Both germ line and somatic genetics of the p53 pathway affect ovarian cancer incidence and survival.

PURPOSE: Although p53 is one of the most studied genes/proteins in ovarian carcinomas, the predictive value of p53 alterations is still ambiguous. EXPERIMENTAL DESIGN: We performed analyses of the TP53 mutational status and its protein expression using immunohistochemistry. Moreover, the single nucleotide polymorphism SNP309 in the P2 promoter of the MDM2 gene was investigated. We correlated the results with age of onset and outcome from 107 patients with ovarian carcinoma. RESULTS: In our study, we identified a large group of patients with p53 overexpression despite having a wild-type gene (49% of all patients with wild-type TP53). This was associated with a significantly shortened overall survival time (P = 0.019). Patients with p53 alterations (especially those with overexpression of wild-type TP53) were also more refractory to chemotherapy compared with patients with normal p53 (P = 0.027). The G-allele of SNP309 is associated with an earlier age of onset in patients with estrogen receptor-overexpressing FIGO stage III disease (P = 0.048). In contrast, in patients with FIGO stage III disease, a weakened p53 pathway (either the G-allele of SNP309 or a TP53 mutation) was correlated with increased overall survival compared with patients whose tumors were wild-type for both TP53 and SNP309 (P = 0.0035). CONCLUSION: Our study provides evidence that both germ line and somatic alterations of the p53 pathway influence the incidence and survival of ovarian carcinoma, and it underscores the importance of assessing the functionality of p53 in order to predict the sensitivity of platinum-based chemotherapies and patient outcome.     

Screening for germ line TP53 mutations in breast cancer patients.

The constant denaturant gel electrophoresis technique was used to screen for TP53 germ line mutations in 237 women with breast carcinoma (167 unselected patients, 30 patients with at least one first-degree relative with breast cancer, and 40 women diagnosed with breast cancer before age 35). A germ line mutation at codon 181 was noted in one of the unselected patients and a codon 245 mutation in one of the early-onset patients. Both had a family history of breast cancer and other malignancies suggestive of Li-Fraumeni syndrome. The codon 245 mutation was also present in this patient's affected mother.     

Induction of genetic instability by gain-of-function p53 cancer mutants

p53 plays critical roles in tumor suppression and the loss of its function is required for cancer progression. In this context, the p53 gene is the most commonly mutated tumor suppressor gene in human cancers. The majority of the p53 gene mutations in human cancers are missense mutations, leading to the expression of the full-length mutant p53 protein in cancer cells. In addition to the loss of tumor suppression activity, p53 cancer mutants gain new oncogenic activities to promote tumorigenesis and drug resistance. Recent studies have identified a novel gain-of-function of p53 cancer mutants in inducing genetic instability by inactivating critical tumor suppressors such as ATM. Genetic instability is a common mechanism by which cancer cells efficiently accumulate genetic mutations to promote their growth, survival and metastatic potential. Therefore, this gain-of-function of p53 cancer mutants could play important roles in tumorigenesis and drug resistance of various types of human cancers. In addition, because many cancer therapies such as radiation therapy suppress or kill cancer cells by activating ATM-dependent responses to DNA double-stranded break damage, elucidation of this gain-of-function of p53 cancer mutants will have important implications on cancer therapy.     

Distinct tumor protein p53 mutants in breast cancer subgroups

Tumor protein p53 (TP53) is mutated in approximately 30% of breast cancers, but this frequency fluctuates widely between subclasses. We investigated the p53 mutation status in 572 breast tumors, classified into luminal, basal and molecular apocrine subgroups. As expected, the lowest mutation frequency was observed in luminal (26%), and the highest in basal (88%) tumors. Luminal tumors showed significantly higher frequency of substitutions (82 vs. 65%), notably A/T to G/C transitions (31 vs. 15%), whereas molecular apocrine and basal tumors presented much higher frequencies of complex mutations (deletions/insertions) (36 and 33%, respectively, vs. 18%). Accordingly, missense mutations were significantly more frequent in luminal tumors (75 vs. 54%), whereas basal tumors displayed significantly increased rates of TP53 truncations (43 vs. 25%), resulting in loss of function and/or expression. Interestingly, as basal tumors, molecular apocrine tumors presented with a high rate of complex mutations, but paradoxically, these were not associated with increased frequency of p53 truncation. As in luminal tumors, this could reflect a selective pressure for p53 gain of function, possibly through P63/P73 inactivation. Collectively, these observations point not only to different mechanisms of TP53 alterations, but also to different functional consequences in the different breast cancer subtypes.     

