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Støyten M, Knutsen T, Stikbakke E, Agledahl I, Wilsgaard T, Eggen AE, Richardsen E, Giovannucci E, Thune I, Haugnes HS. Excess weight, weight gain, and prostate cancer risk and prognosis: the PROCA-life study. Acta Oncol 2024; 63:154-163. [PMID: 38591351 DOI: 10.2340/1651-226x.2024.32953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 02/16/2024] [Indexed: 04/10/2024]
Abstract
BACKGROUND Studies of excess weight and weight changes throughout adult life for prostate cancer (PCa) risk and prognosis have shown inconsistent results. METHODS In a population-based cohort, the Prostate Cancer Study throughout life (PROCA-life), 16,960 healthy men from the prospective cohort Tromsø Study (1994-2016) were included. Body mass index (BMI) and weight were measured at all four attendings, and weight change was calculated as the difference between the first and last of either Tromsø4, Tromsø5 or Tromsø6. Overall, 904 men developed PCa during 16 years of follow-up, and Poisson regression with fractional polynomials was used to investigate trends in incidence. Cox proportional hazard and logistic regression models were used to study associations between measurements of BMI and weight change and PCa risk, severity, and mortality. RESULTS At study entry, 46% of the participants (median age 44 years) were overweight, and 14% were obese (BMI > 30 kg/m2). We observed a 127% increase in overall age adjusted PCa incidence in the cohort during 1995 through 2019. No overall associations between BMI or weight change and PCa risk were observed. However, in sub-group analysis, weight gain among obese men was associated with a three-fold higher PCa risk (HR 3.03, 95% CI 1.39-6.58) compared with obese men with stable weight. Overweight was associated with lower risk of metastatic cancer (OR 0.48, 95% CI 0.30-0.75) at diagnosis. Men with obesity had higher risk of PCa-specific death (HR 1.72, 95% CI 1.03-2.88), while nonsmoking obese PCa cases had two times higher PCa-specific mortality compared with normal weighted PCa cases (HR 2.10, 95% CI 1.11-3.70). INTERPRETATION In our cohort, weight gain among obese men was associated with higher risk of PCa, and obesity was associated with higher PCa-specific mortality, especially among nonsmokers. The relationship between weight and risk for PCa remains complicated, and future studies are needed to determine clinical implications.
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Affiliation(s)
- Martin Støyten
- Institute of Clinical Medicine, UIT - The Arctic University, Tromsø, Norway
| | - Tore Knutsen
- Department of Urology, University Hospital of North Norway, Tromsø, Norway
| | - Einar Stikbakke
- Institute of Clinical Medicine, UIT - The Arctic University, Tromsø, Norway; Department of Oncology, University Hospital of North Norway, Tromsø, Norway
| | - Ingvild Agledahl
- Department of Urology, University Hospital of North Norway, Tromsø, Norway
| | - Tom Wilsgaard
- Institute of Community Medicine, UIT-The Arctic University, Tromsø, Norway
| | - Anne Elise Eggen
- Institute of Community Medicine, UIT-The Arctic University, Tromsø, Norway
| | - Elin Richardsen
- Department of Pathology, University Hospital of North Norway, Tromsø, Norway; Department of Medical Biology, UIT - The Arctic University, Tromsø, Norway
| | - Edward Giovannucci
- Departments of Nutrition and Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Inger Thune
- Institute of Clinical Medicine, UIT - The Arctic University, Tromsø, Norway; Insitute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Oncology, Oslo University Hospital, Norway
| | - Hege S Haugnes
- Institute of Clinical Medicine, UIT - The Arctic University, Tromsø, Norway; Department of Oncology, University Hospital of North Norway, Tromsø, Norway.
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Rakaee M, Andersen S, Giannikou K, Paulsen EE, Kilvaer TK, Busund LTR, Berg T, Richardsen E, Lombardi AP, Adib E, Pedersen MI, Tafavvoghi M, Wahl SGF, Petersen RH, Bondgaard AL, Yde CW, Baudet C, Licht P, Lund-Iversen M, Grønberg BH, Fjellbirkeland L, Helland Å, Pøhl M, Kwiatkowski DJ, Donnem T. Machine learning-based immune phenotypes correlate with STK11/KEAP1 co-mutations and prognosis in resectable NSCLC: a sub-study of the TNM-I trial. Ann Oncol 2023; 34:578-588. [PMID: 37100205 DOI: 10.1016/j.annonc.2023.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 04/12/2023] [Accepted: 04/13/2023] [Indexed: 04/28/2023] Open
Abstract
BACKGROUND We aim to implement an immune cell score model in routine clinical practice for resected non-small-cell lung cancer (NSCLC) patients (NCT03299478). Molecular and genomic features associated with immune phenotypes in NSCLC have not been explored in detail. PATIENTS AND METHODS We developed a machine learning (ML)-based model to classify tumors into one of three categories: inflamed, altered, and desert, based on the spatial distribution of CD8+ T cells in two prospective (n = 453; TNM-I trial) and retrospective (n = 481) stage I-IIIA NSCLC surgical cohorts. NanoString assays and targeted gene panel sequencing were used to evaluate the association of gene expression and mutations with immune phenotypes. RESULTS Among the total of 934 patients, 24.4% of tumors were classified as inflamed, 51.3% as altered, and 24.3% as desert. There were significant associations between ML-derived immune phenotypes and adaptive immunity gene expression signatures. We identified a strong association of the nuclear factor-κB pathway and CD8+ T-cell exclusion through a positive enrichment in the desert phenotype. KEAP1 [odds ratio (OR) 0.27, Q = 0.02] and STK11 (OR 0.39, Q = 0.04) were significantly co-mutated in non-inflamed lung adenocarcinoma (LUAD) compared to the inflamed phenotype. In the retrospective cohort, the inflamed phenotype was an independent prognostic factor for prolonged disease-specific survival and time to recurrence (hazard ratio 0.61, P = 0.01 and 0.65, P = 0.02, respectively). CONCLUSIONS ML-based immune phenotyping by spatial distribution of T cells in resected NSCLC is able to identify patients at greater risk of disease recurrence after surgical resection. LUADs with concurrent KEAP1 and STK11 mutations are enriched for altered and desert immune phenotypes.
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Affiliation(s)
- M Rakaee
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, USA; Department of Clinical Pathology, University Hospital of North Norway, Tromso; Department of Clinical Medicine, UiT The Arctic University of Norway, Tromso.
| | - S Andersen
- Department of Clinical Medicine, UiT The Arctic University of Norway, Tromso; Department of Oncology, University Hospital of North Norway, Tromso, Norway
| | - K Giannikou
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, USA; Division of Hematology and Oncology, Cancer and Blood Disease Institute, Children's Hospital Los Angeles, Los Angeles, USA
| | - E-E Paulsen
- Department of Clinical Medicine, UiT The Arctic University of Norway, Tromso; Department of Pulmonology, University Hospital of North Norway, Tromso
| | - T K Kilvaer
- Department of Clinical Medicine, UiT The Arctic University of Norway, Tromso; Department of Oncology, University Hospital of North Norway, Tromso, Norway
| | - L-T R Busund
- Department of Clinical Pathology, University Hospital of North Norway, Tromso; Department of Medical Biology, UiT The Arctic University of Norway, Tromso, Norway
| | - T Berg
- Department of Clinical Pathology, University Hospital of North Norway, Tromso; Department of Medical Biology, UiT The Arctic University of Norway, Tromso, Norway
| | - E Richardsen
- Department of Clinical Pathology, University Hospital of North Norway, Tromso; Department of Medical Biology, UiT The Arctic University of Norway, Tromso, Norway
| | - A P Lombardi
- Department of Medical Biology, UiT The Arctic University of Norway, Tromso, Norway
| | - E Adib
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, USA; Lank Center for Genitourinary Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, USA
| | - M I Pedersen
- Department of Clinical Medicine, UiT The Arctic University of Norway, Tromso
| | - M Tafavvoghi
- Department of Community Medicine, UiT The Arctic University of Norway, Tromso
| | - S G F Wahl
- Department of Oncology, St. Olav's Hospital, Trondheim University Hospital, Trondheim; Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - R H Petersen
- Department of Cardiothoracic Surgery, Copenhagen University Hospital, Rigshospitalet, Copenhagen; Department of Clinical Medicine, University of Copenhagen, Copenhagen
| | - A L Bondgaard
- Department of Pathology, Copenhagen University Hospital, Rigshospitalet, Copenhagen
| | - C W Yde
- Center for Genomic Medicine, Copenhagen University Hospital, Rigshospitalet, Copenhagen
| | - C Baudet
- Center for Genomic Medicine, Copenhagen University Hospital, Rigshospitalet, Copenhagen
| | - P Licht
- Department of Cardiothoracic Surgery, Odense University Hospital, Odense, Denmark
| | - M Lund-Iversen
- Department of Pathology, The Norwegian Radium Hospital, Oslo University Hospital, Oslo
| | - B H Grønberg
- Department of Oncology, St. Olav's Hospital, Trondheim University Hospital, Trondheim; Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - L Fjellbirkeland
- Department of Respiratory Medicine, Oslo University Hospital, University of Oslo, Oslo
| | - Å Helland
- Department of Cancer Genetics, Institute for Cancer Research, Norwegian Radium Hospital, Oslo University Hospital, Oslo; Department of Oncology, Oslo University Hospital, Oslo; Department of Clinical Medicine, University of Oslo, Oslo, Norway
| | - M Pøhl
- Department of Oncology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - D J Kwiatkowski
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, USA; Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, USA
| | - T Donnem
- Department of Clinical Medicine, UiT The Arctic University of Norway, Tromso; Department of Oncology, University Hospital of North Norway, Tromso, Norway
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Hjelle LV, Sælen M, Aarsæther E, Knutsen T, Andersen S, Bentzen AG, Richardsen E, Wilsgaard T, Fosså SD, Haugnes HS. The Longitudinal Course of Prospectively Recorded Patient-reported Outcomes in Prostate Cancer Patients Treated with Surgery and Salvage Radiotherapy. EUR UROL SUPPL 2023; 53:6-15. [PMID: 37441342 PMCID: PMC10334245 DOI: 10.1016/j.euros.2023.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/05/2023] [Indexed: 07/15/2023] Open
Abstract
Background Patient-reported outcome measures (PROMs) after prostate cancer (PC) treatment, including both radical prostatectomy (RP) and salvage radiation therapy (SRT), are under-reported. Objective To investigate PROMs longitudinally from before SRT until 18 mo after SRT for men treated with contemporary treatment modalities. Design setting and participants This prospective, longitudinal cohort study included 120 men (whole cohort) treated with SRT administered with volumetric modulated arc radiotherapy from 2016 to 2021 at the University Hospital of North Norway. The whole cohort was followed from before SRT until 18 mo after SRT. A subcohort of 48 men was followed from before RP until 18 mo after SRT. Outcome measurements and statistical analysis PROMs were collected with the Expanded Prostate Cancer Index-26 (EPIC-26), covering symptoms of urinary incontinence, urinary irritative, bowel, sexual, and hormonal domains. The domain scores were inquired before RP, 3 mo after RP, before SRT, at SRT termination, and 3 and 18 mo after SRT. We used linear mixed models with repeated measurements design to assess changes in PROMs throughout the treatment period. Results and limitations The median age before SRT was 63 yr. For the whole cohort, all five domains worsened at 3 and 18 mo after SRT compared with those before SRT. The estimated mean changes from before SRT to 18 mo after SRT are as follows: urinary incontinence -13.1, urinary irritative function -10.4, bowel -16.8, sexual function -9.1, and hormonal function -20.2 (at clinically important levels for all domains but sexual). For the subcohort, the mean urinary incontinence, bowel, sexual, and hormonal functions were significantly worsened 3 and 18 mo after SRT compared with those before RP at clinically important levels. Conclusions Men treated for PC report particular increased severity of urinary, bowel, sexual, and hormonal symptoms after SRT compared with baseline status. Patient summary For men with prostate cancer, the treatment combination of surgery and salvage radiotherapy worsens urinary incontinence and bowel, sexual, and hormonal functions.
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Affiliation(s)
- Line V. Hjelle
- Department of Oncology, University Hospital of North Norway, Tromsø, Norway
| | - Marie Sælen
- Department of Oncology, University Hospital of North Norway, Tromsø, Norway
| | - Erling Aarsæther
- Department of Urology, University Hospital of North Norway, Tromsø, Norway
| | - Tore Knutsen
- Department of Urology, University Hospital of North Norway, Tromsø, Norway
- Department of Clinical Medicine, UIT The Artic University, Tromsø, Norway
| | - Sigve Andersen
- Department of Oncology, University Hospital of North Norway, Tromsø, Norway
- Department of Clinical Medicine, UIT The Artic University, Tromsø, Norway
| | - Anne G. Bentzen
- Department of Oncology, University Hospital of North Norway, Tromsø, Norway
| | - Elin Richardsen
- Department of Pathology, University Hospital of North Norway, Tromsø, Norway
| | - Tom Wilsgaard
- Institute of Community Medicine, UIT-The Artic University, Tromsø, Norway
| | - Sophie D. Fosså
- Division of Cancer Medicine and Radiotherapy, Oslo University Hospital, Oslo, Norway
| | - Hege S. Haugnes
- Department of Oncology, University Hospital of North Norway, Tromsø, Norway
- Department of Clinical Medicine, UIT The Artic University, Tromsø, Norway
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Sælen MG, Hjelle LV, Aarsæther E, Knutsen T, Andersen S, Bentzen AG, Richardsen E, Fosså SD, Haugnes HS. Patient-reported outcomes after curative treatment for prostate cancer with prostatectomy, primary radiotherapy or salvage radiotherapy. Acta Oncol 2023; 62:657-665. [PMID: 37353983 DOI: 10.1080/0284186x.2023.2224051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 05/29/2023] [Indexed: 06/25/2023]
Abstract
BACKGROUND Trials reporting adverse health outcomes (AHOs) in terms of patient-reported outcome measures (PROMs) after contemporary curative treatment of prostate cancer (PC) are hampered by study heterogeneity and lack of new treatment techniques. Particularly, the evidence regarding toxicities after radiotherapy (RT) with the volumetric arc therapy (VMAT) technique is limited, and comparisons between men treated with surgery, primary radiotherapy (PRT) and salvage radiotherapy (SRT) are lacking. The aim of the study was to evaluate change in PROMs 3 months after treatment with robotic-assisted laparoscopic prostatectomy (RALP), PRT and SRT administered with VMAT. MATERIAL AND METHODS A prospective cohort study of men with PC who received curative treatment at the University Hospital of North Norway between 2012 and 2017 for RALP and between 2016 and 2021 for radiotherapy was conducted. A cohort of 787 men were included; 406 men treated with RALP, 265 received PRT and 116 received SRT. Patients completed the validated PROM instrument EPIC-26 before (pre-treatment) and 3 months after treatment. EPIC-26 domain summary scores (DSSs) were analysed, and changes from pre-treatment to 3 months reported. Changes were deemed clinically relevant if exceeding validated minimally clinically important differences (MCIDs). RESULTS Men treated with RALP reported clinically relevant declining urinary incontinence DSS (-41.7 (SD 30.7)) and sexual DSS (-46.1 (SD 30.2)). Men who received PRT reported worsened urinary irritative DSS (-5.2 (SD 19.6)), bowel DSS (-8.2 (SD 15.1)) and hormonal DSS (-9.6 (SD 18.2)). Men treated with SRT experienced worsened urinary incontinence DSS (-7.3 (SD 18.2)), urinary irritative DSS (-7.5 (SD 14.0)), bowel DSS (-12.5 (SD 16.1)), sexual DSS (-14.9 (SD 18.9)) and hormonal DSS (-23.8 (SD 20.9)). CONCLUSION AHOs 3 months after contemporary curative treatment for PC varied according to treatment modality and worsened in all treatment groups, although most in SRT.
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Affiliation(s)
- Marie G Sælen
- Department of Oncology, University Hospital of North Norway, Tromsø, Norway
| | - Line V Hjelle
- Department of Oncology, University Hospital of North Norway, Tromsø, Norway
| | - Erling Aarsæther
- Department of Urology, University Hospital of North Norway, Tromsø, Norway
| | - Tore Knutsen
- Department of Urology, University Hospital of North Norway, Tromsø, Norway
- Department of Clinical Medicine, UIT The Artic University, Tromsø, Norway
| | - Sigve Andersen
- Department of Oncology, University Hospital of North Norway, Tromsø, Norway
- Department of Clinical Medicine, UIT The Artic University, Tromsø, Norway
| | - Anne G Bentzen
- Department of Oncology, University Hospital of North Norway, Tromsø, Norway
| | - Elin Richardsen
- Department of Pathology, University Hospital of North Norway, Tromsø, Norway
| | - Sophie D Fosså
- Division of Cancer Medicine and Radiotherapy, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Hege S Haugnes
- Department of Oncology, University Hospital of North Norway, Tromsø, Norway
- Department of Clinical Medicine, UIT The Artic University, Tromsø, Norway
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Rakaee M, Adib E, Ricciuti B, Sholl LM, Shi W, Alessi JV, Cortellini A, Fulgenzi CAM, Viola P, Pinato DJ, Hashemi S, Bahce I, Houda I, Ulas EB, Radonic T, Väyrynen JP, Richardsen E, Jamaly S, Andersen S, Donnem T, Awad MM, Kwiatkowski DJ. Association of Machine Learning-Based Assessment of Tumor-Infiltrating Lymphocytes on Standard Histologic Images With Outcomes of Immunotherapy in Patients With NSCLC. JAMA Oncol 2023; 9:51-60. [PMID: 36394839 PMCID: PMC9673028 DOI: 10.1001/jamaoncol.2022.4933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Accepted: 08/10/2022] [Indexed: 11/18/2022]
Abstract
Importance Currently, predictive biomarkers for response to immune checkpoint inhibitor (ICI) therapy in lung cancer are limited. Identifying such biomarkers would be useful to refine patient selection and guide precision therapy. Objective To develop a machine-learning (ML)-based tumor-infiltrating lymphocytes (TILs) scoring approach, and to evaluate TIL association with clinical outcomes in patients with advanced non-small cell lung cancer (NSCLC). Design, Setting, and Participants This multicenter retrospective discovery-validation cohort study included 685 ICI-treated patients with NSCLC with median follow-up of 38.1 and 43.3 months for the discovery (n = 446) and validation (n = 239) cohorts, respectively. Patients were treated between February 2014 and September 2021. We developed an ML automated method to count tumor, stroma, and TIL cells in whole-slide hematoxylin-eosin-stained images of NSCLC tumors. Tumor mutational burden (TMB) and programmed death ligand-1 (PD-L1) expression were assessed separately, and clinical response to ICI therapy was determined by medical record review. Data analysis was performed from June 2021 to April 2022. Exposures All patients received anti-PD-(L)1 monotherapy. Main Outcomes and Measures Objective response rate (ORR), progression-free survival (PFS), and overall survival (OS) were determined by blinded medical record review. The area under curve (AUC) of TIL levels, TMB, and PD-L1 in predicting ICI response were calculated using ORR. Results Overall, there were 248 (56%) women in the discovery cohort and 97 (41%) in the validation cohort. In a multivariable analysis, high TIL level (≥250 cells/mm2) was independently associated with ICI response in both the discovery (PFS: HR, 0.71; P = .006; OS: HR, 0.74; P = .03) and validation (PFS: HR = 0.80; P = .01; OS: HR = 0.75; P = .001) cohorts. Survival benefit was seen in both first- and subsequent-line ICI treatments in patients with NSCLC. In the discovery cohort, the combined models of TILs/PD-L1 or TMB/PD-L1 had additional specificity in differentiating ICI responders compared with PD-L1 alone. In the PD-L1 negative (<1%) subgroup, TIL levels had superior classification accuracy for ICI response (AUC = 0.77) compared with TMB (AUC = 0.65). Conclusions and Relevance In these cohorts, TIL levels were robustly and independently associated with response to ICI treatment. Patient TIL assessment is relatively easily incorporated into the workflow of pathology laboratories at minimal additional cost, and may enhance precision therapy.
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Affiliation(s)
- Mehrdad Rakaee
- Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
- Department of Clinical Medicine, UiT The Arctic University of Norway, Tromso, Norway
- Department of Clinical Pathology, University Hospital of North Norway, Tromso, Norway
| | - Elio Adib
- Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
- Lank Center for Genitourinary Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts
| | - Biagio Ricciuti
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts
| | - Lynette M. Sholl
- Department of Pathology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Weiwei Shi
- Department of Pathology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Joao V. Alessi
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts
| | - Alessio Cortellini
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom
| | - Claudia A. M. Fulgenzi
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom
- Department of Medical Oncology, University Campus Bio-Medico, Rome, Italy
| | - Patrizia Viola
- Department of Cellular Pathology, Imperial College London NHS Trust, London, United Kingdom
| | - David J. Pinato
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom
- Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy
| | - Sayed Hashemi
- Department of Pulmonology, Amsterdam UMC, Amsterdam, the Netherlands
| | - Idris Bahce
- Department of Pulmonology, Amsterdam UMC, Amsterdam, the Netherlands
| | - Ilias Houda
- Department of Pulmonology, Amsterdam UMC, Amsterdam, the Netherlands
| | - Ezgi B. Ulas
- Department of Pulmonology, Amsterdam UMC, Amsterdam, the Netherlands
| | - Teodora Radonic
- Department of Pathology, Amsterdam UMC, Amsterdam, the Netherlands
| | - Juha P. Väyrynen
- Cancer and Translational Medicine Research Unit, Medical Research Center, Oulu University Hospital, University of Oulu, Oulu, Finland
| | - Elin Richardsen
- Department of Clinical Pathology, University Hospital of North Norway, Tromso, Norway
| | - Simin Jamaly
- Department of Medical Biology, UiT The Arctic University of Norway, Tromso, Norway
| | - Sigve Andersen
- Department of Clinical Medicine, UiT The Arctic University of Norway, Tromso, Norway
- Department of Oncology, University Hospital of North Norway, Tromso, Norway
| | - Tom Donnem
- Department of Clinical Medicine, UiT The Arctic University of Norway, Tromso, Norway
- Department of Oncology, University Hospital of North Norway, Tromso, Norway
| | - Mark M. Awad
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts
| | - David J. Kwiatkowski
- Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
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Rakaee M, Adib E, Ricciuti B, Sholl LM, Alessi JVM, Cortellini A, Fulgenzi CA, Pinato DJJ, Hashemi SMS, Bahce I, Houda I, Väyrynen JP, Richardsen E, Busund LTR, Andersen S, Donnem T, Awad MM, Kwiatkowski DJ. Digital quantification of lymphocytic infiltration on routine H&E images and immunotherapy response in non–small cell lung cancer. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.16_suppl.9066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
9066 Background: Current biomarker(s) for immuno-oncology (IO) therapy response prediction in lung cancer are limited. Additional predictive biomarkers are useful to help refine patient selection and guide precision therapy. Methods: Biopsy and surgical specimens stained with hematoxylin-eosin (H&E) were subjected to whole-slide scanning for 446 advanced stage non-small cell lung cancer (NSCLC) treated with single agent immune check point inhibitors (ICI). A machine learning model was trained on H&E images for classification of tumor infiltrating lymphocytes (TILs), tumor cells, and stromal cells in specific tissue types. Results: TIL levels were found to be highly variable, with a range of 12 to 4270 cells/mm2, and median of 319 (Q1 = 159, Q3 = 681). TIL levels were assessed on tissue samples from multiple organs which had shown primary or metastatic NSCLC, and were similar across all specimen sites except the liver, for which median TIL levels were significantly lower, at 90 cells/mm2. There was no correlation between tumor mutational burden (TMB) and TIL levels, while high TIL levels were correlated with high PD-L1 (≥ 50%) expression. Patients who experienced a partial/complete response to ICI therapy had a trend to higher median TILs compared to those who had progressive/stable disease (350 versus 310 cells/mm2, P = 0.09). In a multivariable analysis after controlling for covariates (incl. sex, age, cigarette smoking, ECOG, PD-L1, TMB & treatment line), a higher TIL level (≥ 250 cells/mm2) was an independent predictor of IO response for both progression-free survival (PFS; HRadj 0.70; 95% CI, 0.55 - 0.89; P = 0.003) and overall survival (HRadj 0.73; 95% CI, 0.56 - 0.95; P = 0.02). In a ROC analysis considering single biomarkers, PD-L1 had the highest AUC (0.68, P < 0.001), while TIL (AUC = 0.53, P = 0.08) and TMB (AUC = 0.55, P = 0.05) had similar AUC values for classifying responders from non-responders based on objective response rate. Using weighted linear regression approach to combine the biomarkers, paired PD-L1/TMB had the greatest AUC (0.70, P < 0.001) compared to PD-L1 single assay. In the PD-L1 negative (< 1%, N = 50) subgroup, TIL levels had superior predictive performance for classification of IO responders (AUC = 0.77, P = 0.02) compared to TMB (AUC = 0.57, P = 0.3), such that patients with a high TIL level (≥ 250 cells/mm2) had an improved PFS (median PFS: 2.7 vs 2.2 months; HR = 0.48; 95% CI, 0.26 - 0.87; P = 0.02). Conclusions: Digital TIL quantification with use of machine learning is feasible. TIL levels appear to be a robust and independent biomarker of likelihood of response to IO treatment in NSCLC, especially in the PD-L1 negative subgroup. The findings of this study are under validation in additional lung cancer cohorts.
