Determination of the proliferative potential of human brain tumors using the monoclonal antibody Ki-67

Summary The proliferative activity of 133 human tumors of the nervous system was investigated by means of immunohistochemistry using the monoclonal antibody Ki-67 in order to evaluate the usefulness of this method for histopathological tumor grading. Ki-67 recognizes a proliferation-associated nuclear antigen present in human cells during all active phases of the cell cycle but absent in the G₀ phase [Gerdes J, Schwab U, Lemke H, Stein H (1983) Int J Cancer 31:13–20]. In 28 WHO grade I and II gliomas of all major types Ki-67 indices were generally low with mean values ranging from less than 1% in pilocytic astrocytomas to 4.2% in grade II oligodendrogliomas. Individual cases of grade II astrocytomas and oligodendrogliomas had, however, values up to 8.5%. In 13 primary anaplastic gliomas of WHO grade III consistently higher statistical means were obtained with values ranging from 8.6% for anaplastic astrocytomas to 14.2% for anaplastic mixed gliomas. Interestingly, 18 WHO grade IV glioblastomas demonstrated a mean value of only 7%, which is probably due to the pronounced phenothypic heterogeneity in this tumor group. This heterogeneity results in enormous intraand intertumor variability in Ki-67 indices (range <1%–22.1%). Investigation of 17 recurrent gliomas revealed mean values for Ki-67 ranging from 1.7% for three WHO grade II astrocytomas up to 48.5% obtained in two highly anaplastic recurrent astrocytomas corresponding to WHO grade IV. Other tumors of the nervous system evaluated included 9 medulloblastomas (mean 17.9%, range 5.0%–42.0%), 17 benign meningiomas (mean 1.1%, range 0%–5%), 15 metastatic carcinomas (mean 16.5%, range <1%–46.0%), and individual tumors of various types. Our results indicate that Ki-67 immunohistochemistry can add useful additional information for histopathological grading which, by supplementing and refining the traditional WHO grading system, might lead to a better assessment of the biological behaviour of human tumors of the nervous system.Supported by the Deutsche Forschungsgemeinschaft, SFB 200     

Analysis of epidermal growth factor (EGF) receptor and effect of EGF on the growth of cultured Graves' and non-neoplastic human thyroid cells

We analyzed epidermal growth factor receptors (EGF-R) and the growth stimulatory effects of epidermal growth factor (EGF) in the presence or absence of TSH on cultured human non-neoplastic and Graves' thyroid cells. All cells studied possessed EGF-R composed of two components. There was no significant differences in the binding characters of EGF-R among non-neoplastic thyroid cells whether they were obtained from thyroid tissues adjacent to malignant carcinoma or benign adenoma. Ten nM of EGF stimulated (3H)-thymidine (dTR) incorporation of non-neoplastic thyroid cells by about 50%. However, TSH had no effect on the growth of these cells. Both EGF-R binding parameters and cell proliferation effects of EGF and TSH were simultaneously examined in non-neoplastic thyroid cells from 8 patients. A significant inverse correlation (r = -0.757) was observed between binding affinity (Ka1) and EGF-induced increase of dTR incorporation. Binding capacity (Cmax) did not correlate significantly with dTR incorporation. In Graves' thyroid cells, all parameters of EGF-R were significantly lower than those of non-neoplastic thyroid cells, higher basal dTR incorporation was observed, and their goiter size significantly correlated with EGF-induced increase of dTR incorporation (r = 0.879) and also appeared to correlate inversely with Ka1. These data indicate a close relationship between the binding affinity of EGF-R and thyroid cell growth.     

大肠癌组织中表皮生长因子及受体的检测

本文应用免疫组化ABC法检测52例大肠癌和18例正常结肠组织中表皮生长因子（EGF）和表皮生长因子受体（EGF－R）的表达状况。正常组织中EGF阳性率22．2％，EGF－R阳性率16．7％，大肠癌EGF阳性率67．3％，EGF－R阳性率61．5％，二者均明显高于正常对照组织，（P＜0．05）。EGF和EGF－R阳性率与患者年龄，性别及肿瘤部位无明显相关，但随着肿瘤浸润度的加深，EGF与EGF－R的阳性率逐渐增高，有淋巴结转移者二者阳性率高于淋转阴性者，特别是EGF与EGF－R双阳者中有82．6％为进展期大肠癌，另发现低分化大肠癌中EGF和EGF－R阳性率明显低于中高分化癌。本文结果提示：部分大肠癌存在EGF或EGF－R的过度表达；EGF与EGF－R的过度表达与肿瘤润度及淋巴转移有关，其检测可作为诊断肿瘤恶性程度的一项辅助指标，部分正常大肠粘膜组织中也有少量EGF或EGF－R表达。     

