Variation in DNA repair gene XRCC3 affects susceptibility to astrocytomas and glioblastomas

The gene XRCC3 (X-ray cross complementing group 3) has the task of repairing damage that occurs when there is recombination between homologous chromosomes. Repair of recombination between homologous chromosomes plays an important role in maintaining genome integrity, although it is known that double-strand breaks are the main inducers of chromosomal aberrations. Changes in the XRCC3 protein lead to an increase in errors in chromosome segregation due to defects in centrosomes, resulting in aneuploidy and other chromosomal aberrations, such as small increases in telomeres. We examined XRCC3 Thr241Met polymorphism using PCR-RFLP in 80 astrocytoma and glioblastoma samples. The individuals of the control group (N = 100) were selected from the general population of the Sao Paulo State. Odds ratio and 95%CI were calculated using a logistic regression model. Patients who had the allele Met of the XRCC3 Thr241Met polymorphism had a significantly increased risk of tumor development (odds ratio = 3.13; 95% confidence interval = 1.50-6.50). There were no significant differences in overall survival of patients. We suggest that XRCC3 Thr241Met polymorphism is involved in susceptibility for developing astrocytomas and glioblastomas.

Differential MiRNA expression in childhood acute lymphoblastic leukemia and association with clinical and biological features

The present study aimed to analyze the expression profile of the microRNAs previously described as associated with childhood ALL, miR-92a, miR-100, miR-125a-5p, miR-128a, miR-181b, miR-196b and let-7e, and their association with biological/prognostic features in 128 consecutive samples of childhood acute lymphoblastic leukemia (ALL) by quantitative real-time PCR. A significant association was observed between higher expression levels of miR-196b and T-ALL, miR-100 and patients with low white blood cell count at diagnosis and t(12;21) positive ALL. These findings suggest a potential activity of these microRNAs in pediatric ALL biology. (C) 2011 Elsevier Ltd. All rights reserved.

Cytostatic in vitro Effects of DTCM-Glutarimide on Bladder Carcinoma Cells

Bladder cancer is a common malignancy worldwide. Despite the increased use of cisplatin-based combination therapy, the outcomes for patients with advanced disease remain poor. Recently, altered activation of the PI3K/Akt/mTOR pathway has been associated with reduced patient survival and advanced stage of bladder cancer, making its upstream or downstream components attractive targets for therapeutic intervention. In the present study, we showed that treatment with DTCM-glutaramide, a piperidine that targets PDK1, results in reduced proliferation, diminished cell migration and G1 arrest in 5637 and T24 bladder carcinoma cells. Conversely, no apoptosis, necrosis or autophagy were detected after treatment, suggesting that reduced cell numbers in vitro are a result of diminished proliferation rather than cell death. Furthermore previous exposure to 10 mu g/ml DTCM-glutarimide sensitized both cell lines to ionizing radiation. Although more studies are needed to corroborate our findings, our results indicate that PDK1 may be useful as a therapeutic target to prevent progression and abnormal tissue dissemination of urothelial carcinomas.

Using Prior Information from the Medical Literature in GWAS of Oral Cancer Identifies Novel Susceptibility Variant on Chromosome 4-the AdAPT Method

Background: Genome-wide association studies (GWAS) require large sample sizes to obtain adequate statistical power, but it may be possible to increase the power by incorporating complementary data. In this study we investigated the feasibility of automatically retrieving information from the medical literature and leveraging this information in GWAS. Methods: We developed a method that searches through PubMed abstracts for pre-assigned keywords and key concepts, and uses this information to assign prior probabilities of association for each single nucleotide polymorphism (SNP) with the phenotype of interest - the Adjusting Association Priors with Text (AdAPT) method. Association results from a GWAS can subsequently be ranked in the context of these priors using the Bayes False Discovery Probability (BFDP) framework. We initially tested AdAPT by comparing rankings of known susceptibility alleles in a previous lung cancer GWAS, and subsequently applied it in a two-phase GWAS of oral cancer. Results: Known lung cancer susceptibility SNPs were consistently ranked higher by AdAPT BFDPs than by p-values. In the oral cancer GWAS, we sought to replicate the top five SNPs as ranked by AdAPT BFDPs, of which rs991316, located in the ADH gene region of 4q23, displayed a statistically significant association with oral cancer risk in the replication phase (per-rare-allele log additive p-value [p(trend)] = 2.5 x 10(-3)). The combined OR for having one additional rare allele was 0.83 (95% CI: 0.76-0.90), and this association was independent of previously identified susceptibility SNPs that are associated with overall UADT cancer in this gene region. We also investigated if rs991316 was associated with other cancers of the upper aerodigestive tract (UADT), but no additional association signal was found. Conclusion: This study highlights the potential utility of systematically incorporating prior knowledge from the medical literature in genome-wide analyses using the AdAPT methodology. AdAPT is available online (url: http://services.gate.ac.uk/lld/gwas/service/config).