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Affiliation(s)
- Mehrdad Rakaee
- Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
| | - Elio Adib
- The Lank Center for Genitourinary Oncology, Dana-Farber Cancer Institute and Brigham and Women's Hospital, Boston, MA
| | - Biagio Ricciuti
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, MA
| | - Lynette M. Sholl
- Department of Pathology, Brigham and Women's Hospital, Boston, MA
| | | | - Alessio Cortellini
- Department of Surgery and Cancer, Imperial College London, Faculty of Medicine, Hammersmith Hospital, London, United Kingdom; Department of Biotechnology and Applied Clinical Sciences, University of L'Aquila, London, United Kingdom
| | - Claudia A.M. Fulgenzi
- Department of Surgery and Cancer, Imperial College London, Hammersmith Hospital, London, United Kingdom
| | | | | | - Idris Bahce
- VU medisch centrum School of Medical Sciences, Amsterdam, Netherlands
| | | | | | - Elin Richardsen
- Department of Medical Biology, UiT The Arctic University of Tromsø, Tromsø, Norway
| | | | - Sigve Andersen
- Institute of Clinical Medicine, University of Tromsø/Department of Oncology, University Hospital of Tromsø, Tromsø, Norway
| | - Tom Donnem
- Department of Clinical Medicine, UiT The Arctic University of Norway, Tromso, Norway
| | - Mark M. Awad
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, MA
| | - David J. Kwiatkowski
- Cancer Genetics Laboratory, Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
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Stikbakke E, Wilsgaard T, Haugnes HS, Pedersen MI, Knutsen T, Støyten M, Giovannucci E, Eggen AE, Thune I, Richardsen E. Expression of miR-24-1-5p in Tumor Tissue Influences Prostate Cancer Recurrence: The PROCA- life Study. Cancers (Basel) 2022; 14:cancers14051142. [PMID: 35267449 PMCID: PMC8909269 DOI: 10.3390/cancers14051142] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Revised: 02/18/2022] [Accepted: 02/21/2022] [Indexed: 12/22/2022] Open
Abstract
The role of miR-24-1-5p and its prognostic implications associated with prostate cancer are mainly unknown. In a population-based cohort, the Prostate Cancer Study throughout life (PROCA-life), all men had a general health examination at study entry and were followed between 1994 and 2016. Patients with available tissue samples after a prostatectomy with curative intent were identified (n = 189). The tissue expression of miR-24-1-5p in prostate cancer was examined by in situ hybridization (ISH) in tissue microarray (TMA) blocks by semi-quantitative scoring by two independent investigators. Multivariable Cox regression models were used to study the associations between miR-24-1-5p expression and prostate cancer recurrence. The prostate cancer patients had a median age of 65.0 years (range 47−75 years). The Cancer of the Prostate Risk Assessment Postsurgical Score, International Society of Urological Pathology grade group, and European Association of Urology Risk group were all significant prognostic factors for five-year recurrence-free survival (p < 0.001). Prostate cancer patients with a high miR-24-1-5p expression (≥1.57) in the tissue had a doubled risk of recurrence compared to patients with low expression (HR 1.99, 95% CI 1.13−3.51). Our study suggests that a high expression of miR-24-1-5p is associated with an increased risk of recurrence of prostate cancer after radical prostatectomy, which points to the potential diagnostic and therapeutic value of detecting miR-24-1-5p in prostate cancer cases.
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Affiliation(s)
- Einar Stikbakke
- Department of Clinical Medicine, Faculty of Health Sciences, UiT, The Arctic University of Norway, 9037 Tromsø, Norway; (H.S.H.); (T.K.); (M.S.); (I.T.)
- Department of Oncology, University Hospital of North Norway, 9038 Tromsø, Norway
- Correspondence:
| | - Tom Wilsgaard
- Department of Community Medicine, Faculty of Health Sciences, UiT, The Arctic University of Norway, 9037 Tromsø, Norway; (T.W.); (A.E.E.)
| | - Hege Sagstuen Haugnes
- Department of Clinical Medicine, Faculty of Health Sciences, UiT, The Arctic University of Norway, 9037 Tromsø, Norway; (H.S.H.); (T.K.); (M.S.); (I.T.)
- Department of Oncology, University Hospital of North Norway, 9038 Tromsø, Norway
| | - Mona Irene Pedersen
- Translational Cancer Research Group, Institute of Clinical Medicine, UiT, The Arctic University of Norway, 9037 Tromsø, Norway; (M.I.P.); (E.R.)
| | - Tore Knutsen
- Department of Clinical Medicine, Faculty of Health Sciences, UiT, The Arctic University of Norway, 9037 Tromsø, Norway; (H.S.H.); (T.K.); (M.S.); (I.T.)
- Department of Urology, University Hospital of North Norway, 9038 Tromsø, Norway
| | - Martin Støyten
- Department of Clinical Medicine, Faculty of Health Sciences, UiT, The Arctic University of Norway, 9037 Tromsø, Norway; (H.S.H.); (T.K.); (M.S.); (I.T.)
- Department of Oncology, University Hospital of North Norway, 9038 Tromsø, Norway
| | - Edward Giovannucci
- Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA;
- Departments of Nutrition and Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Anne Elise Eggen
- Department of Community Medicine, Faculty of Health Sciences, UiT, The Arctic University of Norway, 9037 Tromsø, Norway; (T.W.); (A.E.E.)
| | - Inger Thune
- Department of Clinical Medicine, Faculty of Health Sciences, UiT, The Arctic University of Norway, 9037 Tromsø, Norway; (H.S.H.); (T.K.); (M.S.); (I.T.)
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, 0316 Oslo, Norway
- Department of Oncology, The Cancer Centre, Oslo University Hospital, 0424 Oslo, Norway
| | - Elin Richardsen
- Translational Cancer Research Group, Institute of Clinical Medicine, UiT, The Arctic University of Norway, 9037 Tromsø, Norway; (M.I.P.); (E.R.)
- Department of Medical Biology, Faculty of Health Sciences, UiT, The Arctic University of Norway, 9037 Tromsø, Norway
- Department of Clinical Pathology, University Hospital of North Norway, 9038 Tromsø, Norway
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8
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Stikbakke E, Schirmer H, Knutsen T, Støyten M, Wilsgaard T, Giovannucci EL, McTiernan A, Eggen AE, Haugnes HS, Richardsen E, Thune I. Systolic and diastolic blood pressure, prostate cancer risk, treatment, and survival. The PROCA‐
life
study. Cancer Med 2021; 11:1005-1015. [PMID: 34939344 PMCID: PMC8855905 DOI: 10.1002/cam4.4523] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 12/06/2021] [Accepted: 12/08/2021] [Indexed: 12/12/2022] Open
Abstract
Background Inflammation has been linked to prostate cancer and hypertension, but it remains equivocal whether elevated blood pressure (BP) influence prostate cancer risk and survival. Method Using Cox regression models, we examined the association between prediagnostic BP and prostate cancer risk among 12,271 men participating in the Prostate Cancer throughout life (PROCA‐life) study. Systolic and diastolic BP were measured. A total of 811 men developed prostate cancer, and followed for additional 7.1 years, and we studied the association between prediagnostic BP and overall mortality among patients with prostate cancer. Results Men (>45 years) with a systolic BP >150 mmHg had a 35% increased risk of prostate cancer compared with men with a normal systolic BP (<130 mmHg) (HR 1.35, 95% CI 1.08–1.69). Among patients with prostate cancer, men with systolic BP >150 mmHg had a 49% increased overall mortality compared with men with a normal systolic BP (HR 1.49, 1.06–2.01). Among patients with prostate cancer treated with curative intent, those with a high diastolic BP (>90 mmHg) had a threefold increase in overall mortality risk (HR 3.01, 95% CI 1.40–6.46) compared with patients with a normal diastolic BP (<80 mmHg). Conclusion Our results support that systolic and diastolic BP are important factors when balancing disease management in patients with prostate cancer.
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Affiliation(s)
- Einar Stikbakke
- Department of Clinical Medicine Faculty of Health Sciences UiT The Arctic University of Norway Tromsø Norway
- Department of Oncology University Hospital of North Norway Tromsø Norway
| | - Henrik Schirmer
- Department of Cardiology Akershus University Hospital Lørenskog Norway
- Institute of Clinical Medicine Campus Ahus University of Oslo Oslo Norway
| | - Tore Knutsen
- Department of Clinical Medicine Faculty of Health Sciences UiT The Arctic University of Norway Tromsø Norway
- Department of Urology University Hospital of North Norway Tromsø Norway
| | - Martin Støyten
- Department of Clinical Medicine Faculty of Health Sciences UiT The Arctic University of Norway Tromsø Norway
- Department of Oncology University Hospital of North Norway Tromsø Norway
| | - Tom Wilsgaard
- Department of Community Medicine Faculty of Health Sciences UiT The Arctic University of Norway Tromsø Norway
| | - Edward L. Giovannucci
- Department of Medicine Brigham and Women’s Hospital and Harvard Medical School Boston Massachusetts USA
- Departments of Nutrition and Epidemiology Harvard T.H. Chan School of Public Health Boston Massachusetts USA
| | - Anne McTiernan
- Program in Epidemiology Division of Public Health Sciences Fred Hutchinson Cancer Research Center Seattle Washington USA
- Department of Epidemiology School of Public Health, and Department of Medicine, School of Medicine University of Washington Seattle Washington USA
| | - Anne E. Eggen
- Department of Community Medicine Faculty of Health Sciences UiT The Arctic University of Norway Tromsø Norway
| | - Hege S. Haugnes
- Department of Clinical Medicine Faculty of Health Sciences UiT The Arctic University of Norway Tromsø Norway
- Department of Oncology University Hospital of North Norway Tromsø Norway
| | - Elin Richardsen
- Department of Medical Biology Faculty of Health Sciences UiT The Arctic University of Norway Tromsø Norway
- Department of Pathology University Hospital of North Norway Tromsø Norway
| | - Inger Thune
- Department of Clinical Medicine Faculty of Health Sciences UiT The Arctic University of Norway Tromsø Norway
- Institute of Clinical Medicine Faculty of Medicine University of Oslo Oslo Norway
- Department of Oncology, The Cancer Centre, Ullevaal Oslo University Hospital Oslo Norway
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9
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Wahl SGF, Dai HY, Emdal EF, Berg T, Halvorsen TO, Ottestad AL, Lund-Iversen M, Brustugun OT, Førde D, Paulsen EE, Donnem T, Andersen S, Grønberg BH, Richardsen E. The Prognostic Effect of KRAS Mutations in Non-Small Cell Lung Carcinoma Revisited: A Norwegian Multicentre Study. Cancers (Basel) 2021; 13:4294. [PMID: 34503114 PMCID: PMC8428342 DOI: 10.3390/cancers13174294] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 08/20/2021] [Accepted: 08/23/2021] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND due to emerging therapeutics targeting KRAS G12C and previous reports with conflicting results regarding the prognostic impact of KRAS and KRAS G12C in non-small cell lung cancer (NSCLC), we aimed to investigate the frequency of KRAS mutations and their associations with clinical characteristics and outcome. Since mutation subtypes have different preferences for downstream pathways, we also aimed to investigate whether there were differences in outcome according to mutation preference for the Raf, PI3K/Akt, or RalGDS/Ral pathways. METHODS retrospectively, clinicopathological data from 1233 stage I-IV non-squamous NSCLC patients with known KRAS status were reviewed. KRAS' associations with clinical characteristics were analysed. Progression free survival (PFS) and overall survival (OS) were assessed for the following groups: KRAS wild type (wt) versus mutated, KRAS wt versus KRAS G12C versus KRAS non-G12C, among KRAS mutation subtypes and among mutation subtypes grouped according to preference for downstream pathways. RESULTS a total of 1117 patients were included; 38% had KRAS mutated tumours, 17% had G12C. Among KRAS mutated, G12C was the most frequent mutation in former/current smokers (45%) and G12D in never smokers (46%). There were no significant differences in survival according to KRAS status, G12C status, among KRAS mutation subtypes or mutation preference for downstream pathways. CONCLUSION KRAS status or KRAS mutation subtype did not have any significant influence on PFS or OS.
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Affiliation(s)
- Sissel Gyrid Freim Wahl
- Department of Clinical and Molecular Medicine, NTNU, Norwegian University of Technology and Science, N-7491 Trondheim, Norway; (H.Y.D.); (T.O.H.); (A.L.O.); (B.H.G.)
- Department of Pathology, St. Olav’s Hospital, Trondheim University Hospital, N-7006 Trondheim, Norway;
| | - Hong Yan Dai
- Department of Clinical and Molecular Medicine, NTNU, Norwegian University of Technology and Science, N-7491 Trondheim, Norway; (H.Y.D.); (T.O.H.); (A.L.O.); (B.H.G.)
- Department of Pathology, St. Olav’s Hospital, Trondheim University Hospital, N-7006 Trondheim, Norway;
| | - Elisabeth Fritzke Emdal
- Department of Pathology, St. Olav’s Hospital, Trondheim University Hospital, N-7006 Trondheim, Norway;
| | - Thomas Berg
- Department of Clinical Pathology, University Hospital of North Norway, N-9038 Tromsø, Norway; (T.B.); (E.R.)
- Department of Medical Biology, UiT, The Arctic University of Norway, N-9011 Tromsø, Norway
| | - Tarje Onsøien Halvorsen
- Department of Clinical and Molecular Medicine, NTNU, Norwegian University of Technology and Science, N-7491 Trondheim, Norway; (H.Y.D.); (T.O.H.); (A.L.O.); (B.H.G.)
- Department of Oncology, St. Olav’s Hospital, Trondheim University Hospital, N-7030 Trondheim, Norway
| | - Anine Larsen Ottestad
- Department of Clinical and Molecular Medicine, NTNU, Norwegian University of Technology and Science, N-7491 Trondheim, Norway; (H.Y.D.); (T.O.H.); (A.L.O.); (B.H.G.)
- Department of Oncology, St. Olav’s Hospital, Trondheim University Hospital, N-7030 Trondheim, Norway
| | - Marius Lund-Iversen
- Department of Pathology, Oslo University Hospital, The Norwegian Radium Hospital, N-0310 Oslo, Norway;
| | - Odd Terje Brustugun
- Department of Cancer Genetics, Institute for Cancer Research, Oslo University Hospital, The Norwegian Radium Hospital, N-0450 Oslo, Norway;
- Section of Oncology, Drammen Hospital, Vestre Viken Hospital Trust, N-3004 Drammen, Norway
| | - Dagny Førde
- Department of Clinical Medicine, UiT, The Arctic University of Norway, N-9037 Tromsø, Norway; (D.F.); (T.D.); (S.A.)
| | - Erna-Elise Paulsen
- Department of Pulmonary Medicine, University Hospital of North Norway, N-9028 Tromsø, Norway;
| | - Tom Donnem
- Department of Clinical Medicine, UiT, The Arctic University of Norway, N-9037 Tromsø, Norway; (D.F.); (T.D.); (S.A.)
- Department of Oncology, University Hospital of North Norway, N-9038 Tromsø, Norway
| | - Sigve Andersen
- Department of Clinical Medicine, UiT, The Arctic University of Norway, N-9037 Tromsø, Norway; (D.F.); (T.D.); (S.A.)
- Department of Oncology, University Hospital of North Norway, N-9038 Tromsø, Norway
| | - Bjørn Henning Grønberg
- Department of Clinical and Molecular Medicine, NTNU, Norwegian University of Technology and Science, N-7491 Trondheim, Norway; (H.Y.D.); (T.O.H.); (A.L.O.); (B.H.G.)
- Department of Oncology, St. Olav’s Hospital, Trondheim University Hospital, N-7030 Trondheim, Norway
| | - Elin Richardsen
- Department of Clinical Pathology, University Hospital of North Norway, N-9038 Tromsø, Norway; (T.B.); (E.R.)
- Department of Medical Biology, UiT, The Arctic University of Norway, N-9011 Tromsø, Norway
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10
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Stoen MJ, Andersen S, Rakaee M, Pedersen MI, Ingebriktsen LM, Donnem T, Lombardi APG, Kilvaer TK, Busund LTR, Richardsen E. Overexpression of miR-20a-5p in Tumor Epithelium Is an Independent Negative Prognostic Indicator in Prostate Cancer-A Multi-Institutional Study. Cancers (Basel) 2021; 13:cancers13164096. [PMID: 34439249 PMCID: PMC8394585 DOI: 10.3390/cancers13164096] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 08/06/2021] [Accepted: 08/11/2021] [Indexed: 12/24/2022] Open
Abstract
Simple Summary MicroRNAs (miRs) have critical regulatory roles in cell functions, and are involved in prostate cancer tumorigenesis. miR-20a-5p is a member of the oncogenic miR-17-92 cluster. Overexpressed miR-20a-5p has been shown to increase both cell proliferation and cell migration in cancers. The aim of our cohort study was to evaluate the prognostic role of miR-20a-5p in prostate cancer. We found miR-20a-5p associated with biochemical failure in tumor epithelium and tumor stroma. In the multivariable analysis miR-20a-5p in tumor epithelium was found to be an independent prognostic predictor for biochemical failure. In the functional studies, migration and invasion were significantly increased in miR-20a-5p transfected prostate cancer cell lines. In conclusion, high miR-20a-5p expression in tumor epithelium is a negative independent prognostic factor for biochemical failure in prostate cancer. Abstract Objective: assessing the prognostic role of miR-20a-5p, in terms of clinical outcome, in a large multi-institutional cohort study. Methods: Tissue microarrays from 535 patients’ prostatectomy specimens were constructed. In situ hybridization was performed to assess the expression level of miR-20a-5p in different tissue subregions: tumor stroma (TS) and tumor epithelium (TE). In vitro analysis was performed on prostate cancer cell lines. Results: A high miR-20a-5p expression was found negatively in association with biochemical failure in TE, TS and TE + TS (p = 0.001, p = 0.003 and p = 0.001, respectively). Multivariable analysis confirmed that high miR-20a-5p expression in TE independently predicts dismal prognosis for biochemical failure (HR = 1.56, 95% CI: 1.10–2.21, p = 0.014). Both DU145 and PC3 cells exhibited increased migration ability after transient overexpression of miR-20a-5p, as well as significant elevation of invasion in DU145 cells. Conclusion: A high miR-20a-5p expression in tumor epithelium is an independent negative predictor for biochemical prostate cancer recurrence.
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Affiliation(s)
- Maria J. Stoen
- Translational Cancer Research Group, Institute of Medical Biology, UiT The Arctic University of Norway, N-9037 Tromso, Norway; (L.M.I.); (A.P.G.L.); (T.K.K.); (L.-T.R.B.); (E.R.)
- Correspondence: ; Tel.: +47-97419736
| | - Sigve Andersen
- Translational Cancer Research Group, Institute of Clinical Medicine, UiT The Arctic University of Norway, N-9037 Tromso, Norway; (S.A.); (M.R.); (M.I.P.); (T.D.)
- Department of Oncology, University Hospital of North Norway, N-9038 Tromso, Norway
| | - Mehrdad Rakaee
- Translational Cancer Research Group, Institute of Clinical Medicine, UiT The Arctic University of Norway, N-9037 Tromso, Norway; (S.A.); (M.R.); (M.I.P.); (T.D.)
- Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Mona I. Pedersen
- Translational Cancer Research Group, Institute of Clinical Medicine, UiT The Arctic University of Norway, N-9037 Tromso, Norway; (S.A.); (M.R.); (M.I.P.); (T.D.)
| | - Lise M. Ingebriktsen
- Translational Cancer Research Group, Institute of Medical Biology, UiT The Arctic University of Norway, N-9037 Tromso, Norway; (L.M.I.); (A.P.G.L.); (T.K.K.); (L.-T.R.B.); (E.R.)
- Centre for Cancer Biomarkers CCBIO, Department of Clinical Medicine, Section for Pathology, University of Bergen, N-5021 Bergen, Norway
| | - Tom Donnem
- Translational Cancer Research Group, Institute of Clinical Medicine, UiT The Arctic University of Norway, N-9037 Tromso, Norway; (S.A.); (M.R.); (M.I.P.); (T.D.)
- Department of Oncology, University Hospital of North Norway, N-9038 Tromso, Norway
| | - Ana P. G. Lombardi
- Translational Cancer Research Group, Institute of Medical Biology, UiT The Arctic University of Norway, N-9037 Tromso, Norway; (L.M.I.); (A.P.G.L.); (T.K.K.); (L.-T.R.B.); (E.R.)
| | - Thomas K. Kilvaer
- Translational Cancer Research Group, Institute of Medical Biology, UiT The Arctic University of Norway, N-9037 Tromso, Norway; (L.M.I.); (A.P.G.L.); (T.K.K.); (L.-T.R.B.); (E.R.)
- Department of Oncology, University Hospital of North Norway, N-9038 Tromso, Norway
| | - Lill-Tove R. Busund
- Translational Cancer Research Group, Institute of Medical Biology, UiT The Arctic University of Norway, N-9037 Tromso, Norway; (L.M.I.); (A.P.G.L.); (T.K.K.); (L.-T.R.B.); (E.R.)
- Department of Clinical Pathology, University Hospital of North Norway, N-9038 Tromso, Norway
| | - Elin Richardsen
- Translational Cancer Research Group, Institute of Medical Biology, UiT The Arctic University of Norway, N-9037 Tromso, Norway; (L.M.I.); (A.P.G.L.); (T.K.K.); (L.-T.R.B.); (E.R.)
