The role of tandem duplicator phenotype in tumour evolution in high-grade serous ovarian cancer

High-grade serous ovarian carcinoma (HGSOC) is characterized by genomic instability, ubiquitous TP53 loss, and frequent development of platinum resistance. Loss of homologous recombination (HR) is a mutator phenotype present in 50% of HGSOCs and confers hypersensitivity to platinum treatment. We asked which other mutator phenotypes are present in HGSOC and how they drive the emergence of platinum resistance. We performed whole-genome paired-end sequencing on a model of two HGSOC cases, each consisting of a pair of cell lines established before and after clinical resistance emerged, to describe their structural variants (SVs) and to infer their ancestral genomes as the SVs present within each pair. The first case (PEO1/PEO4), with HR deficiency, acquired translocations and small deletions through its early evolution, but a revertant BRCA2 mutation restoring HR function in the resistant lineage re-stabilized its genome and reduced platinum sensitivity. The second case (PEO14/PEO23) had 216 tandem duplications and did not show evidence of HR or mismatch repair deficiency. By comparing the cell lines to the tissues from which they originated, we showed that the tandem duplicator mutator phenotype arose early in progression in vivo and persisted throughout evolution in vivo and in vitro, which may have enabled continual evolution. From the analysis of SNP array data from 454 HGSOC cases in The Cancer Genome Atlas series, we estimate that 12.8% of cases show patterns of aberrations similar to the tandem duplicator, and this phenotype is mutually exclusive with BRCA1/2 carrier mutations.     

Genetic intra-tumour heterogeneity in epithelial ovarian cancer and its implications for molecular diagnosis of tumours

Genetic analysis of solid tumours using DNA or cDNA expression microarrays may enable individualized treatment based on the profiles of genetic changes that are identified from each patient. This could result in better response to adjuvant chemotherapy and, consequently, improved clinical outcome. So far, most research studies that have tested the efficacy of such an approach have sampled only single areas of neoplastic tissue from tumours; this assumes that the genetic profile within solid tumours is homogeneous throughout. The aim of this study was to evaluate the extent of genetic intra-tumour heterogeneity (ITH) within a series of epithelial ovarian cancers. Several different regions (five to eight regions) of tumour tissue from 16 grade 3, serous epithelial ovarian cancers were analysed for genetic alterations using a combination of microsatellite analysis and single nucleotide polymorphism (SNP) analysis, in order to establish the extent of ITH. Maximum parsimony tree analysis was applied to the genetic data from each tumour to evaluate the clonal relationship between different regions within tumours. Extensive ITH was identified within all ovarian cancers using both microsatellite and SNP analysis. Evolutionary analysis of microsatellite data suggested that the origin of all tumours was monoclonal, but that subsequent clonal divergence created mixed populations of genetically distinct cells within the tumour. SNP analysis suggested that ITH was not restricted to random genetic changes, but affected genes that have an important functional role in ovarian cancer development. The frequent occurrence of ITH within epithelial ovarian cancers may have implications for the interpretation of genetic data generated from emerging technologies such as DNA and mRNA expression microarrays, and their use in the clinical management of patients with ovarian cancer. The basis of genetic ITH and the possible implications for molecular approaches to clinical diagnosis of ovarian cancers may apply to other tumour types.     

The clonal relationships between pre‐cancer and cancer revealed by ultra‐deep sequencing

