Characterization of six tumor suppressor genes and microsatellite instability in hepatocellular carcinoma in southern African blacks

A Review of Cancer Genetics and Genomics Studies in Africa

Cancer is the second leading cause of death globally and is projected to overtake infectious disease as the leading cause of mortality in Africa within the next two decades. Cancer is a group of genomic diseases that presents with intra- and inter-population unique phenotypes, with Black populations having the burden of morbidity and mortality for most types. At large, the prevention and treatment of cancers have been propelled by the understanding of the genetic make-up of the disease of mostly non-African populations. By the same token, there is a wide knowledge gap in understanding the underlying genetic causes of, and genomic alterations associated with, cancer among black Africans. Accordingly, we performed a review of the literature to survey existing studies on cancer genetics/genomics and curated findings pertaining to publications across multiple cancer types conducted on African populations. We used PubMed MeSH terms to retrieve the relevant publications from 1990 to December 2019. The metadata of these publications were extracted using R text mining packages: RISmed and Pubmed.mineR. The data showed that only 0.329% of cancer publications globally were on Africa, and only 0.016% were on cancer genetics/genomics from Africa. Although the most prevalent cancers in Africa are cancers of the breast, cervix, uterus, and prostate, publications representing breast, colorectal, liver, and blood cancers were the most frequent in our review. The most frequently reported cancer genes were BRCA1, BRCA2, and TP53. Next, the genes reported in the reviewed publications’ abstracts were extracted and annotated into three gene ontology classes. Genes in the cellular component class were mostly associated with cell part and organelle part, while those in biological process and molecular function classes were mainly associated with cell process, biological regulation, and binding, and catalytic activity, respectively. Overall, this review highlights the paucity of research on cancer genomics on African populations, identified gaps, and discussed the need for concerted efforts to encourage more research on cancer genomics in Africa.

Involvement of DNA damage response pathways in hepatocellular carcinoma

Hepatocellular carcinoma (HCC) has been known as one of the most lethal human malignancies, due to the difficulty of early detection, chemoresistance, and radioresistance, and is characterized by active angiogenesis and metastasis, which account for rapid recurrence and poor survival. Its development has been closely associated with multiple risk factors, including hepatitis B and C virus infection, alcohol consumption, obesity, and diet contamination. Genetic alterations and genomic instability, probably resulted from unrepaired DNA lesions, are increasingly recognized as a common feature of human HCC. Dysregulation of DNA damage repair and signaling to cell cycle checkpoints, known as the DNA damage response (DDR), is associated with a predisposition to cancer and affects responses to DNA-damaging anticancer therapy. It has been demonstrated that various HCC-associated risk factors are able to promote DNA damages, formation of DNA adducts, and chromosomal aberrations. Hence, alterations in the DDR pathways may accumulate these lesions to trigger hepatocarcinogenesis and also to facilitate advanced HCC progression. This review collects some of the most known information about the link between HCC-associated risk factors and DDR pathways in HCC. Hopefully, the review will remind the researchers and clinicians of further characterizing and validating the roles of these DDR pathways in HCC.

Molecular classification of hepatocellular carcinoma anno 2011

Hepatocellular carcinoma has an increasing incidence and high mortality. Treatment options are limited if the disease is not diagnosed in its early stage. The natural course of the disease is aggressive but not always predictable. Molecular profiling is a promising tool for classification in order to optimize prognosis prediction and treatment for an individual patient. In the last decade a large amount of studies has been conducted to better classify hepatocellular carcinomas. The focus of this review is on implications of molecular classification for prognosis and therapeutic decision making in HCC patients. Most studies used microarray technique for genome wide profiling, but other methods to detect genomic changes and microRNA are gaining interest. The whole genome profiling studies identified differences in affected signalling and tried to relate this to prognosis. Some common subgroups were identified, such as the proliferation cluster and the beta-catenin cluster. However, there is still little overlap between most studies. Better study design and bio-informatical analysis might help in this context.

Microsatellite instability in hepatocellular carcinoma in non-cirrhotic liver in patients older than 60 years

AIM

Hepatocellular carcinoma (HCC) in otherwise normal liver is rare, its pathogenesis remains obscure and the literature on the subject is scarce. We investigated microsatellite instability (MSI) in eight elderly patients (median age 70.7, range 63-76 years) without a clinical history of liver disease and who underwent liver resection for HCC in otherwise normal background liver between 2001 and 2005 at King's College Hospital, London.