- Department of Clinical Pathology, University Hospital of North Norway, N-9038 Tromso, Norway
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11
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Stoen MJ, Andersen S, Rakaee M, Pedersen MI, Ingebriktsen LM, Bremnes RM, Donnem T, Lombardi APG, Kilvaer TK, Busund LT, Richardsen E. High expression of miR-17-5p in tumor epithelium is a predictor for poor prognosis for prostate cancer patients. Sci Rep 2021; 11:13864. [PMID: 34226620 PMCID: PMC8257715 DOI: 10.1038/s41598-021-93208-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Accepted: 06/15/2021] [Indexed: 02/04/2023] Open
Abstract
MicroRNAs (miRs) are small non-coding RNA molecules, which are involved in the development of various malignancies, including prostate cancer (PCa). miR-17-5p is considered the most prominent member of the miR-17-92 cluster, with an essential regulatory function of fundamental cellular processes. In many malignancies, up-regulation of miR-17-5p is associated with worse outcome. In PCa, miR-17-5p has been reported to increase cell proliferation and the risk of metastasis. In this study, prostatectomy specimens from 535 patients were collected. Tissue microarrays were constructed and in situ hybridization was performed, followed by scoring of miR-17-5p expression on different tumor compartments. High expression of miR-17-5p in tumor epithelium was associated with biochemical failure (BF, p < 0.001) and clinical failure (CF, p = 0.019). In multivariate analyses, high miR-17-5p expression in tumor epithelial cells was an independent negative prognostic factor for BF (HR 1.87, 95% CI 1.32-2.67, p < 0.001). In vitro analyses confirmed association between overexpression of miR-17-5p and proliferation, migration and invasion in prostate cancer cell lines (PC3 and DU145). In conclusion, our study suggests that a high cancer cell expression of miR-17-5p was an independent negative prognostic factor in PCa.
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Affiliation(s)
- Maria Jenvin Stoen
- Translational Cancer Research Group, Institute of Medical Biology, UiT the Arctic University of Norway, 9037, Tromso, Norway.
| | - S Andersen
- Translational Cancer Research Group, Institute of Clinical Medicine, UiT the Arctic University of Norway, Tromso, Norway.,Department of Oncology, University Hospital of North Norway, Tromso, Norway
| | - M Rakaee
- Translational Cancer Research Group, Institute of Medical Biology, UiT the Arctic University of Norway, 9037, Tromso, Norway.,Translational Cancer Research Group, Institute of Clinical Medicine, UiT the Arctic University of Norway, Tromso, Norway
| | - M I Pedersen
- Translational Cancer Research Group, Institute of Clinical Medicine, UiT the Arctic University of Norway, Tromso, Norway
| | - L M Ingebriktsen
- Translational Cancer Research Group, Institute of Medical Biology, UiT the Arctic University of Norway, 9037, Tromso, Norway.,Centre for Cancer Biomarkers CCBIO, Department of Clinical Medicine, Section for Pathology, University of Bergen, 5021, Bergen, Norway
| | - R M Bremnes
- Translational Cancer Research Group, Institute of Clinical Medicine, UiT the Arctic University of Norway, Tromso, Norway.,Department of Oncology, University Hospital of North Norway, Tromso, Norway
| | - T Donnem
- Translational Cancer Research Group, Institute of Clinical Medicine, UiT the Arctic University of Norway, Tromso, Norway.,Department of Oncology, University Hospital of North Norway, Tromso, Norway
| | - A P G Lombardi
- Translational Cancer Research Group, Institute of Medical Biology, UiT the Arctic University of Norway, 9037, Tromso, Norway
| | - T K Kilvaer
- Translational Cancer Research Group, Institute of Medical Biology, UiT the Arctic University of Norway, 9037, Tromso, Norway.,Department of Oncology, University Hospital of North Norway, Tromso, Norway
| | - L T Busund
- Translational Cancer Research Group, Institute of Medical Biology, UiT the Arctic University of Norway, 9037, Tromso, Norway.,Department of Clinical Pathology, University Hospital of North Norway, Tromso, Norway
| | - E Richardsen
- Translational Cancer Research Group, Institute of Medical Biology, UiT the Arctic University of Norway, 9037, Tromso, Norway.,Department of Clinical Pathology, University Hospital of North Norway, Tromso, Norway
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12
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Rakaee M, Kilvaer TK, Jamaly S, Berg T, Paulsen EE, Berglund M, Richardsen E, Andersen S, Al-Saad S, Poehl M, Pezzella F, Kwiatkowski DJ, Bremnes RM, Busund LTR, Donnem T. Tertiary lymphoid structure score: a promising approach to refine the TNM staging in resected non-small cell lung cancer. Br J Cancer 2021; 124:1680-1689. [PMID: 33723388 PMCID: PMC8110789 DOI: 10.1038/s41416-021-01307-y] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 01/19/2021] [Accepted: 02/02/2021] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND We previously proposed an immune cell score (tumour node metastasis (TNM)-Immune cell score) classifier as an add-on to the existing TNM staging system for non-small cell lung cancer (NSCLC). Herein, we examined how to reliably assess a tertiary lymphoid structure (TLS) score to refine the TNM staging system. METHODS Using immunohistochemistry (CD8/cytokeratin), we quantified TLS in resected NSCLC whole-tumour tissue sections with three different scoring models on two independent collections (total of 553 patients). In a pilot setting, NanoString gene expression signatures were analysed for associations with TLS. RESULTS The number of TLSs significantly decreased in stage III patients as compared to stage II. The TLS score was an independent positive prognostic factor, regardless of the type of (semi)-quantification strategy used (four-scale semi-quantitative; absolute count of total TLS; subpopulation of mature TLS) or the endpoint (disease-specific survival; overall survival; time to recurrence). Subgroup analyses revealed a significant prognostic impact of TLS score within each pathological stage, patient cohort and main histological subtype. Targeted gene expression analysis showed that high TLS levels were associated with the expression of B cell and adaptive immunity genes/metagenes including tumour inflammation signature. CONCLUSIONS The TLS score increases the prognostic power in each pathological stage and hence has the potential to refine TNM staging in resected NSCLC.
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Affiliation(s)
- Mehrdad Rakaee
- grid.10919.300000000122595234Department of Clinical Medicine, UiT, The Arctic University of Norway, Tromso, Norway ,grid.10919.300000000122595234Department of Medical Biology, UiT, The Arctic University of Norway, Tromso, Norway
| | - Thomas K. Kilvaer
- grid.10919.300000000122595234Department of Clinical Medicine, UiT, The Arctic University of Norway, Tromso, Norway ,grid.412244.50000 0004 4689 5540Department of Oncology, University Hospital of North Norway, Tromso, Norway
| | - Simin Jamaly
- grid.10919.300000000122595234Department of Medical Biology, UiT, The Arctic University of Norway, Tromso, Norway
| | - Thomas Berg
- grid.412244.50000 0004 4689 5540Department of Clinical Pathology, University Hospital of North Norway, Tromso, Norway
| | - Erna-Elise Paulsen
- grid.10919.300000000122595234Department of Clinical Medicine, UiT, The Arctic University of Norway, Tromso, Norway ,grid.412244.50000 0004 4689 5540Department of Oncology, University Hospital of North Norway, Tromso, Norway
| | - Marte Berglund
- grid.412244.50000 0004 4689 5540Department of Clinical Pathology, University Hospital of North Norway, Tromso, Norway
| | - Elin Richardsen
- grid.10919.300000000122595234Department of Medical Biology, UiT, The Arctic University of Norway, Tromso, Norway ,grid.412244.50000 0004 4689 5540Department of Clinical Pathology, University Hospital of North Norway, Tromso, Norway
| | - Sigve Andersen
- grid.10919.300000000122595234Department of Clinical Medicine, UiT, The Arctic University of Norway, Tromso, Norway ,grid.412244.50000 0004 4689 5540Department of Oncology, University Hospital of North Norway, Tromso, Norway
| | - Samer Al-Saad
- grid.412244.50000 0004 4689 5540Department of Clinical Pathology, University Hospital of North Norway, Tromso, Norway
| | - Mette Poehl
- grid.475435.4Department of Oncology, Rigshospitalet, Copenhagen, Denmark
| | - Francesco Pezzella
- grid.4991.50000 0004 1936 8948Nuffield Department of Clinical Laboratory Sciences, University of Oxford, Oxford, UK
| | - David J. Kwiatkowski
- grid.65499.370000 0001 2106 9910Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA USA ,grid.62560.370000 0004 0378 8294Department of Medicine, Brigham and Women’s Hospital, Boston, MA USA
| | - Roy M. Bremnes
- grid.10919.300000000122595234Department of Clinical Medicine, UiT, The Arctic University of Norway, Tromso, Norway ,grid.412244.50000 0004 4689 5540Department of Oncology, University Hospital of North Norway, Tromso, Norway
| | - Lill-Tove Rasmussen Busund
- grid.10919.300000000122595234Department of Medical Biology, UiT, The Arctic University of Norway, Tromso, Norway ,grid.412244.50000 0004 4689 5540Department of Clinical Pathology, University Hospital of North Norway, Tromso, Norway
| | - Tom Donnem
- grid.10919.300000000122595234Department of Clinical Medicine, UiT, The Arctic University of Norway, Tromso, Norway ,grid.412244.50000 0004 4689 5540Department of Oncology, University Hospital of North Norway, Tromso, Norway
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13
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Wahl SGF, Dai HY, Emdal EF, Ottestad AL, Dale VG, Richardsen E, Halvorsen TO, Grønberg BH. Prognostic value of absolute quantification of mutated KRAS in circulating tumour DNA in lung adenocarcinoma patients prior to therapy. J Pathol Clin Res 2021; 7:209-219. [PMID: 33502820 PMCID: PMC8073004 DOI: 10.1002/cjp2.200] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 12/21/2020] [Accepted: 01/04/2021] [Indexed: 12/13/2022]
Abstract
Droplet digital polymerase chain reaction (ddPCR) is a highly sensitive and accurate method for quantification of nucleic acid sequences. We used absolute quantification of mutated v-Ki-ras2 Kirsten rat sarcoma viral oncogene homology gene (KRAS) by ddPCR to investigate the prognostic role of mutated KRAS in patients with KRAS-mutated lung adenocarcinomas. Pre-treatment plasma samples from 60 patients with stages I-IV KRAS-mutated lung adenocarcinomas were analysed for KRAS mutations. The associations between survival, detectable KRAS mutations in plasma, and the plasma concentration of mutated KRAS were assessed. Overall, 23 of 60 (38%) patients had detectable KRAS mutation in plasma. The percentage of patients with detectable mutation was 8% in stage I, 30% in stage II, 71% in stage III, and 73% in stage IV. Estimated overall median progression-free survival (PFS) and overall survival (OS) were 26.2 months [95% confidence interval (CI) 12.5-39.9] and 50.8 months (95% CI 0-107.3), respectively. Patients with detectable mutations in plasma had significantly worse median PFS compared to patients with undetectable mutation (13.1 versus 70.1 months) and shorter median OS (20.7 versus not reached). High circulating tumour DNA (ctDNA) concentrations of mutated KRAS were significantly associated with shorter PFS [hazard ratio (HR) 1.008, 95% CI 1.004-1.012] and OS (HR 1.007, 95% CI 1.003-1.011). All associations remained statistically significant in multivariable analyses. In conclusion, ddPCR is an accurate and easily feasible technique for quantification of KRAS mutations in ctDNA. The presence of detectable KRAS mutation in plasma at baseline was associated with worse PFS and OS. High concentration of mutated KRAS in ctDNA was an independent negative prognostic factor for both PFS and OS.
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Affiliation(s)
- Sissel Gyrid Freim Wahl
- Department of PathologySt. Olavs Hospital, Trondheim University HospitalTrondheimNorway
- Department of Clinical and Molecular MedicineNTNU, Norwegian University of Technology and ScienceTrondheimNorway
| | - Hong Yan Dai
- Department of PathologySt. Olavs Hospital, Trondheim University HospitalTrondheimNorway
- Department of Clinical and Molecular MedicineNTNU, Norwegian University of Technology and ScienceTrondheimNorway
| | - Elisabeth F Emdal
- Department of PathologySt. Olavs Hospital, Trondheim University HospitalTrondheimNorway
| | - Anine L Ottestad
- Department of Clinical and Molecular MedicineNTNU, Norwegian University of Technology and ScienceTrondheimNorway
| | - Vibeke G Dale
- Department of PathologySt. Olavs Hospital, Trondheim University HospitalTrondheimNorway
| | - Elin Richardsen
- Department of Medical BiologyUiT, The Arctic University of NorwayTromsøNorway
- Department of Clinical PathologyUniversity Hospital of North NorwayTromsøNorway
| | - Tarje O Halvorsen
- Department of Clinical and Molecular MedicineNTNU, Norwegian University of Technology and ScienceTrondheimNorway
- Department of OncologySt. Olavs Hospital, Trondheim University HospitalTrondheimNorway
| | - Bjørn Henning Grønberg
- Department of Clinical and Molecular MedicineNTNU, Norwegian University of Technology and ScienceTrondheimNorway
- Department of OncologySt. Olavs Hospital, Trondheim University HospitalTrondheimNorway
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14
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Ramberg H, Richardsen E, de Souza GA, Rakaee M, Stensland ME, Braadland PR, Nygård S, Ögren O, Guldvik IJ, Berge V, Svindland A, Taskén KA, Andersen S. Proteomic analyses identify major vault protein as a prognostic biomarker for fatal prostate cancer. Carcinogenesis 2021; 42:685-693. [PMID: 33609362 PMCID: PMC8163044 DOI: 10.1093/carcin/bgab015] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 01/25/2021] [Accepted: 02/17/2021] [Indexed: 12/13/2022] Open
Abstract
The demographic shift toward an older population will increase the number of prostate cancer cases. A challenge in the treatment of prostate cancer is to avoid undertreatment of patients at high risk of progression following curative treatment. These men can benefit from early salvage treatment. An explorative cohort consisting of tissue from 16 patients who underwent radical prostatectomy, and were either alive or had died from prostate cancer within 10 years postsurgery, was analyzed by mass spectrometry analysis. Following proteomic and bioinformatic analyses, major vault protein (MVP) was identified as a putative prognostic biomarker. A publicly available tissue proteomics dataset and a retrospective cohort of 368 prostate cancer patients were used for validation. The prognostic value of the MVP was verified by scoring immunohistochemical staining of a tissue microarray. High level of MVP was associated with more than 4-fold higher risk for death from prostate cancer (hazard ratio = 4.41, 95% confidence interval: 1.45–13.38; P = 0.009) in a Cox proportional hazard models, adjusted for Cancer of the Prostate Risk Assessments Post-surgical (CAPRA-S) score and perineural invasion. Decision curve analyses suggested an improved standardized net benefit, ranging from 0.06 to 0.18, of adding MVP onto CAPRA-S score. This observation was confirmed by receiver operator characteristics curve analyses for the CAPRA-S score versus CAPRA-S and MVP score (area under the curve: 0.58 versus 0.73). From these analyses, one can infer that MVP levels in combination with CAPRA-S score might add onto established risk parameters to identify patients with lethal prostate cancer.
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Affiliation(s)
- Håkon Ramberg
- Department of Tumor Biology, Institute for Cancer Research, Oslo University Hospital, Oslo, Norway
| | - Elin Richardsen
- Department of Medical Biology, The Arctic University of Norway, Tromsø, Norway.,Department of Clinical Pathology, University Hospital of North Norway, Tromsø, Norway
| | - Gustavo A de Souza
- Department of Immunology and Transfusion Medicine, Oslo University Hospital, Oslo, Norway.,Department of Immunology, Proteomics Core Facility, Oslo University Hospital, Oslo, Norway
| | - Mehrdad Rakaee
- Department of Medical Biology, The Arctic University of Norway, Tromsø, Norway.,Department of Clinical Medicine, The Arctic University of Norway, Tromsø, Norway
| | - Maria Ekman Stensland
- Department of Immunology and Transfusion Medicine, Oslo University Hospital, Oslo, Norway.,Department of Immunology, Proteomics Core Facility, Oslo University Hospital, Oslo, Norway
| | - Peder Rustøen Braadland
- Department of Tumor Biology, Institute for Cancer Research, Oslo University Hospital, Oslo, Norway
| | - Ståle Nygård
- Department of Tumorbiology, Bioinformatic Core Facility, Institute for Cancer Research, Oslo University Hospital, Oslo, Norway.,Center for Bioinformatics, Department of Informatics, University of Oslo, Oslo, Norway
| | - Olov Ögren
- Department of Tumor Biology, Institute for Cancer Research, Oslo University Hospital, Oslo, Norway
| | - Ingrid J Guldvik
- Department of Tumor Biology, Institute for Cancer Research, Oslo University Hospital, Oslo, Norway
| | - Viktor Berge
- Department of Urology, Oslo University Hospital, Oslo, Norway
| | - Aud Svindland
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Kristin A Taskén
- Department of Tumor Biology, Institute for Cancer Research, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Sigve Andersen
- Department of Clinical Medicine, The Arctic University of Norway, Tromsø, Norway.,Department of Oncology, University Hospital of North Norway, Tromsø, Norway
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15
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Andersen MK, Høiem TS, Claes BSR, Balluff B, Martin-Lorenzo M, Richardsen E, Krossa S, Bertilsson H, Heeren RMA, Rye MB, Giskeødegård GF, Bathen TF, Tessem MB. Spatial differentiation of metabolism in prostate cancer tissue by MALDI-TOF MSI. Cancer Metab 2021; 9:9. [PMID: 33514438 PMCID: PMC7847144 DOI: 10.1186/s40170-021-00242-z] [Citation(s) in RCA: 54] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 12/09/2020] [Indexed: 02/07/2023] Open
Abstract
Background Prostate cancer tissues are inherently heterogeneous, which presents a challenge for metabolic profiling using traditional bulk analysis methods that produce an averaged profile. The aim of this study was therefore to spatially detect metabolites and lipids on prostate tissue sections by using mass spectrometry imaging (MSI), a method that facilitates molecular imaging of heterogeneous tissue sections, which can subsequently be related to the histology of the same section. Methods Here, we simultaneously obtained metabolic and lipidomic profiles in different prostate tissue types using matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) MSI. Both positive and negative ion mode were applied to analyze consecutive sections from 45 fresh-frozen human prostate tissue samples (N = 15 patients). Mass identification was performed with tandem MS. Results Pairwise comparisons of cancer, non-cancer epithelium, and stroma revealed several metabolic differences between the tissue types. We detected increased levels of metabolites crucial for lipid metabolism in cancer, including metabolites involved in the carnitine shuttle, which facilitates fatty acid oxidation, and building blocks needed for lipid synthesis. Metabolites associated with healthy prostate functions, including citrate, aspartate, zinc, and spermine had lower levels in cancer compared to non-cancer epithelium. Profiling of stroma revealed higher levels of important energy metabolites, such as ADP, ATP, and glucose, and higher levels of the antioxidant taurine compared to cancer and non-cancer epithelium. Conclusions This study shows that specific tissue compartments within prostate cancer samples have distinct metabolic profiles and pinpoint the advantage of methodology providing spatial information compared to bulk analysis. We identified several differential metabolites and lipids that have potential to be developed further as diagnostic and prognostic biomarkers for prostate cancer. Spatial and rapid detection of cancer-related analytes showcases MALDI-TOF MSI as a promising and innovative diagnostic tool for the clinic. Supplementary Information The online version contains supplementary material available at 10.1186/s40170-021-00242-z.
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Affiliation(s)
- Maria K Andersen
- Department of Circulation and Medical Imaging, NTNU-Norwegian University of Science and Technology, Trondheim, Norway.
| | - Therese S Høiem
- Department of Circulation and Medical Imaging, NTNU-Norwegian University of Science and Technology, Trondheim, Norway
| | - Britt S R Claes
- Maastricht MultiModal Molecular Imaging institute (M4I), Maastricht University, Maastricht, The Netherlands
| | - Benjamin Balluff
- Maastricht MultiModal Molecular Imaging institute (M4I), Maastricht University, Maastricht, The Netherlands
| | - Marta Martin-Lorenzo
- Maastricht MultiModal Molecular Imaging institute (M4I), Maastricht University, Maastricht, The Netherlands
| | - Elin Richardsen
- Department of Medical Biology, UiT The Artic University of Norway, Tromsø, Norway.,Department of Clinical Pathology, University Hospital of North Norway, UNN, Tromsø, Norway
| | - Sebastian Krossa
- Department of Circulation and Medical Imaging, NTNU-Norwegian University of Science and Technology, Trondheim, Norway
| | - Helena Bertilsson
- Department of Clinical and Molecular Medicine, NTNU-Norwegian University of Science and Technology, Trondheim, Norway.,Department of Urology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Ron M A Heeren
- Maastricht MultiModal Molecular Imaging institute (M4I), Maastricht University, Maastricht, The Netherlands
| | - Morten B Rye
- Department of Clinical and Molecular Medicine, NTNU-Norwegian University of Science and Technology, Trondheim, Norway.,Clinic of Surgery, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.,Clinic of Laboratory Medicine, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.,BioCore-Bioinformatics Core Facility, NTNU-Norwegian University of Science and Technology, Trondheim, Norway
| | - Guro F Giskeødegård
- Department of Circulation and Medical Imaging, NTNU-Norwegian University of Science and Technology, Trondheim, Norway
| | - Tone F Bathen
- Department of Circulation and Medical Imaging, NTNU-Norwegian University of Science and Technology, Trondheim, Norway
| | - May-Britt Tessem
- Department of Circulation and Medical Imaging, NTNU-Norwegian University of Science and Technology, Trondheim, Norway. .,Clinic of Surgery, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.
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16
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Andersen MK, Krossa S, Høiem TS, Buchholz R, Claes BSR, Balluff B, Ellis SR, Richardsen E, Bertilsson H, Heeren RMA, Bathen TF, Karst U, Giskeødegård GF, Tessem MB. Simultaneous Detection of Zinc and Its Pathway Metabolites Using MALDI MS Imaging of Prostate Tissue. Anal Chem 2020; 92:3171-3179. [PMID: 31944670 PMCID: PMC7584334 DOI: 10.1021/acs.analchem.9b04903] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
![]()
Levels
of zinc, along with its mechanistically related metabolites citrate
and aspartate, are widely reported as reduced in prostate cancer compared
to healthy tissue and are therefore pointed out as potential cancer
biomarkers. Previously, it has only been possible to analyze zinc
and metabolites by separate detection methods. Through matrix-assisted
laser desorption/ionization mass spectrometry imaging (MSI), we were
for the first time able to demonstrate, in two different sample sets
(n = 45 and n = 4), the simultaneous
spatial detection of zinc, in the form of ZnCl3–, together with citrate, aspartate, and N-acetylaspartate
on human prostate cancer tissues. The reliability of the ZnCl3– detection was validated by total zinc
determination using laser ablation inductively coupled plasma MSI
on adjacent serial tissue sections. Zinc, citrate, and aspartate were
correlated with each other (range r = 0.46 to 0.74)
and showed a significant reduction in cancer compared to non-cancer
epithelium (p < 0.05, log2 fold change
range: −0.423 to −0.987), while no significant difference
between cancer and stroma tissue was found. Simultaneous spatial detection
of zinc and its metabolites is not only a valuable tool for analyzing
the role of zinc in prostate metabolism but might also provide a fast
and simple method to detect zinc, citrate, and aspartate levels as
a biomarker signature for prostate cancer diagnostics and prognostics.
