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1.
J Clin Oncol ; 19(11): 2837-43, 2001 Jun 01.
Artículo en Inglés | MEDLINE | ID: mdl-11387355

RESUMEN

PURPOSE: To study bone marrow micrometastases from colorectal cancer patients for the presence of K-ras mutations and to compare their genotype with that of the corresponding primary tumor. PATIENTS AND METHODS: Bilateral iliac crest aspiration was performed in 51 patients undergoing surgery for colorectal cancer, and bone marrow micrometastases were detected by immunohistochemistry. The presence of K-ras mutations was determined by single-strand conformation polymorphism analysis on both primary tumors and paired bone marrow samples and was confirmed by sequencing. RESULTS: In six patients with primary tumor mutations, it was possible to amplify a mutated K-ras gene also from the bone marrow sample. In three of those patients the pattern of K-ras mutations differed between both samples, in two patients the mutation was identical between the bone marrow and its primary tumor, and in one patient the same mutation plus a different one were found. Fifteen of 17 K-ras mutations found in primary tumors were located in codon 12, whereas in bone marrow, five of seven mutations were found in codon 13 (P =.003). CONCLUSION: Our results demonstrate that, at least for K-ras mutations, disseminated epithelial cells are not always clonal with the primary tumor and they question the malignant genotype of bone marrow micrometastases. They also indicate that different tumoral clones may be circulating simultaneously or sequentially in the same patient. Analysis of the type of mutations suggests that cell dissemination might be an early event in colorectal carcinogenesis.


Asunto(s)
Neoplasias de la Médula Ósea/genética , Neoplasias de la Médula Ósea/secundario , Neoplasias Colorrectales/genética , Neoplasias Colorrectales/patología , ADN de Neoplasias/genética , Genes ras/genética , Anciano , Transformación Celular Neoplásica , Células Clonales , Codón , Análisis Mutacional de ADN , Femenino , Genotipo , Humanos , Masculino , Persona de Mediana Edad , Células Neoplásicas Circulantes , Reacción en Cadena de la Polimerasa , Estudios Prospectivos
2.
J Biol Chem ; 276(36): 33319-27, 2001 Sep 07.
Artículo en Inglés | MEDLINE | ID: mdl-11423551

RESUMEN

Transcriptional elongation of many eukaryotic, prokaryotic, and viral genes is tightly controlled, which contributes to gene regulation. Here we describe this phenomenon for the MAP kinase phosphatase 1 (MKP-1) immediate early gene. In rat GH4C1 pituitary cells, MKP-1 mRNA is rapidly and transiently induced by the thyrotropin-releasing hormone (TRH) and the epidermal growth factor EGF via transcriptional activation of the gene. Ca(2+) signals are necessary for the induction of MKP-1 in response to TRH but not to EGF. Reporter gene analysis with the newly cloned rat promoter sequence shows only limited induction in response to various stimuli, including TRH or EGF. By nuclear run-on assays we demonstrate that in basal conditions, a strong block to elongation in the first exon regulates the MKP-1 gene and that stimulation with either TRH or EGF overcomes the block. Ca(2+) signals are important to release the MKP-1 elongation block in a manner similar to the c-fos oncogene. These results suggest that a common mechanism of intragenic regulation may be conserved between MKP-1 and c-fos in mammalian cells.


Asunto(s)
Calcio/farmacología , Proteínas de Ciclo Celular , Exones , Regulación Enzimológica de la Expresión Génica , Proteínas Inmediatas-Precoces/genética , Proteínas Inmediatas-Precoces/metabolismo , Neuronas/metabolismo , Fosfoproteínas Fosfatasas , Proteínas Tirosina Fosfatasas/genética , Proteínas Tirosina Fosfatasas/metabolismo , Transcripción Genética , Animales , Secuencia de Bases , Northern Blotting , Southern Blotting , Núcleo Celular/metabolismo , Células Cultivadas , Clonación Molecular , Fosfatasa 1 de Especificidad Dual , Factor de Crecimiento Epidérmico/metabolismo , Genes Reporteros , Intrones , Datos de Secuencia Molecular , Regiones Promotoras Genéticas , Proteína Fosfatasa 1 , Proteínas Proto-Oncogénicas c-fos/metabolismo , ARN Mensajero/metabolismo , Ratas , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Homología de Secuencia de Ácido Nucleico , Hormona Liberadora de Tirotropina/metabolismo , Factores de Tiempo , Activación Transcripcional
3.
Pharmacogenomics J ; 1(2): 142-51, 2001.
Artículo en Inglés | MEDLINE | ID: mdl-11911441

