Functional and genomic characterization of three novel cell lines derived from a metastatic gallbladder cancer tumor

BACKGROUND: Gallbladder cancer (GBC) is the most common tumor of the biliary tract. The incidence of GBC shows a large geographic variability, being particularly frequent in Native American populations. In Chile, GBC represents the second cause of cancer-related death among women. We describe here the establishment of three novel cell lines derived from the ascitic fluid of a Chilean GBC patient, who presented 46% European, 36% Mapuche, 12% Aymara and 6% African ancestry. RESULTS: After immunocytochemical staining of the primary cell culture, we isolated and comprehensively characterized three independent clones (PUC-GBC1, PUC-GBC2 and PUC-GBC3) by short tandem repeat DNA profiling and RNA sequencing as well as karyotype, doubling time, chemosensitivity, in vitro migration capability and in vivo tumorigenicity assay. Primary culture cells showed high expression of CK7, CK19, CA 19-9, MUC1 and MUC16, and negative expression of mesothelial markers. The three isolated clones displayed an epithelial phenotype and an abnormal structure and number of chromosomes. RNA sequencing confirmed the increased expression of cytokeratin and mucin genes, and also of TP53 and ERBB2 with some differences among the three cells lines, and revealed a novel exonic mutation in NF1. The PUC-GBC3 clone was the most aggressive according to histopathological features and the tumorigenic capacity in NSG mice. CONCLUSIONS: The first cell lines established from a Chilean GBC patient represent a new model for studying GBC in patients of Native American descent.

Pattern of human epidermal growth factor receptor 2 [HER2] expression in invasive breast carcinoma, immunohistochemical - study on patients in Upper Egypt

Breast cancer is a major public health problem throughout the world. It accounts for 38% of all new cancer cases among women living in Egypt. One of the most important prognostic and determinant factor of the line of its treatment is the human epidermal growth factor receptor 2 [HER2], it is associated with the more aggressive phenotype. Attention has been focused on the expression of HER2 receptor proteins in breast cancer cells especially its membranous domain, it resulted in variable results concerning its percentage of expression as well as its geographic distribution. So there is a need to study HER2 types of expression in breast cancer patients in our location as well as its correlation with the clinicopathological parameters. HER2 expression in 336 retrospective breast cancer specimens was examined immunohistochemically using tissue microarray. Expression was scored into 0, 1, 2 and 3 degrees and was correlated with clinicopathological criteria. HER2 expression in our specimens showed both membranous and cytoplasmic staining patterns. 18.6% of specimens showed membranous immunoreactivity and 74.1% specimens showed cytoplasmic staining pattern. Significant statistical association was found between cytoplasmic staining of HER2 and tumors of low grade, ER positivity [p<0.001, 0.001, 0.008] respectively. There was statistical significance difference between high membranous expression of HER2 and ER negativity [p=0.038], but our results didn't find significant difference with tumor size, lymphvascular invasion or lymph node metastasis. The frequency of high membranous expression of HER2 in our specimens is 18.6% and inversely correlated with ER positive tumors. This group of patients should be subjected to specific treatment with Trastuzumab, to improve their survival. Surprisingly cutoplasmic expression detected in most of our patients with frequency of 74.1% with positive relationship to low tumor grade and hormone receptor positive tumors. Since this group of patients may be resistant to trastuzumab and need specific treatment with tyrosine kinase drug inhibitors, this observation is going to be discussed and need to be followed up in the future

Prognostic Significance of HER2 Gene Amplification According to Stage of Breast Cancer

It is well known that the amplification of the HER2 gene is closely associated with poor prognosis of breast cancer. However, there is controversy about the clinical significance of HER2 according to lymph node status in breast cancer. The aim of this study was to identify the differences in the prognostic significance of HER2 gene amplification according to the stages of breast cancer. We prepared a tissue array for fluorescence in situ hybridization (FISH) with breast cancer specimens from the surgery in 1994 to 1999. Total 338 cases of breast cancer were enrolled and the median follow-up period was 6.3 yr. The detection rates of HER2 gene amplification were as follows: 10.3% in stage I, 22.3% in stage II, and 43.8% in stage III. On survival analyses HER2-positive groups showed worse prognosis in stage III of breast cancer, but not in stage I or II. Multivariate analyses with a Cox-regression model also revealed that HER2 amplification was an independent prognostic factor only in stage III breast cancer. Regarding HER2 gene amplification as a prognostic factor of breast cancer, the clinical significance of the gene was found to be confined to advanced breast cancer.