Cooperative effects of aminopeptidase N (CD13) expressed by nonmalignant and cancer cells within the tumor microenvironment

Processes that promote cancer progression such as angiogenesis require a functional interplay between malignant and nonmalignant cells in the tumor microenvironment. The metalloprotease aminopeptidase N (APN; CD13) is often overexpressed in tumor cells and has been implicated in angiogenesis and cancer progression. Our previous studies of APN-null mice revealed impaired neoangiogenesis in model systems without cancer cells and suggested the hypothesis that APN expressed by nonmalignant cells might promote tumor growth. We tested this hypothesis by comparing the effects of APN deficiency in allografted malignant (tumor) and nonmalignant (host) cells on tumor growth and metastasis in APN-null mice. In two independent tumor graft models, APN activity in both the tumors and the host cells cooperate to promote tumor vascularization and growth. Loss of APN expression by the host and/or the malignant cells also impaired lung metastasis in experimental mouse models. Thus, cooperation in APN expression by both cancer cells and nonmalignant stromal cells within the tumor microenvironment promotes angiogenesis, tumor growth, and metastasis.

A dry extract of Phyllanthus niruri protects normal cells and induces apoptosis in human liver carcinoma cells

The ability to induce apoptosis is an important marker for cytotoxic antitumor agents. Some natural compounds have been shown to modulate apoptosis pathways that are frequently blocked in human cancers, and therefore, these compounds provide novel opportunities for cancer drug development. Phyllanthus, a plant genus of the family Euphorbiaceae, exhibits multiple pharmacological actions. Of these, Phyllanthus niruri extracts exhibit significant antitumor activity, which is consistent with the traditional medicinal use of this plant. To examine the apoptotic effects of a spray-dried extract of P. niruri (SDEPN), human hepatocellular carcinoma cells (HepG2, Huh-7), colorectal carcinoma cells (Ht29) and keratinocytes (HaCaT) were exposed to the extract for 4, 8 and 24 h. Flow cytometry and caspase-3 immunostaining were used to detect apoptosis, while analysis of variance was applied to identify significant differences between groups (P < 0.05). At all timepoints, the SDEPN induced significantly different cytotoxic effects for HepG2 and Huh-7 cells compared with control cells (P < 0.001). In contrast, the SDEPN had a protective effect on HaCaT cells compared with control cells at all timepoints (P < 0.001). In caspase-3 assays, activation was detected after cell death was induced in Huh-7 and HepG2 cancer cells by the SDEPN. In combination, these results indicate that the SDEPN is selectively toxic towards cancer cell lines, yet is protective towards normal cells.

Trends in socioeconomic inequalities in cancer mortality in Barcelona: 1992–2003

Abstract Background The objective of this study was to assess trends in cancer mortality by educational level in Barcelona from 1992 to 2003. Methods The study population comprised Barcelona inhabitants aged 20 years or older. Data on cancer deaths were supplied by the system of information on mortality. Educational level was obtained from the municipal census. Age-standardized rates by educational level were calculated. We also fitted Poisson regression models to estimate the relative index of inequality (RII) and the Slope Index of Inequalities (SII). All were calculated for each sex and period (1992–1994, 1995–1997, 1998–2000, and 2001–2003). Results Cancer mortality was higher in men and women with lower educational level throughout the study period. Less-schooled men had higher mortality by stomach, mouth and pharynx, oesophagus, larynx and lung cancer. In women, there were educational inequalities for cervix uteri, liver and colon cancer. Inequalities of overall and specific types of cancer mortality remained stable in Barcelona; although a slight reduction was observed for some cancers. Conclusion This study has identified those cancer types presenting the greatest inequalities between men and women in recent years and shown that in Barcelona there is a stable trend in inequalities in the burden of cancer.

