p53 accumulation in favorable-histology Wilms tumor is associated with angiogenesis and clinically aggressive disease

The TGFβ-signaling pathway and colorectal cancer: associations between dysregulated genes and miRNAs

Background

The TGFβ-signaling pathway plays an important role in the pathogenesis of colorectal cancer (CRC). Loss of function of several genes within this pathway, such as bone morphogenetic proteins (BMPs) have been seen as key events in CRC progression.

Methods

In this study we comprehensively evaluate differential gene expression (RNASeq) of 81 genes in the TGFβ-signaling pathway and evaluate how dysregulated genes are associated with miRNA expression (Agilent Human miRNA Microarray V19.0). We utilize paired carcinoma and normal tissue from 217 CRC cases. We evaluate the associations between differentially expressed genes and miRNAs and sex, age, disease stage, and survival months.

Results

Thirteen genes were significantly downregulated and 14 were significantly upregulated after considering fold change (FC) of > 1.50 or < 0.67 and multiple comparison adjustment. Bone morphogenetic protein genes BMP5, BMP6, and BMP2 and growth differentiation factor GDF7 were downregulated. BMP4, BMP7, INHBA (Inhibin beta A), TGFBR1, TGFB2, TGIF1, TGIF2, and TFDP1 were upregulated. In general, genes with the greatest dysregulation, such as BMP5 (FC 0.17, BMP6 (FC 0.25), BMP2 (FC 0.32), CDKN2B (FC 0.32), MYC (FC 3.70), BMP7 (FC 4.17), and INHBA (FC 9.34) showed dysregulation in the majority of the population (84.3, 77.4, 81.1, 80.2, 82.0, 51.2, and 75.1% respectively). Four genes, TGFBR2, ID4, ID1, and PITX2, were un-associated or slightly upregulated in microsatellite-stable (MSS) tumors while downregulated in microsatellite-unstable (MSI) tumors. Eight dysregulated genes were associated with miRNA differential expression. E2F5 and THBS1 were associated with one or two miRNAs; RBL1, TGFBR1, TGIF2, and INHBA were associated with seven or more miRNAs with multiple seed-region matches. Evaluation of the joint effects of mRNA:miRNA identified interactions that were stronger in more advanced disease stages and varied by survival months.

Conclusion

These data support an interaction between miRNAs and genes in the TGFβ-signaling pathway in association with CRC risk. These interactions are associated with unique clinical characteristics that may provide targets for further investigations.

Electronic supplementary material

The online version of this article (10.1186/s12967-018-1566-8) contains supplementary material, which is available to authorized users.

Significance of TP53 Mutation in Wilms Tumors with Diffuse Anaplasia: A Report from the Children's Oncology Group

PURPOSE

To investigate the role and significance of TP53 mutation in diffusely anaplastic Wilms tumors (DAWTs).

EXPERIMENTAL DESIGN

All DAWTs registered on National Wilms Tumor Study-5 (n = 118) with available samples were analyzed for TP53 mutations and copy loss. Integrative genomic analysis was performed on 39 selected DAWTs.

RESULTS

Following analysis of a single random sample, 57 DAWTs (48%) demonstrated TP53 mutations, 13 (11%) copy loss without mutation, and 48 (41%) lacked both [defined as TP53-wild-type (wt)]. Patients with stage III/IV TP53-wt DAWTs (but not those with stage I/II disease) had significantly lower relapse and death rates than those with TP53 abnormalities. In-depth analysis of a subset of 39 DAWTs showed seven (18%) to be TP53-wt: These demonstrated gene expression evidence of an active p53 pathway. Retrospective pathology review of TP53-wt DAWT revealed no or very low volume of anaplasia in six of seven tumors. When samples from TP53-wt tumors known to contain anaplasia histologically were available, abnormal p53 protein accumulation was observed by immunohistochemistry.

CONCLUSIONS

These data support the key role of TP53 loss in the development of anaplasia in WT, and support its significant clinical impact in patients with residual anaplastic tumor following surgery. These data also suggest that most DAWTs will show evidence of TP53 mutation when samples selected for the presence of anaplasia are analyzed. This suggests that modifications of the current criteria to also consider volume of anaplasia and documentation of TP53 aberrations may better reflect the risk of relapse and death and enable optimization of therapeutic stratification. Clin Cancer Res; 22(22); 5582-91. ©2016 AACR.

Wilms' tumour: Determinants of prognosis in an African setting

BACKGROUND

The few studies available in the literature on Wilms' tumour (WT) from sub-Saharan Africa have reported a dismal outcome for children with the tumour. This study evaluated the risk factors that have been correlated with outcome in the literature and compare these with outcome among our patients.

