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Kondo K, Muguruma K, Soejima S, Takai C, Kenzaki K, Kawakita N, Toba H, Takizawa H. Aberrant DNA Methylation of NPTX2 as an Indicator of Malignant Behavior in Thymic Epithelial Tumors. Cancers (Basel) 2024; 16:329. [PMID: 38254821 PMCID: PMC10813937 DOI: 10.3390/cancers16020329] [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: 11/22/2023] [Revised: 12/28/2023] [Accepted: 01/09/2024] [Indexed: 01/24/2024] Open
Abstract
Thymic epithelial tumors (TET) consist of thymomas, thymic carcinoma (TC), and neuroendocrine tumors of the thymus (NECTT). Genetic and epigenetic alterations in TET have been the focus of recent research. In the present study, genome-wide screening was performed on aberrantly methylated CpG islands in TET, and this identified neuronal pentraxin 2 (NTPX2) as a significantly hypermethylated CpG island in TC relative to thymomas. NPTX2 is released from pre-synaptic cells in response to neuronal activity/seizure, and plays a role in host immunity and acute inflammation. TET samples were obtained from 38 thymomas, 25 TC, and 6 NECTT. The DNA methylation, mRNA, and protein expression levels of NPTX2 were examined. The DNA methylation rate of the NPTX2 gene was significantly higher in TC than in the normal thymus and thymomas, except B3. The mRNA expression level of NPTX2 was lower in TC than in the normal thymus. An inverse relationship was observed between mRNA expression levels and methylation levels. Relapse-free survival was shorter in patients with high NPTX2 DNA methylation levels than in those with low DNA methylation levels. NECTT showed very high mRNA and protein expression levels and low DNA methylation levels of NPTX2. NPTX2 may function as a tumor suppressor in TC, and have an oncogenic function in NECTT.
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Affiliation(s)
- Kazuya Kondo
- Department of Oncological Medical Services, Graduate School of Biomedical Sciences, Tokushima University, Tokushima 770-8509, Japan; (K.M.); (S.S.); (C.T.)
| | - Kyoka Muguruma
- Department of Oncological Medical Services, Graduate School of Biomedical Sciences, Tokushima University, Tokushima 770-8509, Japan; (K.M.); (S.S.); (C.T.)
| | - Shiho Soejima
- Department of Oncological Medical Services, Graduate School of Biomedical Sciences, Tokushima University, Tokushima 770-8509, Japan; (K.M.); (S.S.); (C.T.)
| | - Chikako Takai
- Department of Oncological Medical Services, Graduate School of Biomedical Sciences, Tokushima University, Tokushima 770-8509, Japan; (K.M.); (S.S.); (C.T.)
| | - Koichiro Kenzaki
- Department of Chest and Breast Surgical Oncology, Takamatsu Red Cross Hospital, Takamatsu 760-0017, Japan;
| | - Naoya Kawakita
- Department of Thoracic, Endocrine Surgery and Oncology, Graduate School of Biomedical Sciences, Tokushima University, Tokushima 770-8503, Japan; (N.K.); (H.T.); (H.T.)
| | - Hiroaki Toba
- Department of Thoracic, Endocrine Surgery and Oncology, Graduate School of Biomedical Sciences, Tokushima University, Tokushima 770-8503, Japan; (N.K.); (H.T.); (H.T.)
| | - Hiromitsu Takizawa
- Department of Thoracic, Endocrine Surgery and Oncology, Graduate School of Biomedical Sciences, Tokushima University, Tokushima 770-8503, Japan; (N.K.); (H.T.); (H.T.)