METHODS

Immunohistochemistry for mutL homolog 1 (MLH1), mutS homolog 2 (MSH2), mutS homolog 6 (MSH6) and post-meiotic segregation increased 2 (PMS2) was carried out on formalin-fixed and paraffin-embedded sections of tumor and background liver. MSI analysis was performed using a panel of monomorphic microsatellites markers: BAT-25, BAT-26, NR21, NR24 and NR27 and pentaplex PCR.

RESULTS

All HCC were solitary large tumors. Two also had satellite nodules. The background liver was usually unremarkable. There was nuclear expression of MLH1, MSH2, MSH6 and PMS2 in all tumors excluding a DNA mismatch repair defect. The same pattern of staining was noted in the hepatocytes of the background liver of all cases. No differences between microsatellite lengths in the background liver and in the tumor, as assessed in PCR products, were found for any of the five microsatellite markers in any patients. These findings provided no evidence for MSI.

CONCLUSION

Our study showed that MSI is not implicated in the pathogenesis of a subset of HCC affecting elderly patients without chronic liver disease. Further studies are needed to clarify the pathogenesis of HCC in this particular setting.

The R246S hot-spot p53 mutant exerts dominant-negative effects in embryonic stem cells in vitro and in vivo

p53 is the most frequently mutated tumour-suppressor gene in human cancers. Mutant p53 is thought to contribute to carcinogenesis by the acquisition of gain-of-function properties or through the exertion of dominant-negative (DN) effects over the remaining wild-type protein. However, the context in which the DN effects are observed is not well understood. We have therefore generated `knock-in' mouse embryonic stem (ES) cells to investigate the effects of expressing a commonly found hot-spot p53 mutant, R246S – the mouse equivalent of human R249S, which is associated with hepatocellular carcinomas. We demonstrate here that R246S mutant p53 exhibits DN effects with respect to target gene expression, cell survival and cell cycle arrest both in cells that are in the undifferentiated state and upon differentiation. The knock-in cells contain higher levels of p53 that localizes to the nucleus even in the absence of genotoxic stress and yet remains non-functional, reminiscent of mutant p53 found in human tumours. In a model based on carbon-tetrachloride-induced liver injury, these cells were consistently highly tumorigenic in vivo, similar to p53–/– cells and in contrast to both p53+/+ and p53+/– ES cells. These data therefore indicate that the DN effects of mutant p53 are evident in the stem-cell context, in which its expression is relatively high compared with terminally differentiated cells.

Hepatocellular carcinoma pathogenesis: from genes to environment

Hepatocellular carcinoma is among the most lethal and prevalent cancers in the human population. Despite its significance, there is only an elemental understanding of the molecular, cellular and environmental mechanisms that drive disease pathogenesis, and there are only limited therapeutic options, many with negligible clinical benefit. This Review summarizes the current state of knowledge of this, the most common and dreaded liver neoplasm, and highlights the principal challenges and scientific opportunities that are relevant to controlling this accelerating global health crisis.

Effect of oncogenes on differentiation and transformation of rat oval cells

AIM: To study the effects of oncogenes on differentiation and transformation of oval cells by detecting and characterizing the expression of AFP and Ha-ras, c-myc genes of rat oval cells in vitro.

METHODS: Proliferation of rat oval cells was induced by chemical carcinogen, 3'-Me-DAB. By using Percoll density gradient centrifugation method, oval cells were isolated,followed by continous cultivation in vitro. The expression of Ha-ras and c-mycgenes and AFP in the oval cells from cultures was dynamically observed by RNA-DNA slot blot hybridization and flow cytometry.

RESULTS: The expression of AFP and Ha-ras, c-myc genes in the cultured oval cells from different phases was synchronous: At the beginning of oval cell cultivation in vitro, both of AFP and oncogenes displayed a higher level expression and then declined. Up to 20th passage, the expression of AFP and oncogenes went up again and then kept a lower level. To 65th passage, the oval cells not only presented a growth rate increased, population doubling time shortened, adiploid chromosomes and growing on soft agar, but also the expression of oncogenes and AFP went up again.

CONCLUSION: Oncogenes and their products participate not only in the regulation of cellular transformation, but also in the process of cell differentiation.

