Oncogene expression in endocrine pancreatie tumors

The mRNA expression of the (proto) oncogenes Ha-ras, Ki-ras, fos, c-myc, N-myc, and sis was studied in five pancreatic endocrine tumors and two non-neoplastic pancreases by in situ hybridization and Northern blot analysis. Ha-ras, Ki-ras, fos and c-myc, but not N-myc or sis mRNA was detected in all the tumors as well as in the non-neoplastic pancreatic tissues. Compared with non-tumorous pancreatic tissue, Ha-ras and Ki-ras mRNA was overexpressed up to 42-fold in all the tumors; metastasizing tumors showed 2–6 times higher Ha-ras mRNA levels than benign neoplasias. In contrast, c-myc mRNA levels were higher in normal tissue than in tumors and fos mRNA levels did not differ significantly between tumors and normal tissue. The activities of Ki-ras, fos and c-myc mRNA expression did not correlate with any of the histological or biological properties of the tumors, nor with the clinical course of disease. Our results, although based on a limited number of cases, suggest that Ha-ras and Ki-ras mRNA overexpression is associated with the development of pancreatic endocrine tumors. The measurement of Ha-ras mRNA levels may contribute to the assessment of tumor prognosis. Supported by grants of the “ Fonds zur F?rderung der Forschung” (P 5314) and by the “Jubil?umsfonds” of the Austrian National Bank (P 2889) to H.H.     

Oncogene expression in endocrine pancreatic tumors

The mRNA expression of the (proto)oncogenes Ha-ras, Ki-ras, fos, c-myc, N-myc, and sis was studied in five pancreatic endocrine tumors and two non-neoplastic pancreatic tissues. Compared with non-tumorous pancreatic tissue, Ha-ras and Ki-ras mRNA was overexpressed up to 42-fold in all the tumors; metastasizing tumors showed 2-6 times higher Ha-ras mRNA levels than benign neoplasias. In contrast, c-myc mRNA levels were higher in normal tissue than n tumors and fos mRNA levels did not differ significantly between tumors and normal tissue. The activities of Ki-ras, fos and c-myc mRNA expression did not correlate with any of the histological or biological properties of the tumors, nor with the clinical course of disease. Our results, although based on a limited number of cases, suggest tha Ha-ras and Ki-ras mRNA overexpression is associated with the development of pancreatic endocrine tumors. The measurement of Ha-ras mRNA levels may contribute to the assessment of tumor prognosis.     

Telomerase in endocrine and endocrine-dependent tumors

Telomerase, the ribonucleoprotein enzyme that elongates chromosomal ends, or telomeres, is repressed in most normal somatic cells but reactivated in transformed cells to compensate for the progressive erosion of the telomeres during cell divisions. In accordance with this hypothesis, the presence of telomerase activity has been reported in more than 90% of human cancers, whereas most normal tissues or benign tumors contain low or undetectable telomerase activity. Reactivation of telomerase has also been widely reported in endocrine neoplasms and in hormone-related cancers. In the present study, we review the most recent publications on telomerase in these types of tumors. The hormonal regulation of telomerase activity and the possible strategies for cancer therapy based on the inhibition of telomerase has also been discussed.     

Protein kinase a alterations in endocrine tumors

Various molecular and cellular alterations of the cyclic adenosine monophosphate (cAMP) pathway have been observed in endocrine tumors. Since protein kinase A (PKA) is a central key component of the cAMP pathway, studies of the alterations of PKA subunits in endocrine tumors reveal new aspects of the mechanisms of cAMP pathway alterations in human diseases. So far, most alterations have been observed for the regulatory subunits, mainly PRKAR1A and to a lower extent, PRKAR2B. One of the best examples of such alteration today is the multiple neoplasia syndrome Carney complex (CNC). The most common endocrine gland manifestations of CNC are pituitary GH-secreting adenomas, thyroid tumors, testicular tumors, and ACTH-independent Cushing's syndrome due to primary pigmented nodular adrenocortical disease (PPNAD). Heterozygous germline inactivating mutations of the PKA regulatory subunit RIα gene (PRKAR1A) are observed in about two-third of CNC patients, and also in patients with isolated PPNAD. PRKAR1A is considered as a tumor suppressor gene. Interestingly, these mutations can also be observed as somatic alterations in sporadic endocrine tumors. More than 120 different PRKAR1A mutations have been found today. Most of them lead to an unstable mutant mRNA, which will be degraded by nonsense mediated mRNA decay. In vitro and in vivo functional studies are in progress to understand the mechanisms of endocrine tumor development due to PKA regulatory subunits inactivation. PRKAR1A mutations stimulate in most models PKA activity, mimicking in some way cAMP pathway constitutive activation. Cross-talks with other signaling pathways summarized in this review have been described and might participate in endocrine tumorigenesis.     

