Alterations of the retinoblastoma gene in metastatic breast cancer

Germline mutations affecting the retinoblastoma gene (RB1) predispose to inherited retinoblastomas but also other malignancies, including breast cancer. While somatic RB1 mutations have been detected in different malignancies, information about the potential role of RB1 mutations in breast cancer is limited. Recently, we discovered RB1 mutations to be associated with resistance to anthracyclines/mitomycin in primary breast cancer. The present work is the first report evaluating RB1 mutation and epigenetic status in metastatic breast cancer. Among 148 breast cancer samples analyzed by MLPA, four samples harbored intragenic deletions/duplications: Thus, exons 1–2 were deleted in two tumors and exons 21–23 in one tumor, while one sample harbored duplication of exons 18–23. The entire RB1 gene was duplicated in two tumors and multiple amplifications were revealed in one sample. Reduced copy number was observed in 17 samples (11.5%). No point mutation or promoter hypermethylation was discovered (n = 38 and 114 tumors analyzed, respectively). Interestingly, among seven tumors expressing lack of response to epirubicin, two samples harbored alterations in RB1, contrasting none out of 16 tumors with stable disease or an objective response (P = 0.08). In summary, the frequency of RB1 alterations in metastatic lesions was not increased when compared to primary breast cancer, indicating that RB1 alterations do not play a major role in metastatic development. While a non-significant association suggesting RB1 alterations to be linked to therapy resistance was observed, our data do not suggest a major role for RB1 alterations explaining acquired drug resistance.     

侵袭性骨肿瘤中RB基因及其蛋白产物表达的研究

目的探讨抑癌基因ＲＢ的改变与骨肿瘤的关系。方法采用地高辛标记的ＲＢｃＤＮＡ探针对３４例侵袭性骨肿瘤组织及同体正常软组织进行ＳｏｕｔｈｅｒｎＢｌｏｔ检测，同时应用ＬＳＡＢ免疫组化法对９９例侵袭性骨肿瘤及１４例瘤旁软组织进行ＲＢ蛋白表达的检测。结果２１例骨肉瘤中有９例可检出ＲＢ基因的结构异常（４２．９％），ＲＢ蛋白的缺失仅在２６．９％（７／２６）的骨肉瘤和２１．７％（５／２３）的软骨肉瘤中检测到，良性的骨巨细胞瘤和软骨母细胞瘤中未检出ＲＢ蛋白的缺失，其二者差异有意义（Ｐ＜０．０５）；分化差、异型性明显的骨肉瘤细胞其ＲＢ蛋白表达为阴性，低分化的软骨肉瘤及间叶性软骨肉瘤其ＲＢ蛋白亦多为阴性。结论ＲＢ基因结构的异常、ＲＢ蛋白的缺失，可能与骨的恶性肿瘤的发生及其演进有关。     

Altered expression of the retinoblastoma gene product in human sarcomas

BACKGROUND. The retinoblastoma-susceptibility (Rb) gene is a prototype tumor-suppressor gene originally isolated from patients with heritable retinoblastoma. This gene encodes a nuclear phosphoprotein whose expression is altered in several types of human tumors. METHODS. We studied the expression of the Rb protein in 44 primary and 12 metastatic high-grade human sarcomas by means of immunohistochemical methods and Western blotting. Computerized image analysis was used to quantify the level of Rb gene product in individual tumor cells. The expression of the Rb gene was then correlated with clinical outcome in the patients with primary tumors. RESULTS. Of the 44 patients with primary sarcomas, 13 (30 percent) had tumors with normal, homogeneous expression of the Rb protein in essentially all tumor cells. Thirty-one patients with primary tumors (70 percent) had altered Rb expression; in 18 (40 percent) the Rb protein was heterogeneously expressed, and in 13 (30 percent) it was detected in fewer than 20 percent of the tumor cells. All 12 of the patients with metastatic sarcomas had altered expression of the Rb protein. When the findings in the patients with primary tumors were correlated with clinical outcome, survival was found to be significantly increased in the patients whose tumors had homogeneous Rb expression, as compared with those with either heterogeneous expression (P = 0.026) or no expression (P = 0.012). CONCLUSIONS. Tumors in which the expression of Rb gene product was decreased were more aggressive than tumors in which this protein was expressed by nearly all cells. The Rb gene product may be an important prognostic variable in patients with these tumors.     