Bilateral breast cancer in a patient with a strong family history of cancer: Analysis of p53 germ line mutations

We report a case of bilateral breast carcinoma in a patient with a strong family history, including 4 cases of breast carcinoma, 1 case of prostate carcinoma (father), 1 case of hepatocellular carcinoma (mother), 2 cases of gastric carcinoma, 1 case of lung carcinoma, and 1 case of lingual carcinoma, in second degree relatives, together with analysis of germ line p53 mutations. The patient was a 51-year-old female who had undergone mastectomy 9 years previously for an invasive ductal carcinoma of the right breast. Lymph nodes were free of metastases and the tumor had negative estrogen receptor (ER) status. Bone and lung metastases developed 18 months after surgery, and had been well controlled with chemoendocrine therapy. She subsequently underwent a modified radical mastectomy for carcinoma in the contralateral breast. This was an invasive lobular carcinoma with negative lymph node metastasis, negative p53 immunoreaction, negative c-erbB-2 protein and positive ER status. In this breast-prostate carcinoma-type cancer family there was a high incidence of breast carcinoma; the father, who had prostate carcinoma, was possibly a carrier of a breast carcinoma susceptible gene. We have however detected to p53 germ line mutations in the lymphocytes DNA of the patient and her niece. The accumulation of cancers in this family line remains to be elucidated further using other genetic markers.     

A link between the p53 germ line polymorphisms and white blood cells apoptosis in lung cancer patients

The p53 protein acts as a checkpoint in the cell cycle, either preventing or initiating apoptosis. Since cancer is the unchecked proliferation of cells, p53s role is critical. Thus, we have sought a link between the p53 polymorphisms and apoptosis. Wild-type p53 tumor suppressor gene exhibits several common single nucleotide polymorphisms (SNP) both in coding and non-coding regions. We focused on two of them, the p53 BstUI SNP on the fourth exon, and the p53 MspI SNP on the sixth intron. We investigated a presence of these two polymorphisms in relation to apoptosis of white blood cells in lung cancer patients and healthy controls. We found that both the p53 BstUI and the p53 MspI homozygous genotypes A2/A2 were associated with significantly higher content of apoptotic white blood cells in comparison to relevant A2/A1 heterozygous genotypes (P<0.001,0.05) in lung cancer patients. These observations suggest that the p53 BstUI and the p53 MspI SNPs may play a certain role in p53 dependent apoptotic pathway.     

Structure-function-rescue: the diverse nature of common p53 cancer mutants

The tumor suppressor protein p53 is inactivated by mutation in about half of all human cancers. Most mutations are located in the DNA-binding domain of the protein. It is, therefore, important to understand the structure of p53 and how it responds to mutation, so as to predict the phenotypic response and cancer prognosis. In this review, we present recent structural and systematic functional data that elucidate the molecular basis of how p53 is inactivated by different types of cancer mutation. Intriguingly, common cancer mutants exhibit a variety of distinct local structural changes, while the overall structural scaffold is largely preserved. The diverse structural and energetic response to mutation determines: (i) the folding state of a particular mutant under physiological conditions; (ii) its affinity for the various p53 target DNA sequences; and (iii) its protein-protein interactions both within the p53 tetramer and with a multitude of regulatory proteins. Further, the structural details of individual mutants provide the basis for the design of specific and generic drugs for cancer therapy purposes. In combination with studies on second-site suppressor mutations, it appears that some mutants are ideal rescue candidates, whereas for others simple pharmacological rescue by small molecule drugs may not be successful.     