Surgical treatment of endocrine tumors of the pancreas

Surgeons have a key role in the management of most endocrine tumors of the pancreas. The objective of surgery is either curative or palliative, according to the resectability of the tumor. The preoperative management includes the assertion of the tumoral syndrome, the localization of the tumor by imaging techniques and the preparation of the patient to surgery. Emergency indications to operate have become exceptional since the temporary control of inappropriate secretions by pharmacologic agents is available. Intraoperative ultrasonography is useful both for detection of the tumors and selection of the best procedure for resection. A careful postoperative follow-up is advocated for patients with malignant tumors and MEN-1, since iterative resections can be undertaken in case of limited tumoral recurrence or liver metastases. The place of hepatic transplantation for diffuse metastases is still under evaluation.     

Heterozygous Men1 mutant mice develop a range of endocrine tumors mimicking multiple endocrine neoplasia type 1

Multiple endocrine neoplasia type 1 (MEN1) is a hereditary syndrome characterized by the occurrence of multiple endocrine tumors of the parathyroid, pancreas, and anterior pituitary in patients. To study tumorigenesis related to the MEN1 syndrome, we have generated Men1 knockout mice using the gene targeting approach. Heterozygous Men1 mutant mice developed the same range of major endocrine tumors as is seen in MEN1 patients, affecting the parathyroid, pancreatic islets, pituitary and adrenal glands, as well as the thyroid, and exhibiting multistage tumor progression with metastatic potential. In particular, extrapancreatic gastrinoma, pancreatic glucagonoma, and mixed hormone-producing tumors in islets were observed. In addition, there was a high incidence of gonadal tumors of endocrine origin, i.e. Leydig cell tumors, and ovary sex-cord stromal cell tumors in heterozygous Men1 mutant mice. Hormonal disturbance, such as abnormal PTH and insulin levels, was also observed in these mice. These tumors were associated with loss of heterozygosity of the wild-type Men1 allele, suggesting that menin is involved in suppressing the development of these endocrine tumors. All of these features are reminiscent of MEN1 symptoms in humans and establish heterozygous Men1 mutant mice as a suitable model for this disease.     

Anti-tumor and endocrine effects of non-steroidal aromatase inhibitors on estrogen-dependent rat mammary tumors

The non-steroidal aromatase inhibitor CGS 20 267, at maximally effective doses in non-tumor bearing adult female rats, elicits endocrine effects mimicking those seen after surgical ovariectomy and thus induces a “medical” ovariectomy. We now report on studies characterizing the anti-tumor and endocrine effects of three orally active non-steroidal aromatase inhibitors, CGS 20 267, CGP 45 688 and CGP 47 645, in adult female rats bearing estrogen-dependent DMBA-induced mammary tumors. Doses ranging from 3 to 3000 μg/kg were given by gavage once daily for 6 weeks. After 6 weeks of treatment, the ED₅₀ for suppression of tumor volume was 10–30, 100 and 3–10 μg/kg for CGS 20 267, CGP 45 688 and CGP 47 645, respectively. The maximally effective dose for anti-tumor efficacy was 300, 1000 and 100 μg/kg for each of the three inhibitors, respectively. The observed potent anti-tumor efficacy was accompanied by potent endocrine effects. Thus, disruption of ovarian cyclicity (at maximal doses rats remained in constant diestrus) was observed in all animal from the 2nd or 3rd week of treatment to the end of the 6-week treatment period. Uterine weight, at the maximally effective doses for each of the three inhibitors, was suppressed to between 42 and 28% of pre-treatment levels. This suppression was similar to the suppression of uterine weight (27% of pre-treatment) seen after ovariectomy. Serum estradiol concentrations in rats treated with 300 μg/kg CGS 20 267 were significantly suppressed to 12% of pre-treatment levels and serum luteinizing hormone (LH) concentrations were elevated 3 to 4-fold over pre-treatment levels. Thus the potent anti-tumor efficacy seen with each of the three non-steroidal aromatase inhibitors was accompanied in each case by a variety of endocrine effects corresponding to those seen after ovariectomy.