SMARCA4 and SMARCE1 in gastric cancer: Correlation with ARID1A, and microsatellite stability, and SMARCE1/ERBB2 co-amplification

BACKGROUND

Recent studies have shown an association between certain subunits of the SWI/SNF complex with specific tumor characteristics in gastric cancer (GC). In an earlier study, we applied multiregional whole exome sequencing on multiple primary tumor samples and found alterations of the SWI/SNF complex in 78% of the cases. ERBB2, which encodes for Her2/neu, is a well-known predictive biomarker used to guide the treatment of GC in the palliative setting. SMARCE1, which encodes for a subunit of the SWI/SNF complex, is localized in close genetic proximity to ERBB2.

AIM

As little is known about the significance of the SWI/SNF complex in GC biology and the potential relationship between ERBB2 and SMARCE1 upregulation, we examined the expression patterns of SMARCA4 and SMARCE1, two mutually exclusive catalytic ATPase subunits of the SWI/SNF complex, in a well characterized GC cohort.

MATERIALS AND METHODS

The expression of SMARCA4 and SMARCE1 was studied by immunohistochemistry in connection with clinicopathological patient characteristics in a cohort of 468 GCs. Digital droplet polymerase chain reaction was performed for amplification analysis on ERBB2 and SMARCE1.

RESULTS

Immunohistochemical staining of whole-mount tissue sections found a diffusely "gray scale" expression of SMARCA4 in 446 (95.2%) GCs and of SMARCE1 in 463 (98.8%) GCs. The expression of SMARCA4 and SMARCE1 correlated significantly with ARID1A, p53, and microsatellite status. No correlation was found with the patient prognosis. The amplification analysis of SMARCE1 showed amplification in 4 of 34 cases. In 3 of 34 cases, SMARCE1 was co-amplified with ERBB2. We also found a co-expression of SMARCE1 and Her2/neu in a subset of patients.

CONCLUSION

While the effect of a co-amplification is currently unknown, synergistic effects of SMARCE1 and Her2/neu overexpression should be explored in future studies, holding potential for an improved treatment of GC.

[Combination of Crohn's disease and anorexia nervosa signs and symptoms (author's transl)]

In two female patients whose disease had been diagnosed as anorexia nervosa, later examination revealed Crohn's disease. Hence, the frequency of anorexia nervosa signs and symptoms seen in patients with Crohn's disease who had been hospitalised for internistic-psychosomatic treatment, was scrutinised by the authors. Eight out of 25 consecutively treated patients showed these symptoms. Particularly frequent signs were refusal of adequate food intake to regain normal weight, as well as acute conflict situations due to disturbed neurotic development. On account of the frequency of anorectic signs and symptoms in Crohn's disease, therefore, this disease should be diagnostically excluded before accepting anorexia nervosa as final diagnosis.