Análise de metilação do gene FOXE1 em carcinoma de células escamosas em cães: padronização metodológica

It is believed that epigenetic mechanisms such as DNA methylation are important for the tumorigenesis and maintenance of the altered state of tumor cells. DNA methylation occurs by the addition of a methyl group to carbon 5 of cytosine, catalyzed by the enzyme DNA methyl-transferase, which can change the expression of a gene, including the tumor suppressor genes. In human squamous cell carcinoma, several features have shown the etiological role of genes in tumor development. Among them, FOXE1 gene (forkhead box E1 - thyroid transcription factor) is presented with an important role in susceptibility to disease. Similarly the FOXE1 methylation pattern could alter the expression of this gene in dogs and predisposed to tumor on. Therefore, this study aims to investigate in dogs, the validity of the strategy employed in humans to analyze the FOXE1 methylation status. DNA extraction from fresh frozen tumoral samples was performed by Wizard Genomic® DNA Purification Kit. The methylation status was determined by MSP-PCR (methylation-specific polymerase chain reaction), using 2.0 ng of DNA treated with sodium bisulphate. One hundred micrograms of bisulphite-modified DNA was amplified using primers specific for either methylated or unmethylated DNA (primers sequences are available at http://pathology2.jhu.edu/pancreas/primer.pdf). The analysis of fragments was loaded on to 7% polyacrylamide gels and silver nitrate staining. In this stage of technical approach, 60% were FOXE1 hypermethylated. In conclusion, it was observed that the standard technique for assessing the methylation pattern of gene FOXE1 in humans can be used for the same evaluation in dogs. The correlation of these molecular data with clinical and histopathological parameters may have diagnostic and prognostic value and still be used as a tumor marker for therapeutic decision and surgical approach

Predicting necrosis in residual mass analysis after retroperitoneal lymph node dissection: a retrospective study

Background: Recent studies have demonstrated that pathological analysis of retroperitoneal residual masses of patients with testicular germ cell tumors revealed findings of necrotic debris or fibrosis in up to 50% of patients. We aimed at pursuing a clinical and pathological review of patients undergoing post chemotherapy retroperitoneal lymph node dissection (PC-RPLND) in order to identify variables that may help predict necrosis in the retroperitoneum. Methods: We performed a retrospective analysis of all patients who underwent PC-RPLND at the University Hospital of the University of Sao Paulo and Cancer Institute of Sao Paulo between January 2005 and September 2011. Clinical and pathological data were obtained and consisted basically of: measures of retroperitoneal masses, histology of the orchiectomy specimen, serum tumor marker and retroperitoneal nodal size before and after chemotherapy. Results: We gathered a total of 32 patients with a mean age of 29.7; pathological analysis in our series demonstrated that 15 (47%) had necrosis in residual retroperitoneal masses, 15 had teratoma (47%) and 2 (6.4%) had viable germ cell tumors (GCT). The mean size of the retroperitoneal mass was 4.94 cm in our sample, without a difference between the groups (P = 0.176). From all studied variables, relative changes in retroperitoneal lymph node size (P = 0.04), the absence of teratoma in the orchiectomy specimen (P = 0.03) and the presence of choriocarcinoma in the testicular analysis after orchiectomy (P = 0.03) were statistically significant predictors of the presence of necrosis. A reduction level of 35% was therefore suggested to be the best cutoff for predicting the absence of tumor in the retroperitoneum with a sensitivity of 73.3% and specificity of 82.4%. Conclusions: Even though retroperitoneal lymph node dissection remains the gold standard for patients with residual masses, those without teratoma in the primary tumor and a shrinkage of 35% or more in retroperitoneal mass have a considerably smaller chance of having viable GCT or teratoma in the retroperitoneum and a surveillance program could be considered.