The impact of atmospheric particulate matter on cancer incidence and mortality in the city of São Paulo, Brazil

This study aimed to verify the impact of inhalable particulate matter (PM10) on cancer incidence and mortality in the city of São Paulo, Brazil. Statistical techniques were used to investigate the relationship between PM10 on cancer incidence and mortality in selected districts. For some types of cancer (skin, lung, thyroid, larynx, and bladder) and some periods, the correlation coefficients ranged from 0.60 to 0.80 for incidence. Lung cancer mortality showed more correlations during the overall period. Spatial analysis showed that districts distant from the city center showed higher than expected relative risk, depending on the type of cancer. According to the study, urban PM10 can contribute to increased incidence of some cancers and may also contribute to increased cancer mortality. The results highlight the need to adopt measures to reduce atmospheric PM10 levels and the importance of their continuous monitoring.

Bedeutung endogener Faktoren für Steady-State-Level und Reparatur oxidativer DNA-Modifikationen in Säugerzellen

Die endogene Bildung reaktiver Sauerstoffspezies (ROS) - wie beispielsweise Hydroxyl-Radikale, Superoxid-Radikalanionen, Wasserstoffperoxid und Singulett-Sauerstoff - bei essentiellen Stoffwechselreaktionen in allen aeroben Lebewesen stellt eine potentielle Gefahr für die Integrität der DNA in jeder Zelle dar. ROS generieren in der DNA unter anderem oxidative DNA-Modifikationen (zum größten Teil wahrscheinlich 8-Hydroxyguanin (8-oxoG)), welche wiederum zu einem Teil zu Mutationen führen.In dieser Arbeit wurden Untersuchungen vorgenommen, in welchem Ausmaß zum einen die Steady-State-Level oxidativer DNA-Schäden in Säugerzellen zum anderen die Reparaturgeschwindig-keiten solcher DNA-Modifikationen durch verschiedene endogene Faktoren beeinflußt werden.Im Mittelpunkt der Arbeit stand dabei die Charakterisierung der 8-Hydroxyguaninglykosylase der Säugerzellen. Sie ist das Produkt des OGG1-Gens, das erst 1997 kloniert wurde. In transfizierten Zellinien konnte durch eine konstitutive Überexpression des menschlichen OGG1-Gens demonstriert werden, daß die Reparatur von induzierten oxidativen Basenmodifikationen bis zu dreifach beschleunigt wird und daß eine Korrelation zwischen dem Grad der Überexpression und der Reparaturrate besteht. Dagegen waren die Steady-State-Level der oxidativen DNA-Schäden durch die Überexpression unbeeinflußt. Sowohl bei den spontanen Mutationsraten als auch bei den durch oxidative Schädigungen induzierten Mutationsfrequenzen konnte keine Erniedrigung bedingt durch die hOGG1-Überexpression beobachtet werden.Weitere Untersuchungen zur Bedeutung von Ogg1-Protein konnten in Mäusezellen durchgeführt werden, in denen das OGG1-homologe Mäusegen, mOGG1, homozygot inaktiviert (mOGG1(-/-)) worden war. Hierbei konnte gezeigt werden, daß in den mOGG1-defizienten Zellen im Vergleich zu den entsprechenden Wildtyp-Zellen (mOGG1(+/+)) eine Reparatur induzierter oxidativer Basenmodifikationen erst nach 8 h einsetzt, während in den Kontrollzellen schon nach 3-4 h 50 % der Modifikationen repariert waren. Die Steady-State-Level oxidativer Modifikationen in mOGG1(-/-)-Zellen waren in immortalisierten, schnell proliferierenden Mäusefibroblasten nur um den Faktor 1.4, in primären Mäusehepatocyten jedoch um den Faktor 2.5 gegenüber den Wildtyp-Zellen erhöht.Inwieweit das menschliche Reparaturprotein Xrcc1 (X-ray repair cross complementing group 1) auch an der Prozessierung oxidativer DNA-Modifikationen beteiligt ist, und ob dabei möglicherweise eine Interaktion mit Ogg1 vorliegt, wurde in der XRCC1-defizienten CHO-Zellinie EM9 untersucht. Dabei wurde ermittelt, daß weder die Steady-State-Level noch die Reparaturkinetiken der oxidativen Basenmodifikationen durch die XRCC1-Defizienz beeinflußt werden. Aufgrund weiterer Ergebnisse kann jedoch nicht ausgeschlossen werden, daß das Xrcc1-Protein zumindest am Ligationsschritt während der Reparatur oxidativer DNA-Schäden beteiligt ist.In einem weiteren Schwerpunkt der Arbeit wurde untersucht, ob Unterschiede im Steady-State-Level in Abhängigkeit von Organ-, Gewebe- und Zelltyp auftreten. Dazu wurden Untersuchungen in Bronchialkarzinom-Zellinien verschiedener Subtypen durchgeführt. Des weiteren wurde zur Frage der Zelltyp-Abhängigkeit in der menschlichen Zellinie HL60 der Einfluß des Zelldifferenzierungsstadiums auf die Steady-State-Level untersucht.

