2 Clinical Pathology Service, Polo Oncologico Regina Elena, Rome, Italy; 3 Laboratory of Ultrastructures, Istituto Superiore di Sanitá, Viale Regina Elena 299, 00161 Rome, Italy; 4 Surgical Department, Polo Oncologico Regina Elena, Rome, Italy; 5 Department of Drug Research and Evaluation, Istituto Superiore di Sanitá, Viale Regina Elena 299, 00161 Rome, Italy; 6 Pathological Anatomy Service, Polo Oncologico Regina Elena, Rome, Italy; 7 Service of Statistics, Polo Oncologico Regina Elena, Rome, Italy; 8 Digestive Endoscopy Service, Polo Oncologico Regina Elena, Rome, Italy; and 9 Institute of Neuroscience, National Research Council, Rome, Italy
Received on March 5, 2004; revised on April 23, 2004; accepted on April 27, 2004
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Abstract |
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Key words: galectin-3 / CD44v6 / colon / adenoma / carcinoma / K-ras
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Introduction |
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Interestingly, transformation of intestinal epithelial cells by the K-ras oncogene family is required for the full manifestation of the malignant phenotype and also leads to the so-called anoikis resistance (Pajkos et al., 2000; Rosen et al., 2000
; Zauber et al., 2001
). Moreover, human colorectal tumors bearing a codon 12 mutation (K12) are aggressive, invasive, and highly metastatic (Guerrero et al., 2000
). This mutation may increase aggressiveness by the differential regulation of K-ras downstream pathways that lead to inhibition of apoptosis, enhanced loss of contact inhibition, and increased predisposition to anchorage-independent growth, that is, anoikis resistance (Guerrero et al., 2000
). Accordingly, K-ras codon 12 mutations are much more frequent in carcinomas than in adenomas (ADs; Capella et al., 1991
) and in metastatic than in nonmetastatic lesions (Finkelstein et al., 1993
). Altogether these findings suggest a relationship between K12 ras codon mutation with both adhesion processes of colorectal epithelial cells and cancer progression.
The aim of the present study was to investigate whether the surface expression of the galectin-related molecules Gal-3 and CD44 v6, whose expression was found altered during deregulated cell growth and malignant transformation, could be a reliable immunocytochemical markers for improving the diagnostic accuracy of conventional histology in both colon AD and adenocarcinoma (ADK). There is not enough knowledge about the function of CD44 molecules, but the expression of CD44 v6 variant was found to be necessary and sufficient factor to confer metastatic potential to some carcinoma cell lines (Gunthert et al., 1991; Jothy, 2003
). In the present article, the evaluation of the expression of both adhesion molecules was conducted in ex vivo samples from AD and ADK in comparison with healthy mucosal samples from the same patients. More important, together with the "conventional" immune-histological approach, our analyses were carried out by using for the first time in this kind of studies tumor "cellularization" methodology (Cerra et al., 1990
) and subsequent flow cytometry (FC) evaluations of dispersed cells. In fact, in consideration of the importance of cell surface expression of CAMs in cell fate, the FC technique seems to represent the most suitable approach. The results obtained clearly indicated that Gal-3 overexpression on the surface of nonmalignant colon cancer cells, with respect to cells from normal mucosa, was paralleled by an increase of its ligand (90k) in blood plasma of the patients.
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Results |
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Quantitative evaluation of Gal-3 and CD44 v6 surface expression in AD and ADK
FC studies allowed us to quantify the surface expression of molecules on isolated living cells from 46 AD and 58 ADK together with their normal counterparts, that is, the normal mucosa (NM) obtained as specified in Materials and methods section. Results obtained are summarized in Figure 3A and 3B, where the distribution of Gal-3 and CD44 v6 expression levels in NM, AD, and ADK are shown. These distributions were statistically analyzed by Wilcoxon tests as reported in Figure 3C (Gal-3) and 3D (CD44 v6), where median values of these distributions are reported. The analysis revealed (1) for AD: A significant increase with respect to NM for Gal-3 surface antigenic expression (z = 2.61, p = 0.009, Fig. 3C), but no significant difference was detected for CD44 v6, Fig. 3D). (2) Conversely for ADK: A significant increase of CD44 v6 surface expression in ADK with respect to NM (z = 2.47, p = 0.001, Fig. 3D), but no significant difference was detected for Gal-3 (Fig. 3C). Finally, regarding Gal-3 expression, Mann-Whitney tests failed to reveal any significant difference between AD and ADK samples. By contrast, regarding CD44 v6, a significant difference (p < 0.01) was detected between the same samples. Hence Gal-3 seems to represent an earlier cell surface marker with respect to CD44 v6 in colon cancer cells, that is, Gal-3 was overexpressed in cells from AD, whereas CD44 v6 was overexpressed on the surface of malignant adenocarcinomatous lesions in comparison with the NM of the same patient.
