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[The human E-cadherin/catenin complex: a potent invasion and tumor suppressor].

Cancer is a disease of the genome, evolving from phenotypically normal tissue to a benign non-invasive tumor, to an invasive tumor, and finally to metastasis. Tumor dissemination or metastasis in organs at a distance from the original tumor makes the disease mostly incurable. During this evolution, a number of genes, known as tumor suppressor genes, are inactivated, whereas a number of other genes, known as tumor promoter genes, are activated. Our research describes the E-cadherin/catenin complex as a potent inhibitor of cancer invasion. At least two elements of this complex, E-cadherin and (E-catenin, are encoded by a gene that meets the criteria of invasion and tumor suppressor genes. If both alleles of one of these genes disappear due to mutation or deletion, the tissue structure is no longer under control, which results in the penetration of tumor cells into other tissues. Originally, we regarded this complex merely as a physical mediator of cell-cell adhesion, a concept that would allow to explain the anti-invasive mechanism in a simple way. Later, however, the E-cadherin/catenin complex appeared to play also an important role as signal transducer. Moreover, we demonstrated inactivating mutations in the E-cadherin gene of a majority of invasive lobular breast cancers. Although this is not a general finding for all human carcinoma types, nearly all human forms of cancer accompanied with invasion show abnormalities of the E-cadherin/catenin complex. Hence, we considered it worthwhile to further study this complex and its still growing number of molecular interactions. Research focuses on genetic and posttranslational regulatory mechanisms of known and new elements of the complex, and explores the possibility of manipulation with therapeutic aims.

Cadherins↗

[A new hypothesis on the natural history of bladder cancer based on the study of tumor DNA levels by flow cytometry].

72 bladder tumors were studied for nuclear DNA content with flow cytometry. A bimodal DNA profile was present in 33 of them (45%). The following findings concerning the aneuploid second peak of these 33 tumors are remarkable. Aneuploid peak DNA index distribution is discontinuous: there is no peak below 1.5 nor between 2.3 and 2.7. Aneuploid peak importance (second peak cell percentage versus all tumor cells in the same sample) increases when its DNA index decreases from 2.0 to 1.5 = this percentage is on average 45% for a DNA index of 2.0 and increases to 75% when DNA index decreases to 1.5. Aneuploid peak mitotic activity increases when DNA index decreases from 2.0 to 1.5 = the percentage of S G2 M cells of the aneuploid peak is in the range of 15% for a DNA index of 2.0 and in the range of 22% for a DNA index of 1.5. These findings are in favor of a dynamics in bladder cancer natural history. Tumors are supposed to share the same clonal evolution, in 3 stages. First stage: transformed tumor cell DNA profile is unimodal with a DNA index in the region of 1; second stage: due to chromosomic non-dysjunction during mitosis, a second peak appears with a DNA index of 2. Third stage: DNA index of this aneuploid second peak progressively decreases from 2 to 1.5 as a consequence of non vital chromosomes loss by tumor cells. It is suggested that DNA index as defined by flow cytometry does not have an absolute prognostic value per se, but in combination with tumors mitotic activity.(ABSTRACT TRUNCATED AT 250 WORDS)

Aneuploidy↗

6q- and loss of the Y chromosome--two common deviations in malignant human salivary gland tumors.

Nine cases of malignant human salivary gland tumors cultured in vitro were subjected to detailed cytogenetic analysis with G-banding. Together with observations from three earlier published cases, the results of 12 cases were surveyed: five adenoid cystic carcinomas, three acinic cell tumors, three adenocarcinomas, and one mucoepidermoid carcinoma. All tumors had stemlines in the diploid-near-diploid mode. The most consistent changes among the adenoid cystic carcinomas were stem lines and/or variant cells with anomalies affecting the terminal part of 6q (i.e., 6q 16-25). Deviations affecting the Y chromosome (losses) and, to a lesser extent, #6 (structural changes) and #8 (gains) characterized the early karyotypic evolution in acinic cell tumors. Two of the three analyzed adenocarcinomas showed stemlines or variant cells with loss of gonosomes. The karyotypic features of the different tumor types, including primary changes, evolutionary characteristics, and progressional pathways, are discussed. The cytogenetic relationships between benign and malignant salivary gland tumors also will be considered.