Determination of the prognostic value of cyclin D1, C-erb B-2, KI-67 and the nucleolar organizer regions [AgNORs] in breast cancer

Four different types of measurements of prognostic factors [cyclin Dl, C-erb B-2, Ki-67 and AgNORs] were applied to a series of 70 breast lesions representing, 35 cases of invasive ductal carcinoma, 10 cases of invasive lobular carcinoma, 5 cases of tubular carcinoma, 10 cases of ducted carcinoma in situ, 10 cases of atypical ductal hyperplasia [ADH], in addition to 7 cases of normal breast tissue as a control, in combination with clinicopathological parameters to evaluate their prognostic significance in breast cancer. Expression of cyclin Dl is negative in atypical ductal hyperplasia [ADH] and ductal carcinoma in situ [DCIS]. However, in 29/50 [58%] of invasive cancer breast, positive expression of cyclin Dl was observed. There is a significant association was observed between cyclin Dl expression and distant metastasis, recurrence, and five-year survival rate of the patients with breast cancer. There is also a significant correlation between C-erb B-2 expression and distant metastases, recurrence and 5-year survival rate. The Ki-67 label index and AgNORs count was found to correlate significantly and increased gradually with progression of breast lesions. The AgNORs size, shape and distribution was found to show a characteristic difference between benign, atypical and malignant groups. Malignant cells were characterized by an irregularly scattered distribution of AgNORs and by a pleomorphic size and shape of the dots in comparison to the round, uniform and regular size and shape of the AgNORs dots in benign lesions. Positive expression of cyclin DI C-erb B-2, Ki-67 and high AgNORs score could be serve as a poor prognostic markers for patients with breast carcinoma independent of nodal metastases and clinical parameters, also expression of cyclin Dl could help in diagnosis of early invasion of breast carcinoma

Epidermal growth factor receptor [Egfr] and C-erbB-2 Expression in colorectal adenoma and adenocarcinoma

The incidence of colorectal cancer [CRC] has been rising worldwide. Discovery of new prognostic markers in CRC patients is necessary to improve the outcome of disease and to select appropriate treatment. The epidermal growth factor receptor [EGFR] is a trans- membrane glycol-protein. An abnormal expression of the EGFR has been described in many human tumors and implicated in the development and prognosis of malignancies. C-erbB-2 is a proto oncogene. Several studies have demonstrated the value of c-erbB-2 in predicting the biological behavior of tumors. Forty five patients were included in our study. Thirty were having colorectal adenocarcinoma [21 male and 9 female] and fifteen having adenoma [11 male and 4 female] with median age of 63 years. EGFR and c-erbB-2 over expression was immunohistochemically analyzed in colorectal adenoma and colorectal adenocarcinomas in order to determine whether there was a relationship between these two proteins and various histological and clinical characteristics with their respective impact on prognosis and to study their potential usage in early diagnosis of colorectal cancer. In the current study the expression of c-erbB-2 was significantly higher in preneoplastic lesions [93.3%] than colorectal cancer [60%] p<0.001. EGFR showed an inverse pattern to c-erbB-2 expression was significantly inversely associated with low grade tumor [GI] p 0.05]. As regards, tumor location only, c-erbB-2 expression was frequently expressed in rectal cancer versus colon cancer cases [p<0.05]. From this study we can conclude that c-erbB-2 can be potentially used in early diagnosis of colorectal cancer and considered as a significant predictor of the occurrence of colorectal carcinoma while EGFR expression is considered as a prognostic tool for prediction of cancer behavior and clinical outcome in CRC cases

FISH for HER-2/neu in breast cancer: standardization makes the difference!