Role of caveolin-1 in the proliferation of solid tumours in vitro

Caveolin-1 (Cav-1), the essential structural constituent of caveolae, which are flask-shaped invaginations of the plasma membrane, has been found to play a key role in the modulation of cell proliferation and cancer development. It seems to act as an oncosuppressor or a promoter of growth, depending on the histotype, stage and grade of each tumour. The aim of this study was to analyze the effects of Caveolin-1 gene silencing on the proliferation of human lung cancer and osteosarcoma in vitro. Our data show that Cav-1 silencing blocks the growth in both metastatic lung cancer cell lines analyzed, suggesting a proliferation promoting action of the protein in these cells. A marked decrease of phospho-Akt, phospho-ERK, STAT3, cyclin D1, CDK4 and consequently of phospho-Rb expression was evident in the cells treated with Cav-1 siRNA. With regards to osteosarcoma, we demonstrated that the suppression of Cav-1 results in the blocking of MG-63 and in the slowing down of HOS proliferation, suggesting a role for Cav-1 as a promoter of tumour growth in these cell lines. A marked decrease of phospho-Akt, cyclin E, CDK2 and phospho-Rb and an increase of p21 expression levels were evident in the cells treated with Cav-1 siRNA. Our results suggest two new cell cycle inhibiting pathways, mediated by Cav-1 knock-down, and provide new insights into the molecular mechanisms underlying the tumour-promoting role of Cav-1 in lung cancer and osteosarcoma. In this work we also investigated the role of estrogens in lung cancer and the functional cross-talk between Cav-1 and estrogens/estrogen receptors in it. Our results show that 17β-estradiol induces proliferation either in RAL or in SCLC-R1 cells and that both cell lines are sensitive to 4-OHT antiproliferative effect. The sensitivity to estrogen stimulation seems to be gender- and/or histological type-independent in metastatic lung cancer in vitro.

Design, synthesis and biological evaluation of substituted naphthalene diimides as anticancer agents