Adenocarcinoma↗

Limited Wegener's disease presenting as pharyngolaryngeal tumor.

Wegener's disease (WD) which is mostly a systemic illness rarely presents as isolated, monoorganic, limited disease. Limited pharyngolaryngeal WD is thus a very rare occurrence. We report the case of a 29 years old man who developed a pharyngolaryngeal tumor with clinically benign evolution, histologically showing granulomatous inflammation and small vessel vasculitis, with no signs of: tuberculosis, sarcoidosis, fungal disease, Hodgkin's disease or foreign body aspiration. p-ANCA's were positive. He was considered a limited form of WD and treated with moderate doses of corticoids and cotrimoxazole. One month later, the lesion diminished significantly. The finding of a pharyngolaryngeal tumor with granulomatous inflammation and vasculitis, in the context of p-ANCA positivity and without any evidence for another systemic granulomatous disease, suggested the diagnosis of limited WD. The response to treatment favoured this presumption. Limited pharyngolaryngeal WD is a rare disease, with a potential for life-threatening (even fatal) complications. It should be recognized early and treated promptly. Remissions can be achieved (even without the use of cyclophosphamide).

Adult↗

Lower gingival carcinoma. Clinical and pathologic determinants of regional metastases.

OBJECTIVE: To determine which clinical and pathologic features are associated with regional metastases in patients with lower gingival squamous cell carcinoma. PATIENTS AND METHODS: The medical charts of 155 previously untreated patients seen between 1970 and 1990 were retrospectively analyzed. All patients underwent surgical resection of the primary tumor. In addition, 66 patients underwent elective neck dissection, while a therapeutic neck dissection was performed in 28. Sixty-one patients who had clinically N0 neck disease did not undergo treatment of the cervical lymphatics. RESULTS: T stage (P = .01), radiologic (P = .03) or histologic (P = .01) evidence of mandibular invasion, and decreased tumor differentiation (P = .004) significantly correlated with the presence or evolution of regional metastases. In addition, tumors involving the symphyseal region were associated with an increased incidence of nodal metastases, although the relationship did not achieve statistical significance (P = .08). Occult regional disease was found in 18% of patients who underwent elective neck dissection, and the presence of metastases was pathologically confirmed in 68% who underwent a therapeutic dissection. Six patients with clinically N0 neck disease did not undergo elective dissection and later developed regional metastases. In all patients, survival was adversely impacted by the presence or later development of regional metastases (P < .001). Two- and 5-year survival rates for patients with no cervical metastases were 0.91 and 0.85, respectively, while for those with cervical metastases, the survival at 2 and 5 years declined to 0.72 and 0.59. More importantly, the 2- and 5-year survivals of patients with clinically N0 necks who were found to have lymph node metastases histologically after neck dissection were 1.00 and 0.78. This contrasts with the 0.50 survival rate at 2 and 5 years for those who did not undergo elective dissection and later developed cervical metastases (P = .36). CONCLUSIONS: Patients with adverse clinical and pathologic features, even in the absence of demonstrable neck disease, are at risk for harboring regional metastases. Elective treatment of the cervical lymphatics should be considered for patients with primary tumors that overlie the mandibular symphysis, moderately or poorly differentiated tumors, or radiographic or histologic evidence of mandibular invasion.

Adult↗

Changes in the approach to central nervous system tumors in childhood.

Current approaches to children with brain tumors are in a state of evolution. Currently, 50% of children with all types of brain tumors may be expected to survive 5 years. Therefore, the goals of neuro-oncology have broadened to include improved survival and improved quality of life. This article reviews changes in therapy that have altered survival as well as changes in therapy as a consequence of increasing recognition of complications and toxicity of treatment.

Brain↗

[Endocrine tumors: biology and physiopathology].

