Prognostic significance of Aurora-A expression in human bladder cancer

Aurora-A is an oncogenic serine/threonine kinase, which plays important roles in tumorigenesis, development and chemoresistance of human cancers. The aim of the study was to detect the expression of Aurora-A gene in bladder cancer tissues and analyze its association with prognosis of bladder cancer patients. RT-PCR was performed to detect the expression of Aurora-A mRNA in 20 cases of bladder cancer and corresponding non-tumor tissue samples. Immunohistochemistry was performed to detect the localization of Aurora-A protein in 96 cases of bladder cancer tissue samples. Associations between Aurora-A protein expression and clinico-pathological factors or survival of bladder cancer patients were statistically analyzed. It was found that the expression levels of Aurora-A mRNA in bladder cancer tissues (1.08 ± 0.24) were significantly higher than those in corresponding non-tumor tissues (0.22 ± 0.07; P < 0.01). Moreover, immunohistochemical staining results showed the localization of Aurora-A protein to be mainly located in the cytoplasm of bladder cancer cells. High levels of Aurora-A protein expression were correlated with pathological stage (P = 0.007), lymph node metastasis (P = 0.014) and venous invasion (P = 0.008), but not with other factors including age, gender, tumor grade and recurrence of superficial cancer. Patients with high expression levels of Aurora-A protein showed lower disease-free and overall survival rates than those with low expression levels (P = 0.0072 and 0.0009, respectively). Univariate and multivariate analysis of prognostic factors in bladder cancer patients indicated that Aurora-A expression was an independent unfavorable prognostic factor (hazard ratio: 0.673; 95% confidence interval: 0.388-0.912; P < 0.001). Our study suggests that overexpression of Aurora-A gene may play an important role in the progression of bladder cancer and that Aurora-A expression is an independent factor for predicting the prognosis of bladder cancer in patients.     

Prognostic significance of HOXD13 expression in human breast cancer

Homeobox protein Hox-D13 has been recognized as a tumor suppressor in pancreatic cancer. To evaluate the function of HOXD13 in invasive breast cancer pathogenesis, we examined HOXD13 expression in 434 breast cancer tissues and 230 their counterpart normal breast tissues by immunohistochemistry using a tissue microarray (TMA). The association between HOXD13 expression and clinicopathological factors was analyzed by use of Chi-square test. Kaplan-Meier survival curves and log-rank tests were applied to analyze the survival status. Cox regression was applied for multivariate analysis of prognosis. We found that low HOXD13 expression accounts for 84.3% in breast cancer tissues. Low HOXD13 expression was significantly associated with large tumor size (P=0.038) and positive lymph node metastasis (LNM) (P=0.026). In Kaplan-Meier survival curves and log-rank tests, the patients with HOXD13-negative breast cancer showed significantly poorer outcomes (69.867 ± 1.058 months) in terms of overall survival (OS) than positive-HOXD13-expression patients (76.248 ± 1.069 months) (P=0.003). And in multivariate analysis, low level of HOXD13 expression was a significant unfavorable prognostic factor. So we conclude that down-regulation of HOXD13 might be a potentially useful prognostic marker for patients with breast cancer.     

Prognostic significance of SOX-1 expression in human hepatocelluar cancer

Sex-determining region Y (SRY)-box 1 (SOX1) as a member of the SOX gene superfamily is reported to function as a tumor suppressor in hepatocelluar cancer (HCC). However, the clinicopathological and prognostic significance of SOX-1 expression in HCC is unclear. First, semi-quantitative RT-PCR and Western blot assays were performed to detect the expression of SOX-1 mRNA and protein in 15 paired of HCC tissues and corresponding nontumor tissues. Next, immunohistochemistry was performed to detect SOX-1 protein expression in another 96 cases of HCC tissues, and analyze its correlation with clincopathological factors of patients. Finally, the survival was evaluated by the Kaplan-Meier method and proportional hazards model. Results showed that the expression levels of SOX-1 mRNA and protein in HCC tissues were significantly lower than that in the corresponding nontumor tissues. Statistical analyses indicated that low SOX-1 expression was significantly correlated with higher incidence of venous or lymphatic invasion and advanced TNM stage. Also, patients with high SOX-1 expression showed better overall survival than those with low SOX-1 expression, and multivariate analysis with the Cox proportional hazards indicated that status of SOX-1 expression might be an independent prognostic factor in HCC patients. Collectively, our results indicated that downregulation of SOX-1 was correlated with poor prognosis and tumor development in HCC.     