It has been proved that naphthalene diimide (NDI) derivatives display anticancer properties as intercalators and G-quadruplex-binding ligands, leading to DNA damage, senescence and down-regulation of oncogene expression. This thesis deals with the design and synthesis of disubstituted and tetrasubstituted NDI derivatives endowed with anticancer activity, interacting with DNA together with other targets implicated in cancer development. Disubstituted NDI compounds have been designed with the aim to provide potential multitarget directed ligands (MTDLs), in order to create molecules able to simultaneously interact with some of the different targets involved in this pathology. The most active compound, displayed antiproliferative activity in submicromolar range, especially against colon and prostate cancer cell lines, the ability to bind duplex and quadruplex DNA, to inhibit Taq polymerase and telomerase, to trigger caspase activation by a possible oxidative mechanism, to downregulate ERK 2 protein and to inhibit ERKs phosphorylation, without acting directly on microtubules and tubuline. Tetrasubstituted NDI compounds have been designed as G-quadruplex-binding ligands endowed with anticancer activity. In order to improve the cellular uptake of the lead compound, the N-methylpiperazine moiety have been replaced with different aromatic systems and methoxypropyl groups. The most interesting compound was 1d, which was able to interact with the G-quadruplexes both telomeric and in HSP90 promoter region, and it has been co-crystallized with the human telomeric G-quadruplex, to directly verify its ability to bind this kind of structure, and also to investigate its binding mode. All the morpholino substituted compounds show antiproliferative activity in submicromolar values mainly in pancreatic and lung cancer cell lines, and they show an improved biological profile in comparison with that of the lead compound. In conclusion, both these studies, may represent a promising starting point for the development of new interesting molecules useful for the treatment of cancer, underlining the versatility of the NDI scaffold.

Ruolo dei recettori tirosinchinasici in oncologia animale

Disregolazioni dei recettori tirosinchinasici (RTK) sono di frequente riscontro nei tumori dell’uomo e in molti casi sono indicatori biologici che permettono di definire in maniera più accurata la prognosi dei pazienti. Possono rappresentare inoltre marker predittivi per la risposta a terapie antitumorali con farmaci a bersaglio molecolare. Numerosi inibitori tirosinchinasici (TKI) sono attualmente in corso di studio o già disponibili per l’utilizzo in oncologia umana, e molti di questi hanno dimostrato una significativa efficacia utilizzati singolarmente o in combinazione a terapie convenzionali. Studi recenti indicano che un quadro analogo di disregolazione dei recettori tirosinchinasici è presente anche nelle neoplasie dei piccoli animali, e ne suggeriscono in molti casi un’implicazione prognostica. Gli inibitori tirosinchinasi sono da poco entrati nell’arena dell’oncologia veterinaria, ma i primi risultati lasciano supporre che siano destinati ad essere integrati definitivamente nei protocolli terapeutici standard. La tesi consiste in una parte introduttiva in cui sono trattate le principali funzioni biologiche dei recettori tirosinchinasici, la loro struttura e il loro ruolo nell’oncogenesi e nella progressione tumorale in medicina umana e veterinaria. Si affrontano inoltre le principali metodiche di laboratorio per l’analisi molecolare in oncologia e i meccanismi d’azione dei farmaci inibitori tirosinchinasici, con un cenno ai prodotti maggiormente utilizzati e alle loro indicazioni. Segue la presentazione e la discussione dei risultati di quattro studi relativi alla valutazione delle disregolazioni del recettore tirosinchinasico Kit (espressione aberrante e mutazioni genomiche) nel mastocitoma cutaneo del gatto e del recettore del fattore di crescita epidermico (EGFR) nel carcinoma squamocellulare cutaneo del gatto e nei tumori polmonari primitivi del cane, con particolare attenzione al loro ruolo prognostico.