RESUMEN

Two-dimensional polyacrylamide gel electrophoresis (2-D PAGE) is increasingly used for target discovery in human disease to complement genomic studies. We have assessed the possibilities and limits of 2-D PAGE applied to human colorectal cancer. Up to 10(8) epithelial cells were purified from paired normal and pathological biopsies using Ber-EP4 coated magnetic beads, allowing the elimination of cellular and fluid contaminations. The mean coefficient of variation (CVAR) of repeated 2-D PAGE analysis with silver staining was lying between 20 and 28%. However, only 47% (interrun) to 76% (intrarun) of spots could be matched within a triplicate experiment. Interindividual phenotypic variability was high. Intratumoral phenotypic variability was not found to be significant. When method and tumor variability were added, 90% of CVAR were inferior to 48%. Thus, two-fold up- or down-regulation of protein expression reveals biological significance. Serial paired comparison of 923 proteins in 10 patients showed highly reproducible differences between normal and cancer tissues. Under well defined experimental conditions and after the high variability of the technique has been considered, 2-D PAGE parallel analysis of paired colorectal samples allows patient-specific tumor profiling.


Asunto(s)
Neoplasias Colorrectales/genética , Proteínas de Neoplasias/genética , Proteoma/genética , Neoplasias Colorrectales/patología , Electroforesis en Gel Bidimensional , Células Epiteliales/patología , Humanos , Procesamiento de Imagen Asistido por Computador , Proteínas de Neoplasias/biosíntesis , Fenotipo , Biosíntesis de Proteínas , Desnaturalización Proteica , Proteínas/genética , Estándares de Referencia , Valores de Referencia , Reproducibilidad de los Resultados , Tinción con Nitrato de Plata , Manejo de Especímenes
4.
Br J Cancer ; 82(3): 535-7, 2000 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-10682661

RESUMEN

A polymorphism in hMSH2 gene has been associated with an increased susceptibility to develop colorectal cancer (CRC). Here we show that it is a genetic risk factor for CRC in the Spanish population. However, its presence does not apparently affect hMSH2 function.


Asunto(s)
Empalme Alternativo , Neoplasias Colorrectales/genética , Proteínas de Unión al ADN , Intrones , Polimorfismo Genético , Proteínas Proto-Oncogénicas/genética , Adulto , Anciano , Anciano de 80 o más Años , Secuencia de Bases , Cartilla de ADN , Exones , Humanos , Persona de Mediana Edad , Proteína 2 Homóloga a MutS
5.
Cancer Res ; 60(1): 129-33, 2000 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-10646864

RESUMEN

The INK4a/ARF locus encodes two cell cycle-regulatory proteins, p16INK4a andp14ARF, which share an exon using different reading frames. p14ARF antagonizes MDM2-dependent p53 degradation. However, no point mutations in p14ARF not altering p16INK4a have been described in primary tumors. We report that p14ARF is epigenetically inactivated in several colorectal cell lines, and its expression is restored by treatment with demethylating agents. In primary colorectal carcinomas, p14ARF promoter hypermethylation was found in 31 of 110 (28%) of the tumors and observed in 13 of 41 (32%) colorectal adenomas but was not present in any normal tissues. p14ARF methylation appears in the context of an adjacent unmethylated p16INK4a promoter in 16 of 31 (52%) of the carcinomas methylated at p14ARF. Although p14ARF hypermethylation was slightly overrepresented in tumors with wild-type p53 compared to tumors harboring p53 mutations [19 of 55 (34%) versus 12 of 55 (22%)], this difference did not reach statistical significance. p14ARF aberrant methylation was not related to the presence of K-ras mutations. Our results demonstrate that p14ARF promoter hypermethylation is frequent in colorectal cancer and occurs independently of the p16INK4a methylation status and only marginally in relation to the p53 mutational status.