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Lococo F, Nachira D, Chiappetta M, Evangelista J, Falcoz PE, Ruffini E, Van Schil P, Scarci M, Furàk J, Sollitto F, Guerrera F, Spaggiari L, Aigner C, Evangelia L, Billè A, Moser B, Thomas PA, Liberman M, Boubia S, Campisi A, Ampollini L, Toker A, Enyed A, Voltolini L, Van Raemdonck D, Margaritora S. Does Myasthenia Gravis Affect Long-Term Survival in Thymic Carcinomas? An ESTS Database Analysis. Diagnostics (Basel) 2022; 12:diagnostics12071764. [PMID: 35885668 PMCID: PMC9319380 DOI: 10.3390/diagnostics12071764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 07/04/2022] [Accepted: 07/11/2022] [Indexed: 11/30/2022] Open
Abstract
Background: Thymic carcinoma is a rare and highly malignant tumor with a dismal prognosis, which occasionally coexists with myasthenia gravis (MG). This study aims to investigate the MG incidence on a surgical cohort of patients with thymic carcinoma and to explore its influence on long-term survival. Methods: the prospectively collected data from the ESTS database on thymic epithelial tumors were reviewed. Clinical, pathological, and survival information on thymic carcinoma were analyzed. Results: the analysis was conducted on 203 patients, with an equal gender distribution (96 males and 107 females). MG was detected in 22 (10.8%) patients, more frequently elderly (>60 years, p = 0.048) and male (p = 0.003). Induction therapy was performed in 22 (10.8%) cases. After surgery, 120 (59.1%) patients had a Masaoka stage II−III while complete resection (R0) was achieved in 158 (77.8%). Adjuvant therapy was performed in 68 cases. Mean follow-up was 60 (SD = 14) months. The 3-year, 5-year and 10-year survival rates were 79%, 75% and 63%, respectively. MG did not seem to influence long-term survival (5-year survival in non-MG−TCs 78% vs. 50% in MG−TCs, p = ns) as age < 60 years, female gender, early Masaoka stage, and postoperative radiotherapy did, conversely. Conclusions: myasthenia occurred in about 10% of thymic carcinomas and it did not seem to affect significantly the long-term prognosis in surgically treated thymic carcinoma-patients.
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Affiliation(s)
- Filippo Lococo
- Thoracic Surgey, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (F.L.); (D.N.); (J.E.); (S.M.)
- Thoracic Surgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Dania Nachira
- Thoracic Surgey, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (F.L.); (D.N.); (J.E.); (S.M.)
- Thoracic Surgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Marco Chiappetta
- Thoracic Surgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
- Correspondence: or largoa.gemellie-
| | - Jessica Evangelista
- Thoracic Surgey, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (F.L.); (D.N.); (J.E.); (S.M.)
- Thoracic Surgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Pierre Emmanuel Falcoz
- Department of Surgical Sciences, Strasbourg University Hospital, 67000 Strasbourg, France;
| | - Enrico Ruffini
- Department of Surgical Sciences, University of Torino, 10124 Torino, Italy; (E.R.); (F.G.)
| | - Paul Van Schil
- Department of Thoracic and Vascular Surgery, Antwerp University Hospital, Antwerp University, 2000 Antwerp, Belgium;
| | - Marco Scarci
- Thoracic Surgery Divison of Cardiothoracic Surgery, Imperial College NHS Healthcare Trust, Du Cane Road, London W12 0HS, UK;
| | - Jòzsef Furàk
- Department of Surgery, University of Szeged, Semmelweis u. 8, H-6725 Szeged, Hungary;
| | | | - Francesco Guerrera
- Department of Surgical Sciences, University of Torino, 10124 Torino, Italy; (E.R.); (F.G.)
| | - Lorenzo Spaggiari
- Division of Thoracic Surgery, IEO, European Institute of Oncology, IRCCS, 20139 Milan, Italy;
| | - Clemens Aigner
- Department of Thoracic Surgery, Essen University Hospital—Ruhrlandklinik, 45239 Essen, Germany;
| | | | - Andrea Billè
- Thoracic Surgery Department, Guys Hospital London, London SE1 9RT, UK;
| | - Bernhard Moser
- Department of Thoracic Surgery, Medical University of Vienna, 1090 Vienna, Austria;
| | - Pascal Alexandre Thomas
- Department of Thoracic Surgery, North Hospital Aix-Marseille University, 13015 Marseille, France;
| | - Moishe Liberman
- Division of Thoracic Surgery—Centre Hospital de l’Universite de Montreal, University of Montreal, 900 Rue Saint-Denis, Montreal, QC H2X 0A9, Canada;
| | - Souheil Boubia
- Department of Thoracic Surgery, Universitary Hospital Ibn Rochd Casablanca, Casablanca 20250, Morocco;
| | - Alessio Campisi
- Cardiovascular and Thoracic Department, University of Verona School of Medicine and Verona University Hospital Trust, 37126 Verona, Italy;
| | - Luca Ampollini
- Unit of Thoracic Surgery, Azienda Ospedaliera-Universitaria di Parma, 43126 Parma, Italy;
| | - Alper Toker
- Department of Cardiovascular and Thoracic Surgery, West Virginia University School of Medicine, Morgantown, WV 26506, USA;
| | - Attila Enyed
- Department of Surgery, Faculty of Medicine, University of Debrecen, 22 Moricz Zsigmond Str., H-4032 Debrecen, Hungary;
| | - Luca Voltolini
- Thoracic Surgery Unit, Careggi University Hospital, 50134 Florence, Italy;
| | - Dirk Van Raemdonck
- Department of Thoracic Surgery, University Hospitals Leuven, 3000 Leuven, Belgium;
| | - Stefano Margaritora
- Thoracic Surgey, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (F.L.); (D.N.); (J.E.); (S.M.)
