人中性粒细胞弹性蛋白酶诱导气道黏液高分 泌细胞模型的建立及其机制的初步研究

目的：以人中性粒细胞弹性蛋白酶(HNE)为诱导因素,研究建立黏蛋白(MUC)5AC和5B高表达的细胞模型,同时对黏蛋白高表达机制进行初步研究。方法：培养人肺腺癌细胞A549,以HNE为刺激因素,EGFR中和抗体、表皮细胞生长因子受体（EGFR）磷酸化阻断剂AG1478为干预因素,分组培养。采用四甲基偶氮唑盐光吸收法（MTT法）检测HNE对细胞活性的影响;逆转录-聚合酶链反应（RT-PCR）检测MUC5AC mRNA、MUC5B mRNA的变化;酶联免疫吸附测定法(ELISA)定量分析MUC5AC和MUC5B蛋白含量的差异;细胞免疫化学以及激光共聚焦技术进一步直观观察MUC5AC、MUC5B、p-EGFR蛋白表达的变化。结果：HNE对A549细胞活力的影响呈剂量依赖性;HNE刺激组的MUC5AC、MUC5B基因转录和蛋白表达水平均明显高于对照组,差异有统计学意义（均P<0.01）;HNE刺激组p-EGFR蛋白表达显著增多,EGFR中和抗体、AG1478能显著降低HNE诱导的MUC5AC高表达,但对MUC5B高表达无干预作用。结论：人肺腺癌细胞A549同时表达MUC5AC和MUC5B,HNE能有效刺激A549细胞高表达MUC5AC和MUC5B,黏蛋白高表达细胞模型的建立为研究气道粘液高分泌疾病提供了实验基础。HNE通过激活EGFR信号转导通路诱导MUC5AC的高表达,但MUC5B高表达机制与之不同,有待进一步研究。     

TLR-4 在慢性阻塞性肺病患者肺组织表达的研究

目的:观察COPD患者肺组织中TLR-4,IL-8,MUC5AC的表达,并探讨其在气道炎症、气道高分泌中的作用。方法:非COPD、COPD组男性肺癌病人各20例,取其肺叶切除后的外周肺组织,对肺组织标本行HE及AB-PAS染色,用免疫组织化学方法检测肺组织中TLR-4,IL-8,MUC5AC的表达并分析其相关性。结果:①COPD患者肺组织中TLR-4,IL-8,MUC5AC表达较对照组增高(P<0.05)。TLR-4主要在气道上皮细胞、肺巨噬细胞及血管内皮细胞表达,IL-8在气道壁、肺泡间隔、血管壁及肺组织内浸润的单核细胞、巨噬细胞、多形核白细胞均有表达,MUC5AC主要在气道上皮杯状细胞中表达。②TLR-4、IL-8表达与气道炎细胞评分成正相关(P<0.05)。TLR-4与IL-8、MUC5AC表达成正相关(P<0.05)。结论:COPD患者肺组织中TLR-4高表达可能参与了COPD的气道炎症及气道高分泌,这可能是通过增加IL-8与MUC5AC的表达来实现的。     

MUC5AC在胃型宫颈腺癌组织中的表达及其临床病理特征

目的 分析胃型宫颈腺癌(gastric-type endocervical adenocarcinoma, GAS)组织病理形态学特点,检测MUC5AC在该癌组织中的表达,研究GAS免疫组织化学表型特点及相关特征,并结合AB-PAS特殊染色结果探究GAS潜在诊断方法。方法 回顾性分析2019年7月1日至2020年12月31日于武汉大学中南医院就诊的5例GAS患者的临床资料,总结其临床表现、病理特征、免疫表型及AB-PAS特殊染色特点。结果 免疫组织化学检测显示,5例GAS患者癌组织CK7、MUC6、CEA及MUC5AC阳性,p16、MUC2、CDX2、ER及PR阴性,Pax8表达不稳定,p53均为野生型表达,Ki-67多为阳性高表达。AB-PAS染色显示胞质均呈现红色。结论 与普通型宫颈腺癌相比,GAS具有易被误诊的良性组织形态。本研究发现免疫组织化学标志物MUC5AC的稳定阳性表达及AB-PAS染色后胞质呈红色可能是诊断该病的关键性特征。     

