1
|
Tarín-Nieto A, Solano-Iturri JD, Arrieta-Aguirre I, Valdivia A, Etxezarraga MC, Loizate A, López JI, Larrinaga G. Fibroblast Activation Protein-α (FAP) Identifies Stromal Invasion in Colorectal Neoplasia. Am J Surg Pathol 2023; 47:1027-1033. [PMID: 37366169 DOI: 10.1097/pas.0000000000002075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/28/2023]
Abstract
The increasing detection of colorectal adenomas and early adenocarcinomas (ADCs) in the context of nationwide screening programs has led to a significant increase in the incidence of inconclusive diagnoses in which histopathologic analysis of endoscopic biopsies does not allow pathologists to provide a reliable diagnosis of stromal invasion. The objective of this study was to analyze the discriminative capacity of the immunohistochemical expression of fibroblast activation protein-α (FAP) in distinguishing colorectal adenomas with low-grade dysplasia (LGD) and high-grade dysplasia (HGD) from invasive intestinal-type ADCs. The study analyzed the first endoscopic biopsies from a series of patients classified as inconclusive or conclusive for stromal invasion based on the pathologic report. In total, 30 ADCs, 52 HGDs, and 15 LGDs were included in the study. FAP expression was detected in 23/30 ADCs and was negative in all adenomas with either LGD or HGD features (100% specificity and 76.7% sensitivity, area under the curve=0.883, CI=0.79-0.98). Considering these findings, we conclude that FAP is a potentially useful tool for helping pathologists identify invasive lesions in colorectal endoscopic biopsies, avoiding unnecessary biopsy repetitions.
Collapse
Affiliation(s)
| | - Jon D Solano-Iturri
- Department of Anatomic Pathology, Cruces University Hospital, Cruces (Barakaldo)
- Biocruces-Bizkaia Health Research Institute, Barakaldo
| | | | | | | | - Alberto Loizate
- Department of Surgery, Basurto University Hospital, University of the Basque Country (UPV/EHU), Bilbao
| | - José I López
- Biocruces-Bizkaia Health Research Institute, Barakaldo
| | - Gorka Larrinaga
- Biocruces-Bizkaia Health Research Institute, Barakaldo
- Departments of Nursing
- Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Leioa, Bizkaia Province, Spain
| |
Collapse
|
2
|
Beitia M, Solano-Iturri JD, Errarte P, Sanz B, Perez I, Etxezarraga MC, Loizate A, Asumendi A, Larrinaga G. Altered expression of renin-angiotensin system receptors throughout colorectal adenoma-adenocarcinoma sequence. Int J Med Sci 2019; 16:813-821. [PMID: 31337954 PMCID: PMC6643103 DOI: 10.7150/ijms.32599] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Accepted: 03/27/2019] [Indexed: 12/24/2022] Open
Abstract
Background and Objective: Colorectal cancer (CRC) is a major health problem in developed countries. Adenomatous lesions in the large bowel are the main precursors of CRC and the adenoma-adenocarcinoma sequence still provides a solid model for research on carcinogenesis. The finding of local renin-angiotensin systems (RAS) has been crucial to understand the role of this peptidergic system in cancer and has opened new perspectives in the study of colorectal carcinogenetic processes. Methods: In this study we analyzed the immunohistochemical expression of three main RAS receptors (AT1, AT2 and MAS) in a large series of CRC samples (n=161), including uninvolved intestinal mucosa-adenoma-adenocarcinoma sequences from the same patients (n=50). Results: 1) AT1 and AT2 showed a biphasic expression pattern along the sequence. The expression significantly decreased in adenomas with respect to uninvolved mucosa but increased in CRCs. 2) AT2 expression was lower in advanced CRCs with high local invasion (pT4), high stage (IV), high nodal (N2) and vascular invasion. 3) MAS receptor was moderately expressed in the uninvolved mucosa and in adenomas. This expression increased very significantly in CRC tissues. Conclusions: These results suggest that: 1) RAS receptors are differentially regulated as the genetic and epigenetic alterations accumulate throughout the uninvolved mucosa-adenoma-CRC sequence. 2) Loss of AT2 expression could contribute to the aggressive behavior of advanced CRC cells.