Loss of retinoblastoma gene and amplification of N-myc gene in retinoblastoma.

We have analyzed paired samples of genomic DNA from peripheral leukocyte and primary tumor tissue from nine patients with retinoblastoma (RB) and from two RB cell lines, WERI-Rb-1 and Y79, to detect the molecular alterations of the retinoblastoma susceptibility gene (RB-1) and N-myc gene. In Southern analysis, RB-1 deletions in tumor tissues were detected in five patients (56%), one of these revealed a total loss of RB-1. N-myc amplification was found only in one (11.1%) out of nine patients. We also observed a total loss of RB-1 in WERI-Rb-1, and a more than 100-fold amplification of N-myc in Y79. The analysis of the relationship between molecular events and clinical characteristics such as age, sex, tumor laterality did not reveal any specific correlation. These results suggest that genetic backgrounds of RB in Korean patients are quite similar to those of reported cases elsewhere. The high sensitivity of our method in detecting the RB-1 loss indicates that this method can be a useful tool for initially screening a large number of tumors.     

Mucinous adenocarcinoma of the prostate

A case of mucinous adenocarcinoma of the prostate that was diagnosed with the aid of prostate-specific antigen immunoperoxidase staining is reported. Focal areas of the tumor, which were morphologically similar to the remainder of the tumor, stained with neuron-specific enolase by an immunoperoxidase technique and with the Grimelius stain. This tumor is best thought of as a variant of the classic acinotubular adenocarcinoma of the prostate with well-differentiated cells that secrete mucin, rather than as a completely different type of cancer, as proposed previously.     

Alterations of cell cycle regulators affecting the RB pathway in nonfamilial retinoblastoma

We undertook the present study to examine alterations affecting the RB pathway in the G1 checkpoint and to determine their potential clinical significance in children affected with nonfamilial retinoblastoma. Using immunohistochemistry, patterns of expression of pRB, p16/INK4A, and E2F1 were analyzed in tissue from a cohort of 86 well-characterized patients with nonfamilial retinoblastoma diagnosed at the "Instituto Nacional de Pediatria" in Mexico City. The relationship of these phenotypes to proliferative index was assessed by analysis of Ki67 antigen expression. pRB expression was found in 11 (13%) cases. Using a hypophosphorylated specific pRB antibody, we observed low levels of underphosphorylated pRB expression in only 1 of 9 evaluable positive cases. These data suggest that the detected pRB products were hyperphosphorylated and thus had decreased functional activity. Increased p16 nuclear expression was found in only 6 tumors. No tumors showed deletions or mobility shifts of the INK4A gene. Undetectable pRB levels were significantly associated with undetectable p16 expression (odds ratio, 10.8; 95% confidence interval, 1.4-81.3; P =.03). All tumors showed nuclear immunoreactivities for E2F1 and Ki67. Increased Ki67 proliferative index was associated with increased staining for E2F1 (r =.44; P =.008) and increasing clinical stage (P =.03). Among children with unilateral disease, the mean Ki67 proliferative index was significantly higher in children with advanced clinical disease (stages 3 and 4) (mean 81.25; SD 6.78) than in those with earlier stage disease (mean 69.50; SD 9.45) (P = 0.001). Among children with bilateral disease, however, the mean proliferative index was not significantly higher for children with advanced clinical stage. When examining all cases together, there was a significant trend toward increasing proliferative index with increasing clinical stage (P =.03). In unilateral tumors, we also found that presence of detectable pRB was associated with a lower percentage of cells expressing E2F1 (46.7% v 70.8%) (P = 0.05), whereas there was no association between presence of pRB and E2F1 among bilateral tumors. We have found that expression of some of the cell cycle markers examined varies according to laterality, suggesting underlying differences in the capacity for cell cycle regulation between these 2 forms of the disease. Differences in capacities for cell cycle regulation may account for some differences in clinical behavior. Thus, the inclusion of molecular markers may become useful adjuncts to clinicopathological staging and subsequent determination of therapy.     