Endocrine tumors are defined as neoplastic lesions resulting from the proliferation of cells engaged in an endocrine differentiation pathway, as shown by their expression of a set of specific markers, including true endocrine markers (such as chromogranine A) and neuro-endocrine markers, shared between neurons and endocrine cells (such as synaptophysin). The demonstration of the synthesis and secretion of one or several hormones is not necessary for the assessment of the endocrine nature of a tumor; only tumors associated with a clinical syndrome resulting from hormone overproduction can be said functioning endocrine tumors. Beyond their common features, endocrine tumors are characterized by a marked diversity, which results from the large functional, structural and embryological heterogeneity of normal endocrine cells. The natural history of endocrine tumors is also characterized by a marked heterogeneity in their evolution and rate of progression. While most endocrine tumors are locally and slowly evolving, some of them behave as truly malignant tumors, as shown by their capacity of metastatic dissemination and their fatal evolution. A better understanding of the cellular and molecular mechanisms involved in tumor progression and metastatic dissemination is necessary for the identification of new prognostic tools and novel therapeutic targets.

Cell Division↗

The evolutionarily conserved domain of Beclin 1 is required for Vps34 binding, autophagy and tumor suppressor function.

Atg6/Beclin 1 is an evolutionarily conserved protein family that has been shown to function in vacuolar protein sorting (VPS) in yeast; in autophagy in yeast, Drosophila, Dictyostelium, C.elegans, and mammals; and in tumor suppression in mice. Atg6/Beclin 1 is thought to function as a VPS and autophagy protein as part of a complex with Class III phosphatidylinositol 3'-kinase (PI3K)/Vps34. However, nothing is known about which domains of Atg6/Beclin 1 are required for its functional activity and binding to Vps34. We hypothesized that the most highly conserved region of human Beclin 1 spanning from amino acids 244-337 is essential for Vps34 binding, autophagy, and tumor suppressor function. To investigate this hypothesis, we evaluated the effects of wild-type and mutant beclin 1 gene transfer in autophagy-deficient MCF7 human breast carcinoma cells. We found that, unlike wild-type Beclin 1, a Beclin 1 mutant lacking aa 244-337 (Beclin 1DeltaECD), is unable to enhance starvation-induced autophagy in low Beclin 1-expressing MCF7 human breast carcinoma cells. In contrast to wild-type Beclin 1, mutant Beclin 1DeltaECD is unable to immunoprecipitate Vps34, has no Beclin 1-associated Vps34 kinase activity, and lacks tumor suppressor function in an MCF7 scid mouse xenograft tumor model. The maturation of cathepsin D, which requires intact Vps34-dependent VPS function, is comparable in autophagy-deficient low-Beclin 1 expressing MCF7 cells, autophagy-deficient MCF7 cells transfected with Beclin 1DeltaECD, and autophagy-competent MCF7 cells transfected with wild-type Beclin 1. These findings identify an evolutionarily conserved domain of Beclin 1 that is essential for Vps34 interaction, autophagy function, and tumor suppressor function. Furthermore, they suggest a connection between Beclin 1-associated Class III PI3K/Vps34-dependent autophagy, but not VPS, function and the mechanism of Beclin 1 tumor suppressor action in human breast cancer cells.

Amino Acid Sequence↗

Human renal cell carcinoma xenografts in SCID mice: tumorigenicity correlates with a poor clinical prognosis.

To establish human renal cell carcinoma (RCC) xenografts for preclinical studies, 55 renal tumors (33 primary and 22 metastatic lesions) were transplanted subcutaneously into severe combined immunodeficient mice. Twenty of 49 evaluable tumors (40.8%) grew with a median latency period of 89 days (36 to 209 days) from the day of engraftment. Tumor growth was stabilized after the fifth passage with a median time between passages of 38 days (19 to 80 days). Tumorigenicity was correlated with the metastatic phenotype of the tumor (54% success rate, p = 0.007) and with reduced survival of patients. Despite a possible evolution of histological features and tumor grading, established RCC xenografts were comparable to parental tumors, as assessed by karyotype and DNA-ploidy analyses. Molecular cytogenetic analysis also revealed specific genetic alterations characterizing distinct RCC types that were constant in parental and corresponding xenografts. In addition, this xenograft model has permitted the selection of minor tumor subclones with a proliferative advantage and minimal overexpressed chromosomal regions. We conclude that severe combined immunodeficient mice are useful recipients for the establishment of long-term RCC xenografts that can be used as valuable tools to evaluate the activity of new therapeutic approaches and to study biological parameters determining in vivo aggressiveness of human RCC.