Prognostic and predictive markers in cancer

The elucidation of the human genome and advances in knowledge about molecular abnormalities, signaling pathways, influence of the local tissue milieu and the relevance of genetic polymorphisms offer hope of designing more effective, individualized cancer treatment plans. Although the scientific and medical literature is replete with reports of putative prognostic or predictive markers for cancer, few new diagnostics have been incorporated into routine clinical practice. Criteria are needed to a) identify markers that have the promise to be clinically useful; b) assess the best methodology for clinical evaluation of the markers in question and c) confirm or validate that using the marker adds useful information compared to using standard prognostic factors alone. This review presents a methodology for the clinical evaluation of putative prognostic and predictive markers in cancer, with considerations of pitfalls in the early evaluation, rationale for development and optimization of assay methodology, and examples of possible clinical trials for assessing the clinical utility of putative markers.     

Prognostic significance of angiogenesis in gastrointestinal stromal tumor.

Angiogenesis is important in the growth and metastasis of various kinds of solid tumors. To investigate the potential role of angiogenesis in gastrointestinal stromal tumor (GIST), an immunohistochemical analysis was performed in 95 cases of GISTs for microvessel density (MVD) and vascular endothelial growth factor (VEGF) expression. MVD was evaluated with immunohistochemical staining for CD31. A high level of MVD was significantly correlated with overexpression of VEGF, tumor location (intestine>stomach), tumor size (> or =5 cm), tumor grade (high>intermediate>low grade) (P=<0.0001, 0.0422, 0.0006, 0.0359, respectively). Of the 70 GISTs analyzed, KIT exon 11 mutations were detected in 45 cases (64.3%) and KIT exon 9 mutations in two cases (2.9%). No mutations were found in KIT exons 13 and 17, and platelet-derived growth factor receptor-alpha exons 12 and 18. Interestingly, VEGF expression level was significantly higher in the non-KIT exon 11 mutant group than in the KIT exon 11 mutant group (P=0.0266). In univariate analysis, tumor grade (high grade), tumor size (> or =5 cm), mitotic count (> or =5/50 high-power fields), Ki-67 labeling index (> or =4.6%), MVD (> or =7.0/0.95 mm(2)) and VEGF expression (high) were significantly associated with a shorter period of disease-free survival (P=<0.0001, 0.0199, 0.0055 0.0027, 0.0028 and 0.0302, respectively). In multivariate analysis, tumor grade and MVD were identified as independent worse prognostic factors (P=0.0007, 0.0152, respectively). In conclusion, our results suggest that the evaluation of MVD and VEGF expression is useful for predicting the aggressive biologic behavior of GIST, and that angiogenesis associated with VEGF may play an important role, at least in part, in the progression of GIST.     

Prognostic significance of MCM6 expression in gastrointestinal stromal tumor

Minichromosome maintenance (MCM) proteins are essential for the initiation of DNA replication and they are prognostic markers in various human cancers. The aim of this study was to investigate the role of the MCM6 protein in gastrointestinal stromal tumor (GIST) and its clinical and prognostic significance. We evaluated MCM6 expression in 211 GIST samples using immunohistochemistry. We used the receiver operating characteristic curve (ROC) to identify optimal cut-off values. High MCM6 expression was associated with tumor size, mitosis, tumor necrosis, presence of recurrence/metastasis, and the National Institute of Health (NIH) and Armed Forces Institute of Pathology (AFIP) malignant risk criteria. Patients with high MCM6 expression had significantly shorter overall survival (OS) and disease-free survival (DFS) than those with low MCM6 expression. Univariate analysis indicated that tumor size, mitosis, AFIP and NIH malignant risk criteria, and high MCM6 expression were significantly associated with poor OS and DFS. High MCM6 expression and high-risk group categorization based on the NIH criteria were independent prognostic factors for OS and DFS. High MCM6 expression is significantly associated with tumor progression and aggressiveness and is an independent factor for shorter survival in GIST patients. MCM6 expression could be a predictive biomarker for tumor aggressiveness as well as a treatment target.     

