ABSTRACT
Renal-cell carcinoma (RCC) constitutes a heterogeneous group of tumors with specific chromosome aberrations. Recently, a new small group of RCC, occurring in children and young adults, has been described as characterized by t(6;11)(p21;q12). It has been shown that this translocation results in the fusion of the 5' portion of the ALPHA gene (11q12) with the transcription factor gene TFEB (6p21). Herewith, we report the first complete cytogenetic and molecular characterization of a t(6;11)-positive RCC of an adult patient, a 54-year-old woman. The tumor was histologically defined as RCC with peculiar features and it was negative for epithelial markers and positive for melanocytic markers. Chromosome QFQ banding analysis of short-term cultured cells from the RCC showed t(6;11)(p21;q12) as the sole cytogenetic abnormality. The translocation was confirmed by FISH analysis. RT-PCR analysis, performed on total RNA isolated from both neoplastic and normal tissue samples, revealed an ALPHA-TFEB chimeric transcript in the tumor sample; sequencing of the RT-PCR product defined a novel TFEB gene breakpoint cluster region, broader than the one reported thus far. Western blot analysis showed a band at the expected size of wild-type TFEB in the neoplastic tissue compared to the normal sample, supporting that the fusion gene does not encode for a chimeric protein but it causes an upregulation of the wild-type TFEB. Our data contribute to define better this rare RCC type, which is typical not only of childhood but can also be found in adulthood.
Subject(s)
Carcinoma, Renal Cell/genetics , Chromosomes, Human, Pair 11 , Chromosomes, Human, Pair 6 , Kidney Neoplasms/genetics , Translocation, Genetic , Amino Acid Sequence , Base Sequence , Basic Helix-Loop-Helix Leucine Zipper Transcription Factors/chemistry , Basic Helix-Loop-Helix Leucine Zipper Transcription Factors/genetics , Carcinoma, Renal Cell/pathology , Chromosome Mapping , DNA Primers , Female , Gene Expression Regulation, Neoplastic , Gene Fusion , Helix-Loop-Helix Motifs , Humans , In Situ Hybridization, Fluorescence , Karyotyping , Kidney Neoplasms/pathology , Middle Aged , Molecular Sequence Data , Neoplasm Proteins/chemistry , Neoplasm Proteins/genetics , Polymerase Chain ReactionABSTRACT
CDX-2 is a homeobox gene product essential for intestinal development and differentiation. It can be used as a specific marker of colorectal adenocarcinomas and other tumors with intestinal differentiation, but little is known about its expression in endocrine and neuroendocrine (NE) cells and NE primary and metastatic tumors. Using the Cdx-2-88 monoclonal antibody, we evaluated CDX-2 expression in routine samples of 20 normal endocrine/NE tissues and of 299 samples of well-differentiated NE tumors (WDNET) and high-grade NE carcinomas (NEC) from different sites. For 17 cases, we examined primary and corresponding metastatic lesions. We also examined 8 cytologic samples of liver metastases derived from 4 ileal WDNETs, 1 lung WDNET, and 3 pancreatic endocrine tumors. CDX-2 mRNA expression with RT-PCR technique on frozen material was evaluated in 5 WDNETs. CDX-2 was expressed in normal NE cells of the intestine and gastric fundus. High CDX-2 expression was seen in all ileal and appendiceal WDNET, while low levels were seen in WDNETs from stomach, duodenum, and rectum; no reactivity was seen in other WDNETs. Low levels of CDX-2 expression were seen in one third of nonfunctioning pancreatic WDNET where it was more frequently observed in cases with metastatic disease (P = 0.002). CDX-2 was identified in all cytologic specimens of metastatic ileal WDNETs. CDX-2 mRNA analysis confirmed immunohistochemical results. CDX-2 was expressed at high levels in 81% of intestinal NEC. Unexpectedly, variable levels of expression of CDX-2 were seen also in 39% of NEC of other sites, without any relation with the site of origin. This reactivity frequently overlapped TTF-1 expression, suggesting deregulated expression of homeobox genes in NEC. The restricted pattern of CDX-2 expression may have diagnostic value in the identification of the primary site of a metastatic WDNET. Conversely, a limited diagnostic role is suggested for CDX-2 in NEC because of its frequent expression in nongastrointestinal tumors.
Subject(s)
Genes, Homeobox/genetics , Homeodomain Proteins/genetics , Intestinal Neoplasms/genetics , Intestinal Neoplasms/pathology , Neuroendocrine Tumors/genetics , Neuroendocrine Tumors/pathology , CDX2 Transcription Factor , Gene Expression Regulation, Neoplastic , Humans , Trans-ActivatorsABSTRACT
Cell cycle regulation is often altered in cancer and deregulation of the cell cycle checkpoints is common in human neoplasia. The dual-specificity phosphatase Cdc25A and the cell cycle inhibitor p27 both play an important role in the regulation of the G1-S transition. We evaluated Cdc25A mRNA expression by in situ hybridization and p27 protein expression by immunohistochemistry in 42 histologically indolent B-cell non-Hodgkin lymphoma (NHL and 51 histologically aggressive B-cell NHL. Overexpression of Cdc25A (>50% tumor cells positive) was detected in 5 of 42 cases (12%) of histologically indolent B-cell NHL and in 29 of 51 (57%) of histologically aggressive B-cell NHL (P < 0.001). In contrast, high p27 protein expression (>50% tumor cells positive) was observed in 29 (69%) cases of indolent but in only one case (2%) of aggressive B-cell NHL (P < 0.0001). Thus, overexpression of Cdc25A and concomitant loss of p27 expression are associated with high grade B-cell NHL and may contribute to their aggressive biologic behavior.