Differentiation of hepatocellular carcinoma SMMC-7721 cell line induced by Chinese medicine recipe Weichangan

AIM

To observe the differentiation in hepatocellular carcinoma cell line induced by Chinese medicine recipe Weichangan.

METHODS

Weichangan, contrasted by the retinoic acid and distilled water, was made by using serum pharmacological method. The inhibition on the growth of SMMC-7721 cell line by Weichangan was observed through the method of MTT and Alamar Blue. Radioimmunoassay was applied to determine the concentration of a-fetoprotein and albumin secreted by the incubated cells. Western blot method was used to detect the mutant p53, p16 and p21 protein expression in SMMC-7721 cell line.

RESULTS

MTT assay showed both Weichangan and serum retinoic acid had inhibiting effect on the proliferation of human hepatocellular carcinoma SMMC-7721 cell line. Weichangan reached its maximal inhibition effect after 48 hours, while the effect of retinoic acid decreased gradually after 48 hours. Alamar Blue method showed that significant decrease was found in serum Weihangan after 16 hours compared with that in the control. After 32 hours, the decrease induced by Alamar Blue was more significant than that in cells incubated with serum Weichangan compared with those incubated in serum retinoic acid, indicating the gradual and durable action of Weichangan recipe. The decreased amount (11.4±1.4 mg/L vs 17.2±1.1 mg/L, P =0.036) of a-fetoprotein and increased amount (0.40±0.02 mg/L vs 0.29±0.01 mg/L, P =0.043) of albumin were found in the cells incubated in serum Weichangan. Western blot method showed decreased expression of p53 protein and increased expression of p16 and p21 protein in cells incubated in serum Weichangan.

CONCLUSION

The results suggest that Weichangan inhibits the growth of SMMC-7721 cell line and induces the differentiation in this hepatocellular carcinoma cell line. The effect on p53, p16 and p21 may be the mechanisms of Weichangan in inducing the differentiation of this cell lines.

Expressive characteristic and biological significance of oncogenes during rat hepatocarcinogenesis

AIM

To explore the expressive characteristic and biological significance of oncogenes during experimental hepatocarcinogenesis in rat.

METHODS

A rat model of liver carcinoma was induced with carcinogen 3-Me-DAB. The hepatic expressive characteristic of Ha-ras, c-myc and Ki-ras rats in varied stages in induction of cancer were examined with in situ hybridization and RNA slot blot hybridization.

RESULTS

The hepatic expression and distribution of Ha-ras and c-myc were similar in different periods of cancer induction. In early stage of carcinoma induction, there were more positive cells of Ha-ras and c-myc but little Ki-ras positive cells. In late stage of carcinoma induced, the number of positive cells of three oncogenes was decreased; On the 17th week of induction of cancer, the signals of three oncogenes in all the cancer nodules were negative or weak but stronger in hepatic peri-cancer tissues.

CONCLUSION

Oncogenes Ha-ras and c-myc were activated and had synergistic effect on the malignant transformation of cells in early stage of hepatocarcinogenesis. Ki-ras might be activated in late stage of hepatocarcinogenesis and associated with malignant transformation of hepatocytes.

Biological characteristics of HCC by ultrasound-guided aspiration biopsy and its clinical application

AIM: To probe the pathological biological characteristics of hepatocellular carcinoma (HCC) by the ultrasound-guided aspiration biopsy and assess the clinical application value of this method.

METHODS: The biopsy and DNA analysis by flow cytometry (FCM) were taken in 46 cases with HCC nodules, including 26 cases and 20 cases with nodules ≤ 3 cm and > 3 cm in diameters respectively, and 12 cases with intrahepatic benign hyperplastic nodules. They were taken in 22 cases of 46 cases with HCC before and after the therapy. Fine-needles and automatic histological incised biopsy needles were used. The fresh biopsy tissue was produced into the single cell suspension, which was sent for DNA detection and ratio analysis of cell period. The ratio of each DNA period of cell proliferation of each group was calculated and compared with each other. The DNA aneuploid (AN) and apoptosis cell peak were observed and their percentages were calculated.