Asunto(s)
Proteínas Portadoras/genética , Neoplasias Colorrectales/genética , Silenciador del Gen , Genes p53/genética , Proteínas/genética , Proteínas Portadoras/metabolismo , Neoplasias Colorrectales/metabolismo , Islas de CpG , Inhibidor p16 de la Quinasa Dependiente de Ciclina , Metilación de ADN , Genes ras/genética , Células HL-60 , Humanos , Polimorfismo Conformacional Retorcido-Simple , Proteínas/metabolismo , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Células Tumorales Cultivadas , Proteína p14ARF Supresora de Tumor
6.
Clin Cancer Res ; 5(11): 3454-9, 1999 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-10589758

RESUMEN

Previous studies have shown that allelic losses in a locus mapping to the chromosomal region 4p14-16 are indicative of poor prognosis in colorectal cancer. To further characterize the region involved and to confirm earlier observations, we have analyzed losses of heterozygosity (LOH) in nine microsatellite markers spanning this region in a prospective series of 181 colorectal carcinomas. The extent and the nature of the allelic imbalance were also ascertained by comparative genomic hybridization analysis of selected cases. The minimum common deleted region was confined to marker D4S2397 (LOH in 35% of the informative cases). Surrounding markers displayed LOH in 13-25% of informative cases and (other than the D4S2397 marker itself) showed a higher rate of allelic imbalances in association with mutations in the p53 tumor suppressor gene. Tumors with lymph node invasion also displayed increased rates of LOH in most markers. Regarding patient outcome, LOH solely at the D4S2397 locus was indicative of a shorter disease-free survival (P = 0.027). In consequence, two patterns of allelic loss are defined within the 4p14-16 region: (a) gross losses associated with tumor progression and probably attributable to the genomic instability related to the inactivation of the p53 tumor suppressor gene; and (b) specific losses limited to the D4S2397 locus (within an estimated fragment of 2 Mb) and associated with increased tumor aggressiveness. The presence of one or more putative tumor suppressor genes in this region is postulated.


Asunto(s)
Cromosomas Humanos Par 4 , Neoplasias Colorrectales/genética , Pérdida de Heterocigocidad , Repeticiones de Microsatélite , Alelos , Mapeo Cromosómico , Codón , Neoplasias Colorrectales/mortalidad , Neoplasias Colorrectales/patología , Neoplasias Colorrectales/cirugía , Supervivencia sin Enfermedad , Estudios de Seguimiento , Genes p53 , Genes ras , Marcadores Genéticos , Humanos , Metástasis Linfática , Valor Predictivo de las Pruebas , Pronóstico , Recurrencia , Estudios Retrospectivos , Tasa de Supervivencia , Factores de Tiempo
7.
Oncogene ; 18(30): 4383-7, 1999 Jul 29.
Artículo en Inglés | MEDLINE | ID: mdl-10439046

RESUMEN

Malignant transformation of the cell is accompanied and characterized by disruption of genetic material and aberrant expression of multiple genes. Systematic analysis of differential gene expression in human tumor samples may provide an estimate of the degree of genetic and epigenetic deregulation in neoplastic cells. We have assessed, by means of a RNA differential display technique, the overall gene expression deregulation in a prospectively collected series of 68 human colorectal carcinomas. An index of differential expression has been calculated for each case. A similar proportion of the displayed sequences (23%) was under- and over-represented in the tumor in respect of the normal tissue. An increased variation in the expression profile was observed in advanced Dukes' stages (P < 0.02) and correlated with lymph node invasion (P < 0.05). Furthermore, a diminished overall survival was associated to increased rates of deregulation (Log-rank, P < 0.02) and especially down-regulation (P < 0.001). When Cox multivariate analysis was performed in front of Dukes' stage, both indexes of differential expression were independent indicators of a worse outcome (P = 0.05 and P < 0.01 respectively). We conclude that estimation of the fraction of differentially displayed tags by RNA fingerprinting may have relevant applications in the prognostic assessment of colorectal cancer.


Asunto(s)
Neoplasias Colorrectales/patología , Regulación Neoplásica de la Expresión Génica , Northern Blotting , Neoplasias Colorrectales/diagnóstico , Femenino , Técnicas Genéticas , Humanos , Masculino , Modelos Estadísticos , Reacción en Cadena de la Polimerasa , Pronóstico , ARN/análisis , Factores de Tiempo
8.
J Clin Oncol ; 17(5): 1375-81, 1999 May.
Artículo en Inglés | MEDLINE | ID: mdl-10334521