Identification of protein expression signatures in gastric carcinomas using clustering analysis

Background and Aim: The identification of gastric carcinomas (GC) has traditionally been based on histomorphology. Recently, DNA microarrays have successfully been used to identify tumors through clustering of the expression profiles. Random forest clustering is widely used for tissue microarrays and other immunohistochemical data, because it handles highly-skewed tumor marker expressions well, and weighs the contribution of each marker according to its relatedness with other tumor markers. In the present study, we e identified biologically- and clinically-meaningful groups of GC by hierarchical clustering analysis of immunohistochemical protein expression. Methods: We selected 28 proteins (p16, p27, p21, cyclin D1, cyclin A, cyclin B1, pRb, p53, c-met, c-erbB-2, vascular endothelial growth factor, transforming growth factor [TGF]-beta I, TGF-beta II, MutS homolog-2, bcl-2, bax, bak, bcl-x, adenomatous polyposis coli, clathrin, E-cadherin, beta-catenin, mucin (MUC) 1, MUC2, MUC5AC, MUC6, matrix metalloproteinase [ MMP]-2, and MMP-9) to be investigated by immunohistochemistry in 482 GC. The analyses of the data were done using a random forest-clustering method. Results: Proteins related to cell cycle, growth factor, cell motility, cell adhesion, apoptosis, and matrix remodeling were highly expressed in GC. We identified protein expressions associated with poor survival in diffuse-type GC. Conclusions: Based on the expression analysis of 28 proteins, we identified two groups of GC that could not be explained by any clinicopathological variables, and a subgroup of long-surviving diffuse-type GC patients with a distinct molecular profile. These results provide not only a new molecular basis for understanding the biological properties of GC, but also better prediction of survival than the classic pathological grouping.

Factors associated with serum CA19-9 levels among healthy children: a cross-sectional study

Abstract Background CA19-9 is a tumor marker mainly used for biliary tract, pancreas and colorectum. Since the marker applies usually for adults, the normal range of serum CA19-9 among children has been rarely reported. This is the first study reporting the distribution of serum CA19-9 levels among cancer-free children as well as their parents, taking into account the Lewis and secretor gene polymorphism and physical growth. Methods Study subjects were 972 apparently healthy Japanese Brazilians including 476 children aged from 1 to 19 years. Results The comparisons in five-year age groups demonstrated that the mean values of serum CA19-9 was lower in the boys than in the girls, and higher in younger age groups; 22.5 U/ml for 1–4 year-old (n=13), 17.4 U/ml for 5–9 year-old (n=36), 15.5 U/ml for 10–14 year-old (n=96) and 10.2 U/ml for 15–19 year-old (n=74) in boys, and 25.3 U/ml (n=11), 27.1 U/ml (n=50), 17.7 U/ml (n=105) and 13.5 U/ml (n=59) in girls, respectively. The difference in those geometric means was statistically significant among four age groups (p=0.006, ANOVA adjusted for sex). After Lewis and secretor genotypes, which are definitive factors of serum CA19-9, were taken into account, geometric mean of serum CA19-9 was associated with any of BMI (p<0.001), height (p<0.001) and weight (p<0.001) among children excluding those with le/le genotype. The associations were still significant when age was adjusted. Conclusions Serum CA19-9 values were higher among children than among adults, and influenced by sex, height, weight, and BMI even after the adjustment for age as well as Le and Se genotypes.