RESULTS: The ratios of S and G₂/M periods of DNA, which reflect cell hyperproliferation, in the group with HCC tumors > 3 cm in diameter were markedly higher than those of the group with HCC nodules ≤ 3 cm in diameter and the group with the benign hyperplastic nodules (P < 0.01 except A:B of S period, P < 0.05). The ratios of the middle group were also apparently higher than those of the latter group (P < 0.01). The ratio of DNA AN of 46 cases with HCC nodules was 34.8% (16/46). None of the cases with the intrahepatic hyperplastic nodules appeared AN. The DNA AN appeared more apparently with the growth of the tumors. The AN ratio of the group with tumors > 3 cm in diameter was 55% (11/20), markedly higher than that of the group with tumors ≤ 3 cm in diameter which was 19.2% (5/26) (P < 0.01). The FCM DNA analysis of 22 specimens of hepatic carcinoma tissue before therapy showed that the aneuploid peaks appeared in 5 cases (22.7%). The ratio of G₁ period rose after therapy while the S period and G₂/M ratios fell (P < 0.01). The aneuploid peak disappeared in the 5 cases after the therapy, while the apoptosis peaks in 12 cases (54.5%) appeared.

CONCLUSION: Addition to supply the information of the pathological morphology of the tumor, the ultrasound-guided fine-needle aspiration tissue could be sent for FCM DNA analysis to comprehend its pathological biological characteristics. This can not only provide the clinic the reliable information about the occurrence, development, diagnosis, curative effect and prognosis of tumors but also supply biological information for clinic to choose therapeutic schemes.

Codon 249 mutation in exon 7 of p53 gene in plasma DNA: maybe a new early diagnostic marker of hepatocellular carcinoma in Qidong risk area, China

AIM: One of the characteristics of hepatocellular carcinoma (HCC) in Qidong area is the selective mutation resulting in a serine substitution at codon 249 of the p53 gene (1, 20), and it has been identified as a “hotspot” mutation in heptocellular carcinomas occurring in populations exposed to aflatoxin and with high prevalence of hepatitis B virus carriers (2, 3, 9, 10, 16, 24). We evaluated in this paper whether this “hotspot” mutation could be detected in cell-free DNA circulating in plasma of patients with hepatocellular carcinoma and cirrhosis in Qidong, China, and tried to illustrate the significance of the detection of this molecular biomarker.

METHODS: We collected blood samples from 25 hepatocellular carcinoma patients, 20 cirrhotic patients and 30 healthy controls in Qidong area. DNA was extracted and purified from 200 µl of plasma from each sample. The 249^Ser p53 mutation was detected by restriction digestion analysis and direct sequencing of exon-7 PCR products.

RESULTS: We found in exon 7 of p53 gene G→T transversion at the third base of codon 249 resulting 249^Arg→249^Ser mutation in 10/25 (40%) hepatocellular carcinoma cases, 4/20 (20%) cirrhotics, and 2/30 (7%) healthy controls. The adjusted odds ratio for having the mutation was 22.1 (95%CI, 3.2~91.7) for HCC cases compared to controls.

CONCLUSION: These data show that the 249^Ser p53 mutation in plasma is strongly associated with hepatocellular carcinoma in Qidong patients. We found this mutation was also detected, although it was at a much lower frequency, in plasma DNA of Qidong cirrhotics and healthy controls; We consider that these findings, together with the usual method of HCC diagnosis, will give more information in early diagnosis of HCC, and 249^Ser p53 mutation should be developed to a new early diagnostic marker for HCC.

Mutation and methylation of hMLH1 in gastric carcinomas with microsatellite instability

AIM: To appraise the correlation of mutation and methylation of hMSH1 with microsatellite instability (MSI) in gastric cancers.

METHODS: Mutation of hMLH1 was detected by Two-dimensional electrophoresis (Two-D) and DNA sequencing; Methylation of hMLH1 promoter was measured with methylation-specific PCR; MSI was analyzed by PCR-based methods.

RESULTS: Sixty-eight cases of sporadic gastric carcinoma were studied for mutation and methylation of hMLH1 promoter and MSI. Three mutations were found, two of them were caused by a single bp substitution and one was caused by a 2 bp substitution, which displayed similar Two-D band pattern. Methylation of hMLH1 promoter was detected in 11 (16.2%) gastric cancer. By using five MSI markers, MSI in at least one locus was detected in 17/68 (25%) of the tumors analyzed. Three hMLH1 mutations were all detected in MSI-H (≥ 2 loci, n = 8), but no mutation was found in MSI-L (only one locus, n = 9) or MSS (tumor lacking MSI or stable, n = 51). Methylation frequency of hMLH1 in MSI-H (87.5%, 7/8) was significantly higher than that in MSI-L (11.1%, 1/9) or MSS (5.9%, 3/51) (P < 0.01-0.001), but no difference was found between MSI-L and MSS (P > 0.05).