Prognostic significance of RIN1 gene expression in human non-small cell lung cancer

Ras interaction/interference 1 (RIN1), originally identified as a Ras effector protein, has been implicated in tumorigenesis and development of human cancers. The aim of this study was to detect RIN1 expression in human non-small cell lung cancer (NSCLC) and to analyze its association with prognosis of NSCLC patients. Quantitative real-time RT-PCR was performed to examine the expression of RIN1 mRNA in 25 cases of NSCLC and corresponding non-tumor tissue samples. Immunohistochemistry was performed to detect the expression of RIN1 in 90 NSCLC tissues. We found that the expression levels of RIN1 mRNA in NSCLC tissues were significantly higher than those in corresponding non-tumor tissues. High-level RIN1 expression was observed in 53.3% (48 of 90 cases), and correlated with poor tumor differentiation (P = 0.024), TNM stage (P = 0.032), and lymph node metastasis (P = 0.018). Patients with high expression levels of RIN1 showed lower overall survival rate than those with low expression levels (P = 0.033). Multivariate analysis showed that high RIN1 protein expression was an independent prognostic factor for NSCLC patients (P = 0.021). Our study suggests that over-expression of RIN1 may play an important role in the progression of NSCLC and RIN1 expression may offer a valuable marker for predicting the outcome of patients with NSCLC.     

Prognostic and predictive molecular markers in DCIS: a review

Eighteen percent of all new breast cancers detected on screening mammography are ductal carcinoma in situ (DCIS), a preinvasive lesion that is highly curable. However, some women with DCIS will develop life-threatening invasive breast cancer. Because the determinants of invasive recurrence are unknown, all women with DCIS require the same treatment (usually with surgery and radiation). Therefore, there is a need to identify biologic markers and create a profile that will provide prognostic information that is more accurate than the currently used van Nuys Index to predict invasive recurrence. In the present review, we examined the many biologic markers studied in breast cancer, describe their main biologic role and their expression in DCIS, and review the various studies regarding their ability to serve as prognostic factors in breast cancer with an emphasis on predicting invasive recurrence in patients with DCIS. This review covers established markers, namely, ER, PR and HER2/neu, that are used routinely to make treatment decisions as well as investigative biologic factors involved in cell proliferation, cell cycle regulation, extracellular molecules, factors involved in extracellular matrix degradation, and angiogenesis. However, controversies exist regarding the value of these prognostic factors, their interrelationship, and their advantages over morphologic evaluation.     

胃肠道钙化性纤维性肿瘤分子标志物的研究进展

钙化性纤维性肿瘤(calcifying fibrous tumor,CFT)是一种罕见的良性病变,其临床表现、影像学检查等不具有特异性.发生于胃肠道的CFT,易与其他胃肠道间叶源性肿瘤混淆,如胃肠道间质瘤(gastrointestinal stromal tumor,GIST)和炎性肌纤维母细胞瘤(inflammatory myofibroblastic tumor,IMT),在临床诊断时需进行分子标志物检测才可鉴别.CFT发病原因不明.近年来,越来越多的学者认为胃肠道CFT与IgG4相关性疾病(IgG4-RD)有关.     

Prognostic significance of cytokeratin-positive breast cancer metastases

The most important discriminant in staging carcinoma of the breast is the presence of positive axillary lymph nodes. In this study, we determined if 45 female breast cancer patients originally classified as lymph node-negative by standard light microscopy (SLM) could be more accurately classified by immunohistochemical (IH) examination of their lymph nodes with an anticytokeratin monoclonal antibody cocktail. Identical sections of lymph nodes were sequentially examined by SLM and IH. Eight nodes (1%) in a total of five patients (11%) were positive by SLM. In comparison, 12 nodes (1.5%) in a total of nine patients (20%) were positive by IH. Five nodes were positive by IH and negative by SLM. There was no correlation between IH-detected metastases and tumor size or patient age. The survival curve for patients with IH-detected metastases was significantly worse than that of patients without IH-detected metastases. IH detection methods may be an important adjunct in staging breast cancer patients.     