Effects of the immunomodulator PSK on growth of human prostate adenocarcinoma in immunodeficient mice

Tumor growth alterations were studied using an immunomodulator, PSK. Four human prostate tumor lines were grown in two types of immunodeficient mice. Two of the lines were selected because they are able to metastasize to lungs in host animals. Outbred NIH Swiss athymic mice having normal natural killer cells and athymic Beige mice deficient in natural killer cells were used as animal hosts. PSK treatment was given to tumor-bearing hosts to some animals soon after solid tumors were injected and to others after solid tumors were well-established. Low dose cyclophosphamide was given to some animals to decrease host natural killer cells and polyinosinic-polycytidylic acid (poly I:C) was given to other animals to increase natural killer cell activity. Measurement of tumor doubling times, host survival and metastatic capabilities showed that either poly I:C or PSK treatment in NIH Swiss animals soon after tumor cells were injected significantly increased tumor doubling times and host survival and decreased the incidence and number of metastatic lung lesions. Two of the tumor lines incapable of metastasizing in NIH Swiss mice were metastatic in the Beige athymic, natural killer-cell-deficient animals.     

视网膜母细胞瘤基因对人骨肉瘤细胞株OS732的影响

目的 观察外源性N端截短的视网膜母细胞瘤（Rb)基因对骨肉瘤细胞株OS732的生长和细胞间缝隙连接信息通讯能力的影响。方法 构建N端截短的长度为1.65kb Rb基因的真核表达质粒,并用DOTAP将其导入骨肉瘤细胞株OS732。应用逆转录－聚合酶链反应（RT－PCR）和Northern blot检测Rb基因的表达;用细胞计数,流式细胞仪分析和软琼脂克隆形成试验观察OS732细胞的生成状况;用半定量RT－PCR法和罗氏黄荧光传输法检测细胞间缝隙连接信息通讯的能力。结果 转染N端截短的Rb基因后,OS732细胞内可检测到内源性和外源性Rb基因的mRNA表达。OS732细胞的形态发生改变,其生长速度减慢,软琼脂形成集落能力降低,细胞周期阻滞于G0－G1期;缝隙连接蛋白基因Gonnexin43的表达和细胞信息通讯能力增强。结论 N端截短的Rb基因可抑制骨肉瘤细胞株OS732的恶性生长表型以及增强细胞间信息通讯能力。     

Oncogenic point mutations in the human retinoblastoma gene: their application to genetic counseling

Mutations of the retinoblastoma gene, most of which cannot be detected by conventional Southern blotting, are known to cause both the nonhereditary and hereditary forms of retinoblastoma and have been implicated in the development of other cancers. Nonhereditary retinoblastoma is caused by a somatic mutation. Hereditary retinoblastoma is caused by a germ-cell mutation, most often a new one, and thus there is usually no family history of the disease. Unlike patients with the nonhereditary disease, those with the hereditary form are at risk for additional retinoblastomas, and their progeny are at risk for the tumors. We used a sensitive technique of primer-directed enzymatic amplification, followed by DNA sequence analysis, to identify mutations as small as a single nucleotide change in tumors from seven patients with simplex retinoblastoma (with no family history of the disease). In four patients the mutation involved only the tumor cells, and in three it involved normal somatic cells as well as tumor cells but was not found in either parent; thus, these mutations appeared to be new, germ-cell mutations. In addition, we found point mutations in cells from a bladder carcinoma, a small-cell carcinoma of the lung, and another retinoblastoma. We conclude that the technique that we have described can distinguish hereditary from nonhereditary retinoblastoma and that it is useful in risk estimation and genetic counseling.     