Konditionale Modellsysteme zur Untersuchung der ERBB2-induzierten Tumorgenese

Konditionale Modellsysteme zur Untersuchung der ERBB2-induzierten Tumorgenese Die Rezeptor-Tyrosinkinase ERBB2 ist in einer Vielzahl epithelialer Tumore, wie Mamma- und Ovarialkarzinomen, überexprimiert. Diese erhöhte Expression korreliert mit aggressivem Tumorwachstum, verstärkter Metastasierung und schlechter Prognose für den Patienten. Zur genaueren Untersuchung molekularer Mechanismen, die zur Tumorentstehung infolge der ERBB2-Überexpression führen, wurden im Rahmen dieser Arbeit mit Hilfe des Tet-Systems induzierbare MCF-7 Zelllinien generiert. Diese exprimieren bei Gabe von Doxyzyklin ERBB2 bzw. die zum humanen ERBB2 homologe und durch Punktmutation onkogen aktivierte Rattenvariante NeuT. Nachdem die stringente Regulierbarkeit durch Doxyzyklin für die untersuchten Zellklone gezeigt werden konnte, stellte sich bei der Charakterisierung der Zelllinien heraus, dass die Induktion von ERBB2 erstaunlicherweise nicht zur Proliferation der Zellen, sondern zum Wachstumsarrest führt. Bei der Untersuchung verschiedener Zellzyklusregulatoren konnte dieser Zellzyklusarrest dem CDK-Inhibitor P21 zugeordnet werden, dessen Expression durch ERBB2 induziert wird. In P21-Antisense-Experimenten konnte nachgewiesen werden, dass P21 eine Schlüsselrolle beim ERBB2-induzierten Zellzyklusarrest spielt. Neben der Induktion von P21 und der daraus resultierenden Wachstumsinhibition zeigten die Zellen starke morphologische Veränderungen und waren positiv beim Nachweis der Seneszenz-assoziierten -Galaktosidase. Erstmals konnte gezeigt werden, dass die Induktion des Onkogens ERBB2 nicht zur Proliferation, sondern zur Aktivierung eines verfrühten Seneszenz-Programms führt, welches der Zelle Schutz gegen die Onkogeneinwirkung bietet. Bei der Untersuchung verschiedener Signaltransduktionskaskaden mit Inhibitormolekülen konnte die Aktivierung dieses Seneszenz-Programms der Stress-aktivierten Proteinkinase P38 zugeordnet werden. Zur Identifizierung von Genen, die für die ERBB2-induzierte Tumorgenese relevant sind, wurde die differenzielle Genexpression eines NeuT-Klons nach 8- bzw. 48-stündiger Induktion mit Doxyzyklin in einem cDNA-Array untersucht. Dabei zeigte sich eine besonders starke Induktion von Integrin 5 und Integrin 1, die zusammen den Fibronektinrezeptor bilden. Der funktionale Nachweis des Rezeptors in einem Adhäsionsassay demonstrierte ein stark erhöhtes Adhäsionsverhalten ERBB2-überexprimierender Zellen an Fibronektin. Bei der Untersuchung von Mamma-, Ovarial- und Endometriumkarzinomen konnte die Expression von ERBB2 mit der von Integrin 5 korreliert werden. Diese Ergebnisse machen Integrin 5 zu einem potenziellen neuen Tumormarker und Therapieziel in ERBB2-überexprimierenden Tumoren. Ein weiteres interessantes Gen, das sich im Array durch ERBB2 überexprimiert zeigte, war die Matrix-Metalloproteinase MMP-9. In einem Zymografieassay konnte die erhöhte Gelatinaseaktivität von MMP-9 in Dox-induzierten Zellen nachgewiesen werden. Der Einsatz verschiedener Signaltransduktionsinhibitoren ergab, dass auch die ERBB2-induzierte Expression von MMP-9 über die Aktivierung von P38 läuft. Bei der Suche nach weiteren MMPs, die für die ERBB2-induzierte Tumorgenese relevant sein könnten, wurde MMP-13 untersucht. Erstmals konnte gezeigt werden, dass diese Matrix-Metalloproteinase von ERBB2 induziert wird. Dieser interessante Befund wurde auch in einem anderen Zellmodell in NIH3T3 Mausfibroblasten verifiziert. Durch ihre Matrix-degradierenden Eigenschaften sind MMPs potente „Werkzeuge“ für Tumorzellen und stellen ein wichtiges Ziel zur Unterbindung der Invasion und Metastasierung dieser Zellen dar. Neben den Zellkulturarbeiten wurden im Rahmen dieser Dissertation transgene Responder-Mäuse generiert, die NeuT unter Kontrolle eines Tet-responsiven Promotors exprimieren. Von vier transgenen Gründerlinien zeigten zwei eine unerwünschte, basale NeuT-Expression, für die beiden anderen Linien konnte sowohl in MEF-Assays, als auch nach Kreuzung mit rtTA- bzw. tTA-Effektor-Mäusen eine Dox-abhängige Regulation des Transgens gezeigt werden. Die Tiere dieser Linien sollen in Zukunft mit Effektor-Mäusen gepaart werden, die den rtTA bzw. tTA spezifisch in für die ERBB2-Tumorgenese relevanten Geweben, wie Ovarial- oder Lungenepithelzellen, exprimieren. So können individuelle Tumormodelle für die verschiedenen epithelialen Tumore, bei denen die Überexpression von ERBB2 von Bedeutung ist, entwickelt und untersucht werden.