- Thoracic Surgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
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Soejima S, Kondo K, Tsuboi M, Muguruma K, Tegshee B, Kawakami Y, Kajiura K, Kawakita N, Toba H, Yoshida M, Takizawa H, Tangoku A. GAD1 expression and its methylation as indicators of malignant behavior in thymic epithelial tumors. Oncol Lett 2021; 21:483. [PMID: 33968199 PMCID: PMC8100960 DOI: 10.3892/ol.2021.12744] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 03/23/2021] [Indexed: 12/15/2022] Open
Abstract
Thymic epithelial tumors (TETs) comprise thymomas and thymic carcinoma (TC). TC has more aggressive features and a poorer prognosis than thymomas. Genetic and epigenetic alterations in thymomas and TC have been investigated in an attempt to identify novel target molecules for TC. In the present study, genome-wide screening was performed on aberrantly methylated CpG islands in thymomas and TC, and the glutamate decarboxylase 1 gene (GAD1) was identified as the 4th significantly hypermethylated CpG island in TC compared with thymomas. GAD1 catalyzes the production of γ-aminobutyric acid from L-glutamic acid. GAD1 expression is abundant in the brain but rare in other tissues, including the thymus. A total of 73 thymomas and 17 TC tissues were obtained from 90 patients who underwent surgery or biopsy at Tokushima University Hospital between 1990 and 2017. DNA methylation was examined by bisulfite pyrosequencing, and the mRNA and protein expression levels of GAD1 were analyzed using reverse transcription-quantitative PCR and immunohistochemistry, respectively. The DNA methylation levels of GAD1 were significantly higher in TC tissues than in the normal thymus and thymoma tissues, and GAD1 methylation exhibited high sensitivity and specificity for discriminating between TC and thymoma. The mRNA and protein expression levels of GAD1 were significantly higher in TC tissues than in thymomas. Patients with TET with high GAD1 DNA hypermethylation and high mRNA and protein expression levels had significantly shorter relapse-free survival rates than those with low levels. In conclusion, significantly more epigenetic alterations were observed in TC tissues compared with in thymomas, which may contribute to the clinical features and prognosis of patients.
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Affiliation(s)
- Shiho Soejima
- Department of Oncological Medical Services, Graduate School of Biomedical Sciences, Tokushima University, Tokushima 770-8509, Japan
| | - Kazuya Kondo
- Department of Oncological Medical Services, Graduate School of Biomedical Sciences, Tokushima University, Tokushima 770-8509, Japan
| | - Mitsuhiro Tsuboi
- Department of Thoracic, Endocrine Surgery and Oncology, Graduate School of Biomedical Sciences, Tokushima University, Tokushima 770-8503, Japan
| | - Kyoka Muguruma
- Department of Oncological Medical Services, Graduate School of Biomedical Sciences, Tokushima University, Tokushima 770-8509, Japan
| | - Bilguun Tegshee
- Department of Oncological Medical Services, Graduate School of Biomedical Sciences, Tokushima University, Tokushima 770-8509, Japan
| | - Yukikiyo Kawakami
- Department of Thoracic, Endocrine Surgery and Oncology, Graduate School of Biomedical Sciences, Tokushima University, Tokushima 770-8503, Japan
| | - Koichiro Kajiura
- Department of Thoracic, Endocrine Surgery and Oncology, Graduate School of Biomedical Sciences, Tokushima University, Tokushima 770-8503, Japan
| | - Naoya Kawakita
- Department of Thoracic, Endocrine Surgery and Oncology, Graduate School of Biomedical Sciences, Tokushima University, Tokushima 770-8503, Japan
| | - Hiroaki Toba