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Gal-3 and CD44 v6 protein expression in relation to clinicopathological features
The variation of Gal-3 or CD44 v6 expression in neoplastic lesions (both AD and ADK) versus NM was analyzed. Results obtained from 46 AD and 58 ADK (Tables I and II, respectively) indicated a positive trend between the protein expression and some of the variables known to be linked to a risk of transformation in AD patients. In particular (Table I), an increase of Gal-3 expression was found in a high percentage of pathological lesions obtained from severely dysplastic tissue (67.0%) in left colon (82.7%), but it was also largely detected in cells from moderately dysplastic lesions (55.5%). Furthermore, increased expression of Gal-3 was preferentially associated with tubulo-villous/villous lesions (61.3%) features. However, statistical analyses failed to reveal any significant difference between right colon and left colon as well as between mildmoderate lesions and severe dysplastic lesions (Table I). By contrast, regarding CD44 v6, a significant difference (p < 0.01) was detected. Interestingly, regarding ADK, an increased expression of Gal-3 in a high percentage (54.5%) of smaller size tumors (T1T2) was found (Table II).
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Discussion |
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Interestingly, Gasbarri and co-workers (1999) have provided evidence that coexpression of CD44 v6 and Gal-3 can help distinguish between benign and malignant thyroid lesions, especially between well-differentiated follicular carcinomas versus benign follicular proliferation of the thyroid gland. Our results on this matter seem to depict a different scenario as far as colon cancers are concerned. In fact, Gal-3 expression was found significantly higher on the surface of cells from AD samples with respect to the corresponding healthy mucosal cells. Thus on the basis of FC quantitative results, we propose to ascribe to Gal-3 overexpression an important role in the first steps of colon cell transformation. These results were paralleled by the increase of the Gal-3 ligand 90k in the plasma of those patients with an increased Gal-3 cell surface expression. This is in accordance with the fact that circulating 90k has been reported to up-regulate the expression of CAMs in tumor cells. It was also found at high levels in plasma of patients with various types of cancers, such as breast, colon, stomac, ovary, and lung (Natoli et al., 1996
). This increase strongly suggested a role for 90k as a possible progression marker in neoplastic disorders (Nakamura et al., 1999
; Scambia et al., 1988
).
FC analyses seem to provide an intriguing approach in terms of valuable quantitative analysis of cell surface antigenic expression. In fact, although the bulk of studies reported in the literature are generally carried out by using qualitative analyses, such as IH, our studies, carried out on isolated cells from bioptic samples, were instead a valuable quantification thanks to a procedure preserving the bioavailability of molecule antigenic expression. The results obtained by analytical cytology appear, however, to be strongly correlated to those detected by conventional histopathology analysis. Importantly, this correlation was even more evident for CD44 v6 (82%) than for Gal-3 (60%) expression. This could be due to the fact that Gal-3 is present both into the cell cytoplasm and on the cell surface, whereas CD44 v6 is solely expressed on the cell surface, where it plays its function. In fact, IH analysis revealed both intracytoplasmic as well as cell surface molecules, whereas FC, performed in living (propidium iodidenegative), nonpermeabilized cells, was able to identify cell surface molecules only. Data reported in the literature suggested that such a biological effect of Gal-3 was mainly related with its surface expression rather than to its intracellular presence. In addition, apoptotic proneness and anoikis resistance associated to the surface expression of certain CAMs, including Gal-3, have also been evidenced (Kim et al., 1999; Matarrese et al., 2000
). Hence, our results are consistent with the key role played by Gal-3 surface expression as cell growth regulatory molecule (Danguy et al., 2002
; Matarrese et al., 2000
). Another clue suggesting a role for Gal-3 in suppressing apoptosis has been provided by studies performed in nonadhering cells (i.e., Jurkat cells), where, thanks to a sequence similarity between Gal-3 and Bcl-2, the intracytoplasmic Gal-3 could directly interact with Bcl-2 by a NWGR motif to form heterodimers, thus interfering with apoptotic pathway (Yang et al., 1996
).
Recent lines of evidence have also implicated Gal-3 as a regulator of immune cell homeostasis (Fukumori et al., 2003; Rabinovich et al., 2002
). In fact, soluble Gal-3 (e.g., secreted by tumor cells) was found to represent a powerful apoptotic inducer in human T cells. Thus Gal-3 might also contribute to the immune escape strategy exerted by cancer cells (Fukumori et al., 2003
).
