bonito P, Paba P, Accardi L, Mariani L, Ruutu M, Favalli C, Syrjänen K. Down-regulated nucleoside diphosphate kinase nm23-H1 expression is unrelated to high-risk human papillomavirus but associated with progression of cervical intraepithelial neoplasia and unfavourable prognosis in cervical cancer. J Clin Pathol 2006; 59:1044-51. [PMID: 16537673 PMCID: PMC1861749 DOI: 10.1136/jcp.2005.033142] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
OBJECTIVE One of the factors leading to an invasive phenotype is the nm23 family of metastases-associated genes. Of the six known members, nm23-H1 is the most frequently studied potential anti-metastatic gene in cervical cancer. However, the possible molecular links to oncogenic human papillomavirus (HPV) are completely unexplored as yet. MATERIALS AND METHODS As a part of the HPV-Pathogen Istituto Superiore di Sanità study, a series of 150 squamous cell carcinomas (SCCs) and 152 cervical intraepithelial neoplasia (CIN) lesions were examined by immunohistochemical staining for nm23-H1, and tested for HPV by polymerase chain reaction (PCR) with three sets of primers (MY09/11, GP5(+)/GP6(+) and short PCR fragment). Follow-up data were available on all patients with SCC, and 67 CIN lesions were monitored by serial PCR for clearance or persistence of HPV after cone treatment. RESULTS A linear decrease (p = 0.001) was observed in nm23-H1 expression, starting from CIN1 (85% with normal expression), with the most dramatic down regulation on transition from CIN2 (70% normal) to CIN3 (39%) and further to SCC (25%). Reduced expression was associated with CIN3 or cancer at an odds ratio 8.72 (95% confidence interval 4.13 to 18.41). Nm23-H1 was of no use as a marker of the high-risk human papillomavirus (HR-HPV) type, and it did not predict clearance or persistence of HR-HPV after treatment of CIN. Importantly, nm23-H1 expression was a significant prognostic factor in cervical cancer, reduced expression being associated with lower survival (p = 0.022) in univariate analysis. In the multivariate (Cox) regression model, however, only the International Federation of Gynecology and Obstetrics stage (p = 0.001) and age (p = 0.011) remained independent prognostic predictors. CONCLUSIONS Down-regulated nm23-H1 expression is markedly associated with progression from CIN2 to CIN3, and predicts poor prognosis in cervical cancer. Nm23-H1 down regulation is probably orchestrated by mechanisms independent of HR-HPV oncoproteins and is possibly related to the emergence of a proteolytic phenotype.
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Affiliation(s)
- M Branca
- Unità Citoistopatologia, Centro Nazionale di Epidemiologia, Sorveglianza e Promozione della Salute, Istituto Superiore di Sanità (ISS), Rome, Italy
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Hudelist G, Czerwenka K, Singer C, Pischinger K, Kubista E, Manavi M. cDNA array analysis of cytobrush-collected normal and malignant cervical epithelial cells: a feasibility study. ACTA ACUST UNITED AC 2005; 158:35-42. [PMID: 15771902 DOI: 10.1016/j.cancergencyto.2004.08.007] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2004] [Revised: 07/12/2004] [Accepted: 07/13/2004] [Indexed: 10/25/2022]
Abstract
Analysis of gene expression pattern is a useful approach to evaluating the biological behavior and clinical outcome of several human malignancies. Differentially expressed genes in malignant squamous cervical cells and the feasibility of gene expression profiling on squamous cervical cells obtained from cervical swabs were investigated. Cervical squamous cells from three women with high-risk human papilloma virus (HR-HPV) positive invasive squamous cervical carcinoma and from three HPV-negative women with normal ectocervical smears were analyzed with cDNA array. Immunoblot analysis was performed to detect the proteins corresponding to the highest upregulated genes with cDNA array. mRNA expression of ERBB2, KIT, FLT1, MYCN, RAS, CDKN2A, CCND1, NME1, NME2, MET, FGF7, FGFR2, and STAT1 was increased in malignant samples. Several expressed genes associated with antiapoptosis (such as BCL2), cell structuring, or cell attachment were also upregulated in carcinoma cells. Decreased gene expression was observed for members of the transforming growth factor receptor superfamily (TGF) and integrin family, interleukin 1 (IL1), and insulin-like growth factor binding proteins (IGFBPs). This study shows the feasibility of gene expression profiling of cervical squamous cells obtained with cytobrushes by identifying a characteristic gene expression pattern that clearly distinguishes between malignant and normal cervical epithelia of squamous type. We hypothesize that this noninvasive technique could be used in the evaluation of ambiguous Papanicolaou (PAP) smears.