Microsatellite instability in adenocarcinoma of the prostate.

Instability of dinucleotide tandem repeat sequences has been reported to play a major role in the carcinogenic pathway of familial colon cancer, as well as a potential role in the carcinogenesis of other sporadic neoplasms. To determine the frequency of short tandem repeat instability in adenocarcinoma of the prostate, we studied 40 tumors that were stratified according to tumor grade. The tissue samples were screened with di-, tri- and tetranucleotide markers spanning a wide range of chromosomal loci, including an androgen receptor gene trinucleotide repeat. Microsatellite instability was observed overall in only one of the 40 (2.5%) prostate adenocarcinomas studied. This replication error-positive tumor demonstrated repeat length alterations at two loci. Five other tumors showed an alteration in microsatellite size at a single locus. These tumors were not considered to have the microsatellite instability phenotype. All changes were identified either within tetranucleotide sequences or within the androgen receptor gene repeat (4 or 20 total markers analyzed). Both repeat length expansions and contractions were identified. The replication error-positive case also included separate metastatic nodal tissue. Additional microsatellite analysis of the metastatic tumor tissue revealed allelic patterns identical with the normal tissue control. Our data indicate that microsatellite instability is rare in prostate adenocarcinoma. Therefore, observation of this low replication error frequency suggests that most prostate carcinomas develop in the absence of widespread accumulation of somatic mutations in short tandem repeat sequences. Additionally, these genetic alterations appear to occur more often in tetranucleotide repeat sequences as well as in an androgen receptor gene trinucleotide repeat.     

Diagnosis of limited adenocarcinoma of the prostate

This article provides an overview of the diagnosis of limited prostate cancer on needle biopsy. A few of the more common mimickers of prostate cancer, such as adenosis, partial atrophy, and high-grade prostatic intraepithelial neoplasia, are also covered. A systematic approach to diagnosing prostate cancer by evaluating architectural, nuclear, intraluminal and ancillary features is presented. The use of immunohistochemistry, including its pitfalls and limitations, is described and illustrated. By the use of a systematic diagnostic approach as outlined in this article, the threshold for diagnosing limited carcinoma of the prostate can be decreased. If a pathologist is not comfortable in diagnosing carcinoma in a particular small focus, this review will help them to recognize these foci as atypical and suspicious for carcinoma, so that further workup might lead to a more definitive diagnosis. Some of the more common situations leading to an atypical diagnosis have also been presented to help prevent the overdiagnosis of prostatic malignancy.     

Pleiotropic effects of the gene for retinoblastoma

Vigorous treatment of retinoblastoma in the last 30 years has resulted in a large population of survivors with useful vision, in which the late effects of genetically associated tumours can be seen. An increase in second primary tumours, mainly osteogenic sarcoma, has been found in those children who carry the germinal mutations, and not in the majority of survivors of unilateral disease. The findings indicate a pleiotropic effect of the retinoblastoma gene which may act as an initiator in two forms of neoplasia.     

前列腺基底细胞腺癌

目的：探讨前列腺基底细胞腺癌和腺瘤诊断和鉴别诊断标准。方法：对基底细胞腺瘤３例,基底细胞腺瘤１例,复习其临床和病理资料及进行随访。再次常规切片ＨＥ染色和采用ＬＳＡＢ法,对ＰＳＡ、ＰＡＰ、ＣＫ、ＣＥＡ、ＰＣＮＡ、ｂｃｌ－２、ｐ５３和ｃ－ｅｒｂＢ－２８种抗体标记结果进行观察。结果：前列腺基底细胞腺癌为分化差的帝体癌在底细胞癌样排列,核分裂象多,癌巢中央伴坏死,可见局灶性鳞状细胞,移行细胞或腺管分化,