- Department of Thoracic, Endocrine Surgery and Oncology, Graduate School of Biomedical Sciences, Tokushima University, Tokushima 770-8503, Japan
| | - Mitsuteru Yoshida
- Department of Thoracic, Endocrine Surgery and Oncology, Graduate School of Biomedical Sciences, Tokushima University, Tokushima 770-8503, Japan
| | - Hiromitsu Takizawa
- Department of Thoracic, Endocrine Surgery and Oncology, Graduate School of Biomedical Sciences, Tokushima University, Tokushima 770-8503, Japan
| | - Akira Tangoku
- Department of Thoracic, Endocrine Surgery and Oncology, Graduate School of Biomedical Sciences, Tokushima University, Tokushima 770-8503, Japan
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Zu Y, Luo Y, Li C, Zhao J, He T, Shi X, Li X. Complete remission following icotinib administration in an advanced ectopic thymic carcinoma patient harbouring the EGFR exon 19 deletion. J Gene Med 2021; 23:e3340. [PMID: 33835620 PMCID: PMC8365660 DOI: 10.1002/jgm.3340] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 03/15/2021] [Accepted: 04/01/2021] [Indexed: 12/21/2022] Open
Abstract
Background Ectopic thymic carcinoma (TC) is an extremely rare disease with a poor prognosis. The main treatment for early TC is surgery, although an effective treatment for advanced TC is lacking. Methods We present the case of a 61‐year‐old man with advanced posterior mediastinum thymic squamous cell carcinoma. Amplification refractory mutation system (ARMS)–polymerase chain reaction (PCR) analysis was used to investigate the molecular and mutational characteristics of this tumour. Results After chemotherapy and radiotherapy, the tumour showed disease progression. Immunohistochemistry revealed that the tumour was positive for CD117 (specific for primary TC), CK19, CD56 and Ki67. ARMS‐PCR analysis revealed an EGFR exon 19 deletion in the patient. The patient subsequently received icotinib treatment and achieved complete remission for 3 years. Conclusions This case report suggests that tyrosine kinase inhibitors are a potential treatment strategy for patients with TC harbouring EGFR alterations.
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Affiliation(s)
- Yunfen Zu
- Department of Oncology, Second People's Hospital of Yunnan Province, Kunming, China
| | - Yan Luo
- Department of Oncology, Second People's Hospital of Yunnan Province, Kunming, China
| | - Chongyang Li
- Department of Oncology, Second People's Hospital of Yunnan Province, Kunming, China
| | | | | | | | - Xin Li
- Department of Oncology, Second People's Hospital of Yunnan Province, Kunming, China
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Theermann R, Ohlmeier M, Hartwig CH, Wolff T, Gehrke T, Citak M. [Case report of an osseous (and lymphogenic) thymic carcinoma in an adult]. DER ORTHOPADE 2021; 50:326-332. [PMID: 32350550 DOI: 10.1007/s00132-020-03911-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
A Thymic carcinoma in adults is rare. We present the case of a 47-year-old man, who was treated conservatively for spondylolisthesis L5/S1 in our institution for several years. In the further course, the patient complained about pain exacerbation with acute lower back pain. Cross-sectional scanning showed a tumor of the lumbar vertebral body three. A biopsy of this mass revealed a metastatic thymic carcinoma of the squamous cells. After palliative therapy, the patient died 9 months after initial diagnosis.
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Affiliation(s)
- R Theermann
- Abteilung für Gelenkchirurgie, Helios ENDO-Klinik, Holstenstraße 2, 22767, Hamburg, Deutschland. .,MVZ Orthopädie Mühlenkamp, Mühlenkamp 33a, 22303, Hamburg, Deutschland.