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Affiliation(s)
- Gernot Hudelist
- Department of Gynecology and Obstetrics, Division of Special Gynecology, University of Vienna Medical Center, Vienna, Austria
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Feng H, Cheung ANY, Xue WC, Wang Y, Wang X, Fu S, Wang Q, Ngan HYS, Tsao SW. Down-regulation and promoter methylation of tissue inhibitor of metalloproteinase 3 in choriocarcinoma. Gynecol Oncol 2004; 94:375-82. [PMID: 15297175 DOI: 10.1016/j.ygyno.2004.04.019] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2003] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To assess the differential gene expression in neoplastic and normal trophoblastic cells and evaluate the effect of methylation on tissue inhibitor of metalloproteinase 3 (TIMP3) expression in choriocarcinoma (CCA) cells. METHODS The Atlas Human Cancer 1.2 Array (Clontech) was used to compare differential gene expression in a trophoblastic cell line (B6) established from first term placenta with two choriocarcinoma cell lines (JAR and JEG-3). The differentially expressed candidate genes in the placental and malignant trophoblastic cells in these cell lines were confirmed by real-time polymerase chain reaction (PCR), Western blotting and immunohistochemistry. Differential expression of a specific gene, TIMP3, was confirmed by immunohistochemistry using clinical specimens of choriocarcinoma and placenta. The involvement of promoter methylation in suppression of TIMP3 expression in choriocarcinoma was examined using methylation-specific PCR (MSP) and demethylation treatment. RESULTS Differential expression of 23 genes was observed in choriocarcinoma cell lines compared to the placental trophoblastic cells using the cDNA array analysis (Atlas Human Cancer Array, Clontech). Among these differentially expressed genes, down-regulation of TIMP3, PLAB, IGFBP3 and up-regulation of CCNB1 were confirmed by real-time PCR determination. Reduced expression of TIMP3 was further confirmed in clinical samples of choriocarcinoma by immunohistochemical staining. Methylation of TIMP3 promoter was detected in choriocarcinoma cell lines and clinical samples of choriocarcinoma. Treatment with a demethylation drug, 5-aza-2'-deoxycytidine, in choriocarcinoma cell lines restored TIMP3 expression. CONCLUSION Down-regulation of TIMP3, PLAB, IGFBP3 and up-regulation of CCNB1 were observed in choriocarcinoma cells compared to placental trophoblasts. Down-regulation of TIMP3 expression was confirmed in clinical specimens of choriocarcinoma and may play a role in its pathogenesis. Promoter methylation of the TIMP3 is involved in suppression of TIMP3 expression. Differentiation expression of TIMP3 in choriocarcinoma may have potential application in clinical diagnosis and patient treatment.