The study of the relationships between pre‐cancer and cancer and identification of early driver mutations is becoming increasingly important as the value of molecular markers of early disease and personalised drug targets is recognized, especially now the extent of clonal heterogeneity in fully invasive disease is being realized. It has been assumed that pre‐cancerous lesions exhibit a fairly passive progression to invasive disease; the degree to which they, too, are heterogeneous is unknown. We performed ultra‐deep sequencing of thousands of selected mutations, together with copy number analysis, from multiple, matched pre‐invasive lesions, primary tumours and metastases from five patients with oral cancer, some with multiple primary tumours presenting either synchronously or metachronously, totalling 75 samples. This allowed the clonal relationships between the samples to be observed for each patient. We expose for the first time the unexpected variety and complexity of the relationships between this group of oral dysplasias and their associated carcinomas and, ultimately, the diversity of processes by which tumours are initiated, spread and metastasize. Instead of a series of genomic precursors of their adjacent invasive disease, we have shown dysplasia to be a distinct dynamic entity, refuting the belief that pre‐cancer and invasive tumours with a close spatial relationship always have linearly related genomes. We show that oral pre‐cancer exhibits considerable subclonal heterogeneity in its own right, that mutational changes in pre‐cancer do not predict the onset of invasion, and that the genomic pathway to invasion is neither unified nor predictable. Sequence data from this study have been deposited in the European Nucleotide Archive, Accession No. PRJEB6588. Copyright © 2015 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.     

Rhabdoid tumour of the bladder: a histological, ultrastructural and immunohistochemical study

A rapidly fatal bladder tumour which had the features of a rhabdoid tumour was studied by sequential biopsies and at autopsy. This is the first rhabdoid tumour recorded at this site and the first in which there was co-existent transitional cell carcinoma. The possibility that rhabdoid tumour is histogenetically heterogeneous is discussed.     

磁靶向定位灌注化疗膀胱癌磁性吡柔比星纳米粒的制备与评价

目的构建一种新型的磁靶向定位灌注化疗膀胱癌的吡柔比星纳米制剂,并探讨其磁靶向定位及抗膀胱癌细胞特性,为定位灌注化疗膀胱癌的临床应用提供帮助。方法通过N-N'-羰基二咪唑(CDI)交联剂将治疗膀胱癌的临床药物吡柔比星(pirarubicin,THP)连接在表面氨基化的四氧化三铁(Fe3O4)磁性纳米粒上,制备具有磁性的THP纳米制剂,并在体外考察其磁定位性能和对膀胱癌细胞的抑制作用。结果 THP成功地连接到了粒径40 nm左右的Fe3O4磁性纳米粒上,磁性药物制剂在不同p H值的缓冲液中药物在90%以上,并可在外界磁场作用下定位于靶向部位。对膀胱癌细胞可造成THP和Fe3O4双重抑制效果,抑制率高达58.44%。结论该纳米制剂可通过外界磁场定位于靶向部位,膀胱癌细胞抑制效果明显,为临床定位灌注化疗的应用奠定了基础。     

Bench to bedside: recent advances in lung cancer pathological research with implications for diagnostic clinical practice

After decades of relative stagnation lung cancer is emerging as a disease type where rapid progress is being made in diagnosis and therapy, as well as in our understanding of disease biology. Much of this progress is of immediate impact to diagnosticians, and more is likely to affect diagnostic practice in the near future. In this review we seek to briefly summarize several key areas of active research of immediate or probable imminent value to trainee and consultant pulmonary pathologists alike. We cover some major changes in tumour classification, grading, and patient stratification, as well as considering the state of the art in machine-assisted interpretation of lung cancer histology, and the use of genetically modified lung cancer models.     

靶向沉默膀胱癌T24细胞系VEGF对树突状细胞分化成熟及免疫功能的影响

目的观察靶向沉默膀胱癌T24细胞系VEGF对树突状细胞(DC)分化成熟及免疫功能的影响。方法构建VEGF慢病毒干扰载体LV-VEGFA-RNAi(实验组)及慢病毒阴性对照载体LV-CON(阴性对照组),分别感染各组T24细胞,空白对照组不采取任何干预措施。分别用RT-PCR和ELISA检测各组T24细胞VEGF mRNA和蛋白的表达。各组T24上清分别与PBMC来源的未成熟DC共培养,用流式细胞仪检测DC分化成熟指标CD1a、CD83及免疫功能指标CD86。结果与空白对照组和阴性对照组相比,实验组T24细胞VEGF mRNA及蛋白的表达均受到显著抑制(P<0.05)。实验组DC表型CD1a、CD83和CD86较空白对照组明显增高(P<0.05),较阴性对照组亦明显增高(P<0.05)。结论靶向沉默膀胱癌T24细胞VEGF的表达,有利于微环境中DC的成熟及其免疫功能的发挥,可能通过修复DC被损害的免疫监视功能,增加DC的抗肿瘤能力。     