CONCLUSION: Both mutation and methylation of hMLH1 are involved in the MSI pathway but not related to the LOH pathway in gastric carcinogenesis.

Methylation of hMLH1 and hMSH2 promoter in colorectal cancer with microsatellite instability

AIM: To explore methylation of hMLH1 and hMSH2 promoter with microsatellite instability (MSI) in colorectal carcinomas.

METHODS: Methylation of hMLH1 and hMSH2 promoter was measured with methylation-specific PCR; MSI was analyzed by PCR-based methods.

RESULTS: No methylation of hMLH1 and hMSH2 promoter was found in 10 normal colorectal mucosas. Seventy-six cases of sporadic colorectal carcinoma were studied for methylation of hMLH1 and hMSH2 promoter and MSI. Methylation of hMLH1 promoter was detected in 8 (10.5%)colorectal carcinomas and none in hMSH2. Frequence of hMLH1 methylation on right-sided colorectal cancer (23.1%)was significantly higher than that on left one (4.0%, P < 0.05). MSI was detected in at least one locus in 26.3%(20/76) of the tumors analyzed with five microsatellite markers. Frequence of hMLH1 methylation in gastric cancer with MSI-H (80.0%)was significantly higher than that in gastric cancer with MSI-L (20.0%, P < 0.01) and with MSS (10.7%, P < 0.001).

CONCLUSION: Methylation of hMLH1 promoter is related to right-sided colorectal cancer and involved in the MSI pathway.

Expression of p53 and C-myc genes and its clinical relevance in the hepatocellular carcinomatous and pericarcinomatous tissues

AIM

To investigate the possible roles of p53 and C-myc genes in the primary hepatocellular carcinogenesis and the relationship between the liver hyperplastic nodule (LHN) and hepatocellular carcinoma(HCC).

METHODS

The expression of p53 and C-myc genes was detected immunohistochemically in 73 and 60 cases of HCC and pericarcinomatous tissues, respectively.

RESULTS

The positive expression of p53 in HCC was significantly higher than that in pericarcinomatous tissues (P<0.05). In pericarcinomatous tissues, the p53 expression was observed only in LHN, but not in liver cirrhosis (LC) and normal liver tissues. The positive expression rate of C-myc in HCC or LHN was significantly higher than that in LC or normal liver tissues (P<0.05 and P<0.01), however, no significant difference was found between HCC and LHN (P>0.05). The positive expression rate of p53 and C-myc in HCC was correlated with the histological differentiation, that in the poorly differentiated was significantly higher than that in well differentiated samples (P<0.05).

CONCLUSION

The overexpression of p53 and C-myc genes might play a role in the carcinogenesis of HCC; And LHN seems a preneoplastic lesion related to hepatocarcinogenesis; No evidence supports that LC contribute directly to the hepatocarcinogenesis.

Expression of liver cancer associated gene HCCA3

AIM: To study and clone a novel liver cancer related gene, and to explore the molecular basis of liver cancer genesis.

METHODS: Using mRNA differential display polymerase chain reaction (DDPCR), we investigated the difference of mRNA in human hepatocellular carcinoma (HCC) and paired surrounding liver tissues, and got a gene probe. By screening a human placenta cDNA library and genomic homologous extend, we obtained a full-length cDNA named HCCA3. We analyzed the expression of this novel gene in 42 pairs of HCC and the surrounding liver tissues, and distribution in human normal tissues by means of Northern blot assay.

RESULTS: A full-length cDNA of liver cancer associated gene HCCA3 has been submitted to the GeneBank nucleotide sequence databases (Accession No. AF276707). The positive expression rate of this gene was 78.6% (33/42) in HCC tissues, and the clinical pathological data showed that the HCCA3 was closely associated with the invasion of tumor capsule (P = 0.023) and adjacant small metastasis satellite nodules lesions (P = 0.041). The HCCA3 was widely distributed in the human normal tissues, which was intensively expressed in lungs, brain and colon tissues, while lowly expressed in the liver tissues.

CONCLUSION: A novel full-length cDNA was cloned and differentiated, which was highly expressed in liver cancer tissues. The high expression was closely related to the tumor invasiveness and metastasis, that may be the late heredited change in HCC genesis.