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Affiliation(s)
- Huichen Feng
- Department of Anatomy, The University of Hong Kong, 21 Sassoon Road, Hong Kong, China
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Wang PH, Chang H, Ko JL, Lin LY. Nm23-H1 immunohistochemical expression in multisteps of cervical carcinogenesis. Int J Gynecol Cancer 2003; 13:325-30. [PMID: 12801264 DOI: 10.1046/j.1525-1438.2003.13180.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
To evaluate the expression of nm23-H1 protein in normal, precancerous, and cancerous tissues of the uterine cervix and its role in cervical carcinogenesis, metastasis and recurrence, 82 cervical specimens, including 30 squamous cell carcinomas (SCC), 19 high- and 13 low-grade squamous intraepithelial lesions (HSILs and LSILs) and 20 normal samples, were stained using immunohistochemical method with streptavidin-biotin peroxidase immunostaining. The Chi-square and Fisher's exact tests, as well as Chi-square test for trend, were used for comparing nm23-H1 expression among normal, LSIL, HSIL, and cancerous tissues. The correlation of nm23 expression with metastasis or recurrence was analyzed using Fisher's exact test. There were significant differences in levels of nm23-H1 expression between LSIL and HSIL (P = 0.016) and between LSIL and SCC (P = 0.004), but not between HSIL and SCC or normal and LSIL samples. Furthermore, a positive relationship was demonstrated for high nm23-H1 protein expression and degree of malignant transformation (P < 0.05). Among the 30 SCC cases, high nm23-H1 expression did not show significant association with either carcinomatous metastasis or recurrence (P = 0.123, 0.372, respectively). High nm23-H1 expression appears related to critical progression of LSIL to HSIL but not to metastasis or recurrence of SCC.
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Affiliation(s)
- P-H Wang
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
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Yang X, Zhang Z, Jia C, Li J, Yin L, Jiang S. The relationship between expression of c-ras, c-erbB-2, nm23, and p53 gene products and development of trophoblastic tumor and their predictive significance for the malignant transformation of complete hydatidiform mole. Gynecol Oncol 2002; 85:438-44. [PMID: 12051871 DOI: 10.1006/gyno.2002.6652] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The aims of this retrospective study by means of immunohistochemical staining were (1) to study the expression of c-ras, c-erbB-2, p53, and nm23 gene products in complete hydatidiform moles that progress to gestational trophoblastic tumor and in those that remit spontaneously after evacuation, and (2) to estimate the predictive value of the expression of these four gene products in malignant transformation of complete hydatidiform mole. METHODS Clinical data of patients with complete hydatidiform mole were obtained by retrospective chart review. Formalin-fixed paraffin sections of 50 cases of complete mole that progressed to gestational tumor and 32 cases of complete mole that remitted spontaneously were studied immunohistochemically for c-ras, c-erbB-2, p53, and nm23 proteins. The prognostic value of the proteins for the malignant transformation of complete mole was analyzed by multiple logistic regression and stepwise logistic estimation. Sections of 30 cases of invasive mole and 19 cases of choriocarcinoma were also immunohistologically studied for expression of the proteins. RESULTS Expression of c-erbB-2 and p53 gene products was significantly increased and expression of nm23 and c-ras products was remarkably decreased in complete hydatidiform moles that progressed into postmolar tumor compared with those that remitted spontaneously after evacuation. There was no significant difference in the expression of the four genes in invasive mole and in choriocarcinoma. A logistic estimation model for predicting malignant transformation of complete mole was established based on the expression of gene products. When the expression of four gene products was used, the predictive sensitivity of the regression model was 86.0%, and the specificity was 75.0%. The positive predictive value was 84.3%, the negative predictive value was 77.4%. Logistic stepwise regression analysis showed that the altered expression of c-erbB-2 and nm23 products had strong predictive value, while the expression of c-ras and p53 products had no significant predictive value for the malignant transformation of complete mole. CONCLUSION The altered expression of c-ras, c-erbB-2, nm23, and p53 gene products may be important in the pathogenesis of gestational trophoblastic tumor. The decreased expression of nm23 protein and increased expression of c-erbB-2 protein are strong predictors for the malignant transformation of complete mole.
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Affiliation(s)
- Xingsheng Yang
- Department of Obstetrics and Gynecology, Qilu Hospital, Jinan, People's Republic of China
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