Insulin-like growth factor-I receptors in human glial tumors

Insulin and insulin-like growth factors (IGFs) are anabolic effectors in many tissues and cultured cells, including astrocytes and neurons. Receptors for insulin and IGFs are found throughout the human brain. We examined the level of insulin and IGF receptors on membranes prepared from surgical specimens of tumor (astrocytomas and glioblastomas) and normal human brain. Specific binding (per 100 micrograms membrane protein) of insulin was less than 5% in all normal and tumor samples. Specific binding of IGF-I to 12 normal brain specimens ranged from 1-8%. IGF-I binding to 18 glioma specimens ranged from 2-25%. Scatchard analyses of IGF-I binding confirmed increased IGF-I-binding sites in some glial tumors vs. normal brain, but detected no difference in affinity characteristics. Cross-linking of [125I]IGF-I demonstrated that glioma tissue expressed the same lower mol wt (approximately 118 kDa) alpha-subunit as the normal brain confirming the neural origin of the cells expressing the IGF-I receptor. IGF-binding proteins (approximately 40 kDa) were also found in the membranes of some of the glioma but none of the normal brain specimens. In cell lines derived from glioma specimens, IGF binding was readily detectable (4-10% specific binding), but insulin binding was barely detectable (0-03%) in every line examined. The size of the IGF-I alpha-subunit in the cultured cells was larger (approximately 133 kDa) than that in the original tissue. Most glioma cell lines exhibited an IGF-I dose-dependent stimulation of thymidine incorporation into DNA, and partially purified IGF-I receptors from these cells exhibited a dose-dependent stimulation of the autophosphorylation of the beta-subunit. We conclude that human glioma cells have functional IGF-I receptors and suggest a role for this receptor in glioma cell growth.     

Flow cytometry in brain tumors. I. Ploidy abnormalities

Flow cytometry (FCM) was introduced for estimation of DNA content in 75 brain tumors. Among these astrocytomas (38 cases) and meningiomas (16 cases) predominated. Astrocytomas were histologically subdivided into 3 groups of malignancy grade. Aneuploid cell populations were found in 1 out of 4 cases of astrocytoma grade I, in 11 out of 20 astrocytomas grade II and in 10 out of 14 astrocytomas grade III of malignancy. DNA index (DI) in most aneuploid astrocytomas is in the range between 1 and 2. More than one cell population with aneuploid value of DNA was found in 36% of all aneuploid tumors.     

Effects of epidermal growth factor (EGF) on the development of EGF-receptor (EGF-R) binding in fetal rabbit lung organ culture

Epidermal growth factor (EGF) causes gender- and development-specific changes in fetal lung surfactant synthesis. We hypothesized that the effects of EGF on development of surfactant synthesis are related to effects on EGF receptor (EGF-R) expression. We prepared sex-specific fetal rabbit lung organ cultures on gestational days 21 and 24 (term = 31 days) in Waymouth's medium + 10% charcoal-stripped fetal calf serum as control or with added EGF (10 ng/mL). After 3, 5, and 7 days of culture, we measured specific EGF-R binding in fetal lung plasma membrane preparations. Analysis of variance (ANOVA) revealed significant effects of fetal gender (P = 0.0003), time in culture (P = 0.01), and EGF treatment (P = 0. 0003) on EGF specific binding. In control cultures from days 21 and 24 (both male and female), EGF specific binding tended to decrease with time in culture. Specific binding in EGF-treated female 21-day cultures was significantly higher than in controls, both after 5 days (184% of control, P = 0.007) and after 7 days (151% of control, P = 0.01; Bonferroni multiple comparisons) of treatment, whereas males exhibited no response to EGF treatment. As opposed to these effects in 21-day cultures, EGF had little effect on 24-day cultures. We conclude that EGF affects the expression of the EGF-R on EGF specific binding in the fetal lung. The development of surfactant synthesis in the fetal lung may be controlled by upregulation of the EGF-R.     