热休克蛋白90参与糖皮质激素及其受体对气道黏蛋白5AC表达调控的机制

目的:探讨热休克蛋白90(HSP90)在糖皮质激素(GC)信号通路中的作用及其对气道黏蛋白(MUC)5AC表达的调控机制。方法:体外培养气道上皮细胞株BEAS-2B,给予HSP90特异性阻断剂格尔德霉素(GA)和地塞米松(DEX)刺激,比较各组MUC5AC的含量,糖皮质激素受体(GR)的核蛋白表达和GR结合活性。结果:与对照组相比,DEX组的MUC5AC mRNA和蛋白水平降低,伴GR核蛋白水平增高(P0.05);与DEX组相比,GA+DEX组MUC5AC mRNA和蛋白水平升高,GR核蛋白水平降低。放射配体结合实验显示,与对照组相比,GA组的受体最大结合容量(Bmax)降低,平衡解离常数(Kd)升高。结论:HSP90可参与GC及GR的抗气道黏液高分泌效应,其抑制剂可阻断上述效应,该效应是通过降低GR的结合活性来调控的。     

香烟烟雾暴露对支气管哮喘大鼠肺组织水通道蛋白5表达的影响

目的探讨香烟烟雾暴露对支气管哮喘大鼠肺组织水通道蛋白5(Aquaporin 5,AQP5)和黏蛋白5AC(MUC5AC)表达的影响。方法将30只雄性SD大鼠随机分为3组(n=10),对照组雾化生理盐水,哮喘组采用卵清白蛋白(OVA)致敏并吸入激发制备哮喘模型,哮喘+烟雾暴露组于每日雾化激发OVA前给予香烟烟雾吸入。收集支气管肺泡灌洗液(BALF)进行白细胞计数及分类,测定肺组织病理变化及湿干重比值。实时定量PCR(Realtime PCR)测定AQP5和MUC5AC mRNA的表达,免疫组化法测定AQP5蛋白分布情况,免疫印迹法(Western blot)测定AQP5蛋白的表达,酶联免疫吸附试验(ELISA)测定BALF中MUC5AC的含量。结果①与对照组相比,哮喘组大鼠BALF中白细胞、淋巴细胞、嗜酸粒细胞、中性粒细胞数量明显增加;与哮喘组相比,暴露组大鼠BALF中白细胞、中性粒细胞数量明显增加,差异均有统计学意义(P<0.05)。②与对照组相比,哮喘组和暴露组大鼠肺组织中AQP5表达明显减少,而MUC5AC蛋白含量明显增加;与哮喘组相比,暴露组大鼠肺组织中AQP5明显减少,而MUC5AC蛋白含量明显增加,差异均有统计学意义(P<0.05)。③肺组织中AQP5表达与肺组织BALF中MUC5AC蛋白含量呈负相关(r=-0.852和-0.895,P<0.05)。结论香烟烟雾暴露可导致哮喘大鼠肺组织AQP5表达减少而MUC5AC含量增加,进一步加重哮喘气道炎症和黏液高分泌反应,这可能为哮喘吸烟患者的早期防治提供新思路。     

γ干扰素抑制幼儿支气管上皮细胞MUC5AC表达

本研究主要探讨了IFN-γ在黏蛋白产生中的作用,特别是在儿童支气管上皮细胞中的MUC5AC转录。通过采用人肺黏液表皮样癌细胞系(NCI-H292)和正常人支气管上皮细胞(NHBE),本研究评估了IFN-γ对MUC5AC转录的影响,发现转化生长因子(TGF)-α和双链RNA (polyI:C)诱导的MUC5AC mRNA和蛋白表达被IFN-γ以浓度依赖性方式抑制。IFN-γ对TGF-α和polyI:C诱导的表皮生长因子受体(EGFR)和细胞外信号调节激酶(ERK)的激活作用有限。染色质免疫沉淀实验表明Sp1与位于MUC5AC启动子上的同源序列结合。Sp1抑制剂光神霉素A抑制MUC5AC mRNA,表明Sp 1在MUC5AC诱导中起关键作用,同时IFN-γ阻碍Sp1与MUC5AC启动子的结合。本研究初步表明,IFN-γ可以抑制MUC5AC的表达,干扰Sp1与其靶序列的结合。     