MATERIALS AND METHODS

Cases of histologically confirmed WT between 2009 and 2013 in a tertiary hospital in Northwestern Nigeria were evaluated for gender, age, laterality, symptoms, duration before presentation, stage at presentation, histologic subtype and p53 mutation. These were then correlated with outcome.

RESULTS

Totally, 30 cases of WT were diagnosed with mean age of 4.8 ± 1.9 years; and male:female ratio of 2:1. No statistically significant relationship with outcome was found for gender (P = 0.138) or histologic subtype (P = 0.671). The most significant variables which positively influenced the outcome were presentation at earlier stages (P = 0.007) and completion of therapy (P = 0.0007). p53 mutation was seen in 3 (16.7%) of 18 cases and was not associated with a poor outcome (P = 0.089). However, 2 of the 3 cases presented in Stage IV and none of them survived the 1 st year.

CONCLUSION

This study shows that even though p53 mutation was associated with a more aggressive phenotype, the most significant determinants of a good outcome among patients in a developing country like ours is non-blastemal dominant histologic subtype, early stage at presentation and completion of therapy.

Astrocyte elevated gene-1 overexpression in histologically favorable Wilms tumor is related to poor prognosis

OBJECTIVE

Astrocyte elevated gene-1 (AEG-1) is associated with tumorigenesis and progression in various types of human cancers. However, the status of AEG-1 expression and its significance in Wilms tumor are still unclear. In this study, we investigated the expression of AEG-1 and evaluated its clinical and prognostic significance in favorable-histology Wilms tumor (FHWT).

MATERIALS AND METHODS

Immunohistochemistry was performed to examine AEG-1 protein expression in paraffin-embedded tissues from 38 FHWT patients. All patients underwent radical nephrectomy from January 2003 to June 2008 with subsequent therapy according to National Wilms Tumor Study Group protocols. Statistical analyses were performed to evaluate the association between AEG-1 expression and clinical parameters.

RESULTS

We found high AEG-1 expression in 17 of 38 (44.7%) patients. AEG-1 expression was significantly correlated with clinical stage (p = 0.019) and status of recurrence (p = 0.023). Importantly, patients with high AEG-1 expression had a shorter disease-free survival and overall survival compared with those with low AEG-1 expression (p = 0.011 and p = 0.013).

CONCLUSION

AEG-1 expression is associated with FHWT outcome in this study, and AEG-1 may represent a novel and valuable predictor for prognostic evaluation of FHWT patients.

Relation between expression pattern of wild-type p53 and multidrug resistance proteins in human nephroblastomas

One of the best characterized resistance mechanisms of human cancer is multidrug resistance (MDR) mediated by P-glycoprotein (Pgp/MDR1) and multidrug-resistant related protein (MRP1). In addition to Pgp/MDR1 and MRP1, p53 inactivation or mutation might play a relevant role in therapeutic failure. This study involved 25 children (17 girls and 8 boys) aged 7 months to 10 years treated for unilateral Wilms' tumor. 25 tissue samples of Wilms' tumor and 5 samples of normal human kidneys were obtained from the Department of Pathological Anatomy, Jessenius Faculty of Medicine in Martin, Slovak Republic. We used an indirect immunohistochemical method to determine expression of Pgp/MDR1, MRP1 and wild-type p53 in 25 tissue samples of nephroblastoma. The minority of nephroblastoma specimens showed positivity for both MDR proteins, as well as for wild-type p53. 24% of tissue samples revealed positive results for Pgp/MDR1, 48% for MRP1 and 8% for wild-type p53. Furthermore, our study showed a statistically significant difference between p53 and MRP1 protein expression (p<0.01), but not between p53 and Pgp/MDR1 (p>0.05). No correlation was found between the expression of both multidrug resistance proteins (Pgp/MDR1 and MRP1) and the expression of wild-type p53. Immunohistochemical detection of the expression of MDR proteins and wild-type p53 at the time of diagnosis might assist in choosing specific chemotherapeutics to improve prognosis and therapy.

Study of histopathological features and proliferation markers in cases of Wilms' tumor

Context:

The spectrum of pediatric renal tumors is different from adult renal tumors, and Wilms’ tumor (WT) forms the majority. The histological type and clinicopathological staging are the two important prognostic parameters. The role of newer prognostic factors is not clear.