Die Rolle von IL-17 in Patienten und im Mausmodell für Lungen-Adenokarzinom

Die Funktion der Th 17-Zelllinie im Lungenkarzinom wurde noch nicht vollständig verstanden. In dieser Studie wurde darüber berichtet, dass die Expression der Th17-Zellmarker (RORA, RORC2, IL-17A) in den Lungen der Patienten mit Adenokarzinom erhöht ist, und diese mit dem Transkriptionsfaktor der regulatorischen T-Zellen FOXP 3 positiv korrelieren, was auf eine Beziehung dieser Zelltypen deutet. Außerdem hat man auch herausgefunden, dass IL-17A mit T-bet Trankriptionsfaktor in den Patienten entgegengesetzt korreliert. Die Blockade in einem Mausmodell für Lungen-Adenokarzinom resultierte die Reduktion von Tumorbefall in der Lunge, lokale Expansion der IFNg produzierenden CD4+ T-Effektorzellen und Reduktion der CD4+CD25+FOXP3+ regulatorischen T-Zellen. Untersuchungen in T-bet(-/-) Mäusen zeigten, dass die antikarzinogenen Wirkungen der antiIL-17A-Behandlung T-bet Transkriptionsfaktor benötigen, um sowohl die FOXP3 regulatorischen T-Zellen als auch die Th17-Zellen in vivo zu supprimieren. Dementsprechend hat man herausgefunden, dass der Th17-Pfad beim Fehlen des T-bet Transkriptionsfaktors durch Hochregulierung des IL-23 Rezeptors in CD4+ T-Zellen stimuliert wurde. Bemerkenswert, dass der IL-17 Rezeptor hauptsächlich auf den CD4+CD62Lhigh naiven T-Zellen exprimiert wird und sowohl auf den CD4+T-bet+ Th1- als auch auf den CD4+CD25+FOXP3+ Treg -Zellen im Tumor fehlt. Dieses resultiert den Verlust der Kontrolle der IL-17 auf Th1 und Treg-Zellentwicklung. Diese Ergebnisse deuten darauf hin, dass die Blockade des IL-17A eine mögliche klinische Behandlung darstellt, weil sie die IFNg produzierenden Th1 Zellen unterstützt und die CD4+CD25+FOXP3+ regulatorischen T Zellen in Lungen Karzinom reduziert.

Die Rolle des IL-2-Signalweges in einem murinen Adenokarzinom-Modell

Die Ursachen für die Entstehung von Lungentumoren sind vielseitig. Aus geschädigtem Drüsengewebe der Lunge kann sich die Tumorart des Adenokarzinoms entwickeln, welches zu den malignen Krebserkrankungen gehört und somit nach Etablierung eines Primärtumors metastasieren kann. Es wurde vielfach gezeigt, daß das Immunsystem bei der Bekämpfung eines mutierten Gewebes im fortschreitenden Verlauf des Tumorwachstums an Effektivität verliert. Die dahinter stehenden Mechanismen sind noch nicht ganz verstanden. Eine mögliche Ursache könnte eine fehlerhafte Regulation der Immunabwehr sein. Das Zytokin, welches bei dieser Regulation eine wichtige Rolle spielt, ist das Interleukin-2 (IL-2). Dieses aktiviert immunkompetente Zellen und gewährleistet deren Fortbestand während der Immunreaktion. In der vorliegenden Arbeit ist in einem murinen Modell von Bronchioadenokarzinom die Regulation von CD4+ T-Zellen durch IL-2 untersucht worden, beziehungsweise inwieweit eine Einflußnahme auf diese Regulation zur Verbesserung der Tumorabwehr beitragen kann. Die alpha-Kette des IL-2 Rezeptorkomplexes (CD25) ist neben dem Transkriptionsfaktor Foxp3 ein gängiger Marker für die Population der so genannten regulatorischen T-Zellen. Regulatorische T-Zellen treten im Tumorgewebe in erhöhtem Maße auf und inhibieren die gegen den Tumor gerichtete Effektorfunktion anderer Immunzellen. Durch intranasale Applikation eines anti-CD25 Antikörpers sollte, im speziellen bei den regulatorischen T-Zellen, das CD25 Molekül blockiert werden, um auf diese Weise die hochaffine Signalgebung zu unterbinden und die regulatorischen T-Zellen intratumoral zu depletieren. Es konnte gezeigt werden, daß die Blockade des IL-2 Rezeptors nicht zur Reduktion des Tumorwachstums beitrug. Trotz Applikation des Antikörpers waren die regulatorischen T-Zellen signifikant erhöht. Lediglich die Produktion des Zytokins Tumornekrosisfaktor-alpha (TNF-alpha) wurde durch die Zugabe des Antikörpers gesteigert, was aber keine Verbesserung der Tumorabwehr bewirkte. Als Alternative zur Blockade des IL-2 Rezeptors wurden verschiedene Dosen von rekombinantem IL-2 ebenfalls intranasal appliziert, um die T-Zell Populationen zusätzlich zu stimulieren. In diesem Fall war bei hohen Dosierungen eine Regression des Tumors zu erreichen. Die Regression ist auf eine erhöhte, durch das IL-2 aktivierte Produktion des Zytokins Interferon-gamma (IFN-gamma) zurückzuführen. Jedoch wurde sowohl bei der Blockade des IL-2 Rezeptors, als auch bei der Stimulation durch IL-2 ersichtlich, daß im Zusammenhang mit Adenokarzinom dem Zytokin TNF-alpha eine besondere Position zugedacht werden muß. Es ist bekannt, daß TNF-alpha in verschiedenen experimentellen Tumor-Modellen unterschiedliche Funktionen besitzt. Die Deletion des TNFs, hier dargestellt mittels TNF-knockout Mäusen, hatte eine kurative Wirkung. Die TNF-knockout Mäuse wiesen fast kein Tumorwachstum auf, die CD4+ T-Zellen aus den knockout Mäusen zeigten eine im Vergleich zum Wildtyp mehrfach höhere Produktion von IFN-gamma, bei gleichzeitiger Reduktion der regulatorischen T-Zellen. Es kann vermutet werden, daß TNF-alpha in dem verwendeten Adenokarzinom-Modell eine tumorunterstützende Wirkung hat. Dahingehend wäre die Neutralisierung der TNF-Signalgebung bei zusätzlicher Stimulation mit IL-2 als wirksamer Therapieansatz in Betracht zu ziehen.