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Affiliation(s)
- Maria K Andersen
- Department of Circulation and Medical Imaging , Norwegian University of Science and Technology (NTNU) , 7491 Trondheim , Norway
| | - Sebastian Krossa
- Department of Circulation and Medical Imaging , Norwegian University of Science and Technology (NTNU) , 7491 Trondheim , Norway
| | - Therese S Høiem
- Department of Circulation and Medical Imaging , Norwegian University of Science and Technology (NTNU) , 7491 Trondheim , Norway
| | - Rebecca Buchholz
- Institute of Inorganic and Analytical Chemistry , University of Münster , D-48149 Münster , Germany
| | - Britt S R Claes
- Maastricht MultiModal Molecular Imaging Institute (M4I) , Maastricht University , 6229 ER Maastricht , The Netherlands
| | - Benjamin Balluff
- Maastricht MultiModal Molecular Imaging Institute (M4I) , Maastricht University , 6229 ER Maastricht , The Netherlands
| | - Shane R Ellis
- Maastricht MultiModal Molecular Imaging Institute (M4I) , Maastricht University , 6229 ER Maastricht , The Netherlands
| | - Elin Richardsen
- Department of Medical Biology , The Arctic University of Norway (UIT) , 9037 Tromsø , Norway.,Department of Clinical Pathology , University Hospital of North Norway, UNN , 9019 Tromsø , Norway
| | - Helena Bertilsson
- Department of Clinical and Molecular Medicine , Norwegian University of Science and Technology (NTNU) , 7491 Trondheim , Norway.,Clinic of Surgery, St. Olavs Hospital , Trondheim University Hospital , 7030 Trondheim , Norway
| | - Ron M A Heeren
- Maastricht MultiModal Molecular Imaging Institute (M4I) , Maastricht University , 6229 ER Maastricht , The Netherlands
| | - Tone F Bathen
- Department of Circulation and Medical Imaging , Norwegian University of Science and Technology (NTNU) , 7491 Trondheim , Norway
| | - Uwe Karst
- Institute of Inorganic and Analytical Chemistry , University of Münster , D-48149 Münster , Germany
| | - Guro F Giskeødegård
- Department of Circulation and Medical Imaging , Norwegian University of Science and Technology (NTNU) , 7491 Trondheim , Norway
| | - May-Britt Tessem
- Department of Circulation and Medical Imaging , Norwegian University of Science and Technology (NTNU) , 7491 Trondheim , Norway.,Clinic of Surgery, St. Olavs Hospital , Trondheim University Hospital , 7030 Trondheim , Norway
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17
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Stikbakke E, Richardsen E, Knutsen T, Wilsgaard T, Giovannucci EL, McTiernan A, Eggen AE, Haugnes HS, Thune I. Inflammatory serum markers and risk and severity of prostate cancer: The PROCA-life study. Int J Cancer 2019; 147:84-92. [PMID: 31583707 DOI: 10.1002/ijc.32718] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 09/02/2019] [Accepted: 09/18/2019] [Indexed: 12/11/2022]
Abstract
Whether chronic inflammation mirrored by high levels of systemic inflammatory markers such as high sensitive-CRP (hs-CRP) and white blood cell count (WBC) are associated with prostate cancer development remains unclear. In the Prostate Cancer Study throughout Life (PROCA-life), a prospective population-based cohort study, 7,356 men were included. Prediagnostic WBC and hs-CRP were assessed from blood collected at study entry; 2,210 participants also had a second CRP measure during follow-up. During a mean 11.8 years follow-up, 509 men developed prostate cancer (mean age at diagnosis 71.7 years). Multivariable Cox proportional hazard regression models were used to study whether individual biomarkers (WBC, hs-CRP), a combined score based on analyte tertiles (score range 2-6), or change in CRP were associated with risk and severity of prostate cancer. We observed a positive dose-response relationship between hs-CRP and prostate cancer risk with a Hazard Ratio (HR) per mg/l of 1.3, 95% CI 1.00-1.07. Men with an increase in hs-CRP between two measurements (Δhs-CRP) of ≥1.00 mg/l had a 36% increased risk of prostate cancer (HR 1.36, 95% CI 1.02-1.82), compared to men with no change or decrease in hs-CRP. Men with a systemic inflammatory score of 5 or 6 had a 68% higher risk of being diagnosed with metastatic disease (HR 1.68, 95% CI, 1.04-2.73) compared to men with lower scores. Our study supports that hs-CRP including repeated measurements alone or in combination with WBC may be a useful inflammation-related biomarker for prostate cancer risk and prognosis.
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Affiliation(s)
- Einar Stikbakke
- Department of Clinical Medicine, Faculty of Health Sciences, UiT, The Arctic University of Norway, Tromsø, Norway.,Department of Oncology, University Hospital of North Norway, Tromsø, Norway
| | - Elin Richardsen
- Department of Medical Biology, Faculty of Health Sciences, UiT, The Arctic University of Norway, Tromsø, Norway.,Department of Clinical Pathology, University Hospital of North Norway, Tromsø, Norway
| | - Tore Knutsen
- Department of Clinical Medicine, Faculty of Health Sciences, UiT, The Arctic University of Norway, Tromsø, Norway.,Department of Urology, University Hospital of North Norway, Tromsø, Norway
| | - Tom Wilsgaard
- Department of Community Medicine, Faculty of Health Sciences, UiT, The Arctic University of Norway, Tromsø, Norway
| | - Edward L Giovannucci
- Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.,Departments of Nutrition and Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Anne McTiernan
- Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA.,Department of Epidemiology, School of Public Health; and Department of Medicine, School of Medicine, University of Washington, Seattle, WA
| | - Anne Elise Eggen
- Department of Community Medicine, Faculty of Health Sciences, UiT, The Arctic University of Norway, Tromsø, Norway
| | - Hege Sagstuen Haugnes
- Department of Clinical Medicine, Faculty of Health Sciences, UiT, The Arctic University of Norway, Tromsø, Norway.,Department of Oncology, University Hospital of North Norway, Tromsø, Norway
| | - Inger Thune
- Department of Clinical Medicine, Faculty of Health Sciences, UiT, The Arctic University of Norway, Tromsø, Norway.,Department of Oncology, The Cancer Centre, Ullevaal, Oslo University Hospital, Oslo, Norway
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18
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Wahl S, Dai H, Emdal E, Ottestad A, Richardsen E, Halvorsen T, Gronberg B. P2.09-03 Prognostic Value of Mutated KRAS in Circulating Tumor DNA Prior to Therapy in Patients with Lung Adenocarcinoma. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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19
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Richardsen E, Andersen S, Al-Saad S, Rakaee M, Nordby Y, Pedersen MI, Ness N, Ingebriktsen LM, Fassina A, Taskén KA, Mills IG, Donnem T, Bremnes RM, Busund LT. Low Expression of miR-424-3p is Highly Correlated with Clinical Failure in Prostate Cancer. Sci Rep 2019; 9:10662. [PMID: 31337863 PMCID: PMC6650397 DOI: 10.1038/s41598-019-47234-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Accepted: 07/15/2019] [Indexed: 01/16/2023] Open
Abstract
Prostate cancer (PC) is a highly heterogenous disease and one of the leading causes of mortality in developed countries. Recently, studies have shown that expression of immune checkpoint proteins are directly or indirectly repressed by microRNAs (miRs) in many types of cancers. The great advantages of using miRs based therapy is the capacity of these short transcripts to target multiple molecules for the same- or different pathways with synergistic immune inhibition effects. miR-424 has previously been described as a biomarker of poor prognosis in different types of cancers. miR-424 is also found to target both the CTLA-4/CD80- and PD-1/PD-L1 axis. In the present study, the clinical significance of miR-424-3p expression in PC tissue was evaluated. Naïve radical prostatectomy specimens from 535 patients was used for tissue microarray construction. In situ hybridization was used to evaluate the expression of miR-424-3p and immunohistochemistry was used for CTLA-4 protein detection. In univariate- and multivariate analyses, low expression of miR-424-3p was significant associated with clinical failure-free survival, (p = 0.004) and p = 0.018 (HR:0.44, CI95% 0.22-0.87). Low expression of miR-424-3p also associated strongly with aggressive phenotype of PC. This highlight the importance of miR-424-3p as potential target for therapeutic treatment in prostate cancer.
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Affiliation(s)
- E Richardsen
- Translational Cancer Research Group, Institute of Medical Biology, UiT The Arctic University of Norway, Tromso, Norway. .,Department of Clinical Pathology, University Hospital of North Norway, Tromso, Norway.
| | - S Andersen
- Translational Cancer Research Group, Institute of Clinical Medicine, UiT The Arctic University of Norway, Tromso, Norway.,Department of Oncology, University Hospital of North Norway, Tromso, Norway
| | - S Al-Saad
- Translational Cancer Research Group, Institute of Medical Biology, UiT The Arctic University of Norway, Tromso, Norway.,Department of Clinical Pathology, University Hospital of North Norway, Tromso, Norway
| | - M Rakaee
- Translational Cancer Research Group, Institute of Medical Biology, UiT The Arctic University of Norway, Tromso, Norway
| | - Y Nordby
- Translational Cancer Research Group, Institute of Clinical Medicine, UiT The Arctic University of Norway, Tromso, Norway.,Department of Urology, University Hospital of North Norway, Tromso, Norway
| | - M I Pedersen
- Translational Cancer Research Group, Institute of Medical Biology, UiT The Arctic University of Norway, Tromso, Norway
| | - N Ness
- Translational Cancer Research Group, Institute of Medical Biology, UiT The Arctic University of Norway, Tromso, Norway
| | - L M Ingebriktsen
- Translational Cancer Research Group, Institute of Medical Biology, UiT The Arctic University of Norway, Tromso, Norway
| | - A Fassina
- Department of Medicine, University of Padua, 35121, Padova, Italy
| | - K A Taskén
- Institute of Cancer Research, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - I G Mills
- Centre for Cancer Research and Cell Biology, Queen's University of Belfast, Belfast, UK.,Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
| | - T Donnem
- Translational Cancer Research Group, Institute of Clinical Medicine, UiT The Arctic University of Norway, Tromso, Norway.,Department of Oncology, University Hospital of North Norway, Tromso, Norway
| | - R M Bremnes
- Translational Cancer Research Group, Institute of Clinical Medicine, UiT The Arctic University of Norway, Tromso, Norway.,Department of Oncology, University Hospital of North Norway, Tromso, Norway
| | - L T Busund
- Translational Cancer Research Group, Institute of Medical Biology, UiT The Arctic University of Norway, Tromso, Norway.,Department of Clinical Pathology, University Hospital of North Norway, Tromso, Norway
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20
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Rakaee M, Busund LTR, Jamaly S, Paulsen EE, Richardsen E, Andersen S, Al-Saad S, Bremnes RM, Donnem T, Kilvaer TK. Prognostic Value of Macrophage Phenotypes in Resectable Non-Small Cell Lung Cancer Assessed by Multiplex Immunohistochemistry. Neoplasia 2019; 21:282-293. [PMID: 30743162 PMCID: PMC6369140 DOI: 10.1016/j.neo.2019.01.005] [Citation(s) in RCA: 88] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 01/14/2019] [Accepted: 01/17/2019] [Indexed: 12/14/2022] Open
Abstract
Macrophages are important inflammatory cells that regulate innate and adaptive immunity in cancer. Tumor-associated macrophages (TAMs) are thought to differentiate into two main phenotypes: proinflammatory M1 and protumorigenic M2. Currently, the prognostic impact of TAMs and their M1 and M2 phenotypes is unclear in non–small cell cancer (NSCLC). The present study was set up to evaluate an approach for identifying common M1 and M2 macrophage markers and explore their clinical significance in NSCLC. Using multiplex chromogenic immunohistochemistry, tissue microarrays of 553 primary tumors and 143 paired metastatic lymph nodes of NSCLC specimens were stained to detect various putative macrophage phenotypes: M1 (HLA-DR/CD68), M2 (CD163/CD68), M2 (CD204/CD68), and pan-macrophage (CD68/CK). Correlation analyses were performed to examine the relationship between TAMs and adaptive/innate immune infiltrates. HLA-DR+/CD68+M1 TAM level significantly decreased from pathological stage I to III. In a compartment-specific correlation analysis, moderate to strong correlations were observed between both TAM subsets (M1 and M2) with CD3-, CD8-, CD4-, and CD45RO-positive immune cells. Survival analyses, in both stromal and intratumoral compartments, revealed that high levels of HLA-DR+/CD68+M1 (stroma, hazard ratio [HR] = 0.73, P = .03; intratumor, HR = 0.7, P = .04), CD204+M2 (stroma, HR = 0.7, P = .02; intratumor, HR = 0.6, P = .004), and CD68 (stroma, HR = 0.69, P = .02; intratumor, HR = 0.73, P = .04) infiltration were independently associated with improved NSCLC-specific survival. In lymph nodes, the intratumoral level of HLA-DR+/CD68+M1 was an independent positive prognostic indicator (Cox model, HR = 0.38, P = .001). In conclusion, high levels of M1, CD204+M2, and CD68 macrophages are independent prognosticators of prolonged survival in NSCLC.
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Affiliation(s)
- Mehrdad Rakaee
- Department of Medical Biology, UiT The Arctic University of Norway, Tromsø, Norway, 9019.
| | - Lill-Tove Rasmussen Busund
- Department of Medical Biology, UiT The Arctic University of Norway, Tromsø, Norway, 9019; Department of Clinical Pathology, University Hospital of North Norway, Tromsø, Norway, 9019.
| | - Simin Jamaly
- Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway, 9019.
| | - Erna-Elise Paulsen
- Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway, 9019; Department of Oncology, University Hospital of North Norway, Tromsø, Norway, 9019.
| | - Elin Richardsen
- Department of Medical Biology, UiT The Arctic University of Norway, Tromsø, Norway, 9019; Department of Clinical Pathology, University Hospital of North Norway, Tromsø, Norway, 9019.
| | - Sigve Andersen
- Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway, 9019; Department of Oncology, University Hospital of North Norway, Tromsø, Norway, 9019.
| | - Samer Al-Saad
- Department of Medical Biology, UiT The Arctic University of Norway, Tromsø, Norway, 9019; Department of Clinical Pathology, University Hospital of North Norway, Tromsø, Norway, 9019.
| | - Roy M Bremnes
- Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway, 9019; Department of Oncology, University Hospital of North Norway, Tromsø, Norway, 9019.
| | - Tom Donnem
- Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway, 9019; Department of Oncology, University Hospital of North Norway, Tromsø, Norway, 9019.
| | - Thomas K Kilvaer
- Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway, 9019; Department of Oncology, University Hospital of North Norway, Tromsø, Norway, 9019.
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21
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Kral R, Osima M, Vestgaard R, Richardsen E, Bjørnerem Å. Women with fracture, unidentified by FRAX, but identified by cortical porosity, have a set of characteristics that contribute to their increased fracture risk beyond high FRAX score and high cortical porosity. Bone 2018; 116:259-265. [PMID: 30153509 DOI: 10.1016/j.bone.2018.08.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Revised: 08/12/2018] [Accepted: 08/24/2018] [Indexed: 12/21/2022]
Abstract
The Fracture Risk Assessment Tool (FRAX) is widely used to identify individuals at increased risk for fracture. However, cortical porosity is associated with risk for fracture independent of FRAX and is reported to improve the net reclassification of fracture cases. We wanted to test the hypothesis that women with fracture who are unidentified by high FRAX score, but identified by high cortical porosity, have a set of characteristics that contribute to their fracture risk beyond high FRAX score and high cortical porosity. We quantified FRAX score with femoral neck areal bone mineral density (FN aBMD), and femoral subtrochanteric architecture, in 211 postmenopausal women aged 54-94 years with non-vertebral fractures, and 232 fracture-free controls in Tromsø, Norway, using StrAx software. Of 211 fracture cases, FRAX score > 20% identified 53 women (sensitivity 25.1% and specificity 93.5%), while cortical porosity cut-off > 80th percentile identified 61 women (sensitivity 28.9% and specificity 87.9%). The 43 (20.4%) additional fracture cases identified by high cortical porosity alone, had lower FRAX score (12.3 vs. 26.2%) than those identified by FRAX alone, they were younger, had higher FN aBMD (806 vs. 738 mg/cm2), and fewer had a prior fracture (23.3 vs. 62.9%), all p < 0.05. They had higher cortical porosity (48.7 vs. 42.1%), thinner cortices (3.75 vs. 4.12 mm), lower cortical and total volumetric BMD (942 vs. 1053 and 586 vs. 699 mg HA/cm3), larger medullary and total cross-sectional areas (245 vs. 190 and 669 vs. 593 mm2), and higher cross-sectional moment of inertia (2619 vs. 2388 cm4) all p < 0.001. When the fracture cases and controls with high cortical porosity were compared, cases had higher cortical porosity, lower cortical vBMD, lower total vBMD, smaller cortical CSA/Total CSA, larger medullary CSA and larger total CSA than controls (all p ≤ 0.05). Thus, fracture cases, unidentified by FRAX, but identified by cortical porosity, had an architecture where the positive impact of larger bone size did not offset the negative effect of thinner cortices with increased porosity. A measurement of cortical porosity may be a marker of other characteristics that capture additional fracture risk components, not captured by FRAX.
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Affiliation(s)
- Rita Kral
- Department of Obstetrics and Gynaecology, University Hospital of North Norway, Tromsø, Norway; Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Marit Osima
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway; Department of Orthopaedic Surgery, University Hospital of North Norway, Tromsø, Norway
| | - Roald Vestgaard
- Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway
| | - Elin Richardsen
- Department of Medical Biology, UiT The Arctic University of Norway, Tromsø, Norway; Department of Clinical Pathology, University Hospital of North Norway, Tromsø, Norway
| | - Åshild Bjørnerem
- Department of Obstetrics and Gynaecology, University Hospital of North Norway, Tromsø, Norway; Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway.
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22
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Rakaee M, Kilvaer TK, Dalen SM, Richardsen E, Paulsen EE, Hald SM, Al-Saad S, Andersen S, Donnem T, Bremnes RM, Busund LT. Evaluation of tumor-infiltrating lymphocytes using routine H&E slides predicts patient survival in resected non–small cell lung cancer. Hum Pathol 2018; 79:188-198. [DOI: 10.1016/j.humpath.2018.05.017] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 05/14/2018] [Accepted: 05/16/2018] [Indexed: 12/25/2022]
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23
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Skjefstad K, Johannessen C, Grindstad T, Kilvaer T, Paulsen EE, Pedersen M, Donnem T, Andersen S, Bremnes R, Richardsen E, Al-Saad S, Busund LT. A gender specific improved survival related to stromal miR-143 and miR-145 expression in non-small cell lung cancer. Sci Rep 2018; 8:8549. [PMID: 29867125 PMCID: PMC5986811 DOI: 10.1038/s41598-018-26864-w] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 05/15/2018] [Indexed: 12/14/2022] Open
Abstract
Micro RNAs (miRNA) are small non-coding RNAs that post-transcriptionally regulate gene expression. Dysregulation of miRNA cluster 143/145 has been reported in several malignancies, but their role in non-small cell lung cancer (NSCLC) remains elusive. This study investigates the prognostic impact of miR-143 and miR-145 in primary tumors and metastatic lymph nodes in NSCLC tissue. Tissue from 553 primary tumors and 143 matched metastatic lymph nodes were collected and tissue microarrays were constructed. In situ hybridization was used to evaluate miR-143 and miR-145 expression in tumor epithelial cells and stromal cells in the primary tumors and lymph nodes. In vivo data was supplemented with functional studies of cell lines in vitro to evaluate the role of miR-143 and miR-145 in NSCLC tumorigenesis. In our cohort, stromal miR-143 (S-miR-143) and miR-145 (S-miR-145) expression in primary tumor tissue were independent prognosticators of improved disease-specific survival (DSS) in female (S-miR-143, HR: 0.53, p = 0.019) and male patients (S-miR-145, HR: 0.58, p = 0.021), respectively. Interesting correlations between the miR cluster 143/145 and previously investigated steroid hormone receptors from the same cohort were identified, substantiating their gender dependent significance.
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Affiliation(s)
- Kaja Skjefstad
- Department of Medical Biology, UiT The Arctic University of Norway, Mailbox 6050 Langnes, N-9037, Tromso, Norway.
| | - Charles Johannessen
- Department of Medical Biology, UiT The Arctic University of Norway, Mailbox 6050 Langnes, N-9037, Tromso, Norway
| | - Thea Grindstad
- Department of Medical Biology, UiT The Arctic University of Norway, Mailbox 6050 Langnes, N-9037, Tromso, Norway
| | - Thomas Kilvaer
- Department of Clinical Medicine, UiT The Arctic University of Norway, Mailbox 6050 Langnes, N-9037, Tromso, Norway.,Department of Oncology, University Hospital of North Norway, Mailbox 13, N-9038, Tromso, Norway
| | - Erna-Elise Paulsen
- Department of Clinical Medicine, UiT The Arctic University of Norway, Mailbox 6050 Langnes, N-9037, Tromso, Norway.,Department of Oncology, University Hospital of North Norway, Mailbox 13, N-9038, Tromso, Norway
| | - Mona Pedersen
- Department of Clinical Medicine, UiT The Arctic University of Norway, Mailbox 6050 Langnes, N-9037, Tromso, Norway
| | - Tom Donnem
- Department of Clinical Medicine, UiT The Arctic University of Norway, Mailbox 6050 Langnes, N-9037, Tromso, Norway.,Department of Oncology, University Hospital of North Norway, Mailbox 13, N-9038, Tromso, Norway
| | - Sigve Andersen
- Department of Clinical Medicine, UiT The Arctic University of Norway, Mailbox 6050 Langnes, N-9037, Tromso, Norway.,Department of Oncology, University Hospital of North Norway, Mailbox 13, N-9038, Tromso, Norway
| | - Roy Bremnes
- Department of Clinical Medicine, UiT The Arctic University of Norway, Mailbox 6050 Langnes, N-9037, Tromso, Norway.,Department of Oncology, University Hospital of North Norway, Mailbox 13, N-9038, Tromso, Norway
| | - Elin Richardsen
- Department of Medical Biology, UiT The Arctic University of Norway, Mailbox 6050 Langnes, N-9037, Tromso, Norway.,Department of Clinical Pathology, University Hospital of North Norway, Mailbox 46, N-9038, Tromso, Norway
| | - Samer Al-Saad
- Department of Medical Biology, UiT The Arctic University of Norway, Mailbox 6050 Langnes, N-9037, Tromso, Norway.,Department of Clinical Pathology, University Hospital of North Norway, Mailbox 46, N-9038, Tromso, Norway
| | - Lill-Tove Busund
- Department of Medical Biology, UiT The Arctic University of Norway, Mailbox 6050 Langnes, N-9037, Tromso, Norway.,Department of Clinical Pathology, University Hospital of North Norway, Mailbox 46, N-9038, Tromso, Norway
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24
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Kiselev Y, Andersen S, Johannessen C, Fjukstad B, Standahl Olsen K, Stenvold H, Al-Saad S, Donnem T, Richardsen E, Bremnes RM, Rasmussen Busund LT. Transcription factor PAX6 as a novel prognostic factor and putative tumour suppressor in non-small cell lung cancer. Sci Rep 2018; 8:5059. [PMID: 29568088 PMCID: PMC5864921 DOI: 10.1038/s41598-018-23417-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Accepted: 03/09/2018] [Indexed: 12/21/2022] Open
Abstract
Lung cancer is the leading cause of cancer deaths. Novel predictive biomarkers are needed to improve treatment selection and more accurate prognostication. PAX6 is a transcription factor with a proposed tumour suppressor function. Immunohistochemical staining was performed on tissue microarrays from 335 non-small cell lung cancer (NSCLC) patients for PAX6. Multivariate analyses of clinico-pathological variables and disease-specific survival (DSS) was carried out, and phenotypic changes of two NSCLC cell lines with knockdown of PAX6 were characterized. While PAX6 expression was only associated with a trend of better disease-specific survival (DSS) (p = 0.10), the pN+ subgroup (N = 103) showed significant correlation between high PAX6 expression and longer DSS (p = 0.022). Median survival for pN + patients with high PAX6 expression was 127.4 months, versus 22.9 months for patients with low PAX6 expression. In NCI-H661 cells, knockdown of PAX6 strongly activated serum-stimulated migration. In NCI-H460 cells, PAX6 knockdown activated anchorage-independent growth. We did not observe any significant effect of PAX6 on proliferation in either of cell lines. Our findings strongly support the proposition of PAX6 as a valid and positive prognostic marker in NSCLC in node-positive patients. There is a need for further studies, which should provide mechanistical explanation for the role of PAX6 in NSCLC.