Hyperphosphorylation of pRb: a mechanism for RB tumour suppressor pathway inactivation in bladder cancer

Loss of heterozygosity, mutations or deletions of the RB1 gene usually result in loss of pRb expression, which has been regarded as an indicator of loss of pRb function in human tumours. It has previously been shown that in addition to loss of pRb expression, aberrantly high (pRb2+) pRb expression also indicates loss of pRb function in bladder tumours compared with moderate (normal, pRb1+) pRb expression. The aim of this study was to elucidate the mechanism by which pRb is functionally inactivated in bladder tumours expressing aberrantly high levels of pRb. Constitutive phosphorylation was therefore investigated as a mechanism of pRb inactivation in bladder tumours. Of 28 bladder tumours examined, western blotting demonstrated pRb hyperphosphorylation in 5/7 (71%) pRb2+ bladder tumours compared with only 4/11 (36%) pRb1+ tumours (p = 0.002). All cases with undetectable pRb showed moderate to high p16 expression and none showed cyclin D1 expression by immunohistochemistry. All pRb1+ tumours with underphosphorylated pRb showed p16 but not cyclin D1 expression. All pRb2+ tumours with hyperphosphorylated pRb showed loss of p16 expression and/or cyclin D1 overexpression. Thus, elevated pRb expression was associated with pRb hyperphosphorylation, which, in turn, was associated with loss of p16 expression and/or increased cyclin D1 expression. In order to analyse this association in vitro, T24 cells, which express high levels of pRb, were transfected with p16 cDNA. Transfection with p16 cDNA resulted in a marked decrease in pRb phosphorylation, decreased cell proliferation, and a change in expression of pRb from high to moderate phenotype as assessed by immunohistochemistry. This paper gives the biological basis for constitutive alteration of pRb function in human tumours in the presence of an intact, expressed pRb protein; the mechanism of pRb inactivation is through hyperphosphorylation, which results from loss of p16 expression and/or cyclin D1 overexpression. Immunohistochemical expression of pRb appears to be a reliable indicator of pRb function.     

High expression level of BLCA-4 correlates with poor prognosis in human bladder cancer

Objectives

To evaluate the association between BLCA-4 tissue expression and patients'' prognosis in bladder cancer (BC).

Methods

BLCA-4 expression was analyzed using immunohistochemical staining methods on tissue samples from a consecutive series of 325 BC patients who underwent resections between 2000 and 2006. The correlation of BLCA-4 expression and patients’ clinicopathological parameters was evaluated. Survival analysis was performed using the Kaplan-Meier method and Cox''s proportional hazards model.

Results

BLCA-4 was highly expressed in 54.8% of the BC patients. BLCA-4 overexpression was significantly associated with tumor grade (P<0.001), and stage (P<0.001). Kaplan-Meier survival analysis showed that high expression level of BLCA-4 resulted in a significantly poor prognosis of BC patients. Multivariate analysis revealed that the BLCA-4 expression level was an independent prognostic parameter for the overall survival rate of BC patients.

Conclusions

These findings provide evidence that high expression level of BLCA-4 serves as a poor prognostic biomarker for BC. BLCA-4 may be a potential target of antiangiogenic therapy for BC.     