Metallothionein in human gastrointestinal cancer

Metallothionein (MT) is a small thiol-rich metalloprotein with antioxidant properties, involved in tumour pathophysiology and therapy resistance. In order to assess the contribution of MT in gastrointestinal carcinogenesis, this study examined both the MT content by radioimmunoassay and the MT localization by immunohistochemistry in pairs of neoplastic and normal-appearing human gastrointestinal tissues. In addition, the relationship between MT expression and major clinicopathological parameters was assessed. The MT concentration of gastric carcinomas and of colorectal adenomas, carcinomas, and liver metastases was found to be significantly lower than that of corresponding normal-appearing tissue. A relatively high MT content, however, was found to be associated with the villous character of colorectal adenomas and with the Dukes' stage of colorectal carcinomas, indicating a relationship between MT level and malignant potential. Immunohistochemical evaluation showed a fairly good correlation with these quantitative data. MT was found to be expressed at a low level and in a patchy pattern in the gastrointestinal neoplastic and metastatic tissues, whereas in normal-appearing gastrointestinal mucosa MT was uniformly distributed in the cytoplasm and/or nucleus of apical cells. Although in the gastric cancer patients no association was found between the MT concentration and the clinicopathological parameters, the strong MT expression in areas with intestinal metaplasia, known to have neoplastic potential, further points to a relationship between this antioxidant metalloprotein and the malignant character of cells. Gastrointestinal neoplasms are apparently accompanied by a low level and decreased expression of MT, but those with a relatively high level seem to have an increased malignant potential. Further studies will be required to determine the clinical relevance of these observations.     

Prognostic significance of morphologic and cytochemical markers in adult acute leukemia.

Survival times in 100 cases of acute leukemia (74 granulocytic, 14 lymphocytic, and 12 undifferentiated) were correlated with classic morphologic and cytochemical criteria. The 14 patients who had lymphocytic leukemia had significantly longer survival compared with the two other groups. Undifferentiated leukemias had a shorter survival time than granulocytic leukemias. Several subclasses of granulocytic leukemias were formed according to the presence or absence of Auer rods and the percentage of peroxidase-positive blasts. Neither of these two features significantly influenced the survival of these patients. In the lymphocytic leukemia group, PAS-positive and negative leukemias had similar survival expectancies. It is concluded that division into lymphocytic and nonlymphocytic leukemias is still helpful in predicting survival times of patients who have acute leukemia, but that further subclassification of these groups based on the presence or absence of Auer rods and the percentages of peroxidase-positive blasts is of no additional benefit.     

Prognostic significance of glucose-related protein 94 in colorectal cancer

AimsThe expression of glucose-related protein 94 (GRP94), a member of the heat shock protein 90 family, was correlated with a variety of clinicopathological factors and patient survival in a large colorectal cancer (CRC) cohort. We aimed to elucidate the role of GRP94 in the prognosis of CRC patients.MethodsTissue microarray blocks were generated from 709 CRC samples and immunohistochemically stained for GRP94.ResultsOf the 709 tumours, 164 (23.1%) and 545 (76.9%) were classified in the low and high expression groups, respectively. GRP94 expression was high in CRC cases with larger tumours (p = 0.005) and advanced pT stage (p = 0.021). GRP94 expression was higher in females than males (p = 0.024). In univariate and multivariate survival analyses, high GRP94 expression was unexpectedly associated with better overall survival in CRC patients younger than 65 years of age (p = 0.001)ConclusionOur conflicting results indicate that GRP94 has the ability to switch between oncogenic and tumour-suppressive roles depending on the conditions and microenvironment of the tumour cells. Furthermore, GRP94 could be a candidate biomarker to predict better prognosis in CRC patients.