Adult↗

[What are the contributions of experimental studies to the diagnosis and therapy of urological tumors?].

The contribution of experimental research in the diagnostics and therapy of urological malignancies is based on different approaches. One of the most important techniques is the development of tumor markers which can predict progression of the tumor. These markers can be detected by molecular biological techniques, by immunohistochemistry or by other quantification techniques such as morphometry and flowcytometry. New indications for progression are initially researched in tumor model systems. The in vitro systems are extremely well suited for those fundamental studies especially molecular biological analysers, because the tumors in these systems are homogeneously composed and lack the heterogeneity of in vivo tumors. The methodology of markers developed by such techniques have subsequently been tested on human tumor material of which the evolution was known (retrospective analyses). Animal models can also contribute to fundamental research in urological tumors, more particularly to evaluate the efficacy of new experimental therapeutic approaches. Therapies with proven effect in the animal models have to be tested subsequently in humans and if effective, have to be investigated further to improve the dose- and/or route of administration. One result of such research is the use of immunotherapeutics in metastatic renal cell carcinoma. Basic research in oncological urology may in this way contribute to the further improvement of the diagnosis and treatment of urological malignancies.

Animals↗

[Muscle metastases: ultrasonic and x-ray computerized tomographic aspects. Apropos of 9 cases].

Clinical, ultrasound and CT scan examinations were carried out in 9 patients with secondary muscle lesions. All muscles can be affected but there was a marked predominance of psoas lesions (6 of the 9 cases). Two contrasting clinical pictures are seen. Secondary muscle tumors can occur during evolution of a known treated cancer (5 of the 9 cases), revealed usually by large, rarely painful, mass. CT scan imaging shows a heterogeneous mass taking up contrast and often partially necrotic, the lesions appearing hypoechogenic or heterogeneous on ultrasound examination. Certain lesions can be totally necrotic. In some cases (4 of the 9 patients) the muscle metastases revealed the presence of a tumor. Symptomatology may be atypical and lead to a delay in diagnosis. Fine needle puncture biopsy can detect the secondary origin of the muscle lesion and also the primary tumor site (4 out of 9 cases), bronchopulmonary and colon cancer predominating. Images are however non-specific and in the absence of NMR imaging the muscle or lymph node metastases can be confused, although this has no practice consequences since treatment is identical.

Adult↗

The role of chemotherapy in the curative treatment of head and neck cancer.

Historically, the application of chemotherapy in patients with squamous cell head and neck cancer had been limited to the palliative setting; however, the role of chemotherapy in the definitive management of these tumors has undergone great evolution during the last 5 to 10 years. Available randomized data currently support a role for chemotherapy as part of combined modality, curative treatment strategies in the management of patients with unresectable disease, advanced nasopharynx cancer, and as part of a larynx preservation approach in patients with advanced larynx or hypopharynx cancer requiring total laryngectomy. Chemoprevention as a strategy to prevent second primary tumors also shows great promise.

Antineoplastic Agents↗

[Colorectal carcinogenesis, frequency and significance of genetic alterations: deletion of the short arm of chromosome 1, and initiating event].

Cytogenetic anomalies described in colo-rectal tumors are numerous. Despite the complexity and the number of the anomalies observed, a combined study of their frequency and of the stage of prognosis of the tumors suggests that the evolution from colonic adenoma to carcinoma often follows a sequence of events comprising a 5q15-22 deletion (DCC), and a 17p deletion (P53). It even seems likely that in many cases, these events are not constant and that others might lead to the same phenotypic transformation. Chromosome 1 involvement in structural rearrangements has been demonstrated in numerous forms of cancers, malignant blood disorders and in solid tumors. In colorectal adenocarcinoma anomalies have been described on short and/or long arms. In a case of adenoma with mild dysplasia a deletion of the distal part of the short arm of chromosome 1 was observed as an isolated cytogenetic anomaly, suggesting it would be an early, perhaps triggering, event for the tumour development. A cytogenetic study in a series of colo-rectal tumours, researches on loss of heterozygosity and microsatellite instability lead to consider deletions at chromosome 1p as an early event in human colorectal tumourigenesis.