Non-radioactive measurement of telomerase activity in human bladder cancer,bladder washings,and in urine

Early diagnosis is still the most important prerequisite for successful cancer treatment and this holds true for bladder cancer. Urine cytology is commonly used as a non-invasive screening procedure for the detection of bladder carcinoma, but this method is labour-intensive and often generates false-negative results. The ribonucleoprotein telomerase appears to be a promising new cancer marker, since its activity has been reported to correlate with indefinite growth. The aim of this study was to investigate whether telomerase activity can be detected in bladder cancer and in corresponding bladder washings. For this purpose, a sensitive non-radioactive TRAP (telomeric repeat amplification protocol) detection system was developed. With this technique, telomerase activity was found in 95 per cent of the carcinomas (n=20), in 70 per cent of the corresponding bladder washings, but in none of the urine samples obtained from patients with bladder carcinoma. No telomerase activity was detectable in normal urothelium or in samples from dysplastic urothelium. The data obtained from bladder washings show that superficial carcinoma cells released into the bladder still harbour telomerase activity. The absence of telomerase activity in voided urine is thus most likely due to degradation or inactivation under these conditions. The high rate of telomerase activity in bladder carcinoma indicates that the activation of telomerase is a common step in the tumourigenesis of bladder cancer. © 1998 John Wiley & Sons, Ltd.     

Simultaneous detection of fluorescent in situ hybridization and in vivo incorporated BrdU in a human bladder tumour

We have used fluorescent in situ hybridization and simultaneous in vivo bromodeoxyuridine labelling of a solid bladder cancer to examine tumour cell subsets for possible proliferative growth differences. In this dual-labelled preparation, most tumour cell nuclei exhibited monosomy 9, consistent with reported karyotypes of bladder cancer. Incorporated bromodeoxyuridine was visualized with a fluoresceinated antibody in 5-6 per cent of the tumour cells, concordant with S-phase estimates by cell cycle analysis of the flow cytometric DNA histogram. A majority of the bromodeoxyuridine-positive cells also carried the monosomy 9 chromosome abnormality. This is the first report to demonstrate the feasibility of combined in situ hybridization and detection of bromodeoxyuridine incorporated in vivo in human tumour cells in order to provide information on the growth rate of specific subsets of tumour cells identified by chromosomal constitution.     

Frequent genetic alterations in flat urothelial hyperplasias and concomitant papillary bladder cancer as detected by CGH,LOH, and FISH analyses

Flat urothelial hyperplasia, defined as markedly thickened urothelium without cytological atypia, is regarded in the new WHO classification as a urothelial lesion without malignant potential. Frequent deletions of chromosome 9 detected by fluorescence in situ hybridization (FISH) have been previously reported in flat urothelial hyperplasias found in patients with papillary bladder cancer. Using comparative genomic hybridization (CGH) and microsatellite analysis, these hyperplasias and concomitant papillary tumours of the same patients were screened for other genetic alterations to validate and extend the previous findings. Eleven flat hyperplasias detected by 5-ALA-induced fluorescence endoscopy and ten papillary urothelial carcinomas (pTaG1-G2) from ten patients were investigated. After microdissection, the DNA of the lesions was pre-amplified using whole genome amplification (I-PEP-PCR). Loss of heterozygosity (LOH) analyses were performed with five microsatellite markers at chromosomes 9p, 9q, and 17p. CGH was performed using standard protocols. In 6 of 11 hyperplasias and 7 of 10 papillary tumours, deletions at chromosome 9 were simultaneously shown by FISH, LOH, and CGH analyses. There was a good correlation between FISH, LOH, and CGH analyses, with identical results in 6 of 10 patients. In addition to deletions at chromosome 9, further genetic alterations were detected by CGH in 9 of 10 investigated hyperplasias, including changes frequently found in invasive papillary bladder cancer (loss of chromosomes 2q, 4, 8p, and 11p; gain of chromosome 17; and amplification at 11q12q13). There was considerable genetic heterogeneity between hyperplasias and papillary tumours, but a clonal relationship was suggested by LOH and/or CGH analyses in 5 of 10 cases. These data support the hypothesis that flat urothelial hyperplasias can display many genetic alterations commonly found in bladder cancer and could therefore be an early neoplastic lesion in the multistep development of invasive urothelial carcinoma.     