RESUMEN

PURPOSE: p53 gene and K-ras mutations are among the most common genetic alterations present in colorectal cancer. The prognostic utility of such mutations remains controversial. The purpose of this study was to prospectively evaluate the prognostic significance of p53 and K-ras gene mutations in colorectal cancer. PATIENTS AND METHODS: One hundred forty patients were analyzed. Tumors belonging to the microsatellite mutator phenotype were excluded (n = 8). Mutations at the K-ras and p53 genes were detected and characterized by restriction fragment length polymorphism, single-strand conformation polymorphism, and sequencing, as appropriate. RESULTS: p53 mutations were detected in 66 (50%) and K-ras mutations were detected in 54 (41%) of the 132 patients. In 26 cases (20%), ras and p53 mutations coexisted; in 38 cases (29%), neither mutation was found. Multivariate analysis of the whole population analyzed (n = 132) showed that survival was strongly correlated with the presence of p53 mutations alone or in combination with K-ras mutations (P = .002; log-rank test). When only patients undergoing a radical resection were considered (R0; n = 101), p53 mutations were no longer of prognostic significance. CONCLUSION: p53 mutations alone or in combination with K-ras mutations are correlated with a worse outcome. However, the routine use of these mutations as prognostic markers in the clinical setting is not recommended.


Asunto(s)
Neoplasias Colorrectales/genética , Genes p53/genética , Genes ras/genética , Adulto , Anciano , Anciano de 80 o más Años , Análisis de Varianza , Codón/genética , Neoplasias Colorrectales/mortalidad , Neoplasias Colorrectales/patología , Femenino , Humanos , Masculino , Repeticiones de Microsatélite/genética , Persona de Mediana Edad , Estadificación de Neoplasias , Reacción en Cadena de la Polimerasa , Polimorfismo de Longitud del Fragmento de Restricción , Pronóstico , Estudios Prospectivos , Análisis de Regresión , Tasa de Supervivencia
9.
Br J Cancer ; 77(12): 2349-56, 1998 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-9649157

RESUMEN

C-myc gene activation is a common event in multiple types of neoplasia and has been associated with different cellular processes relevant to the malignant transformation of cancer cells. C-myc gene amplification has been analysed in colorectal carcinomas by means of an innovative DNA fingerprinting method based on the arbitrarily primed PCR. This method requires a low amount of DNA, uses multiple internal controls and appears sensitive and reproducible. Clinicopathological and molecular correlates have been investigated in a series of 70 colorectal carcinomas. The incidence of c-myc amplification was 26%, ranging from two- to fivefold increase in copy number. C-myc amplification occurrence was more frequent in more advanced stages of tumour invasion (P < 0.001) and was associated with mutations in the p53 tumour-suppressor gene (P = 0.048). The presence of c-myc amplification was indicative of a shorter disease-free survival period but, because of its strong association with Dukes' stage, its prognostic value is questionable.


Asunto(s)
Neoplasias Colorrectales/genética , Neoplasias Colorrectales/patología , Amplificación de Genes , Genes myc , Adulto , Anciano , Anciano de 80 o más Años , Alelos , Dermatoglifia del ADN , Cartilla de ADN , ADN de Neoplasias/genética , Femenino , Regulación Neoplásica de la Expresión Génica , Genes p53 , Humanos , Masculino , Persona de Mediana Edad , Mutación , Estadificación de Neoplasias , Reacción en Cadena de la Polimerasa/métodos , Activación Transcripcional
10.
Lab Invest ; 78(3): 309-17, 1998 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-9520944

RESUMEN

RNA arbitrarily primed (RAP)-PCR is a powerful tool for studying differential gene expression in cancer cells. Systematic analysis of human tumor samples may provide a list of markers with potential application to the diagnosis, prognostic assessment, and treatment of the disease. Nevertheless, because of characteristics inherent to the samples and technique, artifactual results are likely. We have assessed the effects of several factors on RAP-PCR performance to determine the sensitivity and reproducibility of the technique, as well as the accuracy of its results, under different conditions in human cell lines and in a series of 129 paired human normal colonic mucosa-colorectal carcinoma samples. Our results show that RAP-PCR provides reliable fingerprints in a relatively wide spectrum of circumstances, including variations in RNA concentration and contamination by DNA. Densitometric analysis indicated that relative band-intensity variations more than 20% were reproducible in 95% of the cases. Serial analysis of paired normal-tumor cases yielded a number of bands that were recurrently either underexpressed or overexpressed in tumor relative to normal mucosa. These differentially expressed bands are prime targets of research because they represent candidate tumor-specific up- or down-regulated genes with a relevant role in carcinogenesis.