Die Rolle der humanen Enzyme Paraoxonase-2 und -3 bei Krebserkrankungen und Pseudomonas-Infektionen

Die vorliegende Arbeit befasste sich mit der Charakterisierung molekularer Funktionen humaner Paraoxonase (PON) Enzyme, insbesondere die der Proteine PON2 und PON3 im Hinblick auf medizinisch-relevante Fragestellungen. Zum einen wurde die Rolle von PON3 in der Tumorgenese und zum anderen eine mögliche Schutzfunktion von PON2 und PON3 gegenüber P. aeruginosa Infektionen untersucht. Bereits seit dem Jahr 2000 ist die anti-oxidative Eigenschaft von PON3 bekannt, jedoch war der zugrundeliegende Mechanismus bisher ungeklärt. Im Rahmen dieser Arbeit wurde gezeigt, dass PON3 die Superoxid-Entstehung in den Mitochondrien abschwächt, wobei sie ihre anti-oxidative Eigenschaft vermutlich durch eine direkte Coenzym Q10-Interaktion in der inneren mitochondrialen Membran vermittelt. Dies führt zu weniger oxidativen Stress, zur Abschwächung mitochondrial-induzierter apoptotischer Signalwege und zur erhöhten Resistenz gegenüber Chemotherapeutika. Gleichzeitig wurde demonstriert, dass sich Tumorzellen diese anti-oxidative Eigenschaft zu Nutze machen. PON3 war in zahlreichen Tumorgeweben überexprimiert. Es konnte eine mögliche Funktion von PON3 als Tumormarker und Angriffspunkt in der Krebstherapie aufgezeigt werden. Die hier erlangten Daten liefern wertvolle Hinweise auf die Rolle von PON3 in Krebserkrankungen, welche eine Basis für zukünftige Analysen darstellen, die der Entwicklung neuer Krebstherapien dienen könnten. Ein weiterer Teil der Arbeit befasste sich mit der gegenseitigen Beeinflussung der Enzyme PON2 / PON3 und der für P.aeruginosa essentiellen Virulenzfaktoren Pyocyanin (PCN) und dem Lacton 3OC12. Erstmalig wurde gezeigt, dass PON3 zellschädigende PCN-Effekte abschwächen kann, nämlich die PCN-induzierte Superoxid-Produktion, NF-kB-Aktivierung und IL-8-Sekretion. PON2 schützt in gleicher Weise gegen PCN und hydrolysiert zugleich noch das Lacton 3OC12. Folglich sind PON2 und PON3 wichtige Bestandteile der angeborenen Immunität, werden jedoch durch eine 3OC12-induzierte Ca2+-Mobilisation inaktiviert. Weitere Analysen ergaben, dass die PON2-Inaktivierung wahrscheinlich über einen Ca2+ / Calcineurin / Calmodulin-abhängigen Signalweg erfolgt, welcher eine offenbar regulative Serin311-Dephosphorylierung in PON2 vermittelt. Ähnliches könnte für PON3 gelten und wird derzeit erforscht, da eine Stabilisierung der enzymatischen Aktivitäten von PON2 und PON3 der bakteriellen Virulenz entscheidend entgegen wirken könnte.

Hepatic arterial infusion enhances DOTATOC radiopeptide therapy in patients with neuroendocrine liver metastases

Intravenously administered radiolabeled peptides targeting somatostatin receptors are used for the treatment of unresectable gastroenteropancreatic neuroendocrine tumors (GEP-NETs). Recently, we demonstrated a high first-pass effect during intra-arterial (i.a.) administration of positron emission tomography (PET) labeled (68)Ga-DOTA(0)-d-Phe(1)-Tyr(3)-octreotide (DOTATOC). In this pilot study, we investigated the therapeutic effectiveness of arterial administered DOTATOC, labeled with the therapeutic β emitters (90)Y and (177)Lu. (90)Y- and/or (177)Lu-DOTATOC were infused into the hepatic artery of 15 patients with liver metastases arising from GEP-NETs. Response was assessed using DOTATOC-PET, multiphase contrast enhanced computed tomography, magnetic resonance imaging, and the serum tumor marker chromogranin A. Pharmacokinetic data of the arterial approach were assessed using (111)In-DOTATOC scans. With the treatment regime of this pilot study, complete remission was achieved in one (7%) patient and partial remission was observed in eight (53%) patients, six patients were classified as stable (40%; response evaluation criteria in solid tumors criteria). The concomitant decrease of elevated serum tumor marker confirmed the radiologic response. Median time to progression was not reached within a mean follow-up period of 20 months. Receptor saturation and redistribution effects were identified as limiting factors for i.a. DOTATOC therapy. The high rate of objective radiologic response in NET patients treated with arterial infusion of (90)Y-/(177)Lu-DOTATOC compares favorably with systemic chemotherapy and intravenous radiopeptide therapy. While i.a. DOTATOC therapy is only applicable to patients with tumors of limited anatomic distribution, the results of this pilot study are a promising development in the treatment of GEP-NET and warrants further investigation of this novel approach.