The chromosome 9q genes TGFBR1, TSC1, and ZNF189 are rarely mutated in bladder cancer

This study assessed a series of bladder tumours and bladder tumour cell lines for sequence variation in the Krüppel-like zinc finger gene ZNF189, the tuberous sclerosis complex gene 1 (TSC1), and the TGF beta receptor type I (TGFBR1). All three genes have been mapped to 9q regions commonly deleted in transitional cell carcinoma of the bladder. Mutation analysis of the coding sequence of these genes revealed several variant bands that were shown to represent polymorphisms. Mutation analysis of the ZNF189 gene in bladder cancer cell lines identified one amino acid substitution (lysine-->isoleucine) at position 323 in exon 4. For the TSC1 gene, two mutations were identified in two out of 27 independent cell lines. Both mutations result in a truncated protein. Furthermore, one out of 36 bladder tumours had a frameshift mutation in exon 7 of the TSC1 gene. No tumour-specific mutations were found in the TGFBR1 gene. The length of the polyalanine tract present in exon 1 of the TGFBR1 gene was also investigated. It has been suggested that the allele with six alanines (6A) is more frequent in patients with bladder and other cancers, so bladder cancer patients were compared with normal controls. In both groups, the percentage of heterozygotes was 17%. These data do not support a role for the 6A allele in bladder cancer susceptibility.     

膀胱癌干细胞标志物及相关信号通路:抗体靶向治疗思路

背景:膀胱癌是泌尿系统中最常见的恶性肿瘤之一,严重威胁患者的生命健康.膀胱癌干细胞的不断深入研究为膀胱癌治愈提供了新的治疗方向,近年来对膀胱癌干细胞重要标志物和信号通路的研究为膀胱癌靶向治疗提供了有力依据.目的:综述近年来国内外对膀胱癌干细胞主要标志物和信号通路的研究进展.方法:计算机检索中国期刊全文数据库(CNKI)...     

Hereditary breast cancer: syndromes,tumour pathology and molecular testing

Hereditary factors account for a significant proportion of breast cancer risk. Approximately 20% of hereditary breast cancers are attributable to pathogenic variants in the highly penetrant BRCA1 and BRCA2 genes. A proportion of the genetic risk is also explained by pathogenic variants in other breast cancer susceptibility genes, including ATM, CHEK2, PALB2, RAD51C, RAD51D and BARD1, as well as genes associated with breast cancer predisposition syndromes – TP53 (Li–Fraumeni syndrome), PTEN (Cowden syndrome), CDH1 (hereditary diffuse gastric cancer), STK11 (Peutz–Jeghers syndrome) and NF1 (neurofibromatosis type 1). Polygenic risk, the cumulative risk from carrying multiple low-penetrance breast cancer susceptibility alleles, is also a well-recognised contributor to risk. This review provides an overview of the established breast cancer susceptibility genes as well as breast cancer predisposition syndromes, highlights distinct genotype–phenotype correlations associated with germline mutation status and discusses molecular testing and therapeutic implications in the context of hereditary breast cancer.     