Asunto(s)
Neoplasias Colorrectales/genética , Expresión Génica/genética , Reacción en Cadena de la Polimerasa/métodos , ARN Neoplásico/genética , Dermatoglifia del ADN/métodos , Humanos , Mucosa Intestinal/fisiología , Valores de Referencia , Reproducibilidad de los Resultados , Sensibilidad y Especificidad , Células Tumorales Cultivadas
11.
J Clin Oncol ; 15(10): 3230-40, 1997 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-9336360

RESUMEN

PURPOSE: Here we evaluate the prognostic significance of the relative value of genomic damage assessed by DNA fingerprinting in colorectal cancer. MATERIALS AND METHODS: Sixty-three tumor and paired normal mucosa samples were included in the study. Genomic damage was assessed by comparative analysis of paired normal and tumor tissue DNA fingerprints by the arbitrarily primed polymerase chain reaction (AP-PCR). Decreases and increases of intensity in bands were computed and referred to the total number of visualized bands per case. An index reflecting the genomic damage fraction (GDF), with separated values for losses and gains, was obtained for each tumor. This index was used to determine molecular and clinicopathologic correlates after exclusion of eight cases displaying microsatellite instability. RESULTS: Fifty-five cases were considered for the statistical analysis. The average fraction of altered bands per tumor was 0.287+/-0.121. When losses and gains were computed separately, the average fraction of changes was 0.126+/-0.113 and 0.161+/-0.120, respectively. Tumors lacking a ras mutation showed an increased GDF, primarily because of a higher fraction of gains. Tumors that were at advanced Dukes' stages and that were poorly differentiated also displayed a higher GDF. Finally, disease-free survival was significantly diminished in tumors with a GDF greater than 0.314 (P < .001). The prognostic significance of the GDF was independent of Dukes' stage (Cox multivariate analysis, P = .005). CONCLUSION: The degree of genomic damage assessed by unbiased DNA fingerprinting correlates with genotypic, phenotypic, and clinical variables in colorectal carcinoma and may be useful in assessing prognosis in colorectal cancer.


Asunto(s)
Neoplasias Colorrectales/genética , Daño del ADN , Dermatoglifia del ADN , ADN de Neoplasias/genética , Anciano , Anciano de 80 o más Años , Neoplasias Colorrectales/mortalidad , Supervivencia sin Enfermedad , Femenino , Genes p53/genética , Genes ras/genética , Humanos , Masculino , Repeticiones de Microsatélite , Persona de Mediana Edad , Mutación , Reacción en Cadena de la Polimerasa , Pronóstico
12.
Electrophoresis ; 18(3-4): 622-4, 1997.
Artículo en Inglés | MEDLINE | ID: mdl-9150950

RESUMEN

Large tissue samples from ten patients operated for colorectal cancer were prepared in the operating room in iced phosphate buffered saline, containing ethylene diaminetetraacetic acid and protease inhibitors. After cutting the specimens into small fragments, the tissues were gently pressed through a steel mesh. Membranes were permeabilized in chilled ethanol 70% to allow cytosolic fluoresceine isothiocyanate labeling, performed with anti-cytokeratin (CAM 5.2) antibodies. Samples were quantitatively sorted with a fluorescence activated cell sorter (FACS) and denatured before processing separation by two-dimensional electrophoresis on polyacrylamide gels. This procedure made it possible to sample about 4 x 10(7) viable normal and tumoral cells before fixation, and up to 4 x 10(6) cells after FACS. The gels run before and after fixation showed no major differences. The rate of cytokeratin-positive cells in the samples was the following (mean, CI 5-95%): mucosa 29.5% (8.9-66.7%), tumor 44.3% (6.6-94.8%). The epithelial cell content in colorectal cancer and normal mucosa shows important intersample variations. This is important for any comparison of fresh samples, whether at DNA, RNA, or at the protein level. We propose a method allowing the preparation of pure epithelial cell samples from normal and tumoral colonic fresh mucosa.


Asunto(s)
Neoplasias Colorrectales/patología , Electroforesis en Gel Bidimensional/métodos , Humanos
13.
Artículo en Alemán | MEDLINE | ID: mdl-9574342

RESUMEN

An European research network grouping surgeons, pathologists, biochemists and molecular biologists is presented. The aim of this network is to define new diagnostic, prognostic and therapeutic markers at protein and RNA levels in colorectal cancer. The methodology is based on specific sample preparation techniques, allowing the isolation of pure epithelial cells, and on differential-display techniques, such as two-dimensional polyacrylamide gel electrophoresis (2D-PAGE) and reverse arbitrarily-primed polymerase chain reaction (RAP-PCR).