Collapse
MESH Headings
- Adenocarcinoma/genetics
- Adenocarcinoma/mortality
- Adenocarcinoma/pathology
- Adenoma/genetics
- Adenoma/mortality
- Adenoma/pathology
- Adult
- Aged
- Aged, 80 and over
- Biomarkers, Tumor/genetics
- Biomarkers, Tumor/metabolism
- Carcinogenesis/genetics
- Carcinogenesis/pathology
- Colorectal Neoplasms/genetics
- Colorectal Neoplasms/mortality
- Colorectal Neoplasms/pathology
- Epigenesis, Genetic
- Female
- Follow-Up Studies
- Gene Expression Regulation, Neoplastic
- Humans
- Intestinal Mucosa/pathology
- Kaplan-Meier Estimate
- Male
- Middle Aged
- Prognosis
- Proto-Oncogene Mas
- Proto-Oncogene Proteins/genetics
- Proto-Oncogene Proteins/metabolism
- Receptor, Angiotensin, Type 1/genetics
- Receptor, Angiotensin, Type 1/metabolism
- Receptor, Angiotensin, Type 2/genetics
- Receptor, Angiotensin, Type 2/metabolism
- Receptors, G-Protein-Coupled/genetics
- Receptors, G-Protein-Coupled/metabolism
- Renin-Angiotensin System/genetics
Collapse
Affiliation(s)
- Maider Beitia
- Department of Nursing I, School of Nursing, University of the Basque Country (UPV/EHU), Leioa, Bizkaia, Spain
- Department of Physiology, Faculty of Medicine and Dentistry, University of the Basque Country (UPV/EHU), Leioa, Bizkaia, Spain
- BioCruces Health Research Institute, Barakaldo, Bizkaia, Spain
| | - Jon Danel Solano-Iturri
- Department of Anatomic Pathology, Cruces University Hospital, University of the Basque Country (UPV/EHU), Barakaldo, Bizkaia, Spain
- BioCruces Health Research Institute, Barakaldo, Bizkaia, Spain
| | - Peio Errarte
- Department of Physiology, Faculty of Medicine and Dentistry, University of the Basque Country (UPV/EHU), Leioa, Bizkaia, Spain
- BioCruces Health Research Institute, Barakaldo, Bizkaia, Spain
| | - Begoña Sanz
- Department of Physiology, Faculty of Medicine and Dentistry, University of the Basque Country (UPV/EHU), Leioa, Bizkaia, Spain
- BioCruces Health Research Institute, Barakaldo, Bizkaia, Spain
| | - Itxaro Perez
- Department of Nursing I, School of Nursing, University of the Basque Country (UPV/EHU), Leioa, Bizkaia, Spain
- BioCruces Health Research Institute, Barakaldo, Bizkaia, Spain
| | - María C. Etxezarraga
- Department of Anatomic Pathology, Basurto University Hospital, University of the Basque Country (UPV/EHU), Bilbao, Bizkaia, Spain
- BioCruces Health Research Institute, Barakaldo, Bizkaia, Spain
| | - Alberto Loizate
- Department of Surgery, Basurto University Hospital, University of the Basque Country (UPV/EHU), Bilbao, Bizkaia, Spain
| | - Aintzane Asumendi
- Department of Cell Biology and Histology, School of Medicine and Dentistry, University of the Basque Country (UPV/EHU), Leioa, Bizkaia, Spain
| | - Gorka Larrinaga
- Department of Nursing I, School of Nursing, University of the Basque Country (UPV/EHU), Leioa, Bizkaia, Spain
- Department of Physiology, Faculty of Medicine and Dentistry, University of the Basque Country (UPV/EHU), Leioa, Bizkaia, Spain
- BioCruces Health Research Institute, Barakaldo, Bizkaia, Spain
| |
Collapse
|
3
|
Larrinaga G, Perez I, Sanz B, Beitia M, Errarte P, Fernández A, Blanco L, Etxezarraga MC, Gil J, López JI. Dipeptidyl-peptidase IV activity is correlated with colorectal cancer prognosis. PLoS One 2015; 10:e0119436. [PMID: 25790122 PMCID: PMC4366149 DOI: 10.1371/journal.pone.0119436] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2014] [Accepted: 01/14/2015] [Indexed: 12/15/2022] Open
Abstract
Background Dipeptidyl-peptidase IV (EC 3.4.14.5) (DPPIV) is a serine peptidase involved in cell differentiation, adhesion, immune modulation and apoptosis, functions that control neoplastic transformation. Previous studies have demonstrated altered expression and activity of tissue and circulating DPPIV in several cancers and proposed its potential usefulness for early diagnosis in colorectal cancer (CRC). Methods and principal findings The activity and mRNA and protein expression of DPPIV was prospectively analyzed in adenocarcinomas, adenomas, uninvolved colorectal mucosa and plasma from 116 CRC patients by fluorimetric, quantitative RT-PCR and immunohistochemical methods. Results were correlated with the most important classic pathological data related to aggressiveness and with 5-year survival rates. Results showed that: 1) mRNA levels and activity of DPPIV increased in colorectal neoplasms (Kruskal-Wallis test, p<0.01); 2) Both adenomas and CRCs displayed positive cytoplasmic immunostaining with luminal membrane reinforcement; 3) Plasmatic DPPIV activity was lower in CRC patients than in healthy subjects (Mann-U test, p<0.01); 4) Plasmatic DPPIV activity was associated with worse overall and disease-free survivals (log-rank p<0.01, Cox analysis p<0.01). Conclusion/significance 1) Up-regulation of DPPIV in colorectal tumors suggests a role for this enzyme in the neoplastic transformation of colorectal tissues. This finding opens the possibility for new therapeutic targets in these patients. 2) Plasmatic DPPIV is an independent prognostic factor in survival of CRC patients. The determination of DPPIV activity levels in the plasma may be a safe, minimally invasive and inexpensive way to define the aggressiveness of CRC in daily practice.