Expression patterns of Bmi-1 and p16 significantly correlate with overall, disease-specific, and recurrence-free survival in oropharyngeal squamous cell carcinoma

BACKGROUND: The objective of this study was to link expression patterns of B-cell-specific Moloney murine leukemia virus integration site 1 (Bmi-1) and p16 to patient outcome (recurrence and survival) in a cohort of 252 patients with oral and oropharyngeal squamous cell cancer (OSCC). METHODS: Expression levels of Bmi-1 and p16 in samples from 252 patients with OSCC were evaluated immunohistochemically using the tissue microarray method. Staining intensity was determined by calculating an intensity reactivity score (IRS). Staining intensity and the localization of expression within tumor cells (nuclear or cytoplasmic) were correlated with overall, disease-specific, and recurrence-free survival. RESULTS: The majority of cancers were localized in the oropharynx (61.1%). In univariate analysis, patients who had OSCC and strong Bmi-1 expression (IRS >10) had worse outcomes compared with patients who had low and moderate Bmi-1 expression (P = .008; hazard ratio [HR], 1.82; 95% confidence interval [CI], 1.167-2.838); this correlation was also observed for atypical cytoplasmic Bmi-1 expression (P = .001; HR, 2.164; 95% CI, 1.389-3.371) and for negative p16 expression (P < .001; HR, 0.292; 95% CI, 0.178-0.477). The combination of both markers, as anticipated, had an even stronger correlation with overall survival (P < .001; HR, 8.485; 95% CI, 4.237-16.994). Multivariate analysis demonstrated significant results for patients with oropharyngeal cancers, but not for patients with oral cavity tumors: Tumor classification (P = .011; HR, 1.838; 95%CI, 1.146-2.947) and the combined marker expression patterns (P < .001; HR, 6.254; 95% CI, 2.869-13.635) were correlated with overall survival, disease-specific survival (tumor classification: P = .002; HR, 2.807; 95% CI, 1.477-5.334; combined markers: P = .002; HR, 5.386; 95% CI, 1.850-15.679), and the combined markers also were correlated with recurrence-free survival (P = .001; HR, 8.943; 95% CI, 2.562-31.220). CONCLUSIONS: Cytoplasmic Bmi-1 expression, an absence of p16 expression, and especially the combination of those 2 predictive markers were correlated negatively with disease-specific and recurrence-free survival in patients with oropharyngeal cancer. Therefore, the current results indicate that these may be applicable as predictive markers in combination with other factors to select patients for more aggressive treatment and follow-up. Cancer 2011;. © 2011 American Cancer Society.