| | - M Ohlmeier
- Abteilung für Gelenkchirurgie, Helios ENDO-Klinik, Holstenstraße 2, 22767, Hamburg, Deutschland
| | - C H Hartwig
- Abteilung für Gelenkchirurgie, Helios ENDO-Klinik, Holstenstraße 2, 22767, Hamburg, Deutschland.,MVZ Orthopädie Mühlenkamp, Mühlenkamp 33a, 22303, Hamburg, Deutschland
| | - T Wolff
- Onkologische Schwerpunktpraxis, Lerchenfeld 14, 22303, Hamburg, Deutschland
| | - T Gehrke
- Abteilung für Gelenkchirurgie, Helios ENDO-Klinik, Holstenstraße 2, 22767, Hamburg, Deutschland
| | - M Citak
- Abteilung für Gelenkchirurgie, Helios ENDO-Klinik, Holstenstraße 2, 22767, Hamburg, Deutschland
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6
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Melis E, Gallo E, di Martino S, Gallina FT, Laquintana V, Casini B, Visca P, Ganci F, Alessandrini G, Caterino M, Cecere FL, Mandoj C, Papadantonakis A, De Bello N, Lattanzio R, Palmieri G, Garassino MC, Girard N, Conti L, Blandino G, Fazi F, Facciolo F, Pescarmona E, Ciliberto G, Marino M. Thymic Epithelial Tumors as a Model of Networking: Development of a Synergistic Strategy for Clinical and Translational Research Purposes. Front Oncol 2020; 10:922. [PMID: 32760665 PMCID: PMC7372300 DOI: 10.3389/fonc.2020.00922] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 05/11/2020] [Indexed: 12/23/2022] Open
Abstract
Among the group of thymic epithelial tumors (TET), thymomas often show either uncertain or explicit malignant biological behavior, local invasiveness, and intrathoracic relapse and are often difficult to manage. From the initial stages, thymic carcinomas tend to show aggressive behavior and extrathoracic spread. Moreover, the interplay of epithelial cells and thymocytes in thymomas causes complex immune derangement and related systemic autoimmune diseases. Due to their rare occurrence and to the limited funding opportunities available for rare tumors, it is challenging to make advances in clinical and translational research in TET. The authors of this paper are all members of a multidisciplinary clinical and research thoracic tumor team. Strong input was given to the team by long-standing expertise in TET in the Pathology Department. In addition, thanks to the collaboration between research units at our Institute as well as to national collaborations, over the last 10 years we were able to perform several tissue-based research studies. The most recent studies focused on microRNA and on functional studies on the thymic carcinoma cell line 1889c. The recent implementation of our biobank now provides us with a new tool for networking collaborative research activities. Moreover, the participation in a worldwide community such as ITMIG (International Thymic Malignancy Interest Group) has allowed us to significantly contribute toward fundamental projects/research both in tissue-based studies (The Cancer Genome Atlas) and in clinical studies (TNM staging of TET). Our achievements derive from constant commitment and long-standing experience in diagnosis and research in TET. New perspectives opened up due to the establishment of national [the Italian Collaborative Group for ThYmic MalignanciEs (TYME)] and European reference networks such as EURACAN, for an empowered joint clinical action in adult solid rare tumors. The challenge we face still lies in the advancement of clinical and basic science in thymic epithelial malignancies.
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Affiliation(s)
- Enrico Melis
- Thoracic Surgery Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Enzo Gallo
- Department of Pathology, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Simona di Martino
- Department of Pathology, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | | | - Valentina Laquintana
- Department of Pathology, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Beatrice Casini
- Department of Pathology, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Paolo Visca
- Department of Pathology, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Federica Ganci
- Oncogenomic and Epigenetic Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | | | - Mauro Caterino
- Radiology Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | | | - Chiara Mandoj
- Clinical Pathology, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | | | - Nicoletta De Bello
- Thoracic Surgery Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Rossano Lattanzio
- University “G. d'Annunzio,” Department of Medical, Oral and Biotechnological Sciences, Center for Advanced Studies and Technology (CAST), Chieti, Italy
| | - Giovannella Palmieri
- Scientific Direction, Department of Clinical Medicine and Surgery, Rare Tumors Reference Center, University Federico II, Naples, Italy
| | - Marina Chiara Garassino
- Thoracic Oncology Unit, Division of Medical Oncology, Foundation IRCCS–Italian National Cancer Institute, Milan, Italy
| | - Nicolas Girard
- Institut du Thorax Curie-Montsouris, Institut Curie, Paris, France
| | - Laura Conti
- Clinical Pathology, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Giovanni Blandino
- Oncogenomic and Epigenetic Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Francesco Fazi
- Department of Anatomical, Histological, Forensic & Orthopedic Sciences, Section of Histology & Medical Embryology, Sapienza University of Rome, Laboratory Affiliated to Instituto Pasteur Italia-Fondazione Cenci Bolognetti, Rome, Italy
| | - Francesco Facciolo
- Thoracic Surgery Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Edoardo Pescarmona
- Department of Pathology, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Gennaro Ciliberto
- Scientific Direction, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Mirella Marino
- Department of Pathology, IRCCS Regina Elena National Cancer Institute, Rome, Italy
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