Chromosome Deletion↗

Clonality and genetic divergence in multifocal low-grade superficial urothelial carcinoma as determined by chromosome 9 and p53 deletion analysis.

Multifocality and recurrence are clinically important features of urothelial carcinomas of the urinary bladder. Recent molecular genetic studies have suggested that multifocal urothelial carcinomas are monoclonally derived from an identical transformed progenitor cell. However, most of these studies investigated advanced and poorly differentiated tumors. The study presented focuses on early papillary tumors, including 52 superficial well-differentiated multifocal and recurrent bladder carcinomas from 10 patients. Microdissection separating urothelium from stromal cells was considered essential to obtain pure tumor cell populations. Genetic analysis was carried out by applying two different methods. Dual color fluorescence in situ hybridization (FISH) with centromeric probes for chromosomes 9 and 17 and gene-specific probes for chromosome loci 9q22, 9p21, and 17p13 was carried out in parallel to loss of heterozygosity (LOH) analyses applying 5 microsatellite markers on these chromosomes. Overall, deletions on chromosome 9p were found in 47 tumors (90%), at chromosome 9q in 36 tumors (69%) and at chromosome 17p in 3 tumors (6%). There was a very high correlation of the results between FISH and LOH analysis. Ten early superficial papillary tumors showed deletion of chromosome 9p without deletion of 9q, suggesting 9p deletions as a very early event in the development of papillary urothelial carcinoma. Although in four patients, all investigated tumors showed identical genetic alterations and one patient showed no genetic alterations at the loci investigated, in five patients, two or more clones with different deletions were found. In four of these patients, the results are compatible with clonal divergence and selection of different cell subpopulations derived from a common progenitor cell. However, in one patient different alleles in two markers at chromosome 9 were deleted, favoring an independent evolution of two recurring tumor cell clones. In summary, we could show that there is considerable genetic heterogeneity in early multifocal and recurring urothelial carcinoma and demonstrated the occurrence of two independent clones in at least one patient as an indicator of possible initial oligoclonality of bladder cancer.

Aged↗

Preferred genetic evolutionary sequences in human breast cancer: a case study.

Multiparameter flow cytometry studies were performed on the cells of an aggressive human breast cancer at the time of diagnosis and at relapse. The aneuploid cells that overexpressed large amounts of both HER-2/neu and ras survived intensive chemotherapy and were responsible for tumor relapse. At relapse, these cells were shown to overexpress simultaneously at least five oncogenes: HER-2/neu, ras, EGF receptor, p53 and c-myc. A partial reconstruction of the genetic evolutionary sequence in this tumor indicated that HER-2/neu overexpression was an early step in the sequence. Subsequent HER-2/neu overexpression, EGF receptor overexpression and p53 protein overexpression were each associated with ras overexpression. The data suggest that ploidy and oncogene overexpression cannot be used as independent clinical prognostic factors. The ability to characterize tumors according to the degree of advancement in the genetic evolutionary might serve as a basis for genetic staging for adjuvant therapy.

Adult↗

Evidence of clonal divergence in colorectal carcinoma.

BACKGROUND: The aim of this study was to investigate the generation of DNA ploidy diversity in different stages of colorectal carcinoma development. METHODS: DNA flow cytometry was performed on tissue samples from 20 colorectal adenomas, 38 colorectal carcinomas, 30 lymph node metastases, and 70 hematogenous metastases. RESULTS: DNA aneuploidy was detected in 30% of the adenomas, 82% of the primary colorectal tumors, 57% of the lymph node metastases, 92% of the liver metastases, and 100% of the other distant hematogenous metastases. Multiple DNA tumor stemlines were found in 10%, 39%, 29%, 24%, and 40%, respectively. Sixty-two percent of the DNA tumor stemlines detected in the lymph node or liver metastases were also present in the primary tumors. In primary carcinomas and lymph node metastases, the DNA index distribution had a bimodal shape with a minimum at the 1.2-1.4 region. In the hematogenous metastases, a higher percentage of hypertetraploid stemlines was found. CONCLUSIONS: The emergence of DNA aneuploidy as well as clonal divergence seems to take place during the transition from adenoma to carcinoma. The DNA aneuploid stemlines formed during this phase remain relatively stable over time, although ongoing clonal evolution at distant metastatic tumor sites cannot be completely ruled out.