The occurrence of epidermal growth factor receptors and the characterization of EGF-like factors in human ovarian,endometrial, cervical and breast cancer

Summary In this study we investigated the presence of epidermal growth factor receptors (EGF-R) and the tissue levels of EGF-like factors (EFG-F) in ovarian, endometrial, cervical and breast carcinomas. EGF-R were found in 33/40 (83%) cervical, 15/26 (58%) endometrial, 64/141 (45%) ovarian, and 19/59 (33%) breast carcinomas. The highest number of EGF-R binding sites was detected in cervical carcinomas followed by endometrial, breast and ovarian carcinomas. The tissue concentrations of EGF-like factors, were investigated in extracts of 63 ovarian, 25 breast, 12 cervical, 14 endometrial carcinomas and in 21 biopsies of nonmalignant tissue such as myometrium and ovaries. The extracts of nonmalignant tissues had a mean EGF-F level of 1.5±0.7 ng/mg with a concentration range from 0 to 4 ng/mg. The mean EGF-F levels of malignant tissues were: ovarian carcinomas 4.2±1.5 ng/mg (range 0–15 ng), endometrial carcinomas 4.5±1.7 ng/mg (range 0–12 ng), cervical carcinomas 4.15±1.1 ng/mg (range 0–8) and breast carcinomas 3.16±1.1 ng/mg (range 0–10 ng). About 30% ovarian, endometrial and cervical carcinomas and 16% breast carcinomas, respectively, had enhanced EGF levels from 5 ng/mg to 15 ng/mg compared to nonmalignant tissues. The EGF-F of tissue extracts consists of EGF and transforming growth factor TGF) as shown by the results of EGF and TGF radioimmunoassays. It is assumed that in some tumors the EGF-F tissue levels influence the number of biochemically detectable EGF binding sites.Supported by Deutsche Forschungsgemeinschaft (DFG) SFB 31     

Phorbol esters induce transient internalization without degradation of unoccupied epidermal growth factor receptors.

4 beta-Phorbol 12-myristate 13-acetate (PMA) treatment of KB cells at 37 degrees C rapidly induces a 50% reduction in epidermal growth factor (EGF) binding that is maximal by 30 min. EGF binding activity returns to the original value by 1 hr and remains constant for 2 hr thereafter. Using a polyclonal antibody directed against the cytoplasmic domain of the EGF receptor (EGF-R), we examined the fate of the receptor after PMA treatment. Immunofluorescent and electron microscopic localization of the EGF-R after PMA treatment demonstrated that about 50% of the receptor became internalized into endocytic vesicles (receptosomes) and Golgi-associated structures. Unlike EGF-induced internalization, PMA-induced internalization did not cause delivery of EGF-R to lysosomes or receptor degradation. Rather, receptor reappeared on the cell surface. No stimulation of EGF-R synthesis was observed after 1 hr of PMA treatment. Loss of cell surface binding correlated with the internalization of the EGF-R observed morphologically. A possible explanation for these observations is that PMA, an activator of protein kinase C, confers a signal sufficient for EGF-R clustering and internalization but not for transport to lysosomes.     

Down-regulation of the epidermal growth factor receptor in KB cells is due to receptor internalization and subsequent degradation in lysosomes.

Using a monoclonal antibody to the human epidermal growth factor (EGF) receptor (EGF-R1), we have followed the metabolism of the receptor and the pathway of its internalization in KB cells after the addition of EGF. Measurement of surface binding of 125I-labeled EGF showed that about 80% of EGF binding activity disappeared from the plasma membrane after a 10-min exposure to EGF at 37 degrees C. Immunoprecipitation of the receptor from [35S]methionine-labeled cell extracts with EGF-R1 showed that EGF caused the receptor to be degraded with a half-life of 40 min. Immunofluorescence using EGF-R1 showed an EGF-dependent redistribution of the EGF receptor. In cells not exposed to EGF, almost all of the receptor was diffusely distributed on the cell surface. After EGF addition, the receptor was rapidly internalized, first appearing in small punctate organelles characteristic of receptosomes and then in larger perinuclear lysosome-like structures. By 120 min almost all of the immunoreactive EGF receptor had disappeared from the cells. Immunocytochemistry at the electron microscopic level confirmed these light microscopic findings. The diffusely distributed receptor on the cell surface first clustered into clathrin-coated pits in the presence of EGF, next was internalized into receptosomes, appeared transiently in transreticular Golgi elements, and finally was seen in lysosomes. This EGF-dependent down-regulation and degradation of the EGF receptor in KB cells provides a striking example of ligand-dependent clustering and internalization of a receptor, followed by degradation in lysosomes of both ligand and receptor.     

