1
|
Polifka I, Agaimy A, Herrmann E, Spath V, Trojan L, Stöckle M, Becker F, Ströbel P, Wülfing C, Schrader AJ, Barth P, Staehler M, Stief C, Hohenfellner M, Macher-Göppinger S, Wullich B, Noldus J, Brenner W, Roos FC, Walter B, Otto W, Burger M, Höfler H, Haferkamp A, Geppert CI, Stöhr C, Hartmann A. High proliferation rate and TNM stage but not histomorphological subtype are independent prognostic markers for overall survival in papillary renal cell carcinoma. Hum Pathol 2018; 83:212-223. [PMID: 30121370 DOI: 10.1016/j.humpath.2018.08.006] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [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: 05/18/2018] [Revised: 08/02/2018] [Accepted: 08/04/2018] [Indexed: 01/19/2023]
Abstract
Papillary renal cell carcinoma (PRCC) is currently divided in 2 subtypes. We reviewed a large cohort of PRCC and correlated subtype, morphological features and diagnostic marker expression with overall survival (OS) to uncover differences between the 2 subtypes. Three hundred seventy-six renal tumors initially diagnosed as PRCC with clinical and survival data were collected from the participating centers. Two hundred forty-six tumors were classified as PRCC1 (65.4%) and 130 as PRCC2 (34.6%) and graded according to the 2016 World Health Organization/International Society of Urological Pathology grading system. Morphological features (abundant cytoplasm, necrosis, fibrous stroma, foamy macrophages and psammoma bodies) were noted. Immunohistochemical stains (MIB1, p53, Racemase, EMA, CK7, CK20, E-Cadherin) were performed using tissue microarrays. χ2-Tests, log-rank tests and uni- and multivariate Cox regression analysis were performed. Both subtypes displayed different morphological features and immunohistochemical profiles: abundant cytoplasm was more frequent in PRCC2, while foamy macrophages were more common in PRCC1. Abundant cytoplasm and presence of psammoma bodies were associated with poorer OS. PRCC1 showed more frequent CK7 expression, PRCC2 more frequent E-Cadherin, p53 and higher MIB1 expression (>15%). Expression of Racemase and CK7 was associated with better OS, while high MIB1 (>15%) was associated with poorer OS. In multivariate analysis, the only independent predictors of OS were proliferation (MIB1), tumor stage, metastasis and age at surgery. Subtype was not an independent prognostic factor. Therefore, PRCC subtype on its own is not suitable for estimating survival. More data focusing on PRCC tumor biology is needed to define prognostic subgroups, especially in PRCC2.
Collapse
Affiliation(s)
- Iris Polifka
- Institute of Pathology, University Hospital Erlangen, Friedrich Alexander University (FAU), 91054 Erlangen, Germany.
| | - Abbas Agaimy
- Institute of Pathology, University Hospital Erlangen, Friedrich Alexander University (FAU), 91054 Erlangen, Germany
| | - Edwin Herrmann
- Department of Urology, University Hospital Muenster, 48149 Muenster, Germany
| | - Verena Spath
- Institute of Pathology, University Hospital Erlangen, Friedrich Alexander University (FAU), 91054 Erlangen, Germany
| | - Lutz Trojan
- Department of Urology, University Hospital Göttingen, 37075 Göttingen, Germany
| | - Michael Stöckle
- Department of Urology and Pediatric Urology, University of Saarland (UKS), 66421 Homburg, Germany
| | - Frank Becker
- Department of Urology and Pediatric Urology, University of Saarland (UKS), 66421 Homburg, Germany
| | - Philipp Ströbel
- Department of Pathology, University Hospital Göttingen, 37075 Göttingen, Germany
| | - Christian Wülfing
- Department of Urology, University Hospital Muenster, 48149 Muenster, Germany
| | - Andres J Schrader
- Department of Urology, University of Marburg, 35037 Marburg, Germany
| | - Peter Barth
- Department of Urology, University of Marburg, 35037 Marburg, Germany
| | - Michael Staehler
- Department of Urology, University Hospital Munich, 81337 Munich, Germany
| | - Christian Stief
- Department of Urology, University Hospital Munich, 81337 Munich, Germany
| | - Markus Hohenfellner
- Department of Urology, University Hospital Heidelberg, 69120 Heidelberg, Germany
| | | | - Bernd Wullich
- Department of Urology and Pediatric Urology, University Hospital Erlangen, Friedrich Alexander University (FAU), 91058 Erlangen, Germany
| | - Joachim Noldus
- Department of Urology, Marien Hospital Herne, Ruhr University Bochum, 44625 Herne, Germany
| | | | - Frederik C Roos
- Department of Urology, University Hospital Frankfurt, 60590 Frankfurt/Main, Germany
| | - Bernhard Walter
- Department of Urology and Pediatric Urology, University Hospital Erlangen, Friedrich Alexander University (FAU), 91058 Erlangen, Germany
| | - Wolfgang Otto
- Department of Urology, University of Regensburg, 93053 Regensburg, Germany