Adenoma↗

[Detection of Epstein-Barr virus, cell proliferation and apoptosis in thymic tumors].

OBJECTIVE: To investigate the incidence of thymic tumors in Guangzhou, its association with EBV infection and the cell proliferation and apoptosis characteristics of these tumors. METHODS: EBV encoded small RNAs (EBERs) were detected in 43 thymic tumors and 7 thymic hyperplasia samples by use of in situ hybridization, EBNA-1, LMP-1, PCNA, bcl-2 and p53 were examined using immunohistochemical methods, cell apoptosis was evaluated by TUNEL (TdT-mediated dUTP-X nick end labelling) in situ cell death detection kit. RESULTS: 1. Thymic diseases only accounted for 0.057% of biopsies in the Guangzhou area. Thymic tumor and hyperplasia accounted for 74.7% and 18.6% in thymic diseases respectively. Thymic lymphoepithelimoa-like carcinoma (LELC) occurred in 2.7% of thymic tumors. 2. EBV encoded products (EBERs, EBNA-1 and LMP-1) were not detected in 50 thymic disease specimens. 3. Marked proliferation (3+-4+) grade thymomas (0/18 cases) was much lower than that of thymic carcinomas (10/20 cases), and the marked apoptotic (2+-4+) grade was higher in thymomas (15/18) than the thymic carcinomas (13/20). 4. The p53 protein accumulation rate in thymic carcinomas (8/20) was significantly higher than that of thymomas (1/18). The apoptotic grade is significantly related to p53 accumulation in thymic epithelial tumors. 5. The bcl-2 over expression could be detected both in thymomas and thymic carcinomas. CONCLUSIONS: 1. Thymic diseases, including thymic LELC, is very rare in Guangzhou and is not closely associated with EBV infection. 2. Thymic carcinomas have a relatively rapid growth rate compared to thymomas. 3. p53 gene mutation may play an important role in the carcinogenesis of thymic carcinoma, and bcl-2 over-expression may also be involved in the evolution of thymic epithelial tumors. 4. Wild type p53 protein may exert an apoptosis-inducing function in thymic epithelial tumors, including thymomas and carcinomas, and a proliferation inhibiting function only in thymomas.

Adult↗

Etiopathology of feline toxic nodular goiter.

We have discussed the etiopathology of feline toxic nodular goiter in the context of human nodular goiter pathogenesis. We have reviewed thyroid heterogeneity, growth regulation, functional and growth autonomy, nodule and tumor formation, and the evolution of toxic nodular goiter in the human being. By addressing toxic nodular goiter of the cat, the history, morphologic findings, xenotransplantation and cell culture studies, evidence for and against circulating thyroid stimulators and epizootiological studies of the feline disease have been summarized. Due to its structure, the thyroid gland offers some unique possibilities to study the mechanisms that are responsible for cellular heterogeneity, the emergence of autonomous nodular growth and function, and, ultimately, the development of tumors. The demonstration of naturally occurring clones of cells with high intrinsic proliferation potential within the follicular epithelium of the thyroid has fostered promising new concepts on the genesis of nodular growth of benign and possibly malignant endocrine tumors. Hyperthyroid cat goiters contain single or multiple, autonomously (i.e., TSH-independently) functioning and growing nodules. Neither hyperfunction nor growth of these nodules depends on extrathyroidal circulating stimulators. The basic lesion appears to be an excessive intrinsic growth capacity of some thyroid cells. The factors enhancing the transformation of a normal thyroid into a nodular hyperfunctioning goiter over many years are still unknown. Immunological, environmental, and nutritional factors are the focus of ongoing studies, but an infectious agent can not yet be excluded.

Animals↗