Collapse
Affiliation(s)
- Gorka Larrinaga
- Department of Nursing I, School of Nursing, University of the Basque Country (UPV/EHU), Leioa, Bizkaia, Spain
- Department of Physiology, Faculty of Medicine and Dentistry,University of the Basque Country (UPV/EHU), Leioa, Bizkaia, Spain
- BioCruces Health Research Institute, Barakaldo, Bizkaia, Spain
- * E-mail:
| | - Itxaro Perez
- Department of Nursing I, School of Nursing, University of the Basque Country (UPV/EHU), Leioa, Bizkaia, Spain
- Department of Physiology, Faculty of Medicine and Dentistry,University of the Basque Country (UPV/EHU), Leioa, Bizkaia, Spain
- BioCruces Health Research Institute, Barakaldo, Bizkaia, Spain
| | - Begoña Sanz
- Department of Physiology, Faculty of Medicine and Dentistry,University of the Basque Country (UPV/EHU), Leioa, Bizkaia, Spain
- BioCruces Health Research Institute, Barakaldo, Bizkaia, Spain
| | - Maider Beitia
- Department of Nursing I, School of Nursing, University of the Basque Country (UPV/EHU), Leioa, Bizkaia, Spain
- Department of Physiology, Faculty of Medicine and Dentistry,University of the Basque Country (UPV/EHU), Leioa, Bizkaia, Spain
- BioCruces Health Research Institute, Barakaldo, Bizkaia, Spain
| | - Peio Errarte
- Department of Physiology, Faculty of Medicine and Dentistry,University of the Basque Country (UPV/EHU), Leioa, Bizkaia, Spain
- BioCruces Health Research Institute, Barakaldo, Bizkaia, Spain
| | - Ainhoa Fernández
- Department of Physiology, Faculty of Medicine and Dentistry,University of the Basque Country (UPV/EHU), Leioa, Bizkaia, Spain
- BioCruces Health Research Institute, Barakaldo, Bizkaia, Spain
| | - Lorena Blanco
- Department of Physiology, Faculty of Medicine and Dentistry,University of the Basque Country (UPV/EHU), Leioa, Bizkaia, Spain
- BioCruces Health Research Institute, Barakaldo, Bizkaia, Spain
| | - María C. Etxezarraga
- Department of Anatomic Pathology, Basurto University Hospital,University of the Basque Country (UPV/EHU), Bilbao, Bizkaia, Spain
- BioCruces Health Research Institute, Barakaldo, Bizkaia, Spain
| | - Javier Gil
- Department of Physiology, Faculty of Medicine and Dentistry,University of the Basque Country (UPV/EHU), Leioa, Bizkaia, Spain
- BioCruces Health Research Institute, Barakaldo, Bizkaia, Spain
| | - José I. López
- Department of Anatomic Pathology, Cruces University Hospital, University of the Basque Country (UPV/EHU), Barakaldo, Bizkaia, Spain
- BioCruces Health Research Institute, Barakaldo, Bizkaia, Spain
| |
Collapse
|
4
|
Larrinaga G, Perez I, Blanco L, Sanz B, Errarte P, Beitia M, Etxezarraga MC, Loizate A, Gil J, Irazusta J, López JI. Prolyl endopeptidase activity is correlated with colorectal cancer prognosis. Int J Med Sci 2014; 11:199-208. [PMID: 24465166 PMCID: PMC3894405 DOI: 10.7150/ijms.7178] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2013] [Accepted: 11/23/2013] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Prolyl endopeptidase (PEP) (EC 3.4.21.26) is a serine peptidase involved in differentiation, development and proliferation processes of several tissues. Recent studies have demonstrated the increased expression and activity of this cytosolic enzyme in colorectal cancer (CRC). However, there are no available data about the impact of this peptidase in the biological aggressiveness of this tumor in patient survival. METHODS The activity of PEP in tissue (n=80) and plasma (n=40) of patients with CRC was prospectively analyzed by fluorimetric methods. Results were correlated with the most important classic pathological data related to aggressiveness, with 5-year survival rates and other clinical variables. RESULTS 1) PEP is more active in early phases of CRC; 2) Lower levels of the enzyme in tumors were located in the rectum and this decrease could be related with preoperative chemo-radiotherapy; 3) PEP activity in tissue was higher in patients with better overall and disease-free survival (log-rank p<0.01, Cox analysis p<0.01); 4) Plasmatic PEP activity was significantly higher in CRC patients than in healthy individuals and this was associated with distant metastases and with worse overall and disease-free survivals (log-rank p<0.05, Cox analysis p<0.05). CONCLUSIONS PEP activity in tissue and plasma from CRC patients is an independent prognostic factor in survival. The determination of PEP activity in the plasma may be a safe, minimally invasive and inexpensive way to define the aggressiveness of CRC in daily practice.