CONTEXT: Overexpression of HER-2/neu oncogene in breast cancer patients is correlated with disease free survival (DFS) and overall survival (OS). The most commonly used methods for the detection of HER-2/neu status are immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH). However, therse is a lot of controversy with regard to the best method. Most of the FISH studies chose arbitrary cut-off levels for positive results (10%) and had no validation. AIM: In order to address these issues, we designed a pilot study of 38 samples with known IHC status representing all 4 categories. SETTINGS AND DESIGN: FISH was performed using Vysis Pathvysion probe. For validation, 5 cases of reduction mammoplasty were analyzed using same protocols. RESULTS: Our results showed significant discordance between FISH and IHC. The rate of discordance was much higher in the 0, 1+, and 2+ categories compared to published literature. This could be due to the lower cut-off rates for positive amplification established by validation in our study (5.7% vs 10%). Our analysis showed that FISH positive and IHC negative patients have a poor prognosis in terms of DFS and OS compared to FISH negative and IHC negative patients. Further, our results also showed that IHC in comparison to FISH has a comparable specificity (98%), but has a very low sensitivity (46%). CONCLUSION: Based on these results, we consider FISH to be the gold standard for detecting HER-2/neu status in breast cancer.

HER-2/neu Oncogene Amplification by Chromogenic in situ Hybridization in 130 Breast Cancers Using Tissue Microarray and Clinical Follow-up Studies

Determining of HER-2/neu oncogene amplification has become clinically important for managing breast cancer. Fluorescent in situ hybridization (FISH) and immunohistochemistry (IHC) are currently regarded as the standard methods. Chromogenic in situ hybridization (CISH) was investigated as a new modification with an accurate, sensitive technique. From 1998 to 2002, using CISH and IHC, the amplification and protein expression of the HER-2/neu oncogene were examined using paraffin sections in 130 breast carcinomas and to determine the prognostic role of HER-2/neu for outcome after a follow-up of 24- 64 months. Amplifications by CISH and overexpression by IHC were observed in 28 (22%) and 27 cases (20.8%), respectively. Of the 104 patients, 20 patients (19.2%) with amplification had a shorter disease-free interval (34.9 months vs. 38.0 months in controls) (p=0.372). 15 patients (14.4%) had a disease recurrence, but there is no significant difference between 3 patients amplifying the oncogene and 12 patients without oncogene (20.6 months vs. 19.6 months) (p=0.862). 6 patients (5.8%) of these died. CISH is a useful alternative, particularly for confirming the IHC results. There is no relationship between the early recurrence and the HER-2/neu positive group, but lymph node status was statistically significant.

Breast cancer in Egypt: a review of disease presentation and detection strategies

Carcinoma of the breast is the most prevalent cancer among Egyptian women and constitutes 29% of National Cancer Institute cases. Median age at diagnosis is one decade younger than in countries of Europe and North America and most patients are premenopausal. Tumours are relatively advanced at presentation. The majority of tumours are invasive duct subtype and the profile of hormone receptors is positive for estrogen receptors and /or progesterone receptors in less than half of cases. This overview examines genetic changes, potential and established predictive and prognostic markers and end results of surgery, radiotherapy and systemic therapy for early, locally advanced and metastatic disease stages. Disease presentations common to the region and early detection strategies are presented

Activación de los protooncogenes K-ras y c-erbB-2 en adenocarcinomas colónicos humanos / Activation of K-ras and c-erbB-2 protooncogenes in human colonic adenocarcinomas

Aunque los datos de las alteraciones genéticas que conducen al desarrollo de cáncer colorectal son abundantes, las alteraciones genéticas específicas para cada clase de tumor no han sido demostradas. El fenotipo cáncer colorectal es originado por la acumulación de diferentes alteraciones genéticas. La naturaleza de esas alteraciones, su orden de aparición y sus asociaciones, varian ampliamente de un tumor a otro, sugiriendo que el concepto de un modelo único de carcinogénesis no es aplicable a estos tumores. El objetivo del presente trabajo fue estudiar la asociación entre las mutaciones en los protooncogenes K-ras y c-erbB-2 con diferentes variables clinicopatológicas en 54 muestras de adenocarcinomas de colon. La detección de la activación de K-ras en 16 casos fue hecha mediante PCR alelo específica. Para la detección de la amplificación genética en c-erbB-2 se empleó un método de coamplificación por PCR con gen de copia única como referencia. Fueron detectadas mutaciones en K-ras en 16 casos (29,63 por ciento) y amplificación en c-erbB-2 en una muestra (1,85 por ciento). El análisis estadístico mostró una asociación significativa entre frecuencia de mutaciones en el codón 12 de K-ras y el estadio B de Dukes (p<0.005). Por otra parte, no se encontró asociación alguna con los otros parámetros estudiados. Estos resultados indicarian que la activación del protooncogén K-ras podría ocurrir en estadíos tempranos de la enfermedad.