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Affiliation(s)
- Yury Kiselev
- Department of Life Sciences and Health, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, Oslo, Norway. .,Department of Pharmacy, UiT The Arctic University of Norway, Tromso, Norway. .,Department of Medical Biology, UiT The Arctic University of Norway, Tromso, Norway.
| | - Sigve Andersen
- Department of Clinical Medicine, UiT The Arctic University of Norway, Tromso, Norway.,Department of Oncology, University Hospital of North Norway, Tromso, Norway
| | - Charles Johannessen
- Department of Medical Biology, UiT The Arctic University of Norway, Tromso, Norway
| | - Bjørn Fjukstad
- Department of Computer Science, Faculty of Science and Technology, UiT The Arctic University of Norway, Tromso, Norway
| | - Karina Standahl Olsen
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromso, Norway
| | - Helge Stenvold
- Department of Oncology, University Hospital of North Norway, Tromso, Norway
| | - Samer Al-Saad
- Department of Medical Biology, UiT The Arctic University of Norway, Tromso, Norway.,Department of Clinical Pathology, University Hospital of North Norway, Tromso, Norway
| | - Tom Donnem
- Department of Clinical Medicine, UiT The Arctic University of Norway, Tromso, Norway.,Department of Oncology, University Hospital of North Norway, Tromso, Norway
| | - Elin Richardsen
- Department of Medical Biology, UiT The Arctic University of Norway, Tromso, Norway.,Department of Clinical Pathology, University Hospital of North Norway, Tromso, Norway
| | - Roy M Bremnes
- Department of Clinical Medicine, UiT The Arctic University of Norway, Tromso, Norway.,Department of Oncology, University Hospital of North Norway, Tromso, Norway
| | - Lill-Tove Rasmussen Busund
- Department of Medical Biology, UiT The Arctic University of Norway, Tromso, Norway.,Department of Clinical Pathology, University Hospital of North Norway, Tromso, Norway
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25
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Ness N, Andersen S, Khanehkenari MR, Nordbakken CV, Valkov A, Paulsen EE, Nordby Y, Bremnes RM, Donnem T, Busund LT, Richardsen E. The prognostic role of immune checkpoint markers programmed cell death protein 1 (PD-1) and programmed death ligand 1 (PD-L1) in a large, multicenter prostate cancer cohort. Oncotarget 2018; 8:26789-26801. [PMID: 28460462 PMCID: PMC5432297 DOI: 10.18632/oncotarget.15817] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Accepted: 02/20/2017] [Indexed: 12/20/2022] Open
Abstract
Programmed cell death protein 1 (PD-1) and its ligand Programmed death ligand 1 (PD-L1) have gained massive attention in cancer research due to recent availability and their targeted antitumor effects. Their role in prostate cancer is still undetermined. We constructed tissue microarrays from prostatectomy specimens from 535 prostate cancer patients. Following validation of antibodies, immunohistochemistry was used to evaluate the expression of PD-1 in lymphocytes and PD-L1 in epithelial and stromal cells of primary tumors. PD-L1 expression was commonly seen in tumor epithelial cells (92% of cases). Univariate survival analysis revealed a positive association between a high density of PD-1+ lymphocytes and worse clinical failure-free survival, limited to a trend (p = 0.084). In subgroups known to indicate unfavorable prostate cancer prognosis (Gleason grade 9, age < 65, preoperative PSA > 10, pT3) patients with high density of PD-1+ lymphocytes had a significantly higher risk of clinical failure (p = < 0.001, p = 0.025, p = 0.039 and p = 0.011, respectively). In the multivariate analysis, high density of PD-1+ lymphocytes was a significant negative independent prognostic factor for clinical failure-free survival (HR = 2.48, CI 95% 1.12-5.48, p = 0.025).
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Affiliation(s)
- Nora Ness
- Department of Medical Biology, UiT The Arctic University of Norway, N-9037 Tromso, Norway
| | - Sigve Andersen
- Department of Clinical Medicine, UiT The Arctic University of Norway, N-9037 Tromso, Norway.,Department of Oncology, University Hospital of North Norway, N-9038 Tromso, Norway
| | | | - Cecilie V Nordbakken
- Department of Clinical Pathology, University Hospital of North Norway, N-9038 Tromso, Norway
| | - Andrej Valkov
- Department of Clinical Pathology, University Hospital of North Norway, N-9038 Tromso, Norway
| | - Erna-Elise Paulsen
- Department of Clinical Medicine, UiT The Arctic University of Norway, N-9037 Tromso, Norway.,Department of Oncology, University Hospital of North Norway, N-9038 Tromso, Norway
| | - Yngve Nordby
- Department of Clinical Medicine, UiT The Arctic University of Norway, N-9037 Tromso, Norway.,Department of Urology, University Hospital of North Norway, N-9038 Tromso, Norway
| | - Roy M Bremnes
- Department of Clinical Medicine, UiT The Arctic University of Norway, N-9037 Tromso, Norway.,Department of Oncology, University Hospital of North Norway, N-9038 Tromso, Norway
| | - Tom Donnem
- Department of Clinical Medicine, UiT The Arctic University of Norway, N-9037 Tromso, Norway.,Department of Oncology, University Hospital of North Norway, N-9038 Tromso, Norway
| | - Lill-Tove Busund
- Department of Medical Biology, UiT The Arctic University of Norway, N-9037 Tromso, Norway.,Department of Clinical Pathology, University Hospital of North Norway, N-9038 Tromso, Norway
| | - Elin Richardsen
- Department of Medical Biology, UiT The Arctic University of Norway, N-9037 Tromso, Norway.,Department of Clinical Pathology, University Hospital of North Norway, N-9038 Tromso, Norway
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26
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Skjefstad K, Grindstad T, Rakaee Khanehkenari M, Richardsen E, Donnem T, Kilvaer T, Andersen S, Bremnes RM, Busund LT, Al-Saad S. Corrigendum to "Prognostic relevance of estrogen receptor α, β and aromatase expression in non-small cell lung cancer" [Steroids 113 (2016) 5-13]. Steroids 2018; 130:36-37. [PMID: 29273210 DOI: 10.1016/j.steroids.2017.11.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Kaja Skjefstad
- Department of Medical Biology, UiT - The Arctic University of Norway, 9037 Tromso, Norway.
| | - Thea Grindstad
- Department of Medical Biology, UiT - The Arctic University of Norway, 9037 Tromso, Norway
| | | | - Elin Richardsen
- Department of Medical Biology, UiT - The Arctic University of Norway, 9037 Tromso, Norway; Department of Clinical Pathology, University Hospital of North Norway, 9037 Tromso, Norway
| | - Tom Donnem
- Department of Clinical Medicine, UiT - The Arctic University of Norway, 9037 Tromso, Norway; Department of Oncology, University Hospital of North Norway, 9037 Tromso, Norway
| | - Thomas Kilvaer
- Department of Clinical Pathology, University Hospital of North Norway, 9037 Tromso, Norway; Department of Oncology, University Hospital of North Norway, 9037 Tromso, Norway
| | - Sigve Andersen
- Department of Clinical Medicine, UiT - The Arctic University of Norway, 9037 Tromso, Norway; Department of Oncology, University Hospital of North Norway, 9037 Tromso, Norway
| | - Roy M Bremnes
- Department of Clinical Medicine, UiT - The Arctic University of Norway, 9037 Tromso, Norway; Department of Oncology, University Hospital of North Norway, 9037 Tromso, Norway
| | - Lill-Tove Busund
- Department of Medical Biology, UiT - The Arctic University of Norway, 9037 Tromso, Norway; Department of Clinical Pathology, University Hospital of North Norway, 9037 Tromso, Norway
| | - Samer Al-Saad
- Department of Medical Biology, UiT - The Arctic University of Norway, 9037 Tromso, Norway; Department of Clinical Pathology, University Hospital of North Norway, 9037 Tromso, Norway
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27
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Hald SM, Rakaee M, Martinez I, Richardsen E, Al-Saad S, Paulsen EE, Blix ES, Kilvaer T, Andersen S, Busund LT, Bremnes RM, Donnem T. LAG-3 in Non-Small-cell Lung Cancer: Expression in Primary Tumors and Metastatic Lymph Nodes Is Associated With Improved Survival. Clin Lung Cancer 2017; 19:249-259.e2. [PMID: 29396238 DOI: 10.1016/j.cllc.2017.12.001] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2017] [Revised: 11/22/2017] [Accepted: 12/01/2017] [Indexed: 12/29/2022]
Abstract
BACKGROUND Lymphocyte activation gene-3 (LAG-3) is an immune checkpoint receptor and a putative therapeutic target in non-small-cell lung cancer (NSCLC). We explored the prognostic effect of LAG-3+ tumor-infiltrating lymphocytes (TILs) in primary tumors and metastatic lymph nodes in NSCLC and its potential for inclusion in an immunoscore, supplementing the TNM classification. MATERIALS AND METHODS Primary tumor tissue from 553 stage I-IIIB NSCLC patients and 143 corresponding metastatic lymph nodes were collected. The expression of LAG-3 was evaluated by immunohistochemistry on tissue microarrays. RESULTS On univariate analysis, LAG-3+ TILs in the intraepithelial and stromal compartments of primary tumors and in the intraepithelial and extraepithelial compartments of metastatic lymph nodes were associated with improved disease-specific survival (DSS). On multivariate analysis, stromal LAG-3+ TILs were a significant independent predictor of improved DSS (hazard ratio [HR], 0.59; 95% confidence interval [CI], 0.43-0.82; P = .002). Stromal LAG-3+ TILs did not have prognostic impact across all pathologic stages. In the metastatic lymph nodes, intraepithelial (HR, 0.61; 95% CI, 0.38-0.99; P = .049) and extraepithelial (HR, 0.54; 95% CI, 0.29-0.70; P < .001) LAG-3+ TILs were independently associated with favorable DSS. CONCLUSION LAG-3+ TILs are an independent positive prognostic factor in stage I-IIIB NSCLC. LAG-3 in metastatic lymph nodes is a candidate marker for an immunoscore in NSCLC.
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Affiliation(s)
- Sigurd M Hald
- Department of Clinical Medicine, UiT The Arctic University of Norway, Tromso, Norway.
| | - Mehrdad Rakaee
- Department of Clinical Medicine, UiT The Arctic University of Norway, Tromso, Norway
| | - Inigo Martinez
- Department of Clinical Medicine, UiT The Arctic University of Norway, Tromso, Norway
| | - Elin Richardsen
- Department of Clinical Pathology, University Hospital of North Norway, Tromso, Norway; Department of Medical Biology, UiT The Arctic University of Norway, Tromso, Norway
| | - Samer Al-Saad
- Department of Clinical Pathology, University Hospital of North Norway, Tromso, Norway; Department of Medical Biology, UiT The Arctic University of Norway, Tromso, Norway
| | - Erna-Elise Paulsen
- Department of Clinical Medicine, UiT The Arctic University of Norway, Tromso, Norway; Department of Oncology, University Hospital of North Norway, Tromso, Norway
| | - Egil Støre Blix
- Department of Clinical Medicine, UiT The Arctic University of Norway, Tromso, Norway; Department of Oncology, University Hospital of North Norway, Tromso, Norway
| | - Thomas Kilvaer
- Department of Clinical Medicine, UiT The Arctic University of Norway, Tromso, Norway; Department of Oncology, University Hospital of North Norway, Tromso, Norway
| | - Sigve Andersen
- Department of Clinical Medicine, UiT The Arctic University of Norway, Tromso, Norway; Department of Oncology, University Hospital of North Norway, Tromso, Norway
| | - Lill-Tove Busund
- Department of Clinical Pathology, University Hospital of North Norway, Tromso, Norway; Department of Medical Biology, UiT The Arctic University of Norway, Tromso, Norway
| | - Roy M Bremnes
- Department of Clinical Medicine, UiT The Arctic University of Norway, Tromso, Norway; Department of Oncology, University Hospital of North Norway, Tromso, Norway
| | - Tom Donnem
- Department of Clinical Medicine, UiT The Arctic University of Norway, Tromso, Norway; Department of Oncology, University Hospital of North Norway, Tromso, Norway
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28
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Andersen S, Richardsen E, Rakaee M, Bertilsson H, Bremnes R, Børset M, Busund LT, Slørdahl T. Expression of phosphatase of regenerating liver (PRL)-3, is independently associated with biochemical failure, clinical failure and death in prostate cancer. PLoS One 2017; 12:e0189000. [PMID: 29190795 PMCID: PMC5708709 DOI: 10.1371/journal.pone.0189000] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2017] [Accepted: 11/16/2017] [Indexed: 11/19/2022] Open
Abstract
Background Prostate cancer (PC) stratification needs new prognostic tools to reduce overtreatment. Phosphatase of regenerating liver (PRL-3) is a phosphatase found at high levels in several cancer types, where its expression is associated with survival. A recent PC cell line study has shown it to be involved in PC growth and migration. Methods We used a monoclonal antibody to evaluate the expression of PRL-3 in PC tissue of patients in an unselected cohort of 535 prostatectomy patients. We analyzed associations between PRL-3 expression and biochemical failure-free survival (BFFS), clinical failure-free survival (CFFS) and PC death-free survival (PCDFS). Results Cytoplasmic PRL-3 staining in tumor cells was significantly correlated to expression of molecules in the VEGFR-axis, but not to the clinicopathological variables. High PRL-3 was not significantly associated with survival in the univariate analysis for BFFS (p = 0.131), but significantly associated with CFFS (p = 0.044) and PCDFS (p = 0.041). In multivariate analysis for the various end points, PRL-3 came out as an independent and significant indicator of poor survival for BFFS (HR = 1.53, CI95% 1.10–2.13, p = 0.012), CFFS (HR = 2.41, CI95% 1.17–4.98, p = 0.017) and PCDFS (HR = 3.99, CI95% 1.21–13.1, p = 0.023). Conclusions PRL-3 is independently associated with all PC endpoints in this study. Since high PRL-3 expression also correlates with poor prognosis in other cancers and functional studies in PC support these findings, PRL-3 emerges as a potential treatment target in PC.
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Affiliation(s)
- Sigve Andersen
- Translational Cancer Research Group, Department Clinical Medicine, UiT, The Arctic University of Norway, Tromso, Norway
- Department Oncology, University Hospital of North Norway, Tromso, Norway
- * E-mail:
| | - Elin Richardsen
- Translational Cancer Research Group, Department of Medical Biology, UiT, The Arctic University of Norway, Tromso, Norway
- Department Pathology, University Hospital of North Norway, Tromso, Norway
| | - Mehrdad Rakaee
- Translational Cancer Research Group, Department of Medical Biology, UiT, The Arctic University of Norway, Tromso, Norway
| | - Helena Bertilsson
- Department of Cancer Research and Molecular Medicine, NTNU - Norwegian University of Science and Technology, Trondheim, Norway
- Department of Urology, St. Olavs Hospital - Trondheim University Hospital, Trondheim, Norway
| | - Roy Bremnes
- Translational Cancer Research Group, Department Clinical Medicine, UiT, The Arctic University of Norway, Tromso, Norway
- Department Oncology, University Hospital of North Norway, Tromso, Norway
| | - Magne Børset
- Department of Cancer Research and Molecular Medicine, NTNU - Norwegian University of Science and Technology, Trondheim, Norway
- Department of Immunology and Transfusion Medicine, St. Olavs Hospital - Trondheim University Hospital, Trondheim, Norway
| | - Lill-Tove Busund
- Translational Cancer Research Group, Department of Medical Biology, UiT, The Arctic University of Norway, Tromso, Norway
- Department Pathology, University Hospital of North Norway, Tromso, Norway
| | - Tobias Slørdahl
- Department of Cancer Research and Molecular Medicine, NTNU - Norwegian University of Science and Technology, Trondheim, Norway
- Department of Hematology, St. Olavs Hospital - Trondheim University Hospital, Trondheim, Norway
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Vaysse C, Lømo J, Garred Ø, Fjeldheim F, Lofteroed T, Schlichting E, McTiernan A, Frydenberg H, Husøy A, Lundgren S, Fagerland MW, Richardsen E, Wist EA, Muller C, Thune I. Erratum: Inflammation of mammary adipose tissue occurs in overweight and obese patients exhibiting early-stage breast cancer. NPJ Breast Cancer 2017; 3:35. [PMID: 28884144 PMCID: PMC5585409 DOI: 10.1038/s41523-017-0030-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- Charlotte Vaysse
- The Cancer Centre, Oslo University Hospital, Oslo, Norway.,Institut de Pharmacologie et de Biologie Structurale (IPBS), Université de Toulouse, CNRS, UPS, Toulouse, France
| | - Jon Lømo
- Department of Pathology, Oslo University Hospital, Oslo, Norway
| | - Øystein Garred
- Department of Pathology, Oslo University Hospital, Oslo, Norway
| | - Frøydis Fjeldheim
- The Cancer Centre, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Trygve Lofteroed
- The Cancer Centre, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ellen Schlichting
- Department of Breast and Endocrine Surgery, Oslo University Hospital, Oslo, Norway
| | - Anne McTiernan
- Fred Hutchinson Cancer Research Center, Public Health Sciences Division, Seattle, WA USA
| | | | - Anders Husøy
- The Cancer Centre, Oslo University Hospital, Oslo, Norway
| | - Steinar Lundgren
- Department of Oncology, St. Olavs University Hospital, Trondheim, Norway
| | - Morten W Fagerland
- Centre for Biostatistics and Epidemiology, Research Support Services, Oslo University Hospital Oslo, Oslo, Norway.,Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | - Elin Richardsen
- Department of Medical Biology, Department of Clinical Pathology, UiT The Arctic University of Norway, University of North Norway, Tromsø, Norway
| | - Erik A Wist
- The Cancer Centre, Oslo University Hospital, Oslo, Norway
| | - Catherine Muller
- Institut de Pharmacologie et de Biologie Structurale (IPBS), Université de Toulouse, CNRS, UPS, Toulouse, France
| | - Inger Thune
- The Cancer Centre, Oslo University Hospital, Oslo, Norway.,Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway.,Institute of Clinical Medicine, Faculty of Health Sciences, University of Tromsø, Tromsø, Norway
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30
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Al-Saad S, Richardsen E, Kilvaer TK, Donnem T, Andersen S, Khanehkenari M, Bremnes RM, Busund LT. The impact of MET, IGF-1, IGF1R expression and EGFR mutations on survival of patients with non-small-cell lung cancer. PLoS One 2017; 12:e0181527. [PMID: 28742836 PMCID: PMC5526580 DOI: 10.1371/journal.pone.0181527] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Accepted: 07/03/2017] [Indexed: 01/10/2023] Open
Abstract
Introduction To compare the efficacy of silver in situ hybridization (SISH) and immunohistochemistry (IHC) in detecting MET and IGF1R alterations and to investigate their prevalence and prognostic significance. A possible correlation between MET receptor expression, MET gene alterations and the two most frequent occurring EGFR gene mutations was also investigated. Materials and methods Stage I to IIIA tumors from 326 patients with NSCLC were immunohistochemically tested for protein expression of MET and IGF-1. Their cytoplasmic expression was compared with the gene copy number of the MET and IGF1Rgenes by SISH in paraffin-embedded, formalin-fixed material. Correlations were made with the immunohistochemical expression of two frequent EGFR mutations and clinicopathological variables. Univariate and multivariate survival analyses was used to evaluate the prognostic efficacy of the tested markers. Results In univariate analyses, high cytoplasmic MET expression showed a significant negative prognostic effect in adenocarcinoma patients (p = 0.026). MET gene to chromosome 7 ratio was a significant positive prognostic marker (p = 0.005), probably only due to the highly negative prognostic significance of chromosome 7 polysomy (p = 0.002). High IGF1R gene copy number was a negative prognostic marker for all NSCLC patients (p = 0.037). In the multivariate analysis, polysomy of chromosome 7 in tumor cells correlated significantly and independently with a poor prognosis (p = 0.011). In patients with adenocarcinoma, a high cytoplasmic MET expression was an independent negative prognostic marker (p = 0.013). In males a high IGF1R gene copy number to chromosome 15 count ratio was significantly and independently correlated to a poor prognosis (p = 0.018). Conclusion MET protein expression provides superior prognostic information compared with SISH. Polysomy of chromosome 7 is an independent negative prognostic factor in NSCLC patients. This finding has an important implication while examining genes located on chromosome 7 by means of SISH. High IGF1R gene copy number to chromosome 15 count ratio is an independent predictor of inferior survival in male patients with primary NSCLC.
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Affiliation(s)
- Samer Al-Saad
- Institute of Medical Biology, UiT The Arctic University of Norway, Tromso, Norway
- Department of Clinical Pathology, University Hospital of Northern Norway, Tromso, Norway
- * E-mail:
| | - Elin Richardsen
- Institute of Medical Biology, UiT The Arctic University of Norway, Tromso, Norway
- Department of Clinical Pathology, University Hospital of Northern Norway, Tromso, Norway
| | - Thomas K. Kilvaer
- Institute of Clinical Medicine, UiT The Arctic University of Norway, Tromso, Norway
- Department of Oncology, University Hospital of Northern Norway, Tromso, Norway
| | - Tom Donnem
- Institute of Clinical Medicine, UiT The Arctic University of Norway, Tromso, Norway
- Department of Oncology, University Hospital of Northern Norway, Tromso, Norway
| | - Sigve Andersen
- Institute of Clinical Medicine, UiT The Arctic University of Norway, Tromso, Norway
- Department of Oncology, University Hospital of Northern Norway, Tromso, Norway
| | - Mehrdad Khanehkenari
- Institute of Medical Biology, UiT The Arctic University of Norway, Tromso, Norway
| | - Roy M. Bremnes
- Institute of Clinical Medicine, UiT The Arctic University of Norway, Tromso, Norway
- Department of Oncology, University Hospital of Northern Norway, Tromso, Norway
| | - Lill-Tove Busund
- Institute of Medical Biology, UiT The Arctic University of Norway, Tromso, Norway
- Department of Clinical Pathology, University Hospital of Northern Norway, Tromso, Norway
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31
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Paulsen EE, Kilvaer TK, Rakaee M, Richardsen E, Hald SM, Andersen S, Busund LT, Bremnes RM, Donnem T. CTLA-4 expression in the non-small cell lung cancer patient tumor microenvironment: diverging prognostic impact in primary tumors and lymph node metastases. Cancer Immunol Immunother 2017; 66:1449-1461. [PMID: 28707078 PMCID: PMC5645427 DOI: 10.1007/s00262-017-2039-2] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2016] [Accepted: 07/07/2017] [Indexed: 12/11/2022]
Abstract
The immune checkpoint receptor CTLA-4 plays a crucial part in negatively regulating T cell activation and maintaining self-tolerance. It is frequently overexpressed in a variety of malignancies, yet its prognostic impact in non-small cell lung cancer (NSCLC) remains unclear. We constructed tissue microarrays from tumor tissue samples and evaluated the immunohistochemical expression of CTLA-4 in 536 patients with primary resected stage I-IIIA NSCLC. Expression of CTLA-4 was analyzed in tumor and stromal primary tumor tissue and in locoregional metastatic lymph nodes. CTLA-4 expression in neither tumor epithelial cells (T-CTLA-4) nor stromal cells (S-CTLA-4) of primary tumors was significantly associated with disease-specific survival (DSS) in all patients. However, high S-CTLA-4 expression independently predicted significantly improved DSS in the squamous cell carcinoma subgroup (HR 0.62, 95% CI 0.41-0.93, P = 0.021). In contrast, there was an independent negative prognostic impact of T-CTLA-4 expression in metastatic lymph nodes (HR 1.65, 95% CI 1.03-2.65, P = 0.039). Our results indicate that the expression of CTLA-4 has diverging prognostic impacts in metastatic NSCLC lymph nodes versus primary tumors. The presented results highlight important differences in the tumor microenvironments of primary and metastatic NSCLC tissues, and have potential to guide treatment and clinical sampling strategies.