Epidermal growth factor receptor of fibroblasts from patients with scleroderma

Epidermal growth factor receptor (EGF-R) of fibroblasts from 3 patients with scleroderma (progressive systemic sclerosis, PSS) was studied by radioiodinated-EGF binding assay. The binding was 60.9 +/- 4.0% of normal fibroblasts, and the Scatchard plots showed a decrease in the affinity for EGF, not in the number of EGF-R. PSS fibroblasts expressed higher levels (1.15-2.45-fold) of RNA for the v-erbB (EGF-R gene). All-transretinoic acid (retinoid) had little effect on EGF-R, v-erbB gene expression and the proliferation of PSS fibroblasts. These data concerning the abnormality in the EGF-R may all constitute a feature of PSS fibroblasts.     

Identification of IGF2 signaling through phosphoinositide-3-kinase regulatory subunit 3 as a growth-promoting axis in glioblastoma

Amplification or overexpression of growth factor receptors is a frequent occurrence in malignant gliomas. Using both expression profiling and in situ hybridization, we identified insulin-like growth factor 2 (IGF2) as a marker for a subset of glioblastomas (GBMs) that lack amplification or overexpression of EGF receptor. Among 165 primary high-grade astrocytomas, 13% of grade IV tumors and 2% of grade III tumors expressed IGF2 mRNA levels >50-fold the sample population median. IGF2-overexpressing tumors frequently displayed PTEN loss, were highly proliferative, exhibited strong staining for phospho-Akt, and belonged to a subclass of GBMs characterized by poor survival. Using a serum-free culture system, we discovered that IGF2 can substitute for EGF to support the growth of GBM-derived neurospheres. The growth-promoting effects of IGF2 were mediated by the insulin-like growth factor receptor 1 and phosphoinositide-3-kinase regulatory subunit 3 (PIK3R3), a regulatory subunit of phosphoinositide 3-kinase that shows genomic gains in some highly proliferative GBM cases. PIK3R3 knockdown inhibited IGF2-induced growth of GBM-derived neurospheres. The current results provide evidence that the IGF2-PIK3R3 signaling axis is involved in promoting the growth of a subclass of highly aggressive human GBMs that lack EGF receptor amplification. Our data underscore the importance of the phosphoinositide 3-kinase/Akt pathway for growth of high-grade gliomas and suggest that multiple molecular alterations that activate this signaling cascade may promote tumorigenesis. Further, these findings highlight the parallels between growth factors or receptors that are overexpressed in GBMs and those that support in vitro growth of tumor-derived stem-like cells.     

Androgen regulation of signaling pathways in late fetal mouse lung development

During lung development there is tension between positive and negative regulators of fibroblast-epithelial communication controlling type II cell differentiation. A clinical consequence of imbalance of this tension is the increased risk for respiratory distress syndrome in male infants. We hypothesized that chronic intrauterine androgen exposure alters fetal lung fibroblast maturation by down-regulating epidermal growth factor receptor (EGF-R) activity and by up-regulating transforming growth factor-beta receptor (TGFbeta-R) activity, leading to an inhibition of surfactant protein B (SP-B) and -C (SP-C) gene expression in type II cells. We treated pregnant mice with dihydrotestosterone (DHT; 2 mg/day) or vehicle for 7 days, starting on gestational day 11. On day 18, EGF binding, EGF-R phosphorylation, TGFbeta-R binding, and TGFbeta1-induced cell proliferation were studied in sex-specific fibroblast cultures. SP-B and -C messenger RNA levels were measured in whole lungs. Chronic DHT treatment reduced both EGF binding (females to 78+/-8% and males to 65+/-9% of controls) and EGF-induced EGF-R phosphorylation. TGFbeta-R binding was increased (females to 173+/-39% and males to 280+/-64% of controls), and TGFbeta-induced cell proliferation was increased in female cells (231+/-57% of controls). SP-B and -C messenger RNA expression was reduced to 55+/-10% and 75+/-4%, respectively. We conclude that chronic DHT exposure beginning early in lung development alters the balance of growth factor signaling that regulates lung maturation.     

High-dose chemotherapy with autologous stem cell rescue for brain tumors

The use of high-dose chemotherapy with stem cell rescue for malignant brain tumors is reviewed. Promising results have been reported in patients with medulloblastomas, supratentorial PNET's and high-grade astrocytomas. Results thus far have been disappointing for ependymomas and brain stem gliomas. The role of this treatment strategy for other chemotherapy-sensitive tumors such as oligodendrogliomas and central nervous system germ cell tumors has yet to be determined.     