| | - Maximilian Burger
- Department of Urology, University of Regensburg, 93053 Regensburg, Germany
| | - Heinz Höfler
- Institute of Pathology, Technical University of Munich (TUM), 81675 Munich
| | - Axel Haferkamp
- Department of Urology, University Hospital Heidelberg, 69120 Heidelberg, Germany
| | - Carol I Geppert
- Institute of Pathology, University Hospital Erlangen, Friedrich Alexander University (FAU), 91054 Erlangen, Germany
| | - Christine Stöhr
- Institute of Pathology, University Hospital Erlangen, Friedrich Alexander University (FAU), 91054 Erlangen, Germany
| | - Arndt Hartmann
- Institute of Pathology, University Hospital Erlangen, Friedrich Alexander University (FAU), 91054 Erlangen, Germany
| |
Collapse
|
2
|
Jasinski-Bergner S, Reches A, Stoehr C, Massa C, Gonschorek E, Huettelmaier S, Braun J, Wach S, Wullich B, Spath V, Wang E, Marincola FM, Mandelboim O, Hartmann A, Seliger B. Identification of novel microRNAs regulating HLA-G expression and investigating their clinical relevance in renal cell carcinoma. Oncotarget 2018; 7:26866-78. [PMID: 27057628 PMCID: PMC5042021 DOI: 10.18632/oncotarget.8567] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2015] [Accepted: 03/11/2016] [Indexed: 12/18/2022] Open
Abstract
The non-classical human leukocyte antigen G (HLA-G) is expressed at a high frequency in renal cell carcinoma (RCC) and is associated with a higher tumor grade and a poor clinical outcome. This might be caused by the HLA-G-mediated inhibition of the cytotoxicity of T and NK cells. Therefore a selective targeting of HLA-G might represent a powerful strategy to enhance the immunogenicity of RCC lesions. Recent studies identified a number of HLA-G-regulating microRNAs (miRs) and demonstrated an inverse expression of some of these miRs with HLA-G in RCC in vitro and in vivo. However, it was postulated that further miRs might exist contributing to the tightly controlled selective HLA-G expression.By application of a miR enrichment assay (miTRAP) in combination with in silico profiling two novel HLA-G-regulatory miRs, miR-548q and miR-628-5p, were identified. Direct interactions of both miRs with the 3' untranslated region of HLA-G were confirmed with luciferase reporter gene assays. In addition, qPCR analyses and immunohistochemical staining revealed an inverse, expression of miR-628-5p, but not of miR-548q to the HLA-G protein in primary RCC lesions and cell lines. Stable overexpression of miR-548q and miR-628-5p caused a downregulation of HLA-G mRNA and protein. This leads in case of miR-548q to an enhanced NK cell-mediated HLA-G-dependent cytotoxicity, which could be reverted by ILT2 blockade suggesting a control of the immune effector cell activity at least by this miR. The identification of two novel HLA-G-regulatory miRs extends the number of HLA-G-relevant miRs tuning the HLA-G expression and might serve as future therapeutic targets.
Collapse
Affiliation(s)
- Simon Jasinski-Bergner
- Institute of Medical Immunology, Martin Luther University Halle-Wittenberg, Halle, Germany
| | - Adi Reches
- Faculty of Medicine, The Hebrew University of Jerusalem, Ein Kerem, Jerusalem, Israel
| | - Christine Stoehr
- Institute of Pathology, Friedrich Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - Chiara Massa
- Institute of Medical Immunology, Martin Luther University Halle-Wittenberg, Halle, Germany
| | - Evamaria Gonschorek
- Institute of Medical Immunology, Martin Luther University Halle-Wittenberg, Halle, Germany
| | - Stefan Huettelmaier
- Institute of Molecular Medicine, Martin Luther University Halle-Wittenberg, Halle, Germany
| | - Juliane Braun
- Institute of Molecular Medicine, Martin Luther University Halle-Wittenberg, Halle, Germany
| | - Sven Wach
- Clinic of Urology, Friedrich Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - Bernd Wullich
- Clinic of Urology, Friedrich Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - Verena Spath
- Faculty of Medicine, The Hebrew University of Jerusalem, Ein Kerem, Jerusalem, Israel
| | - Ena Wang
- Sidra Medical and Research Center, Qatar Foundation, Doha, Qatar
| | | | - Ofer Mandelboim
- Faculty of Medicine, The Hebrew University of Jerusalem, Ein Kerem, Jerusalem, Israel
| | - Arndt Hartmann
- Institute of Pathology, Friedrich Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - Barbara Seliger
- Institute of Medical Immunology, Martin Luther University Halle-Wittenberg, Halle, Germany
| |
Collapse
|
3
|
Jasinski-Bergner S, Stoehr C, Bukur J, Massa C, Braun J, Hüttelmaier S, Spath V, Wartenberg R, Legal W, Taubert H, Wach S, Wullich B, Hartmann A, Seliger B. Clinical relevance of miR-mediated HLA-G regulation and the associated immune cell infiltration in renal cell carcinoma. Oncoimmunology 2015; 4:e1008805. [PMID: 26155421 DOI: 10.1080/2162402x.2015.1008805] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [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: 10/14/2014] [Revised: 01/08/2015] [Accepted: 01/12/2015] [Indexed: 01/07/2023] Open