Role of APAF-1, E-cadherin and peritumoral lymphocytic infiltration in tumour budding in colorectal cancer

Tumour budding or dedifferentiation at the invasive margin of colorectal cancer (CRC) is an important prognostic marker and linked mechanistically to dysregulation of Wnt pathway signalling. Since budding is observed in only 40% of CRCs, we hypothesized that Wnt pathway dysregulation may be a necessary but insufficient explanation for budding and that buds may be destroyed selectively by tumour immune mechanisms. Twenty potential markers of tumour budding were evaluated in tissue microarrays (TMAs) obtained from the main tumour body of 1164 DNA mismatch repair-proficient CRCs and the findings were correlated with tumour budding, lymphocytic infiltration and survival. Loss of expression of E-cadherin and APAF-1 were independent predictors of budding (sensitivity 70.3% and specificity 48.2% when one or the other was lost). Peritumoral lymphocytes (PTLs) were observed more frequently in CRCs with loss of either E-cadherin or APAF-1 that were budding-negative. PTLs and tumour-infiltrating lymphocytes (TILs) were strongly correlated. The absence of TILs increased the adverse prognostic impact of E-cadherin and APAF-1 loss. Co-occurrence of E-cadherin loss, APAF-1 loss and low TIL counts in CRCs was an independent prognostic factor. The findings were verified in whole tissue sections from 88 CRCs with known KRAS mutation status (which was not associated with budding). Loss of E-cadherin and APAF-1 within the main body of CRCs are independent predictors of tumour budding. The prognostic benefit of lymphocytic infiltration may be explained by the immune destruction of budding cells.     

miR-130b-3p有望作为人膀胱癌的标志物

目的进一步了解miRNA在膀胱癌中的潜在机制。方法芯片分析4对人膀胱癌组织和相邻正常组织中的miRNA的表达。并用RT-q PCR来验证两个最上调的miRNA及其靶基因的表达是否符合miRNA/mRNA芯片结果。通过相关性分析和双荧光素酶报告实验推断并验证miR-130b-3p可以靶向PTEN。应用CCK8、EDU、流式细胞术、划痕、Transwell和细胞骨架等实验证明miR-130b可以影响膀胱癌细胞的增殖、凋亡、迁移和侵袭。用Western blot检测PI3K/AKT和整合素β1/FAK信号通路的关键靶蛋白。结果人膀胱癌中miR-130b-3p表达高于癌旁且与PTEN表达呈负相关。miR-130b-3p可下调PTEN表达,导致PI3K/AKT和整合素β1/FAK信号通路的激活,且与膀胱癌EJ细胞的增殖、迁移和侵袭相关。细胞转染miR-130b-3p抑制剂时,可以重排细胞骨架。结论本结果揭示miR-130b/PTEN有望用于人膀胱癌诊断和治疗的标志物。     

抗人宫颈癌单链抗体的基因构建、空间结构和进化分析

目的:构建抗人宫颈癌单链抗体(scFv)基因CSAs-1,并进行二级结构和三级结构预测、理化性质分析及进化树构建。方法:采用重叠延伸PCR方法,以能特异性分泌抗人宫颈癌mAb的杂交瘤细胞株CSA125为原料,构建抗人宫颈癌scFv基因CSAs-1,进行测序;并通过Internet对其进行结构预测和进化树构建。结果:抗人宫颈癌scFv基因CSAs-1有834bp,对应278个氨基酸的多肽,等电点预测值7.215,为碱性蛋白质;PHDsec二级结构显示CSAs-1属于α β蛋白,VH和VL区均有多个蛋白激酶C磷酸化位点、酪蛋白激酶II磷酸化位点;CSAs-1三级结构建模显示VL和VH形成一个疏水的“口袋”,Linker游离于此结构之外。以上结果表明:CSAs-1符合scFv的结构特点,明显具有抗原结合位点的空间构象,理论上应该具有良好的抗原结合活性。进化分析发现脊椎动物V基因形成三个进化群,CSAs-1V区分布于进化树的A群中。结论:构建一个鼠源性抗人宫颈癌scFv基因CSAs-1,为该基因的进一步原核和真核表达打下了基础;应用信息学技术所获得的预测和分析结果为CSAs-1表达、纯化和活性研究提供了大量的信息;为进一步分析抗体VH、VL在抗体功能中的作用、改造抗体、实现抗体的人源化、提高抗体的活性等方面提供了一定的依据。