AP-1 and heat shock protein 27 expression in human astrocytomas

PURPOSE: In previous work we have shown that the expression of heat shock protein 27 (Hsp27) is associated with anaplastic potential of astrocytomas (Anticancer Res 1997, 17:2677-2682). Heat shock protein-coding genes have been found to have a putative AP-1 (activator protein-1)-binding site in their promoter region and the synthesis of these proteins is induced by the same extracellular stimuli that also activate AP-1 (a homo/heterodimer of members of the Jun and Fos families). In order to detect the putative relation of Hsp27 with AP-1 activation in human astrocytomas we examined eighty astrocytic tumors with different grades of malignancy for c-Jun, c-Fos, and Hsp27 expression. METHODS: Six pilocytic astrocytomas (WHO grade I), 15 diffuse fibrillary astrocytomas (WHO grade II), 19 anaplastic astrocytomas (WHO grade III), and 40 glioblastomas multiforme (WHO grade IV), were studied by immunohistochemistry using monoclonal and polyclonal antibodies directed against human Hsp27, c-Fos, and active (phosphorylated) forms of c-Jun (p-c-Jun). Monoclonal antibodies against the phosphorylated forms of the over-expressed MAP kinases JNK (c-Jun N-terminal kinase) (p-JNK) and p38 (p-p38) were also used. RESULTS: Overexpression of p-c-Jun, c-Fos and p-JNK was observed in the majority of glioblastomas (grade IV) whereas only minimal expression was noted in diffuse fibrillary astrocytomas (grade II). Hsp27 expression was observed only in the tumor specimens where c-Jun and c-Fos were co-expressed. AP-1/Hsp27 co-expression was associated with ascending grading of malignancy and it was independent of the proliferation index of the tumors. CONCLUSIONS: Our findings suggest that during malignant progression of astrocytomas there is activation of signal transduction cascade(s) culminating in AP-1 induction.     

Occurrence of epidermal growth factor receptors in benign and malignant ovarian tumors and normal ovarian tissues: an immunohistochemical study

Summary Epidermal growth factor receptor (EGF-R) was studied with monoclonal antibody 2E9 on 50 ovarian tumors of various histological types and 10 non-tumorous ovarian tissues by immunohistochemistry. Enhanced expression was observed in 26/50 (52%) of the tumors. Only 25 out of 46 epithelial tumors (54%) showed positivity in epithelial tumor cells. Staining was cytoplasmic in all cases. No correlation was established between EGF-R expression and the histological type of the epithelial tumor. Apart from EGF-R expression in tumor cells, low immunoreactivity was also observed in stromal and endothelial cells in both normal and tumorous ovarian tissues. Furthermore in 8/9 specimens containing necrotic areas, EGF-R was noticed in these areas as well. Both of the latter observations may have impact on the evaluation of the prognostic value of EGF-R activity in tumors, when based on EGF-R measurements using biochemical binding studies. We therefore recommend that EGF-R is measured with both methods in studies regarding its clinical value.Supported by grant DDHK 90-05 from the Dutch Cancer Society Koningin Wilhelmina Fonds     

Epidermal growth factor and its receptor in human implantation trophoblast: immunohistochemical evidence for autocrine/paracrine function.

Epidermal growth factor (EGF) and its receptor (EGF-R) were immunohistochemically localized in trophoblast during human implantation from intrauterine and ectopic pregnancies. EGF immunostaining was absent to light in the cytotrophoblast (CT), light to moderate in intermediate trophoblast (IT), and intense in the syncytiotrophoblast (ST). In ST, EGF immunostaining was found mostly in the cytoplasm; however, staining of the plasma membrane was also noted. Immunostaining for the EGF-R was absent to light in the CT and moderate to intense in the IT. Immunostaining for the EGF-R was intense in the ST, with moderate staining in the cytoplasm and intense staining in the plasma membrane. Staining was most intense on the microvilli of the ST. Additionally, EGF-R immunostaining could be demonstrated on nuclear membranes. The increase in the intensity of the immunostaining for both EGF and EGF-R noted in CT, IT, and ST suggests a differentiated expression of this receptor-ligand system in human trophoblast and provides evidence for an autocrine/paracrine role for EGF in trophoblast function. The presence of this receptor-ligand system during early human implantation strongly supports a role for EGF and the EGF-R in embryo-uterine signalling and the implantation process.