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Affiliation(s)
- Erna-Elise Paulsen
- Department of Oncology, University Hospital of North Norway, Mailbox 13, 9038, Tromso, Norway.
- Department of Clinical Medicine, UiT The Arctic University of Norway, Mailbox 6050, Langnes, 9037, Tromso, Norway.
- Translational Cancer Research Group, Department of Clinical Medicine, UiT The Arctic University of Norway, Mailbox 6050, Langnes, 9038, Tromso, Norway.
| | - Thomas K Kilvaer
- Department of Oncology, University Hospital of North Norway, Mailbox 13, 9038, Tromso, Norway
- Department of Clinical Medicine, UiT The Arctic University of Norway, Mailbox 6050, Langnes, 9037, Tromso, Norway
| | - Mehrdad Rakaee
- Department of Medical Biology, UiT The Arctic University of Norway, Mailbox 6050, Langnes, 9037, Tromso, Norway
| | - Elin Richardsen
- Department of Clinical Pathology, University Hospital of North Norway, Mailbox 46, 9038, Tromso, Norway
- Department of Medical Biology, UiT The Arctic University of Norway, Mailbox 6050, Langnes, 9037, Tromso, Norway
| | - Sigurd M Hald
- Department of Clinical Medicine, UiT The Arctic University of Norway, Mailbox 6050, Langnes, 9037, Tromso, Norway
| | - Sigve Andersen
- Department of Oncology, University Hospital of North Norway, Mailbox 13, 9038, Tromso, Norway
- Department of Clinical Medicine, UiT The Arctic University of Norway, Mailbox 6050, Langnes, 9037, Tromso, Norway
| | - Lill-Tove Busund
- Department of Clinical Pathology, University Hospital of North Norway, Mailbox 46, 9038, Tromso, Norway
- Department of Medical Biology, UiT The Arctic University of Norway, Mailbox 6050, Langnes, 9037, Tromso, Norway
| | - Roy M Bremnes
- Department of Oncology, University Hospital of North Norway, Mailbox 13, 9038, Tromso, Norway
- Department of Clinical Medicine, UiT The Arctic University of Norway, Mailbox 6050, Langnes, 9037, Tromso, Norway
| | - Tom Donnem
- Department of Oncology, University Hospital of North Norway, Mailbox 13, 9038, Tromso, Norway
- Department of Clinical Medicine, UiT The Arctic University of Norway, Mailbox 6050, Langnes, 9037, Tromso, Norway
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32
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Vaysse C, Lømo J, Garred Ø, Fjeldheim F, Lofteroed T, Schlichting E, McTiernan A, Frydenberg H, Husøy A, Lundgren S, Fagerland MW, Richardsen E, Wist EA, Muller C, Thune I. Inflammation of mammary adipose tissue occurs in overweight and obese patients exhibiting early-stage breast cancer. NPJ Breast Cancer 2017. [PMID: 28649659 PMCID: PMC5460134 DOI: 10.1038/s41523-017-0015-9] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Growing evidence indicates that adiposity is associated with breast cancer risk and negatively affects breast cancer recurrence and survival, a paracrine role of mammary adipose tissue being very likely in this process. In contrast to other adipose depots, occurrence of a sub-inflammatory state of mammary adipose tissue defined by dying adipocytes surrounded by macrophages forming crown-like structures in overweight and obese subjects, remains only partially described. In a general population of breast cancer patients (107 patients) mostly undergoing breast-conserving surgery, we found a positive association between patient's body composition, breast adipocytes size, and presence of crown-like structures in mammary adipose tissue close to the tumor. Overweight (BMI: 25.0-29.9 kg/m2) and obese (BMI ≥ 30.0 kg/m2) patients have 3.2 and 6.9 times higher odds ratio of crown-like structures respectively, compared with normal weight patients. The relatively small increase in adipocyte size in crown-like structures positive vs. negative patients suggests that mammary adipose tissue inflammation might occur early during hypertrophy. Our results further highlight that body mass index is an adequate predictor of the presence of crown-like structures in mammary adipose tissue among postmenopausal women, whereas in premenopausal women truncal fat percentage might be more predictive, suggesting that mammary adipose tissue inflammation is more likely to occur in patients exhibiting visceral obesity. Finally, the presence of crown-like structures was positively associated with systemic markers such as the Triglyceride/High-density lipoprotein-cholesterol ratio serum C-reactive protein and glucose/(HbA1c) glycated Haemoglobin. These compelling results demonstrate that excess adiposity, even in overweight patients, is associated with mammary adipose tissue inflammation, an event that could contribute to breast cancer development and progression.
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Affiliation(s)
- Charlotte Vaysse
- The Cancer Center, Oslo University Hospital, Oslo, Norway.,Institut de Pharmacologie et de Biologie Structurale (IPBS), Université de Toulouse, CNRS, UPS, Toulouse, France
| | - Jon Lømo
- Department of Pathology, Oslo University Hospital, Oslo, Norway
| | - Øystein Garred
- Department of Pathology, Oslo University Hospital, Oslo, Norway
| | - Frøydis Fjeldheim
- The Cancer Center, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Trygve Lofteroed
- The Cancer Center, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ellen Schlichting
- Department of Breast and Endocrine Surgery, Oslo University Hospital, Oslo, Norway
| | - Anne McTiernan
- Fred Hutchinson Cancer Research Center, Public Health Sciences Division, Seattle, WA USA
| | | | - Anders Husøy
- The Cancer Center, Oslo University Hospital, Oslo, Norway
| | - Steinar Lundgren
- Department of Oncology, St. Olavs University Hospital, Trondheim, Norway
| | - Morten W Fagerland
- Centre for Biostatistics and Epidemiology, Research Support Services, Oslo University Hospital Oslo, Oslo, Norway.,Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | - Elin Richardsen
- Department of Medical Biology, Department of Clinical Pathology, UiT The Arctic University of Norway, University of North Norway, Tromsø, Norway
| | - Erik A Wist
- The Cancer Center, Oslo University Hospital, Oslo, Norway
| | - Catherine Muller
- Institut de Pharmacologie et de Biologie Structurale (IPBS), Université de Toulouse, CNRS, UPS, Toulouse, France
| | - Inger Thune
- The Cancer Center, Oslo University Hospital, Oslo, Norway.,Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway.,Institute of Clinical Medicine, Faculty of Health Sciences, University of Tromsø, Tromsø, Norway
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33
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Hald SM, Kiselev Y, Al-Saad S, Richardsen E, Johannessen C, Eilertsen M, Kilvaer TK, Al-Shibli K, Andersen S, Busund LT, Bremnes RM, Donnem T. Erratum to: Prognostic impact of CXCL16 and CXCR6 in non-small cell lung cancer: combined high CXCL16 expression in tumor stroma and cancer cells yields improved survival. BMC Cancer 2016; 16:916. [PMID: 27884136 PMCID: PMC5122019 DOI: 10.1186/s12885-016-2954-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Accepted: 11/14/2016] [Indexed: 11/10/2022] Open
Affiliation(s)
- Sigurd M Hald
- Department of Clinical Medicine, UiT The Arctic University of Norway, 9037, Tromso, Norway.
| | - Yury Kiselev
- Department of Medical Biology, UiT The Arctic University of Norway, Tromso, Norway.,Department of Pharmacy, UiT The Arctic University of Norway, Tromso, Norway
| | - Samer Al-Saad
- Department of Medical Biology, UiT The Arctic University of Norway, Tromso, Norway.,Department of Clinical Pathology, UniversityHospital of North Norway, Tromso, Norway
| | - Elin Richardsen
- Department of Medical Biology, UiT The Arctic University of Norway, Tromso, Norway.,Department of Clinical Pathology, UniversityHospital of North Norway, Tromso, Norway
| | - Charles Johannessen
- Department of Medical Biology, UiT The Arctic University of Norway, Tromso, Norway
| | - Marte Eilertsen
- Department of Clinical Medicine, UiT The Arctic University of Norway, 9037, Tromso, Norway
| | - Thomas K Kilvaer
- Department of Oncology, University Hospital of North Norway, Tromso, Norway
| | - Khalid Al-Shibli
- Department of Medical Biology, UiT The Arctic University of Norway, Tromso, Norway.,Department of Pathology, Nordland Hospital, Bodo, Norway
| | - Sigve Andersen
- Department of Clinical Medicine, UiT The Arctic University of Norway, 9037, Tromso, Norway.,Department of Oncology, University Hospital of North Norway, Tromso, Norway
| | - Lill-Tove Busund
- Department of Medical Biology, UiT The Arctic University of Norway, Tromso, Norway.,Department of Clinical Pathology, UniversityHospital of North Norway, Tromso, Norway
| | - Roy M Bremnes
- Department of Clinical Medicine, UiT The Arctic University of Norway, 9037, Tromso, Norway.,Department of Oncology, University Hospital of North Norway, Tromso, Norway
| | - Tom Donnem
- Department of Clinical Medicine, UiT The Arctic University of Norway, 9037, Tromso, Norway.,Department of Oncology, University Hospital of North Norway, Tromso, Norway
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Andersen S, Richardsen E, Moi L, Donnem T, Nordby Y, Ness N, Holman ME, Bremnes RM, Busund LT. Fibroblast miR-210 overexpression is independently associated with clinical failure in Prostate Cancer - a multicenter (in situ hybridization) study. Sci Rep 2016; 6:36573. [PMID: 27824162 PMCID: PMC5099893 DOI: 10.1038/srep36573] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Accepted: 10/17/2016] [Indexed: 12/28/2022] Open
Abstract
There is a need for better prognostication in prostate cancer (PC). “The micromanager of hypoxia”, microRNA-210 (miR-210) is directly linked to hypoxia, is overexpressed in PC and has been implied in tumor cell-fibroblast crosstalk. We investigated the prognostic impact of miR-210 in tumor cells and fibroblasts in PC. Tumor and stromal samples from a multicenter PC cohort of 535 prostatectomy patients were inserted into tissue microarrays. To investigate the expression of miR-210, we used in situ hybridization and two pathologists semiquantitatively scored its expression. Overexpression of miR-210 in tumor cells was not associated to biochemical failure-free survival (BFFS, p = 0.85) or clinical failure-free survival (CFFS, p = 0.09). However, overexpression of miR-210 in fibroblasts was significantly associated to a poor CFFS (p = 0.001), but not BFFS (p = 0.232). This feature was validated in both cohorts. Overexpression of miR-210 was independently associated with a reduced CFFS (HR = 2.76, CI 95% 1.25–6.09, p = 0.012). Overexpression of miR-210 in fibroblasts is independently associated with a poor CFFS. This highlights the importance of fibroblasts and cellular compartment crosstalk in PC. miR-210 is a candidate prognostic marker and potential therapeutic target in PC.
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Affiliation(s)
- Sigve Andersen
- Translational Cancer Research Group, Dept Clinical Medicine, UiT, The Arctic University of Norway, 9037 Tromso, Norway.,Dept Oncology, University Hospital of North Norway, 9038 Tromso, Norway
| | - Elin Richardsen
- Translational Cancer Research Group, Dept of Medical Biology, UiT, The Arctic University of Norway, 9037 Tromso, Norway.,Dept Pathology, University Hospital of North Norway, 9038 Tromso, Norway
| | - Line Moi
- Translational Cancer Research Group, Dept of Medical Biology, UiT, The Arctic University of Norway, 9037 Tromso, Norway.,Dept Pathology, University Hospital of North Norway, 9038 Tromso, Norway
| | - Tom Donnem
- Translational Cancer Research Group, Dept Clinical Medicine, UiT, The Arctic University of Norway, 9037 Tromso, Norway.,Dept Oncology, University Hospital of North Norway, 9038 Tromso, Norway
| | - Yngve Nordby
- Translational Cancer Research Group, Dept Clinical Medicine, UiT, The Arctic University of Norway, 9037 Tromso, Norway.,Dept of Urology, University Hospital of North Norway, 9038 Tromso, Norway
| | - Nora Ness
- Translational Cancer Research Group, Dept of Medical Biology, UiT, The Arctic University of Norway, 9037 Tromso, Norway
| | - Marte Eilertsen Holman
- Translational Cancer Research Group, Dept Clinical Medicine, UiT, The Arctic University of Norway, 9037 Tromso, Norway.,Dept Oncology, University Hospital of North Norway, 9038 Tromso, Norway
| | - Roy M Bremnes
- Translational Cancer Research Group, Dept Clinical Medicine, UiT, The Arctic University of Norway, 9037 Tromso, Norway.,Dept Oncology, University Hospital of North Norway, 9038 Tromso, Norway
| | - Lill-Tove Busund
- Translational Cancer Research Group, Dept of Medical Biology, UiT, The Arctic University of Norway, 9037 Tromso, Norway.,Dept Pathology, University Hospital of North Norway, 9038 Tromso, Norway
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35
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Paulsen EE, Kilvaer TK, Khanehkenari MR, Al-Saad S, Hald SM, Andersen S, Richardsen E, Ness N, Busund LT, Bremnes RM, Donnem T. Assessing PDL-1 and PD-1 in Non-Small Cell Lung Cancer: A Novel Immunoscore Approach. Clin Lung Cancer 2016; 18:220-233.e8. [PMID: 27816392 DOI: 10.1016/j.cllc.2016.09.009] [Citation(s) in RCA: 70] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Revised: 09/05/2016] [Accepted: 09/06/2016] [Indexed: 01/11/2023]
Abstract
INTRODUCTION Immune checkpoint inhibitors targeting programmed cell death protein 1 (PD-1) or its ligand, PD-L1, have gained momentum in the treatment of non-small cell lung cancer (NSCLC). However, their prognostic significance remains controversial. The present study evaluated the expression of PD-L1 and PD-1 and their potential role in an Immunoscore, supplementing the TNM classification of NSCLC. MATERIALS AND METHODS Tissue microarrays constructed from tumor tissue samples from 2 cohorts of a total of 536 patients (University Hospital of North Norway, n = 285; Nordland Hospital, n = 251) with primary resected stage I to IIIA NSCLC. PD-L1 and PD-1 were evaluated by immunohistochemistry in the primary tumor and metastatic lymph node tissue. RESULTS In univariate analysis, a high density of PD-L1+ immune cells in the stromal compartment (S-PD-L1) and PD-1+ intraepithelial tumor infiltrating lymphocytes (T-PD-1) was associated with favorable disease-specific survival (DSS; S-PD-L1, P = .004; T-PD-1, P = .012), both limited to the squamous cell carcinoma histologic subgroup (S-PD-L1, P = .002; T-PD-1, P = .034). A combined low S-PD-L1 and T-PD-1 was associated with poor survival in all patients (DSS: hazard ratio [HR], 1.81; 95% confidence interval [CI], 1.37-2.40; P < .001) at both centers and for all pathologic stages. In multivariate analysis, S-PD-L1 and T-PD-1 were independent positive prognostic factors, and combined low scores remained an independent prognosticator for poor survival (DSS: HR, 1.72; 95% CI, 1.29-2.28; P < .001; disease-free survival, P = .001; overall survival, P = .005). CONCLUSION Our study identified S-PD-L1 and T-PD-1 as independent positive prognostic factors for NSCLC patients. Their combination added significant prognostic impact within each pathologic stage and hence are feasible to include in a TNM Immunoscore.
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Affiliation(s)
- Erna-Elise Paulsen
- Department of Oncology, University Hospital of North Norway, Tromso, Norway; Department of Clinical Medicine, UiT The Arctic University of Norway, Tromso, Norway.
| | - Thomas K Kilvaer
- Department of Oncology, University Hospital of North Norway, Tromso, Norway; Department of Clinical Medicine, UiT The Arctic University of Norway, Tromso, Norway
| | | | - Samer Al-Saad
- Department of Clinical Pathology, University Hospital of North Norway, Tromso, Norway
| | - Sigurd M Hald
- Department of Clinical Medicine, UiT The Arctic University of Norway, Tromso, Norway
| | - Sigve Andersen
- Department of Oncology, University Hospital of North Norway, Tromso, Norway; Department of Clinical Medicine, UiT The Arctic University of Norway, Tromso, Norway
| | - Elin Richardsen
- Department of Medical Biology, UiT The Arctic University of Norway, Tromso, Norway; Department of Clinical Pathology, University Hospital of North Norway, Tromso, Norway
| | - Nora Ness
- Department of Medical Biology, UiT The Arctic University of Norway, Tromso, Norway
| | - Lill-Tove Busund
- Department of Medical Biology, UiT The Arctic University of Norway, Tromso, Norway; Department of Clinical Pathology, University Hospital of North Norway, Tromso, Norway
| | - Roy M Bremnes
- Department of Oncology, University Hospital of North Norway, Tromso, Norway; Department of Clinical Medicine, UiT The Arctic University of Norway, Tromso, Norway
| | - Tom Donnem
- Department of Oncology, University Hospital of North Norway, Tromso, Norway; Department of Clinical Medicine, UiT The Arctic University of Norway, Tromso, Norway
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Paulsen EE, Kilvaer T, Khanehkenari MR, Maurseth RJ, Al-Saad S, Hald SM, Al-Shibli K, Andersen S, Richardsen E, Busund LT, Bremnes R, Donnem T. CD45RO(+) Memory T Lymphocytes--a Candidate Marker for TNM-Immunoscore in Squamous Non-Small Cell Lung Cancer. Neoplasia 2016; 17:839-48. [PMID: 26678911 PMCID: PMC4681889 DOI: 10.1016/j.neo.2015.11.004] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Revised: 11/05/2015] [Accepted: 11/08/2015] [Indexed: 12/04/2022] Open
Abstract
Tumor-infiltrating lymphocytes (TILs) are vital in limiting cancer progression and may supplement the TNM classification. CD45RO+ memory TILs show major prognostic impact in various malignancies but have not been extensively explored in non–small cell lung cancer (NSCLC). In this study, we aimed to evaluate their potential in a NSCLC TNM-Immunoscore. Tissue microarrays were constructed from tumor tissue samples from two cohorts including in total 536 patients (University Hospital of North Norway, n = 285; Nordland Hospital, n = 251) with primary resected stage I to IIIA NSCLC. The density of CD45RO+ and CD8+ TILs in tumor epithelial and stromal compartments of the tumors was evaluated by immunohistochemistry. In univariate analyses, intraepithelial CD45RO+ TIL density (T-CD45RO) was a significant prognostic factor for disease-specific survival (P = .007), limited to the squamous cell carcinoma (SCC) histology subgroup (P < .001), where it was significant in both cohorts (University Hospital of North Norway, P = .003; Nordland Hospital, P = .022). Combining T-CD45RO and stromal CD8+ TIL density (S-CD8) increased the prognostic impact in SCC (P < .001) and showed a significant impact within all pathological stages (I, P = .025; II, P < .001; III, P = .001). In the multivariate analysis, T-CD45RO was an independent positive prognostic factor for SCC (hazard ratio 2.65, 95% confidence interval 1.64-4.28, P < .001), and in combination with S-CD8, the prognostic impact increased vastly (high + high versus low + low: hazard ratio 6.50, 95% confidence interval 3.54-11.91, P < .001). In conclusion, T-CD45RO was an independent prognostic factor for SCC NSCLC. When combined with S-CD8, the prognostic impact increased and was significant within each pathological stage. We propose CD45RO as a candidate marker for TNM-Immunoscore in SCC NSCLC.
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Affiliation(s)
- Erna-Elise Paulsen
- Department of Oncology, University Hospital of North Norway, Mailbox 100, N-9038 Tromso, Norway; Department of Clinical Medicine, UiT The Arctic University of Norway, Mailbox 6050 Langnes, N-9037 Tromso, Norway.
| | - Thomas Kilvaer
- Department of Oncology, University Hospital of North Norway, Mailbox 100, N-9038 Tromso, Norway; Department of Clinical Medicine, UiT The Arctic University of Norway, Mailbox 6050 Langnes, N-9037 Tromso, Norway.
| | - Mehrdad Rakaee Khanehkenari
- Department of Medical Biology, UiT The Arctic University of Norway, Mailbox 6050 Langnes, N-9037 Tromso, Norway.
| | | | - Samer Al-Saad
- Department of Clinical Pathology, University Hospital of North Norway, Mailbox 100, N-9038 Tromso, Norway.
| | - Sigurd M Hald
- Department of Clinical Medicine, UiT The Arctic University of Norway, Mailbox 6050 Langnes, N-9037 Tromso, Norway.
| | - Khalid Al-Shibli
- Department of Pathology, Nordland Hospital, Mailbox 1480, 8092 Bodoe, Norway.
| | - Sigve Andersen
- Department of Oncology, University Hospital of North Norway, Mailbox 100, N-9038 Tromso, Norway.
| | - Elin Richardsen
- Department of Clinical Pathology, University Hospital of North Norway, Mailbox 100, N-9038 Tromso, Norway; Department of Medical Biology, UiT The Arctic University of Norway, Mailbox 6050 Langnes, N-9037 Tromso, Norway.
| | - Lill-Tove Busund
- Department of Clinical Pathology, University Hospital of North Norway, Mailbox 100, N-9038 Tromso, Norway; Department of Medical Biology, UiT The Arctic University of Norway, Mailbox 6050 Langnes, N-9037 Tromso, Norway.
| | - Roy Bremnes
- Department of Oncology, University Hospital of North Norway, Mailbox 100, N-9038 Tromso, Norway; Department of Clinical Medicine, UiT The Arctic University of Norway, Mailbox 6050 Langnes, N-9037 Tromso, Norway.
| | - Tom Donnem
- Department of Oncology, University Hospital of North Norway, Mailbox 100, N-9038 Tromso, Norway; Department of Clinical Medicine, UiT The Arctic University of Norway, Mailbox 6050 Langnes, N-9037 Tromso, Norway.
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Skjefstad K, Grindstad T, Khanehkenari MR, Richardsen E, Donnem T, Kilvaer T, Andersen S, Bremnes RM, Busund LT, Al-Saad S. Prognostic relevance of estrogen receptor α, β and aromatase expression in non-small cell lung cancer. Steroids 2016; 113:5-13. [PMID: 27234503 DOI: 10.1016/j.steroids.2016.05.008] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2016] [Revised: 05/16/2016] [Accepted: 05/20/2016] [Indexed: 02/07/2023]
Abstract
Sex steroids and their receptors are important in the fetal development of normal lung tissue. In addition emerging evidence reveals their significance in lung cancer pathogenesis. This encourages the exploitation of hormone receptors as treatment targets in lung cancer, as it has been successfully used in breast cancer. This study investigates the prognostic impact of estrogen receptor (ER) α and β and the aromatase (AR) enzyme in non-small cell lung cancer (NSCLC) patients. Tumor tissue from 335 NSCLC patients was collected and tissue microarrays (TMAs) were constructed. Immunohistochemical analyses were performed to evaluate the expression of ERα, ERβ and AR in the cytoplasme and nuclei of cells in the tumor epithelial and stromal compartment. By use of survival statistics we investigated the markers impact on disease-specific survival (DSS). Nuclear ERβ expression in tumor epithelial cells in female patients (HR 3.03; 95% CI 1.39-6.61) and tumor cell AR expression in all patients (HR 1.55; 95% CI 1.08-2.23) were significant negative prognostic markers of disease-specific survival in our cohort. High ERβ expression correlates with worse outcome in female patients. Further, patients with high AR expression had an unfavorable prognostic outcome compared with patients expressing low AR levels. These results emphasize the importance of sex steroids role in NSCLC, and, as anti-hormonal drugs are widely available, could lead to the development of novel palliative or even adjuvant treatment strategies in this patient population.