Asunto(s)
Neoplasias Colorrectales/genética , Cooperación Internacional , Grupo de Atención al Paciente , Fenotipo , Biomarcadores de Tumor/genética , Neoplasias Colorrectales/patología , Epitelio/patología , Regulación Neoplásica de la Expresión Génica/fisiología , Humanos , Mucosa Intestinal/patología , Proteínas de Neoplasias/genética , Pronóstico , ARN Neoplásico/genética
14.
Electrophoresis ; 18(15): 2842-8, 1997 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-9504818

RESUMEN

New diagnostic and prognostic markers are needed in colorectal cancer. They can be found by differential analysis at DNA, RNA or protein level. The accuracy of phenotypic comparisons of tumor and normal tissues depends on the purity of the samples. We present an effective method to identify and isolate proteins that are differentially expressed under altered conditions, and a two-dimensional reference protein map of the normal human colonic epithelium. Normal colonic mucosa, primary tumors and liver metastases were prepared in the operating room. After washing in an ice-cold medium containing protease inhibitors, crypts were isolated by mechanical preparation without using metalloproteinases. Epithelial cells were then selected using Ber-EP4 Dynabeads. The samples were denaturated before processing for immobilized pH gradient two-dimensional polyacrylamide gel electrophoresis according to SWISS-2DPAGE standards. The samples contained more than 95% epithelial cells as confirmed by fluorescence-activated cell sorting using pan-anticytokeratin antibodies. Cell surfaces were not damaged, as assessed by scanning electronic microscope. A protein reference map of the normal colonic epithelium was defined. Using gel matching, N-terminal sequencing and/or immunoblotting techniques, 60 polypeptides - including proteins specifically expressed in colorectal epithelium - have now been identified. This reproducible method of sample preparation permits the comparison of protein patterns found in various pathological states with the present reference map (http://www.expasy.ch). Some of these patterns might provide diagnostic or prognostic markers, or even molecular targets for therapy in the future.


Asunto(s)
Neoplasias Colorrectales/metabolismo , Electroforesis en Gel Bidimensional , Regulación Neoplásica de la Expresión Génica/fisiología , Mucosa Intestinal/metabolismo , Células Epiteliales/metabolismo , Humanos , Proteínas de Neoplasias/metabolismo , Mapeo Peptídico , Estándares de Referencia , Factores de Tiempo
15.
Clin Cancer Res ; 2(11): 1887-94, 1996 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-9816145

RESUMEN

The Bcl-2 proto-oncogene extends cell survival but does not confer any proliferative advantage to cells that express it. Thus, the loss of apoptosis may have a role in progression allowing the acquisition of additional mutations. To determine whether apoptosis loss at diagnosis is associated with the metastatic advantage of ductal breast carcinomas and to examine the relationship between Bcl-2 expression, p53, and tumor cell death status, we examined tumor samples from 116 patients diagnosed with T1 (2 cm or less) breast cancer with (n = 49) or without (n = 67) lymph node metastases. Apoptosis loss in histological sections was considered when <1% of tumor nuclei were stained with terminal deoxynucleotidyl transferase labeled with biotin. We studied the expression of Bcl-2 and p53 by immunohistochemistry and in 37 p53 mutations by single-strand conformational polymorphism analysis and cycle sequencing. Multivariate logistic regression modeling was used to estimate prevalence odds ratios (pORs) for apoptosis loss and presence of lymph node metastases. Patients with marked apoptosis loss in their tumor cells were about 5 times more likely to present lymph node metastases than those with no apoptosis loss in their tumor cells (adjusted pOR, 4.7; 95% confidence interval, 1.4-15.6; trend test, P = 0.008). Bcl-2 expression was strongly associated with both apoptosis loss (pOR, 6.9; trend test, P < 0.0001) and presence of lymph node metastases (pOR, 5.7; trend test, P = 0.002). These associations were more evident in histological grade I and II tumors than in poorly differentiated histological grade III tumors and in p53-negative tumors than in p53-positive tumors. This study demonstrates for the first time that the lymphatic progression of T1 human breast cancer is strongly related to apoptosis loss.


Asunto(s)
Apoptosis , Biomarcadores de Tumor/biosíntesis , Neoplasias de la Mama/patología , Proteínas Proto-Oncogénicas c-bcl-2/biosíntesis , Adulto , Anciano , Biomarcadores de Tumor/genética , Neoplasias de la Mama/metabolismo , División Celular/genética , Femenino , Humanos , Inmunohistoquímica , Metástasis Linfática , Persona de Mediana Edad , Mutación , Invasividad Neoplásica , Proto-Oncogenes Mas , Proteína p53 Supresora de Tumor/biosíntesis , Proteína p53 Supresora de Tumor/genética
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