Aims:

This study was performed to analyze the histopathological spectrum of pediatric renal tumors and to study the expression of proliferation markers (Ki-67 and p53) in WT and correlate its expression in epithelial and blastema components in different stages.

Materials and Methods:

Twenty-seven cases of pediatric renal tumors were collected over 2 years. Hematoxylin-eosin staining was used for diagnosis. Immunostaining was performed for Ki-67 and p53. Ki-67 proliferation index (PI) and p53 expression were determined in each case and for the epithelial and blastema components separately.

Statistical Analysis and Results:

We had 20 cases of WT (74.1%), three cases of mesoblastic nephroma (11.1%), three cases of clear cell sarcoma (11.1%) and one case of rhabdoid tumor (3.7%). It was observed that the PI of the epithelial component (57.2%) was significantly higher than that of blastema (39.53%) in all stages. The PI in Stage II is significantly higher than that in Stage I. Statistical analysis could not be performed in Stages III and IV due to the small number of cases. p53 expression did not show any significant difference in the epithelial and blastema components. There was also no significant difference between the stages.

Conclusion:

In this study, we found the differences between PI of different tissue components of WT, with the epithelial component having a higher PI, which correlated with the stage of advancement of the disease.

p53 Immunohistochemistry expression in Wilms tumor: a prognostic tool in the detection of tumor aggressiveness

PURPOSE

We studied whether immunohistochemical expression of p53 in Wilms tumors correlates with tumor aggressiveness. We also examined whether preoperative chemotherapy results in any alteration of p53 expression.

MATERIALS AND METHODS

A total of 18 patients underwent preoperative chemotherapy and 30 underwent immediate surgery for Wilms tumor. All children were younger than 10 years and had histologically confirmed disease. Patients with a bilateral tumor or a syndrome related to Wilms tumor were excluded. All pathology slides were uniformly stained for p53 protein, and p53 staining density and intensity were scored. The p53 scoring was then compared to the clinical behavior of the Wilms tumor, ie unfavorable tumor staging, and survival and recurrence rates.

RESULTS

In the direct surgery and the preoperatively treated groups p53 positivity correlated with unfavorable Wilms tumor staging (p = 0.007). In addition, a positive p53 correlation predicted poorer survival (p = 0.017). Interestingly patients who underwent preoperative chemotherapy had an increased intensity of p53 staining compared to the direct surgery group (p <0.001).

CONCLUSIONS

This study provides preliminary evidence that a higher score for immunohistochemical p53 expression correlates with unfavorable Wilms tumor staging and predicts poorer survival. This test could become a useful addition to the current histopathological analysis of Wilms tumor.

Apoptotic protein expression in favorable-histology Wilms tumor correlates with tumor recurrence

PURPOSE

Outcome for patients with Wilms tumor (WT) with favorable histology is good. Deletions of chromosomes 1p and 16q impart a poorer outcome. Value of apoptotic protein expression is not clear.

METHODS

Expression of four immunohistochemically detectable apoptosis-regulating proteins (bcl-2, bcl-x, bax and p53) were analyzed in 30 specimens of WT and compared to recurrence and recurrence-free survival (RFS).

RESULTS

The 30 patients included ranged from 4 to 72 months in age (mean 31). The mean available follow-up was 35.3 months (range 1-54). Six patients developed recurrence. The 5-year RFS for blastema-predominant tumors was 40% as compared to 91% for triphasic histology which was significant (p = 0.048). The 5-year RFS in patients with bcl-2 negative tumors was 63% as compared to 100% for bcl-2 positive tumors, the difference being significant (p = 0.019). The 5-year RFS in patients with p-53 positive tumors was 27% as compared to 91% for p-53 negative tumors; however, this difference in the RFS was not statistically significant (p = 0.143). bax and bcl-x expression were not related to the RFS.

CONCLUSIONS

Tumors that are bcl-2 negative have a relatively higher recurrence rate and a poorer RFS. They may benefit from a more intensive follow-up regime for early detection of recurrence.

Candidate genes and potential targets for therapeutics in Wilms' tumour

Wilms' tumour (WT) is the most common malignant renal tumour of childhood. During the past two decades or so, molecular studies carried out on biopsy specimens and tumour-derived cell lines have identified a multitude of chromosomal and epigenetic alterations in WT. In addition, a significant amount of evidence has been gathered to identify the genes and signalling pathways that play a defining role in its genesis, growth, survival and treatment responsiveness. As such, these molecules and mechanisms constitute potential targets for novel therapeutic strategies for refractory WT. In this report we aim to review some of the many candidate genes and intersecting pathways that underlie the complexities of WT biology.