P53 germ line haplotypes associated with increased risk for colorectal cancer

Three p53 DNA polymorphisms (BstU I and Msp I restriction fragmentlength polymorphisms (RFLPs) in exon 4 and intron 6 respectively,and a 16 bp duplication in intron 3) and their haplotype combinationswere studied in patients with colorectal cancer and comparedwith patients with ulcerative colitis and healthy controls.There were only minor differences between patients with ulcerativecolitis and controls, the only significant difference was observedin the distribution of BstU I-Msp I haplotypes. When singlepolymorphisms were studied, a significantly lower frequencyof the 16 bp duplication was found in patients with colorectalcancer. The protective effect of the 16 bp duplication was morepronounced in haplotype combinations with the BstU I Al andMsp I Al alleles, whereas these alleles in combination withthe 16 bp Al allele (no duplication) were associated with anincreased risk for colorectal cancer. The genotypic combinationBstU I 2–1, 16 bp 1–1, Msp I 2–1 was foundin 8.4% of cases among patients with colorectal cancer and 0.5%of cases in the controls (odds ratio = 18.8). The extended haplotyperesponsible for the high cancer risk of this genotype appearsto be BstU I Al-16 bp Al-Msp I Al. The results of this studyindicate that the haplotype approach to the identification ofp53 germ line alleles associated with increased susceptibilityto cancer is far more powerful than the analysis of single polymorphisms,since the capacity to identify germ line alleles predisposingto cancer should increase with the number of polymorphic sitesincluded in the analysis.     

p53缺失和突变对人肺癌细胞系恶性表型影响的比较

目的 比较研究外源正义和反义p53对所转染细胞系恶性表型的影响。方法 构建正义和反义p53cDNA真核细胞表达载体pEGFP-p53(RS)和pEGFP-p53(AS)。用Lipofectin介导转染801D细胞。PCR检测外源p53和neo基因，荧光显微镜检查转染细胞绿荧光蛋白，免疫组化染色检测突变蛋白表达。比较pEGFP-p53(AS)-801D和pEGFP-p53(RS)-801D的集落形成试验和裸鼠移植试验，用流式细胞术分析细胞周期。结果 PCR检测出外源p53和neo基因存在于细胞，细胞可见绿色荧光，免疫组化检测示pEGFP-p53(AS)-801D突变蛋白呈阴性，母系为阳性，表明反义p53能封闭突变p53蛋白表达，pEGFP-p53（RS）-801D和pEGFP-p53(AS)801D细胞集落形成率和裸鼠移植成瘤性均降低，pEGFP-p53(RS)-801D更为明显。pEGFP-p53(AS)-801D细胞周期阻滞于G1期。结论 在同一细胞背景下，p53缺失比p53突变对恶性增殖起更重要的作用。外源野生型p53在肿瘤细胞中可恢复重建其功能，外源反义p53可封闭突变蛋白表达，阻止细胞停留于G1期。     

p53反义RNA对人肺癌细胞表型和顺铂敏感性的影响

目的 研究外源p53反义RNA对有p53基因248密码点突变的人肺癌细胞系恶性表型和顺铂敏感性的影响。方法 构建p53反义RNA真核细胞表达载体PEGFP－p53（AS),经酶切图证明反向联结质粒。Lipofectin介导转染有p53基因248密码点突变的人肺癌细胞系801D，经G418筛选获耐受克隆。稀释法建立单细胞克隆系，应用PCR检测外源基因，荧光显微镜检测细胞绿色荧光蛋白表达，p53单抗免疫组化染色检测p53突变蛋白表达，体外集落形成实验检测细胞生长，流式细胞仪检测细胞周期，MTT法检测细胞对顺铂药物敏感性。结果 酶切图证明了p53-cDNA反向联结于质粒，构建了PEGFP－p53(AS),并建立了转染单细胞克隆系PEGFP－p53(AS)-801D及空载细胞系PEGFP－801D。PCR检测外源p53基因和neo基因存在于转染细胞系，而荧光显微镜下发现其胞浆有绿荧光蛋白表达。免疫组化染色p53突变蛋白在801D细胞系为阳性，而PEGFP－p53(AS)-801D为阴性，证明外源反义p53在转染细胞稳定表达并封闭内源突变蛋白表达。与母系相比，PEGFP－p53(AS)-801D集落形成抑制率为61％（P＜0．01），流式细胞检测该细胞系G1期细胞数明显增中，出现G1期阻滞的表现。MTT检测PEGFP－p53(AS）－801D对顺铂比母系更为敏感。结论 有p53基因248密码点突变的801D细胞恶性增殖明显，对顺铂耐药，外源p53反义RNA可封闭突变蛋白表达，抑制细胞体外恶性增殖，增加对顺铂的药物敏感性。转染p53反义RNA可抑制p53突变的恶性表型或恢复野生型p53基因功能。     