Pancreatic carcinoma, pancreatitis, and healthy controls: metabolite models in a three-class diagnostic dilemma

Metabolomics as one of the most rapidly growing technologies in the "-omics" field denotes the comprehensive analysis of low molecular-weight compounds and their pathways. Cancer-specific alterations of the metabolome can be detected by high-throughput mass-spectrometric metabolite profiling and serve as a considerable source of new markers for the early differentiation of malignant diseases as well as their distinction from benign states. However, a comprehensive framework for the statistical evaluation of marker panels in a multi-class setting has not yet been established. We collected serum samples of 40 pancreatic carcinoma patients, 40 controls, and 23 pancreatitis patients according to standard protocols and generated amino acid profiles by routine mass-spectrometry. In an intrinsic three-class bioinformatic approach we compared these profiles, evaluated their selectivity and computed multi-marker panels combined with the conventional tumor marker CA 19-9. Additionally, we tested for non-inferiority and superiority to determine the diagnostic surplus value of our multi-metabolite marker panels. Compared to CA 19-9 alone, the combined amino acid-based metabolite panel had a superior selectivity for the discrimination of healthy controls, pancreatitis, and pancreatic carcinoma patients [Formula: see text] We combined highly standardized samples, a three-class study design, a high-throughput mass-spectrometric technique, and a comprehensive bioinformatic framework to identify metabolite panels selective for all three groups in a single approach. Our results suggest that metabolomic profiling necessitates appropriate evaluation strategies and-despite all its current limitations-can deliver marker panels with high selectivity even in multi-class settings.

Suprasellar germinomas in childhood and adolescence: diagnostic pitfalls

The clinical and neuro-endocrine data of seven young male patients with suprasellar germinomas seen between 1984 and 1992 are reported. The most common initial symptom was 'idiopathic' central diabetes insipidus (DI), which occurred in all seven patients. The time interval between the appearance of this first clinical sign and the definitive diagnosis of a suprasellar germinoma ranged from 3 to 66 months. Raised prolactin levels and growth hormone deficiency were indicators of a process located in the hypothalamic-pituitary region. An increased beta-HCG level in the serum or the CSF confirmed the diagnostic suspicion of a germinoma and was helpful as a tumor marker in follow-up. Neuro-radiologic studies (CT or MRI) were also disappointing in the early stage when patients presented only with DI. Later on, as patients developed additional symptoms or signs related to the tumor, imaging studies were positive. Given the variable rate of tumor progression, the nonspecific early signs of hypothalamic-pituitary dysfunction (DI) as well as the often negative early imaging studies, the diagnosis of suprasellar germinoma is difficult but should always be considered in the presence of so-called 'idiopathic' central DI. Repeated brain MRIs are mandatory in young patients with idiopathic DI in order not to miss an underlying suprasellar germinoma.

Regulation of chromatin structure, Smad binding and AFP expression by the Forkhead box transcription factor: Foxa1