Angiogenesis in hepatocellular carcinoma: the retrospectives and perspectives

Hepatocellular carcinoma (HCC) is a typical hypervascular tumor. Many angiogenic factors have been studied in HCC, and several anti-angiogenic therapies have been tested in animal models and patients. This paper summarizes the latest findings, especially regarding the clinical significance of endothelial cell markers and angiogenic factors in HCC, and experimental and clinical anti-angiogenesis therapies. Further developments in this area, such as endothelial cell-oriented research and better experimental and clinical designs in the evaluation of anti-angiogenic therapies are discussed.

Human epidermal growth factor receptor signaling contributes to tumor growth via angiogenesis in her2/neu-expressing experimental Wilms' tumor

BACKGROUND

The human epidermal growth factor family (HER) members play a significant role in the mesenchymal-to-epithelial transition during renal tubulogenesis. HER misexpression has been linked also to loss of growth control, invasiveness, and promotion of angiogenesis in breast cancers and other human malignant tumors

METHODS

The authors screened Wilms' tumor samples and derived cell lines for expression of her2/neu, which was detected in both unfavorable and favorable histology tissues. Xenografts were implanted in mice using her2/neu(+) and her2/neu(-) cell lines and the effect of specific blockade tested using monoclonal anti-her2/neu antibody.

RESULTS

Blocking antibody suppressed tumor growth in her2/neu(+) but not her2/neu(-) experimental Wilms' tumor. In addition, antibody exposure resulted in suppression of tumor angiogenesis but no decrease in tumor cell proliferation in her2/neu(+) xenografts.

CONCLUSIONS

Her2/neu contributes to the growth of some Wilms' tumors, and an important mechanism of its action is promotion of angiogenesis.

Increased microvascular density predicts relapse in Wilms' tumor

BACKGROUND/PURPOSE

Tumor stage and histology are the most important prognostic criteria in Wilms' tumors; however, a subset of patients remains who have favorable histology tumors and unexpectedly relapse. The authors postulated that increased microvascular density (MVD), a hallmark for angiogenesis, could identify patients at risk for relapse.

METHODS

A case-control study was used to compare relapse (n = 15) with nonrelapse tumors (n = 35). Tumor MVD was counted in 5 random high-powered fields (hpf) using anti-Factor VIII antibody and expressed as mean vessel count/hpf +/- SEM. MVD and clinical data were evaluated using univariate analysis and student's t test.

RESULTS

The relapse group had higher MVD than the nonrelapse group (34.9 +/- 2.9 v 22.4 +/- 2; P <.05). When evaluating the favorable histology (FH) group alone, there was higher MVD in the relapse group (32.4 +/- 2.7 v 19 +/- 1.8; P <.05). MVD was found to be the only predictor of relapse when compared with age, sex, tumor weight, and histology.

CONCLUSIONS

These results suggest that increased MVD can identify Wilms' tumor patients at high risk for relapse, especially those patients with favorable histology tumors. A larger study is warranted to determine the potential utility of MVD in stratification of Wilms' tumor patients.

Wilms' tumor growth is suppressed by antiangiogenic pigment epithelium-derived factor in a xenograft model

BACKGROUND/PURPOSE

Pigment epithelium-derived factor (PEDF), a potent endogenous inhibitor of angiogenesis, is highly expressed in the kidney. The authors postulated that systemic administration of PEDF would decrease Wilms' tumor growth in a xenograft model, and increased renal vascularity would result in a mouse null for PEDF.

METHODS

Tumors were induced in athymic mice using human anaplastic Wilms' tumor cells. Purified PEDF protein or vehicle was administered for 7 days beginning 2 to 3 weeks after inoculation. Tumors were stained with anti-PEDF and anti-Factor VIII antibodies. Mitoses and microvascular density (MVD) were counted per high-power field (hpf). PEDF-null mice were generated on a SV129/C57Bl6 background. Wild-type and null kidneys were assessed for MVD.

RESULTS

Mean tumor weight in the 2-week group was 60% less than controls (P <.05). The MVD and mitotic count in treated tumors were significantly less than controls (P <.05). PEDF stained strongly in normal kidneys but was minimal to absent in Wilms' tumor. PEDF-null kidneys had increased MVD compared with wild-type (P <.05).

CONCLUSIONS

PEDF is expressed strongly in normal murine kidney, and loss of its angioinhibitory activity may contribute to pathologic angiogenesis in Wilms' tumor. Systemic PEDF suppresses WT growth by targeting both the tumor cells and its associated vasculature.