Abstract
In human tumors of distinct origin including renal cell carcinoma (RCC), the non-classical human leukocyte antigen G (HLA-G) is frequently expressed, thereby inhibiting the cytotoxic activity of T and natural killer (NK) cells. Recent studies demonstrated a strong post-transcriptional gene regulation of the HLA-G by miR-152, -148A, -148B and -133A. Standard methods were applied to characterize the expression and function of HLA-G, HLA-G-regulatory microRNAs (miRs) and the immune cell infiltration in 453 RCC lesions using a tissue microarray and five RCC cell lines linking these results to clinical parameters. Direct interactions with HLA-G regulatory miRs and the HLA-G 3' untranslated region (UTR) were detected and the affinities of these different miRs to the HLA-G 3'-UTR compared. qPCR analyses and immunohistochemical staining revealed an inverse expression of miR-148A and -133A with the HLA-G protein in situ and in vitro. Stable miR overexpression caused a downregulation of HLA-G protein enhancing the NK and LAK cell-mediated cytotoxicity in in vitro CD107a activation assays revealing a HLA-G-dependent cytotoxic activity of immune effector cells. A significant higher frequency of CD3+/CD8+ T cell lymphocytes, but no differences in the activation markers CD69, CD25 or in the presence of CD56+, FoxP3+ and CD4+ immune cells were detected in HLA-G+ compared to HLA-G- RCC lesions. This could be associated with higher WHO grade, but not with a disease-specific survival. These data suggest a miR-mediated control of HLA-G expression in RCC, which is associated with a distinct pattern of immune cell infiltration.
Collapse
Key Words
- ACTB, β-actin
- APM, antigen processing machinery
- B7-H1, B7 homolog 1
- CDS, coding sequence; Cr, chromium
- COPZ2, coatomer protein complex, subunit zeta 2
- DAC, 5′-aza-2′-desoxycytidine, GAPDH, glyceraldehyde-3-phosphate dehydrogenase
- HLA-G, human leukocyte antigen G
- HRP, horseradish peroxidase
- IFNγ, interferon gamma
- IHC, immunohistochemistry
- IL, interleukin
- ILT, immunoglobulin-like transcript
- LAK, lymphokine-activated killer cell
- MDSC, myeloid-derived suppressor cells
- MFI, mean-specific fluorescence intensity
- NK, natural killer cell
- RCC, renal cell carcinoma
- SNP, single nucleotide polymorphism
- TGF-β, transforming growth factor β
- TIL, tumor infiltrating lymphocyte
- TMA, tissue microarray
- Treg, regulatory T cell
- UTR, untranslated region
- WB, Western blot analysis
- WT, wild type
- immune escape
- luc, luciferase
- mAb, monoclonal antibody
- miR, microRNA
- miTRAP, miRNA trapping by RNA in vitro affinity purification
- microRNA
- n.d., not determined
- n.o.s., not otherwise specified; ntc., non-template control
- non-classical HLA class I molecules
- renal cell carcinoma
- sHLA-G, soluble HLA-G
- tumor-infiltrating lymphocytes
- β-gal, β-galactosidase
- β2-m, β-2-microglobulin
Collapse
Affiliation(s)
- Simon Jasinski-Bergner
- Institute of Medical Immunology; Martin Luther University Halle-Wittenberg ; Halle, Germany
| | - Christine Stoehr
- Institute of Pathology; Friedrich Alexander University Erlangen-Nuremberg ; Erlangen, Germany
| | - Juergen Bukur
- Institute of Medical Immunology; Martin Luther University Halle-Wittenberg ; Halle, Germany
| | - Chiara Massa
- Institute of Medical Immunology; Martin Luther University Halle-Wittenberg ; Halle, Germany
| | - Juliane Braun
- Institute of Molecular Medicine; Martin Luther University Halle-Wittenberg ; Halle, Germany
| | - Stefan Hüttelmaier
- Institute of Molecular Medicine; Martin Luther University Halle-Wittenberg ; Halle, Germany
| | - Verena Spath
- Institute of Pathology; Friedrich Alexander University Erlangen-Nuremberg ; Erlangen, Germany
| | - Roland Wartenberg
- Institute of Pathology; Friedrich Alexander University Erlangen-Nuremberg ; Erlangen, Germany
| | - Wolfgang Legal
- Clinic of Urology; Friedrich Alexander University Erlangen-Nuremberg ; Erlangen, Germany
| | - Helge Taubert
- Clinic of Urology; Friedrich Alexander University Erlangen-Nuremberg ; Erlangen, Germany
| | - Sven Wach
- Clinic of Urology; Friedrich Alexander University Erlangen-Nuremberg ; Erlangen, Germany
| | - Bernd Wullich
- Clinic of Urology; Friedrich Alexander University Erlangen-Nuremberg ; Erlangen, Germany
| | - Arndt Hartmann
- Institute of Pathology; Friedrich Alexander University Erlangen-Nuremberg ; Erlangen, Germany
| | - Barbara Seliger
- Institute of Medical Immunology; Martin Luther University Halle-Wittenberg ; Halle, Germany
| |
Collapse
|