Transcription factors must be able to access their DNA binding sites to either activate or repress transcription. However, DNA wrapping and compaction into chromatin occludes most binding sites from ready access by proteins. Pioneer transcription factors are capable of binding their DNA elements within a condensed chromatin context and then reducing the level of nucleosome occupancy so that the chromatin structure is more accessible. This altered accessibility increases the probability of other transcription factors binding to their own DNA binding elements. My hypothesis is that Foxa1, a ‘pioneer’ transcription factor, activates alpha-fetoprotein (AFP) expression by binding DNA in a chromatinized environment, reducing the nucleosome occupancy and facilitating binding of additional transcription factors.^ Using retinoic-acid differentiated mouse embryonic stem cells, we illustrate a mechanism for activation of the tumor marker AFP by the pioneer transcription factor Foxa1 and TGF-β downstream effector transcription factors Smad2 and Smad4. In differentiating embryonic stem cells, binding of the Foxa1 forkhead box transcription factor to chromatin reduces nucleosome occupancy and levels of linker histone H1 at the AFP distal promoter. The more accessible DNA is subsequently bound by the Smad2 and Smad4 transcription factors, concurrent with activation of transcription. Chromatin immunoprecipitation analyses combined with siRNA-mediated knockdown indicate that Smad protein binding and the reduction of nucleosome occupancy at the AFP distal promoter is dependent on Foxa1. In addition to facilitating transcription factor binding, Foxa1 is also associated with histone modifications related to active gene expression. Acetylation of lysine 9 on histone H3, a mark that is associated active transcription, is dependent on Foxa1, while methylation of H3K4, also associated with active transcription, is independent of Foxa1. I propose that Foxa1 potentiates a region of chromatin to respond to Smad proteins, leading to active expression of AFP.^ These studies demonstrate one mechanism whereby a transcription factor can alter the accessibility of additional transcription factors to chromatin, by altering nucleosome positions. Specifically, Foxa1 exposes DNA so that Smad4 can bind to its regulatory element and activate transcription of the tumor-marker gene AFP.^

Human carbonic anhydrase XII: cDNA cloning, expression, and chromosomal localization of a carbonic anhydrase gene that is overexpressed in some renal cell cancers

We report the cloning and characterization of a tumor-associated carbonic anhydrase (CA) that was identified in a human renal cell carcinoma (RCC) by serological expression screening with autologous antibodies. The cDNA sequence predicts a 354-amino acid polypeptide with a molecular mass of 39,448 Da that has features of a type I membrane protein. The predicted sequence includes a 29-amino acid signal sequence, a 261-amino acid CA domain, an additional short extracellular segment, a 26-amino acid hydrophobic transmembrane domain, and a hydrophilic C-terminal cytoplasmic tail of 29 amino acids that contains two potential phosphorylation sites. The extracellular CA domain shows 30–42% homology with known human CAs, contains all three Zn-binding histidine residues found in active CAs, and contains two potential sites for asparagine glycosylation. When expressed in COS cells, the cDNA produced a 43- to 44-kDa protein in membranes that had around one-sixth the CA activity of membranes from COS cells transfected with the same vector expressing bovine CA IV. We have designated this human protein CA XII. Northern blot analysis of normal tissues demonstrated a 4.5-kb transcript only in kidney and intestine. However, in 10% of patients with RCC, the CA XII transcript was expressed at much higher levels in the RCC than in surrounding normal kidney tissue. The CA XII gene was mapped by using fluorescence in situ hybridization to 15q22. CA XII is the second catalytically active membrane CA reported to be overexpressed in certain cancers. Its relationship to oncogenesis and its potential as a clinically useful tumor marker clearly merit further investigation.

Antibody C219 recognizes an α-helical epitope on P-glycoprotein

The ABC transporter, P-glycoprotein, is an integral membrane protein that mediates the ATP-driven efflux of drugs from multidrug-resistant cancer and HIV-infected cells. Anti-P-glycoprotein antibody C219 binds to both of the ATP-binding regions of P-glycoprotein and has been shown to inhibit its ATPase activity and drug binding capacity. C219 has been widely used in a clinical setting as a tumor marker, but recent observations of cross-reactivity with other proteins, including the c-erbB2 protein in breast cancer cells, impose potential limitations in detecting P-glycoprotein. We have determined the crystal structure at a resolution of 2.4 Å of the variable fragment of C219 in complex with an epitope peptide derived from the nucleotide binding domain of P-glycoprotein. The 14-residue peptide adopts an amphipathic α-helical conformation, a secondary structure not previously observed in structures of antibody–peptide complexes. Together with available biochemical data, the crystal structure of the C219-peptide complex indicates the molecular basis of the cross-reactivity of C219 with non-multidrug resistance-associated proteins. Alignment of the C219 epitope with the recent crystal structure of the ATP-binding subunit of histidine permease suggests a structural basis for the inhibition of the ATP and drug binding capacity of P-glycoprotein by C219. The results provide a rationale for the development of C219 mutants with improved specificity and affinity that could be useful in antibody-based P-glycoprotein detection and therapy in multidrug resistant cancers.