Collapse
Affiliation(s)
- Gorka Larrinaga
- 1. Department of Nursing I, School of Nursing, University of the Basque Country (UPV/EHU), Leioa, Bizkaia, Spain; ; 2. Department of Physiology, Faculty of Medicine and Dentistry, University of the Basque Country (UPV/EHU), Leioa, Bizkaia, Spain; ; 6. BioCruces Health Research Institute, Barakaldo, Bizkaia, Spain
| | - Itxaro Perez
- 1. Department of Nursing I, School of Nursing, University of the Basque Country (UPV/EHU), Leioa, Bizkaia, Spain; ; 2. Department of Physiology, Faculty of Medicine and Dentistry, University of the Basque Country (UPV/EHU), Leioa, Bizkaia, Spain; ; 6. BioCruces Health Research Institute, Barakaldo, Bizkaia, Spain
| | - Lorena Blanco
- 2. Department of Physiology, Faculty of Medicine and Dentistry, University of the Basque Country (UPV/EHU), Leioa, Bizkaia, Spain; ; 6. BioCruces Health Research Institute, Barakaldo, Bizkaia, Spain
| | - Begoña Sanz
- 2. Department of Physiology, Faculty of Medicine and Dentistry, University of the Basque Country (UPV/EHU), Leioa, Bizkaia, Spain; ; 6. BioCruces Health Research Institute, Barakaldo, Bizkaia, Spain
| | - Peio Errarte
- 2. Department of Physiology, Faculty of Medicine and Dentistry, University of the Basque Country (UPV/EHU), Leioa, Bizkaia, Spain; ; 6. BioCruces Health Research Institute, Barakaldo, Bizkaia, Spain
| | - Maider Beitia
- 2. Department of Physiology, Faculty of Medicine and Dentistry, University of the Basque Country (UPV/EHU), Leioa, Bizkaia, Spain; ; 6. BioCruces Health Research Institute, Barakaldo, Bizkaia, Spain
| | - María C Etxezarraga
- 3. Department of Anatomic Pathology, Basurto University Hospital, University of the Basque Country (UPV/EHU), Bilbao, Bizkaia, Spain; ; 6. BioCruces Health Research Institute, Barakaldo, Bizkaia, Spain
| | - Alberto Loizate
- 4. Department of Surgery, Basurto University Hospital, University of the Basque Country (UPV/EHU), Bilbao, Bizkaia, Spain; ; 6. BioCruces Health Research Institute, Barakaldo, Bizkaia, Spain
| | - Javier Gil
- 2. Department of Physiology, Faculty of Medicine and Dentistry, University of the Basque Country (UPV/EHU), Leioa, Bizkaia, Spain; ; 6. BioCruces Health Research Institute, Barakaldo, Bizkaia, Spain
| | - Jon Irazusta
- 2. Department of Physiology, Faculty of Medicine and Dentistry, University of the Basque Country (UPV/EHU), Leioa, Bizkaia, Spain; ; 6. BioCruces Health Research Institute, Barakaldo, Bizkaia, Spain
| | - José I López
- 5. Department of Anatomic Pathology, Cruces University Hospital, University of the Basque Country (UPV/EHU), Barakaldo, Bizkaia, Spain; ; 6. BioCruces Health Research Institute, Barakaldo, Bizkaia, Spain
| |
Collapse
|