Finally, K12 ras gene mutation in colorectal cancer has been hypothesized to represent a risk factor per se in colon cancer progression (Guerrero et al., 2000; Zhu et al., 1997
). Accordingly, our results seem to indicate that changes in CD44 v6 molecule expression were associated with K12 gene mutation, whereas Gal-3 molecule overexpression was not. These results differ from those recently reported on thyroid tumors where follicular carcinoma with K-ras mutations very often dispalyed a Gal-3-negative phenotype and were either minimally or overtly invasive (Nikiforova et al., 2003
). However, on the basis of the results obtained, the possibility that Gal-3 overexpression could represent an early event preceding K-ras gene mutation in adenomatous nonmalignant lesions cannot be ruled out. In fact, a higher expression of Gal-3 was found in AD from wild-type K-ras patients with respect to patients with mutated K-ras. In same vein, according to literature data (Kim et al., 1994
), the expression of CD44 v6 molecule was significantly higher (p < 0.01) in wild-type K-ras samples.
Altogether these results indicate that Gal-3 overexpression might represent per se a useful marker of colon adenoma and, together with the evaluation of its ligand in the blood plasma (90k molecule), it could contribute to the characterization of both malignant and nonmalignant colon cancers.
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Materials and methods |
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Assay for Gal-3 ligand
The 90k molecule is a secreted glycoprotein that binds galectins, in particular Gal-3 (Inohara et al., 1996). The concentration of 90k molecule in the plasma of the patients considered herein was evaluated using a commercial enzyme-linked immunosorbent assay kit (R&D Systems, Minneapolis, MN). Plasma aliquots were assayed for 90k content according to the manufacturer's instructions. The light emission can be quantified using a microtiter plate reader at 405 nm, and 90k concentration was expressed as ng/ml.
DNA isolation
DNA isolation was performed using the MICRO-GENO DNA kit according to the manufacturer's recommendations (AB Analytica, Padoa, Italy). Tissue samples weighing <100 mg were cut using a sterile scalpel and transferred to a 2-ml Eppendorf tube containing 200 µl lysis buffer. Twenty microliters of proteinase K (20 mg/ml) were then added and the suspension left to incubate at 45°C overnight. The quantity of isolated DNA was measured spectrophotometrically and the quality analyzed through a 1% agarose gel electrophoresis. Due to the presence of low-molecular-weight fragments of isolated DNA, 42 out of a total of 47 AD samples and 55 out of a total of 58 ADK samples were considered suitable for genetic analyses.
RFLP-PCR assay
Mutations at K-ras codon 12 were detected from all samples by an "enriched" RFLP-PCR assay according to Kahn et al. (1991). The oligonucleotide primers used for the enzymatic amplification of K-ras sequences were as follows:
The first step amplification was performed on 5001000 ng genomic DNA in a final reaction volume of 100 µl containing amplification buffer (50 mM KCl, 10 mM TrisHCl pH 8.3, 1.5 mM MgCl2, 200 mM dNTPs (Roche Diagnostics, Germany), 2.5 U Taq DNA polymerase (Roche Diagnostics). Primer concentrations were 10 ng each of K-ras 5' and K-ras 3' wild type. For amplification a programmable Progene thermocycler (TECHNE, Cambridge, UK) was used. The amplification parameters were 48'' at 94°C, 90'' at 56°C, and 2'35'' at 72°C for a total of 15 cycles. Five-microliter aliquots of the first amplicon were digested with 20 U enzyme BstNI (Stratagene, La Jolla, CA) in a final volume of 20 µl at 60°C for 3 h. Ten-microliter aliquots of the intermediate digests were used in the second amplification step. These aliquots were diluted to a final volume of 50 µl as described. Primer concentrations were 150 ng each of K-ras 5' and K-ras 3', and amplifications were performed for 30 cycles as described.
Twenty-five-microliter aliquots of the second amplicon were digested with 10 U BstNI restriction enzyme at 60°C for 2 h in a final volume of 35 µl. Products were processed by electrophoresis through a 4% high-resolution agarose gel in TAE buffer. Gels were photographed on a UV light transilluminator.
The positive control was DNA prepared from the SW480 cell line (homozygous for the codon 12 K-ras valine mutation, GTT), whereas a DNA derived from the lymphocytes of healthy donors was used as a wild-type control in each run of the PCR.
Statistical analyses
Cytofluorimetric comparison of Gal-3 and CD44 v6 expression in NM versus neoplastic lesions (AD or ADK) for each single patient was conducted by CellQuest Software using the parametric Kolmogorov-Smirnov test on a population of at least 20,000 cells. Only p values of less than 0.01 were considered as significant. Statistical analyses of the distribution of CAM expression level in paired samples of NM and AD or NM and ADK (all patients) were conducted by using a Wilcoxon nonparametric test. Only p values of less than 0.05 were considered as significant. Chi-square tests were used to evaluate K-ras status experiments. Statistical analyses between Gal-3 expression in neoplastic lesions and 90k in the plasma of patients were carried out using regression analysis. CAM expression (Gal-3 or CD44 v6) and K-ras status in AD or ADK were compared by using the Mann-Whitney nonparametric test. All analyses were carried out by using Statview 5.1 (software for Macintosh).
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Footnotes |
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Abbreviations |
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References |
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