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Affiliation(s)
- Kaja Skjefstad
- Department of Medical Biology, UiT - The Arctic University of Norway, 9037 Tromso, Norway.
| | - Thea Grindstad
- Department of Medical Biology, UiT - The Arctic University of Norway, 9037 Tromso, Norway
| | | | - Elin Richardsen
- Department of Medical Biology, UiT - The Arctic University of Norway, 9037 Tromso, Norway; Department of Clinical Pathology, University Hospital of North Norway, 9037 Tromso, Norway
| | - Tom Donnem
- Department of Clinical Medicine, UiT - The Arctic University of Norway, 9037 Tromso, Norway; Department of Oncology, University Hospital of North Norway, 9037 Tromso, Norway
| | - Thomas Kilvaer
- Department of Clinical Pathology, University Hospital of North Norway, 9037 Tromso, Norway; Department of Oncology, University Hospital of North Norway, 9037 Tromso, Norway
| | - Sigve Andersen
- Department of Clinical Medicine, UiT - The Arctic University of Norway, 9037 Tromso, Norway; Department of Oncology, University Hospital of North Norway, 9037 Tromso, Norway
| | - Roy M Bremnes
- Department of Clinical Medicine, UiT - The Arctic University of Norway, 9037 Tromso, Norway; Department of Oncology, University Hospital of North Norway, 9037 Tromso, Norway
| | - Lill-Tove Busund
- Department of Medical Biology, UiT - The Arctic University of Norway, 9037 Tromso, Norway; Department of Clinical Pathology, University Hospital of North Norway, 9037 Tromso, Norway
| | - Samer Al-Saad
- Department of Medical Biology, UiT - The Arctic University of Norway, 9037 Tromso, Norway; Department of Clinical Pathology, University Hospital of North Norway, 9037 Tromso, Norway
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Bremnes RM, Busund LT, Kilvær TL, Andersen S, Richardsen E, Paulsen EE, Hald S, Khanehkenari MR, Cooper WA, Kao SC, Dønnem T. The Role of Tumor-Infiltrating Lymphocytes in Development, Progression, and Prognosis of Non-Small Cell Lung Cancer. J Thorac Oncol 2016; 11:789-800. [PMID: 26845192 DOI: 10.1016/j.jtho.2016.01.015] [Citation(s) in RCA: 320] [Impact Index Per Article: 40.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Revised: 01/24/2016] [Accepted: 01/26/2016] [Indexed: 12/25/2022]
Abstract
A malignant tumor is not merely an accumulation of neoplastic cells, but constitutes a microenvironment containing endothelial cells, fibroblasts, structural components, and infiltrating immune cells that impact tumor development, invasion, metastasis, and outcome. Hence, the evolution of cancers reflects intricate cellular and molecular interactions between tumor cells and constituents of the tumor microenvironment. Recent studies have shed new light on this complex interaction between tumor and host immune cells and the resulting immune response. The composition of the immune microenvironment differs across patients as well as in cancers of the same type, including various populations of T cells, B cells, dendritic cells, natural killer cells, myeloid-derived suppressor cells, neutrophils, and macrophages. The type, density, location, and organization of immune cells within solid tumors define the immune contexture, which has proved to be a major determinant of tumor characteristics and patient outcome. Lung cancer consists mostly of non-small cell lung cancer (85%); it is our most deadly malignant disease, with the 5-year survival rate being merely 15%. This review focuses on the immune contexture; the tumor-suppressing roles of tumor-infiltrating lymphocytes; and the relevance of this immune contexture for cancer diagnostics, prognostication, and treatment allocation, with an emphasis on non-small cell lung cancer.
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Affiliation(s)
- Roy M Bremnes
- Institute of Clinical Medicine, The Arctic University of Norway, Tromsø, Norway; Department of Oncology, University Hospital of Northern Norway, Tromsø, Norway.
| | - Lill-Tove Busund
- Institute of Medical Biology, The Arctic University of Norway, Tromsø, Norway; Department of Pathology, University Hospital of Northern Norway, Tromsø, Norway
| | - Thomas L Kilvær
- Institute of Clinical Medicine, The Arctic University of Norway, Tromsø, Norway; Department of Oncology, University Hospital of Northern Norway, Tromsø, Norway
| | - Sigve Andersen
- Institute of Clinical Medicine, The Arctic University of Norway, Tromsø, Norway; Department of Oncology, University Hospital of Northern Norway, Tromsø, Norway
| | - Elin Richardsen
- Institute of Medical Biology, The Arctic University of Norway, Tromsø, Norway; Department of Pathology, University Hospital of Northern Norway, Tromsø, Norway
| | - Erna Elise Paulsen
- Institute of Clinical Medicine, The Arctic University of Norway, Tromsø, Norway; Department of Oncology, University Hospital of Northern Norway, Tromsø, Norway
| | - Sigurd Hald
- Institute of Clinical Medicine, The Arctic University of Norway, Tromsø, Norway; Department of Oncology, University Hospital of Northern Norway, Tromsø, Norway
| | | | - Wendy A Cooper
- Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia; School of Medicine, University of Western Sydney, New South Wales, Australia; Sydney Medical School, University of Sydney, New South Wales, Australia
| | - Steven C Kao
- Chris O'Brien Lifehouse, Sydney, New South Wales, Australia; Asbestos Diseases Research Institute, Sydney, New South Wales, Australia; University of Sydney, Sydney, New South Wales, Australia
| | - Tom Dønnem
- Institute of Clinical Medicine, The Arctic University of Norway, Tromsø, Norway; Department of Oncology, University Hospital of Northern Norway, Tromsø, Norway
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Donnem T, Kilvaer TK, Andersen S, Richardsen E, Paulsen EE, Hald SM, Al-Saad S, Brustugun OT, Helland A, Lund-Iversen M, Solberg S, Gronberg BH, Wahl SGF, Helgeland L, Fløtten O, Pohl M, Al-Shibli K, Sandanger TM, Pezzella F, Busund LT, Bremnes RM. Strategies for clinical implementation of TNM-Immunoscore in resected nonsmall-cell lung cancer. Ann Oncol 2015; 27:225-32. [PMID: 26578726 DOI: 10.1093/annonc/mdv560] [Citation(s) in RCA: 124] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Accepted: 11/07/2015] [Indexed: 02/06/2023] Open
Abstract
Immunoscore is a prognostic tool defined to quantify in situ immune cell infiltrates and appears highly promising as a supplement to the tumor-node-metastasis (TNM) classification of various tumors. In colorectal cancer, an international task force has initiated prospective multicenter studies aiming to implement TNM-Immunoscore (TNM-I) in a routine clinical setting. In breast cancer, recommendations for the evaluation of tumor-infiltrating lymphocytes (TILs) have been proposed by an international working group. Regardless of promising results, there are potential obstacles related to implementing TNM-I into the clinic. Diverse methods may be needed for different malignancies and even within each cancer entity. Nevertheless, a uniform approach across malignancies would be advantageous. In nonsmall-cell lung cancer (NSCLC), there are several previous reports indicating an apparent prognostic importance of TILs, but studies on TILs in a TNM-I setting are sparse and no general recommendations are made. However, recently published data is promising, evoking a realistic hope of a clinical useful NSCLC TNM-I. This review will focus on the TNM-I potential in NSCLC and propose strategies for clinical implementation of a TNM-I in resected NSCLC.
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Affiliation(s)
- T Donnem
- Department of Oncology, University Hospital of North Norway, Tromso Institute of Clinical Medicine, The Arctic University of Norway, Tromso
| | - T K Kilvaer
- Department of Oncology, University Hospital of North Norway, Tromso
| | - S Andersen
- Department of Oncology, University Hospital of North Norway, Tromso
| | - E Richardsen
- Department of Clinical Pathology, University Hospital of North Norway, Tromso Institute of Medical Biology, The Arctic University of Norway, Tromso
| | - E E Paulsen
- Department of Oncology, University Hospital of North Norway, Tromso Institute of Clinical Medicine, The Arctic University of Norway, Tromso
| | - S M Hald
- Institute of Clinical Medicine, The Arctic University of Norway, Tromso
| | - S Al-Saad
- Department of Clinical Pathology, University Hospital of North Norway, Tromso Institute of Medical Biology, The Arctic University of Norway, Tromso
| | - O T Brustugun
- Department of Oncology, Oslo University Hospital, The Norwegian Radium Hospital, Oslo
| | - A Helland
- Department of Oncology, Oslo University Hospital, The Norwegian Radium Hospital, Oslo Department of Cancer Genetics, Oslo University Hospital, The Norwegian Radium Hospital, Oslo
| | - M Lund-Iversen
- Department of Pathology, Oslo University Hospital, The Norwegian Radium Hospital, Oslo
| | - S Solberg
- Department of Cardiothoracic Surgery, Oslo University Hospital, Rikshospitalet, Oslo
| | - B H Gronberg
- The Cancer Clinic, St Olavs Hospital, Trondheim University Hospital, Trondheim Department of Cancer Research and Molecular Medicine, European Palliative Care Research Centre, Norwegian University of Science and Technology, Trondheim
| | - S G F Wahl
- Department of Pathology and Medical Genetics, St Olavs Hospital-Trondheim University Hospital, Trondheim
| | - L Helgeland
- Department of Pathology, Haukeland University Hospital, Bergen, Norway
| | - O Fløtten
- Department of Thoracic Medicine, Haukeland University Hospital, Bergen, Norway
| | - M Pohl
- Department of Oncology, Rigshospitalet, Copenhagen, Denmark
| | - K Al-Shibli
- Department of Pathology, Nordland Hospital, Bodo
| | - T M Sandanger
- Department of Community Medicine, The Artic University of Tromso, Tromso, Norway
| | - F Pezzella
- Nuffield Department of Clinical Laboratory Sciences, University of Oxford, John Radcliffe Hospital, Oxford, UK
| | - L T Busund
- Department of Clinical Pathology, University Hospital of North Norway, Tromso Institute of Medical Biology, The Arctic University of Norway, Tromso
| | - R M Bremnes
- Department of Oncology, University Hospital of North Norway, Tromso Institute of Clinical Medicine, The Arctic University of Norway, Tromso
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Nordby Y, Andersen S, Richardsen E, Ness N, Al-Saad S, Melbø-Jørgensen C, Patel HRH, Dønnem T, Busund LT, Bremnes RM. Stromal expression of VEGF-A and VEGFR-2 in prostate tissue is associated with biochemical and clinical recurrence after radical prostatectomy. Prostate 2015; 75:1682-93. [PMID: 26268996 DOI: 10.1002/pros.23048] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2015] [Accepted: 06/05/2015] [Indexed: 12/13/2022]
Abstract
BACKGROUND There is probably significant overtreatment of patients with prostate cancer due to a lack of sufficient diagnostic tools to predict aggressive disease. Vascular endothelial growth factors (VEGFs) and their receptors (VEGFRs) are potent mediators of angiogenesis and tumor proliferation, but have been examined to a limited extent in large prostate cancer studies. Meanwhile, recent promising results on VEGFR-2 inhibition have highlighted their importance, leading to the need for further investigations regarding their expression and prognostic impact. DESIGN Using tissue microarray and immunohistochemistry, the expression of VEGFs (VEGF-A and VEGF-C) and their receptors (VEGFR-2 and VEGFR-3) were measured in neoplastic tissue and corresponding stroma from radical prostatectomy specimens in 535 Norwegian patients. Their expression was evaluated semiquantatively and associations with event-free survival were calculated. RESULTS High expression of VEGFR-2 in either stroma or epithelium was independently associated with a higher incidence of prostate cancer relapse (HR = 4.56, P = 0.038). A high combined expression of either VEGF-A, VEGFR-2 or both in stroma was independently associated with a higher incidence of biochemical failure (HR = 1.77, P = 0.011). CONCLUSIONS This large study highlights the prognostic importance of VEGF-A and VEGFR-2 stromal expression. Analyses of these biomarkers may help distinguish which patients will benefit from radical treatment. Together with previous studies showing efficiency of targeting VEGFR-2 in prostate cancer, this study highlights its potential as a target for therapy, and may aid in future selection of prostate cancer patients for novel anti-angiogenic treatment.
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Affiliation(s)
- Yngve Nordby
- Department Clinical Medicine, The Arctic University of Norway, Tromso, Norway
- Department Urology, University Hospital of North Norway, Tromso, Norway
| | - Sigve Andersen
- Department Clinical Medicine, The Arctic University of Norway, Tromso, Norway
- Department Oncology, University Hospital of North Norway, Tromso, Norway
| | - Elin Richardsen
- Department Clinical Pathology, University Hospital of North Norway, Tromso, Norway
- Department Medical Biology, The Arctic University of Norway, Tromso, Norway
| | - Nora Ness
- Department Medical Biology, The Arctic University of Norway, Tromso, Norway
| | - Samer Al-Saad
- Department Clinical Pathology, University Hospital of North Norway, Tromso, Norway
- Department Medical Biology, The Arctic University of Norway, Tromso, Norway
| | | | - Hiten R H Patel
- Department Clinical Medicine, The Arctic University of Norway, Tromso, Norway
- Department Urology, University Hospital of North Norway, Tromso, Norway
| | - Tom Dønnem
- Department Clinical Medicine, The Arctic University of Norway, Tromso, Norway
- Department Oncology, University Hospital of North Norway, Tromso, Norway
| | - Lill-Tove Busund
- Department Clinical Pathology, University Hospital of North Norway, Tromso, Norway
- Department Medical Biology, The Arctic University of Norway, Tromso, Norway
| | - Roy M Bremnes
- Department Clinical Medicine, The Arctic University of Norway, Tromso, Norway
- Department Oncology, University Hospital of North Norway, Tromso, Norway
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Richardsen E, Ness N, Melbø-Jørgensen C, Johannesen C, Grindstad T, Nordbakken C, Al-Saad S, Andersen S, Dønnem T, Nordby Y, Bremnes RM, Busund LT. The Prognostic Significance of CXCL16 and Its Receptor C-X-C Chemokine Receptor 6 in Prostate Cancer. The American Journal of Pathology 2015; 185:2722-30. [DOI: 10.1016/j.ajpath.2015.06.013] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Revised: 06/22/2015] [Accepted: 06/29/2015] [Indexed: 01/12/2023]
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Pøhl M, Olsen KE, Holst R, Donnem T, Busund LT, Bremnes RM, Al-Saad S, Andersen S, Richardsen E, Ditzel HJ, Hansen O. Keratin 34betaE12/keratin7 expression is a prognostic factor of cancer-specific and overall survival in patients with early stage non-small cell lung cancer. Acta Oncol 2015; 55:167-77. [PMID: 26057535 DOI: 10.3109/0284186x.2015.1049291] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
BACKGROUND Carcinomas and their metastases often retain the keratin patterns of their epithelial origin, and are therefore useful as lineage-specific markers in diagnostic pathology. Recently, it has become clear that intermediate filaments composed by keratins play a role in modulation of cell proliferation, migration, and possibly cancer invasion, factors impacting prognosis in early stage non-small cell lung cancer (NSCLC). MATERIAL AND METHODS Tumor tissue from a retrospective Danish cohort of 177 patients with completely resected NSCLC, stage I-IIIA tumors, were analyzed for keratin 7 (K7) and keratin 34βE12 expression by immunohistochemistry and validated in a comparable independent Norwegian cohort of 276 stage I-IIIA NSCLC patients. RESULTS Based on keratin 34βE12/K7 expression, three subgroups with significantly different median cancer-specific survival rates were identified (34βE12+/K7+, 168 months vs. 34βE12+/K7+, 73 months vs. 34βE12-/K7+, 30 months; p = 0.0004). In multivariate analysis, stage II-IIIA (HR 2.9), 34βE12+/K7+ (HR 1.90) and 34βE12-/K7+ (HR 3.7), were prognostic factors of poor cancer-specific survival (CSS) (p < 0.001). Validation in the Norwegian cohort confirmed that stage II-IIIA (HR 2.3), 34βE12+/K7+ (HR 1.6), and 34βE12-/K7+ (HR 2.0) were prognostic factors of poor CSS (p < 0.05). Multivariate Cox proportional-hazard analysis demonstrated that 34βE12+/K7 + and 34βE12+/K7 + status was significantly associated with poor overall survival (p < 0.05). CONCLUSION Keratin 34βE12/K7 expression is a prognostic parameter in resected early stage NSCLC that allows identification of high-risk NSCLC patients with poor cancer-specific and overall survival.
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Affiliation(s)
- Mette Pøhl
- a Department of Oncology , Odense University Hospital , Odense , Denmark
- b Institute of Clinical Research, University of Southern Denmark , Odense , Denmark
- f Department of Oncology , Rigshospitalet , Copenhagen , Denmark
| | - Karen Ege Olsen
- b Institute of Clinical Research, University of Southern Denmark , Odense , Denmark
- c Department of Pathology , Odense University Hospital , Odense , Denmark
| | - Rene Holst
- d Department of Statistics , University of Southern Denmark , Odense , Denmark
| | - Tom Donnem
- g Institute of Clinical Medicine, University of Tromso , Tromso , Norway
- h Department of Oncology , University Hospital of North Norway , Tromso , Norway
| | - Lill-Tove Busund
- i Institute of Medical Biology, University of Tromso , Tromso , Norway
- j Department of Clinical Pathology , University Hospital of North Norway , Tromso , Norway
| | - Roy M Bremnes
- g Institute of Clinical Medicine, University of Tromso , Tromso , Norway
- h Department of Oncology , University Hospital of North Norway , Tromso , Norway
| | - Samer Al-Saad
- i Institute of Medical Biology, University of Tromso , Tromso , Norway
- j Department of Clinical Pathology , University Hospital of North Norway , Tromso , Norway
| | - Sigve Andersen
- g Institute of Clinical Medicine, University of Tromso , Tromso , Norway
- h Department of Oncology , University Hospital of North Norway , Tromso , Norway
| | - Elin Richardsen
- i Institute of Medical Biology, University of Tromso , Tromso , Norway
- j Department of Clinical Pathology , University Hospital of North Norway , Tromso , Norway
| | - Henrik J Ditzel
- a Department of Oncology , Odense University Hospital , Odense , Denmark
- e Department of Cancer and Inflammation Research , Institute of Molecular Medicine, University of Southern Denmark , Odense , Denmark
| | - Olfred Hansen
- a Department of Oncology , Odense University Hospital , Odense , Denmark
- b Institute of Clinical Research, University of Southern Denmark , Odense , Denmark
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Andersen S, Solstad Ø, Moi L, Donnem T, Eilertsen M, Nordby Y, Ness N, Richardsen E, Busund LT, Bremnes RM. Organized metabolic crime in prostate cancer: The coexpression of MCT1 in tumor and MCT4 in stroma is an independent prognosticator for biochemical failure. Urol Oncol 2015; 33:338.e9-17. [PMID: 26066969 DOI: 10.1016/j.urolonc.2015.05.013] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2015] [Revised: 05/11/2015] [Accepted: 05/11/2015] [Indexed: 11/15/2022]
Abstract
BACKGROUND Lactate import or export over cell membranes is facilitated by monocarboxylate transporters (MCTs) 1 and 4. Expression profiles can be markers of an oxidative or glycolytic phenotype. Descriptive studies and functional studies in neoplastic cells and fibroblasts in prostate cancer (PC) have suggested a distinct phenotype. We aimed to explore expression of MCT1 and MCT4 in PC cells and surrounding stroma in a large cohort. Additionally, we wanted to find out if distinct expression profiles were associated with biochemical failure-free survival (BFFS). METHODS Tissue microarrays were constructed from 535 patients with radical prostatectomies between January 1, 1995, and December 31, 2005. Immunohistochemistry was used to detect expression, and degrees of expression were evaluated semiquantitatively by 2 pathologists using light microscopy. RESULTS For MCT1, there was only epithelial expression, whereas there was a low level of expression of MCT4 in tumor and stroma. A total of 172 patients had a low expression of MCT1 in tumor and MCT4 in stroma. There were 232 patients who had a high expression of MCT1 and a low expression of MCT4 in stroma. Only 11 patients had a low tumoral MCT1 expression and a high stromal MCT4 expression, and 26 patients (5%) had a high expression of both. Patients with a high-high combination had a significantly reduced BFFS (P = 0.011), and when adjusting for other factors, its effect was significant and independent (HR = 1.99, CI 95%: 1.09-3.62; P = 0.024). CONCLUSIONS This study adds to the current understanding of the reversed Warburg effect to be a significant phenotype in PC. High coexpression of MCT1 in tumor and MCT4 in stroma is independently associated to a worse BFFS, and the strength of this association is as strong as having a Gleason score of ≥9.
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Affiliation(s)
- Sigve Andersen
- Department of Clinical Medicine, Translational Cancer Research Group, The Arctic University of Norway, Tromso, Norway; Department of Oncology, University Hospital of North Norway, Tromso.
| | - Ørjan Solstad
- Department of Pathology, University Hospital of North Norway, Tromso, Norway
| | - Line Moi
- Department of Pathology, University Hospital of North Norway, Tromso, Norway; Department of Medical Biology, Translational Cancer Research Group, The Arctic University of Norway, Tromso, Norway
| | - Tom Donnem
- Department of Clinical Medicine, Translational Cancer Research Group, The Arctic University of Norway, Tromso, Norway; Department of Oncology, University Hospital of North Norway, Tromso
| | - Marte Eilertsen
- Department of Clinical Medicine, Translational Cancer Research Group, The Arctic University of Norway, Tromso, Norway
| | - Yngve Nordby
- Department of Clinical Medicine, Translational Cancer Research Group, The Arctic University of Norway, Tromso, Norway; Department of Urology, University Hospital of North Norway, Tromso, Norway
| | - Nora Ness
- Department of Medical Biology, Translational Cancer Research Group, The Arctic University of Norway, Tromso, Norway
| | - Elin Richardsen
- Department of Pathology, University Hospital of North Norway, Tromso, Norway; Department of Medical Biology, Translational Cancer Research Group, The Arctic University of Norway, Tromso, Norway
| | - Lill-Tove Busund
- Department of Pathology, University Hospital of North Norway, Tromso, Norway; Department of Medical Biology, Translational Cancer Research Group, The Arctic University of Norway, Tromso, Norway
| | - Roy M Bremnes
- Department of Clinical Medicine, Translational Cancer Research Group, The Arctic University of Norway, Tromso, Norway; Department of Oncology, University Hospital of North Norway, Tromso
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Skjefstad K, Richardsen E, Donnem T, Andersen S, Kiselev Y, Grindstad T, Hald SM, Al-Shibli K, Bremnes RM, Busund LT, Al-Saad S. The prognostic role of progesterone receptor expression in non-small cell lung cancer patients: Gender-related impacts and correlation with disease-specific survival. Steroids 2015; 98:29-36. [PMID: 25668612 DOI: 10.1016/j.steroids.2015.01.020] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2014] [Revised: 01/21/2015] [Accepted: 01/22/2015] [Indexed: 01/05/2023]
Abstract
PURPOSE Progesterone has been shown to impact the development of hormone-sensitive cancers, such as breast and ovarian cancers. Emerging evidence has revealed a possible role of progesterone in the tumorigenesis of other cancers, including lung cancer. Herein, we aimed to elucidate the prevalence and prognostic significance of progesterone receptor (PR) expression in non-small cell lung cancer (NSCLC) tissue. EXPERIMENTAL Tumor tissue samples were collected from our patient cohort consisting of 335 NSCLC patients with stage I-IIIA disease. Tissue microarrays (TMAs) were constructed, and immunohistochemical (IHC) analyses were performed to evaluate the PR expression in the tumor epithelial and stromal compartments. RESULTS In a univariate analysis, positive PR expression in the stromal tumor compartment (P=0.005) was significantly and independently associated with a favorable outcome for both genders. Furthermore, positive PR expression in tumor epithelial cells (P=0.003) correlated with a poor prognosis for female patients. In a multivariate analysis, positive PR expression in the tumor stroma (P=0.007) was an independent prognostic factor for improved disease-specific survival (DSS). Positive PR expression in tumor epithelial cells emerged as an independent prognostic factor in female patients (P=0.001) for poor DSS. CONCLUSIONS We show that PR expression in tumor-surrounding stromal cells is associated with improved DSS for both male and female patients. Additionally, we reveal that positive PR expression in tumor epithelial cells is an independent, unfavorable prognosticator for DSS in female patients, making PR expression a potential marker for prognostic stratification in NSCLC.