The Lutheran blood group glycoprotein, another member of the immunoglobulin superfamily, is widely expressed in human tissues and is developmentally regulated in human liver.

Glycoproteins expressing the Lutheran blood group antigens were isolated from human erythrocyte membranes and from human fetal liver. Amino acid sequence analyses allowed the design of redundant oligonucleotides that were used to generate a 459-bp, sequence-specific probe by PCR. A cDNA clone of 2400 bp was isolated from a human placental lambda gt 11 library and sequenced, and the deduced amino acid sequence was studied. The predicted mature protein is a type I membrane protein of 597 amino acids with five potential N-glycosylation sites. There are five disulfide-bonded, extracellular, immunoglobulin superfamily domains (two variable-region set and three constant-region set), a single hydrophobic, membrane-spanning domain, and a cytoplasmic domain of 59 residues. The overall structure is similar to that of the human tumor marker MUC 18 and the chicken neural adhesion molecule SC1. The extracellular domains and cytoplasmic domain contain consensus motifs for the binding of integrin and Src homology 3 domains, respectively, suggesting possible receptor and signal-transduction function. Immunostaining of human tissues demonstrated a wide distribution and provided evidence that the glycoprotein is under developmental control in liver and may also be regulated during differentiation in other tissues.

Expression of the cell surface mucin gene family in adenocarcinomas

Cell surface mucins are complex glycoproteins expressed on the apical membrane surface of mucosal epithelial cells. In malignant epithelial cells they are thought to influence cell adhesion, and are clinical targets for tumor immunotherapy and serum tumor marker assays. We have compared expression of MUC1, MUC3, MUC4, MUC11, MUC12 and MUC13 mRNA in epithelial cancers and/or cell lines with non-malignant tissues. In non-malignant tissues, MUC3, 4, 11, 12 and 13 were expressed at highest levels in gastrointestinal tissues, whereas MUC1 was more widely distributed. Significant down-regulation of the MUC4, MUC12 and MUC13 genes was observed in colonic cancers compared with normal tissue, whereas MUC1 was upregulated. In rectal cancers, levels of all six mucin genes were not significantly different to those in normal rectal tissues. Both MUC1 and MUC4 were down-regulated in gastric cancers, whereas cancer and normal tissue levels were similar for MUC3, 11, 12 and 13. In esophageal cancers there was a general trend toward higher levels than in normal tissue for MUC1, 3, 12 and 13. In ovarian cancers MUC1 levels were very high, whereas only low levels of all other mucins were observed. We also report expression in renal cell carcinomas, bladder carcinomas and breast cancer cell lines. The reported expression profiles of the cell surface mucin gene family will help direct biological and clinical studies of these molecules in mucosal biology, and in malignant and inflammatory diseases of epithelial tissues.

Ovarian sertoli-leydig cell tumour with heterologous elements of gastrointestinal type associated with elevated serum alpha-fetoprotein level: an unusual case and literature review

Here we describe the case of a 19-year-old woman with a poorly differentiated ovarian Sertoli-Leydig cell tumor and an elevated serum alphafetoprotein level. The patient presented with diffuse abdominal pain and bloating. Physical examination, ultrasound, and magnetic resonance imaging revealed a right ovarian tumor that was histopathologically diagnosed as a poorly differentiated Sertoli-Leydig cell tumor with heterologous elements. Her alpha-fetoprotein serum level was undetectable after tumor resection. Sertoli-Leydig cell tumors are rare sex cord-stromal tumors that account for 0.5% of all ovarian neoplasms. Sertoli-Leydig cell tumors tend to be unilateral and occur in women under 30 years of age. Although they are the most common virilizing tumor of the ovary, about 60% are endocrineinactive tumors. Elevated serum levels of alpha-fetoprotein are rarely associated with Sertoli-Leydig cell tumors, with only approximately 30 such cases previously reported in the literature. The differential diagnosis should include common alpha-fetoprotein-producing ovarian entities such as germ cell tumors, as well as other non-germ cell tumors that have been rarely reported to produce this tumor marker.