Prevalence of TP53 germ line mutations in young Pakistani breast cancer patients

Women from Pakistan and India are more often diagnosed with early-onset breast cancer than Caucasian women. Given that only 12% of Pakistani women diagnosed with breast cancer at or before 30 years of age have previously been shown to harbor germ line mutations in the breast cancer susceptibility genes BRCA1 and BRCA2, the genetic causes of the majority of early-onset cases are unexplained. Since germ line mutations in the tumor suppressor gene TP53 predispose women to early-onset breast cancer, we assessed the prevalence of TP53 mutations in 105 early-onset breast cancer patients from Pakistan, who had previously been found to be negative for BRCA1 and BRCA2 germ line mutations. The patient group included 67 women diagnosed with early-onset breast cancer at or before age 30 with no family history of breast or ovarian cancer (EO30NFH group) and 38 women diagnosed with breast cancer at or before age 40 with one or more first- or second-degree relatives with breast or ovarian cancer (EO40FH group). Mutation analysis of the complete TP53 coding region was performed using denaturing high-performance liquid chromatography analysis, followed by DNA sequencing of variant fragments. One deleterious mutation, c.499-500delCA in exon 5, was identified in the 105 breast cancer patients (1%). This mutation is novel in the germ line and has not been described in other populations. It was detected in a 28-year-old patient with no family history of breast or ovarian cancer. This mutation is rare as it was not detected in additional 157 recently recruited non-BRCA1 and non-BRCA2-associated early-onset breast cancer patients. Our findings show that TP53 mutations may account for a minimal portion of early-onset breast cancer in Pakistan.     

p53 polymorphism influences response in cancer chemotherapy via modulation of p73-dependent apoptosis

Intact p73 function is shown to be an important determinant of cellular sensitivity to anticancer agents. Inhibition of p73 function by dominant-negative proteins or by mutant p53 abrogates apoptosis and cytotoxicity induced by these agents. A polymorphism encoding either arginine (72R) or proline (72P) at codon 72 of p53 influences inhibition of p73 by a range of p53 mutants identified in squamous cancers. Clinical response following cisplatin-based chemo-radiotherapy for advanced head and neck cancer is influenced by this polymorphism, cancers expressing 72R mutants having lower response rates than those expressing 72P mutants. Polymorphism in p53 may influence individual responsiveness to cancer therapy.     

Analysis of a germ line polymorphism of the p53 gene in lung cancer patients; discrete results with smoking history

The p53 tumor suppresser gene is often mutated in various humancancers and a common polymorphism is known at codon 72 of exon4, with two alleles encoding either arginine (CGC) or proline(CCC). Association of this polymorphism with any human cancersusceptibility has yet to be clarified. We have conducted acase—control study in Japan on the distribution of thethree genotypes with 191 lung cancer patients, 152 control patientswith non-cancerous pulmonary diseases and 115 colorectal cancerpatients. The genotypes were examined by PCR using DNA samplesfrom peripheral blood lymphocytes. Frequency distributions ofthe three genotypes were quite comparable with each other amonggroups, with allelic frequencies of