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Affiliation(s)
- Kaja Skjefstad
- Department of Medical Biology, University of Tromso, 9037 Tromso, Norway.
| | - Elin Richardsen
- Department of Medical Biology, University of Tromso, 9037 Tromso, Norway; Department of Clinical Pathology, University Hospital of North Norway, 9037 Tromso, Norway
| | - Tom Donnem
- Department of Clinical Medicine, University of Tromso, 9037 Tromso, Norway; Department of Oncology, University Hospital of North Norway, 9037 Tromso, Norway
| | - Sigve Andersen
- Department of Clinical Medicine, University of Tromso, 9037 Tromso, Norway; Department of Oncology, University Hospital of North Norway, 9037 Tromso, Norway
| | - Yury Kiselev
- Department of Medical Biology, University of Tromso, 9037 Tromso, Norway; Department of Pharmacy, University of Tromso, 9037 Tromso, Norway
| | - Thea Grindstad
- Department of Medical Biology, University of Tromso, 9037 Tromso, Norway
| | - Sigurd M Hald
- Department of Clinical Medicine, University of Tromso, 9037 Tromso, Norway
| | - Khalid Al-Shibli
- Department of Medical Biology, University of Tromso, 9037 Tromso, Norway; Department of Pathology, Nordland Central Hospital, 8005 Bodo, Norway
| | - Roy M Bremnes
- Department of Clinical Medicine, University of Tromso, 9037 Tromso, Norway; Department of Oncology, University Hospital of North Norway, 9037 Tromso, Norway
| | - Lill-Tove Busund
- Department of Medical Biology, University of Tromso, 9037 Tromso, Norway; Department of Clinical Pathology, University Hospital of North Norway, 9037 Tromso, Norway
| | - Samer Al-Saad
- Department of Medical Biology, University of Tromso, 9037 Tromso, Norway; Department of Clinical Pathology, University Hospital of North Norway, 9037 Tromso, Norway
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Hald SM, Kiselev Y, Al-Saad S, Richardsen E, Johannessen C, Eilertsen M, Kilvaer TK, Al-Shibli K, Andersen S, Busund LT, Bremnes RM, Donnem T. Prognostic impact of CXCL16 and CXCR6 in non-small cell lung cancer: combined high CXCL16 expression in tumor stroma and cancer cells yields improved survival. BMC Cancer 2015; 15:441. [PMID: 26021984 PMCID: PMC4447015 DOI: 10.1186/s12885-015-1446-z] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2014] [Accepted: 05/19/2015] [Indexed: 02/07/2023] Open
Abstract
Background The chemokine CXCL16 and its receptor CXCR6 are expressed by a variety of immune cells and have been shown to influence angiogenesis. The expression of CXCR6 and CXCL16 has been examined in numerous human cancers; however no studies have yet investigated their influence on prognosis in non-small cell lung cancer (NSCLC). We aimed to explore their prognostic significance in NSCLC, in addition to examining associations with previously investigated markers. Methods Resected tumor tissue from 335 consecutive unselected stage I-IIIA NSCLC patients (1990–2005) were collected. Immunohistochemistry was used to evaluate the expression of CXCR6 and CXCL16 on tissue microarrays. In vitro, NSCLC cells (NCI-H460, A549 cells) were transfected with CXCL16 siRNA to examine effects on proliferation. Results In univariate analysis, ↑ stromal cell CXCL16 expression was a significant positive prognostic factor (P = 0.016). CXCR6 was expressed in cancer cells, but did not show any prognostic impact. In the multivariate analysis, combined ↑cancer, and ↑stromal cell CXCL16 expression was an independent positive prognostic factor when compared to ↓stromal and ↓cancer cell expression (HR: 0.42; 95 % CI: 0.20–0.88; P = 0.022). Knockdown of CXCL16 by siRNA resulted in accelerated proliferation of NSCLC cell lines. Conclusion We have shown that combined ↑cancer and ↑stromal cell CXCL16 expression is an independent positive prognostic factor in NSCLC. Further studies are warranted to elucidate the biological mechanism underlying this finding.
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Affiliation(s)
- Sigurd M Hald
- Department of Clinical Medicine, UiT The Arctic University of Norway, 9037, Tromso, Norway.
| | - Yury Kiselev
- Department of Medical Biology, UiT The Arctic University of Norway, Tromso, Norway.,Department of Pharmacy, UiT The Arctic University of Norway, Tromso, Norway
| | - Samer Al-Saad
- Department of Medical Biology, UiT The Arctic University of Norway, Tromso, Norway.,Department of Clinical Pathology, University Hospital of North Norway, Tromso, Norway
| | - Elin Richardsen
- Department of Medical Biology, UiT The Arctic University of Norway, Tromso, Norway.,Department of Clinical Pathology, University Hospital of North Norway, Tromso, Norway
| | - Charles Johannessen
- Department of Medical Biology, UiT The Arctic University of Norway, Tromso, Norway
| | - Marte Eilertsen
- Department of Clinical Medicine, UiT The Arctic University of Norway, 9037, Tromso, Norway
| | - Thomas K Kilvaer
- Department of Oncology, University Hospital of North Norway, Tromso, Norway
| | - Khalid Al-Shibli
- Department of Medical Biology, UiT The Arctic University of Norway, Tromso, Norway.,Department of Pathology, Nordland Hospital, Bodo, Norway
| | - Sigve Andersen
- Department of Clinical Medicine, UiT The Arctic University of Norway, 9037, Tromso, Norway.,Department of Oncology, University Hospital of North Norway, Tromso, Norway
| | - Lill-Tove Busund
- Department of Medical Biology, UiT The Arctic University of Norway, Tromso, Norway.,Department of Clinical Pathology, University Hospital of North Norway, Tromso, Norway
| | - Roy M Bremnes
- Department of Clinical Medicine, UiT The Arctic University of Norway, 9037, Tromso, Norway.,Department of Oncology, University Hospital of North Norway, Tromso, Norway
| | - Tom Donnem
- Department of Clinical Medicine, UiT The Arctic University of Norway, 9037, Tromso, Norway.,Department of Oncology, University Hospital of North Norway, Tromso, Norway
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Grindstad T, Andersen S, Al-Saad S, Donnem T, Kiselev Y, Nordahl Melbø-Jørgensen C, Skjefstad K, Busund LT, Bremnes RM, Richardsen E. High progesterone receptor expression in prostate cancer is associated with clinical failure. PLoS One 2015; 10:e0116691. [PMID: 25723513 PMCID: PMC4344236 DOI: 10.1371/journal.pone.0116691] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Accepted: 12/08/2014] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Prostate cancer is a highly heterogeneous disease and one of the leading causes of mortality in developed countries. Specific prognostic and predictive markers for prostate cancer patients are still lacking. A causal relationship between androgens and the development of prostate cancer is generally considered biologically plausible, but androgens are not the sole effector in the complexity of prostate carcinogenesis. The aim of this study was to evaluate the prognostic significance of progesterone receptor in tumor tissue of T1-3N0 prostate cancer patients undergoing prostatectomy. METHODS Tissue microarrays from 535 patients with prostate cancer were constructed. Duplicate cores of tumor cells and tumor stromal tissue from each resected specimen were extracted. Immunohistochemistry was used to evaluate the in-situ expression of progesterone receptor. RESULTS In univariate analyses, high tumor cell density (p = 0.006) and high tumor stromal cell density level (p = 0.045) of progesterone receptor were both significantly associated with tumor progression and clinical failure. In multivariate analysis, progesterone receptor expression in tumor cells was an independent negative prognostic factor for clinical failure (HR: 2.5, 95% CI: 1.2-5.2, p = 0.012). CONCLUSION High progesterone receptor density in tumor cells of the prostate cancer tumor is an independent negative prognostic factor for clinical failure.
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Affiliation(s)
- Thea Grindstad
- Dept. of Medical Biology, UiT - The Arctic University of Norway, Tromso, Norway
- * E-mail:
| | - Sigve Andersen
- Dept. of Clinical Medicine, UiT - The Arctic University of Norway, Tromso, Norway
- Dept. of Oncology, University Hospital of North Norway, Tromso, Norway
| | - Samer Al-Saad
- Dept. of Medical Biology, UiT - The Arctic University of Norway, Tromso, Norway
- Dept. of Clinical Pathology, University Hospital of North Norway, Tromso, Norway
| | - Tom Donnem
- Dept. of Clinical Medicine, UiT - The Arctic University of Norway, Tromso, Norway
- Dept. of Oncology, University Hospital of North Norway, Tromso, Norway
| | - Yury Kiselev
- Dept. of Medical Biology, UiT - The Arctic University of Norway, Tromso, Norway
- Dept. of Pharmacy, UiT—The Arctic University of Norway, Tromso, Norway
| | | | - Kaja Skjefstad
- Dept. of Medical Biology, UiT - The Arctic University of Norway, Tromso, Norway
| | - Lill-Tove Busund
- Dept. of Medical Biology, UiT - The Arctic University of Norway, Tromso, Norway
- Dept. of Clinical Pathology, University Hospital of North Norway, Tromso, Norway
| | - Roy M. Bremnes
- Dept. of Medical Biology, UiT - The Arctic University of Norway, Tromso, Norway
- Dept. of Clinical Medicine, UiT - The Arctic University of Norway, Tromso, Norway
| | - Elin Richardsen
- Dept. of Medical Biology, UiT - The Arctic University of Norway, Tromso, Norway
- Dept. of Clinical Pathology, University Hospital of North Norway, Tromso, Norway
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47
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Donnem T, Hald SM, Paulsen EE, Richardsen E, Al-Saad S, Kilvaer TK, Brustugun OT, Helland A, Lund-Iversen M, Poehl M, Olsen KE, Ditzel HJ, Hansen O, Al-Shibli K, Kiselev Y, Sandanger TM, Andersen S, Pezzella F, Bremnes RM, Busund LT. Stromal CD8+ T-cell Density—A Promising Supplement to TNM Staging in Non-Small Cell Lung Cancer. Clin Cancer Res 2015; 21:2635-43. [PMID: 25680376 DOI: 10.1158/1078-0432.ccr-14-1905] [Citation(s) in RCA: 233] [Impact Index Per Article: 25.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2014] [Accepted: 02/01/2015] [Indexed: 11/16/2022]
Abstract
PURPOSE Immunoscore is a prognostic tool defined to quantify in situ immune cell infiltrates, which appears to be superior to the tumor-node-metastasis (TNM) classification in colorectal cancer. In non-small cell lung cancer (NSCLC), no immunoscore has been established, but in situ tumor immunology is recognized as highly important. We have previously evaluated the prognostic impact of several immunological markers in NSCLC, yielding the density of stromal CD8(+) tumor-infiltrating lymphocytes (TIL) as the most promising candidate. Hence, we validate the impact of stromal CD8(+) TIL density as an immunoscore in NSCLC. EXPERIMENTAL DESIGN The prognostic impact of stromal CD8(+) TILs was evaluated in four different cohorts from Norway and Denmark consisting of 797 stage I-IIIA NSCLC patients. The Tromso cohort (n = 155) was used as training set, and the results were further validated in the cohorts from Bodo (n = 169), Oslo (n = 295), and Denmark (n = 178). Tissue microarrays and clinical routine CD8 staining were used for all cohorts. RESULTS Stromal CD8(+) TIL density was an independent prognostic factor in the total material (n = 797) regardless of the endpoint: disease-free survival (P < 0.001), disease-specific survival (P < 0.001), or overall survival (P < 0.001). Subgroup analyses revealed significant prognostic impact of stromal CD8(+) TIL density within each pathologic stage (pStage). In multivariate analysis, stromal CD8(+) TIL density and pStage were independent prognostic variables. CONCLUSIONS Stromal CD8(+) TIL density has independent prognostic impact in resected NSCLC, adds prognostic impact within each pStage, and is a good candidate marker for establishing a TNM-Immunoscore.
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Affiliation(s)
- Tom Donnem
- Department of Oncology, University Hospital of North Norway, Tromso, Norway. Institute of Clinical Medicine, The Arctic University of Norway, Tromso, Norway.
| | - Sigurd M Hald
- Institute of Clinical Medicine, The Arctic University of Norway, Tromso, Norway
| | - Erna-Elise Paulsen
- Department of Oncology, University Hospital of North Norway, Tromso, Norway. Institute of Clinical Medicine, The Arctic University of Norway, Tromso, Norway
| | - Elin Richardsen
- Department of Clinical Pathology, University Hospital of North Norway, Tromso, Norway. Institute of Medical Biology, The Arctic University of Norway, Tromso, Norway
| | - Samer Al-Saad
- Department of Clinical Pathology, University Hospital of North Norway, Tromso, Norway. Institute of Medical Biology, The Arctic University of Norway, Tromso, Norway
| | - Thomas K Kilvaer
- Department of Oncology, University Hospital of North Norway, Tromso, Norway
| | - Odd Terje Brustugun
- Department of Oncology, Oslo University Hospital, The Norwegian Radium Hospital, Oslo, Norway. Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Aslaug Helland
- Department of Oncology, Oslo University Hospital, The Norwegian Radium Hospital, Oslo, Norway. Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | | | - Mette Poehl
- Department of Oncology, Rigshospitalet, Copenhagen, Denmark. Department of Oncology, Odense University Hospital, Odense, Denmark. Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Karen Ege Olsen
- Institute of Clinical Research, University of Southern Denmark, Odense, Denmark. Department of Pathology, Odense University Hospital, Odense, Denmark
| | - Henrik J Ditzel
- Department of Oncology, Odense University Hospital, Odense, Denmark. Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark
| | - Olfred Hansen
- Department of Oncology, Odense University Hospital, Odense, Denmark. Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
| | | | - Yury Kiselev
- Institute of Medical Biology, The Arctic University of Norway, Tromso, Norway. Department of Pharmacy, The Arctic University of Tromso, Tromso, Norway
| | - Torkjel M Sandanger
- Department of Community Medicine, The Artic University of Tromso, Tromso, Norway
| | - Sigve Andersen
- Department of Oncology, University Hospital of North Norway, Tromso, Norway
| | - Francesco Pezzella
- Nuffield Department of Clinical Laboratory Sciences, University of Oxford, John Radcliffe Hospital, Oxford, United Kingdom
| | - Roy M Bremnes
- Department of Oncology, University Hospital of North Norway, Tromso, Norway. Institute of Clinical Medicine, The Arctic University of Norway, Tromso, Norway
| | - Lill-Tove Busund
- Department of Clinical Pathology, University Hospital of North Norway, Tromso, Norway. Institute of Medical Biology, The Arctic University of Norway, Tromso, Norway
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Richardsen E, Uglehus RD, Johnsen SH, Busund LT. Macrophage-colony stimulating factor (CSF1) predicts breast cancer progression and mortality. Anticancer Res 2015; 35:865-874. [PMID: 25667468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
BACKGROUND Macrophage colony-stimulating factor (CSF1), also known as colony-stimulating factor-1 (CSF1), and its receptor CSF1R have been correlated with poor prognosis in many cancer types including breast cancer. Herein, we investigated the prognostic impact of CSF1 and CSF1R expression in tumor epithelial and stromal compartments in primary breast cancer and axillary lymph node metastases. In addition, the density of CD68+ tumor-associated macrophages (TAMs) and CD3+ T-lymphocytes was examined. MATERIALS AND METHODS Tumor tissue was obtained at the time of primary surgery from 68 prior treatment breast cancer patients, 38 with axillary lymph node metastases and 30 patients without metastases. Digital video analysis was performed on immunohistochemically stained slides. RESULTS The expression of CSF1, CSF1R and the density of TAMs and CD3+ T-lymphocytes were then correlated to metastases and disease-specific mortality. Metastasized primary cancers had higher tumor epithelial and stromal expressions of CSF1 (p<0.001 and p=0.002, respectively) and CSF1R (both p=0.03) compared to non-metastatic cancers. Similar findings were made for the density of CD68+ (p=0.003) and CD3+ cells in the tumor epithelium (p<0.001). In multivariate analysis, a high tumor epithelial expression of CSF1 in primary breast cancer predicted mortality (hazard ratio (HR)=8.6, p=0.039). CONCLUSION High expression of CSF1 and CSF1R and high density of TAMs and CD3+ T-lymphocytes were related to breast cancer progression. CSF1 expression in tumor epithelium predicted breast cancer mortality.
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Affiliation(s)
- Elin Richardsen
- Department of Clinical Pathology, University Hospital of Northern Norway, Tromsø, Norway Department of Medical Biology, The Arctic University of Norway, Tromsø, Norway
| | - Rebecca Dale Uglehus
- Department of Clinical Pathology, University Hospital of Northern Norway, Tromsø, Norway
| | - Stein Harald Johnsen
- Department of Neurology and Clinical Neurophysiology, University Hospital of Northern Norway, Tromsø, Norway Department of Clinical Medicine, The Arctic University of Norway, Tromsø, Norway
| | - Lill-Tove Busund
- Department of Clinical Pathology, University Hospital of Northern Norway, Tromsø, Norway Department of Medical Biology, The Arctic University of Norway, Tromsø, Norway
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Melbø-Jørgensen C, Ness N, Andersen S, Valkov A, Dønnem T, Al-Saad S, Kiselev Y, Berg T, Nordby Y, Bremnes RM, Busund LT, Richardsen E. Stromal expression of MiR-21 predicts biochemical failure in prostate cancer patients with Gleason score 6. PLoS One 2014; 9:e113039. [PMID: 25401698 PMCID: PMC4234532 DOI: 10.1371/journal.pone.0113039] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2014] [Accepted: 10/17/2014] [Indexed: 11/29/2022] Open
Abstract
AIM microRNAs (miRNAs) are involved in various neoplastic diseases, including prostate cancer (PCs). The aim of this study was to investigate the miRNA profile in PC tissue, to assess their association with clinicopathologic data, and to evaluate the potential of miRNAs as diagnostic and prognostic markers. MATERIALS AND METHODS From a cohort of 535 patients submitted to radical prostatectomy (RP), a sample of 30 patients (14 patients with rapid biochemical failure (BF) and 16 patients without BF) with Gleason score 7 were analyzed. A total of 1435 miRNAs were quantified by microarray hybridization, and selected miRNAs with the highest Standard deviation (n = 50) were validated by real-time quantitative PCR (qRT-PCR). In situ hybridization (ISH) was used to evaluate the expression of miR-21. RESULTS miR-21 was the only miR that was significantly up-regulated in the BF group (p = 0.045) miR-21 was up-regulated in patients with BF compared with non-BF group (p = 0.05). In univariate analyses, high stromal expression of miR-21 had predictive impact on biochemical failure-free survival (BFFS) and clinical failure-free survival (CFFS) (p = 0.006 and p = 0.04, respectively). In the multivariate analysis, high stromal expression of miR-21 expression was found to be an independent prognostic factor for BFFS in patients with Gleason score 6 (HR 2.41, CI 95% 1.06-5.49, p = 0.037). CONCLUSION High stromal expression of miR-21 was associated with poor biochemical recurrence-free survival after RP. For patients with Gleason score 6, miR-21 may help predict the risk of future disease progression and thereby help select patients for potential adjuvant treatment or a more stringent follow-up.
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Affiliation(s)
| | - Nora Ness
- Department of Medical Biology, UIT The Arctic University of Norway, Tromsø, Norway
| | - Sigve Andersen
- Department of Clinical Medicine, UIT The Arctic University of Norway, Tromsø, Norway
- Department Oncology, University Hospital of North Norway, Tromsø, Norway
| | - Andrej Valkov
- Department of Clinical Pathology, University Hospital of North Norway, Tromso, Norway
| | - Tom Dønnem
- Department of Clinical Medicine, UIT The Arctic University of Norway, Tromsø, Norway
- Department Oncology, University Hospital of North Norway, Tromsø, Norway
| | - Samer Al-Saad
- Department of Medical Biology, UIT The Arctic University of Norway, Tromsø, Norway
- Department of Clinical Pathology, University Hospital of North Norway, Tromso, Norway
| | - Yury Kiselev
- Department of Medical Biology, UIT The Arctic University of Norway, Tromsø, Norway
- Department of Pharmacy, UIT The Arctic University of Norway, Tromsø, Norway
| | - Thomas Berg
- Department of Clinical Pathology, University Hospital of North Norway, Tromso, Norway
| | - Yngve Nordby
- Department of Clinical Medicine, UIT The Arctic University of Norway, Tromsø, Norway
- Department of Urology, University Hospital of North Norway, Tromsø, Norway
| | - Roy M. Bremnes
- Department of Clinical Medicine, UIT The Arctic University of Norway, Tromsø, Norway
- Department Oncology, University Hospital of North Norway, Tromsø, Norway
| | - Lill-Tove Busund
- Department of Medical Biology, UIT The Arctic University of Norway, Tromsø, Norway
- Department of Clinical Pathology, University Hospital of North Norway, Tromso, Norway
| | - Elin Richardsen
- Department of Medical Biology, UIT The Arctic University of Norway, Tromsø, Norway
- Department of Clinical Pathology, University Hospital of North Norway, Tromso, Norway
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50
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Ness N, Andersen S, Valkov A, Nordby Y, Donnem T, Al-Saad S, Busund LT, Bremnes RM, Richardsen E. Infiltration of CD8+ lymphocytes is an independent prognostic factor of biochemical failure-free survival in prostate cancer. Prostate 2014; 74:1452-61. [PMID: 25111810 DOI: 10.1002/pros.22862] [Citation(s) in RCA: 76] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2014] [Accepted: 06/27/2014] [Indexed: 01/01/2023]
Abstract
BACKGROUNDS The adaptive immune system can potentially have dual roles in cancer development and progression by contributing to or suppressing tumor progression and metastasis. The aim of this study was to evaluate the prognostic impact of adaptive immune cells residing in different tumor compartments in prostate cancer. METHODS Tissue microarrays from 535 patients were constructed from viable and representative tumor epithelial and stromal areas of primary PC tumors, as well as from normal epithelial and stromal areas. Immunohistochemistry was used to evaluate the density of CD3+, CD4+, CD8+, and CD20+ lymphocytes in both tumor epithelial and tumor stromal areas. RESULTS In univariate analysis, a high density of CD3+ (P = 0.037) and CD8+ lymphocytes (P = 0.010) in tumor epithelial areas was associated with significantly shorter biochemical failure-free survival. When analyzing both tumor epithelial and stromal tissue compartments as one entity, similar relationships were observed for CD3+ (P = 0.046), CD4+ (P = 0.026), and CD8+ (P = 0.003) lymphocytes. In multivariate analysis, high densities of CD8+ lymphocytes limited to tumor epithelial areas (HR = 1.45, P = 0.032), as well as in the total tumor tissue (HR = 1.57, P = 0.007), were independent negative prognostic factors for biochemical failure-free survival. CONCLUSIONS A high density of CD8+ lymphocytes, especially in tumor epithelial areas, is an independent negative prognostic factor for biochemical failure-free survival.
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Affiliation(s)
- Nora Ness
- Institute of Medical Biology, UiT The Arctic University of Norway, Tromso
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