CD44~+/CD24~-和CK5/6在乳腺浸润性导管癌、乳腺普通型导管增生和低级别导管原位癌中的表达

目的探讨乳腺浸润性导管癌、普通型导管增生和低级别导管原位癌组织中CD44~+/CD24~-和CK5/6的表达和意义。方法采用免疫组织化学染色检测30例乳腺浸润性导管癌中CD44~+/CD24~-、CK5/6和P63的表达、30例乳腺普通型导管增生组织中CD44~+/CD24~-、CK5/6、34βE12和CK8的表达和30例低级别导管原位癌中CD44~+/CD24~-、CK5/6的表达。结果 30例乳腺浸润性导管癌中24例呈CD44~+/CD24~-,30例普通型导管增生中9例呈CD44~+/CD24~-和30例低级别导管原位癌中19例呈CD44~+/CD24~-,3组相比具有统计学意义。浸润性导管癌中CD44~+/CD24~-表型与患者的年龄、月经状况、肿瘤大小、淋巴结转移、组织学分级、ER、PR和HER~-2无相关性。30例乳腺浸润性导管癌中6例表达CK5/6,30例乳腺普通型导管增生中全部表达CK5/6,30例低级别导管原位癌中8例表达CK5/6,3组相比具有统计学意义。结论 CD44~+/CD24~-和CK5/6联合使用可用于鉴别乳腺浸润性导管癌、普通型导管增生和低级别导管原位癌。     

MUC1粘蛋白在乳腺肿瘤中的表达及其生物学意义

目的　探讨MIC1粘蛋白在乳腺肿瘤组织中的表达特征及其生物学和临床意义。方法　应用免疫组织化学ABC法对 15例乳腺非典型增生 ,15例乳腺良性肿瘤 ,44例乳腺癌 (2 1例含癌旁组织 )染色 ,观察MUC1在不同类型乳腺组织中的表达特征及其与雌激素受体和孕激素受体表达的关系。结果　MUC1在所检测的乳腺组织中均表达 ,但在不同病变乳腺组织中其表达的方式和强度不同。在癌旁和非典型增生组织中只表达在近管腔或腺腔侧的胞膜上 ,胞浆未见表达。在乳腺癌组织中整个胞膜和胞浆均表达 ,且表达强度与细胞的恶性化程度成正相关 (P <0 0 1)。浸润性癌中MUC1表达明显强于原位癌 (P <0 0 0 5 ) ;乳腺癌组织中MUC1的表达强度与雌激素受体的表达成正相关 (P <0 0 5 ) ,与孕激素受体表达无关 (P >0 0 5 )。乳腺癌组织中MUC1有旁分泌现象。结论　MUC1表达水平可反映乳腺肿瘤恶性化程度 ,并可能作为乳腺癌治疗效果判断和预后评价的参考指标。     

GRP94 和CD8 在宫颈病变组织中的表达及意义

目的:探讨葡萄糖调节蛋白94(glucose-regulated protein94,GRP94)和CD8在宫颈病变组织中的表达及与HPV感染的关系。方法:采用免疫组化S-P法检测32例原发宫颈癌、27例宫颈上皮内瘤变(cervical intraepithelial neoplasia,CIN)及40例慢性宫颈炎组织中GRP94和CD8的表达及定位;采用western blot技术检测6例宫颈癌及6例正常宫颈组织中GRP94和CD8的表达。结果:①在宫颈癌、CIN2/3、CIN1及慢性宫颈炎组织中,GRP94的阳性表达率分别为87.5%、82.4%、40%和22.5%;CD8的阳性表达率分别为28.1%、64.7%、90%和97.5%;GRP94在宫颈癌和CIN2/3中的表达均显著高于慢性宫颈炎和CIN 1组织(P均<0.05);CD8在宫颈癌组的表达显著低于慢性宫颈炎组、CIN1组及CIN2/3组(P均<0.05)。②Western blot结果示GRP94在宫颈癌组织中的表达显著高于正常宫颈组织(P<0.01);CD8在宫颈癌组织中的表达显著低于正常宫颈组织(P<0.01)。③GRP94的表达与宫颈癌分化程度、有无脉管侵袭有关(P<0.05),而与年龄、病理类型、临床分期及有无淋巴结转移无关(P>0.05);CD8的表达与有无脉管侵袭有关(P<0.05),而与年龄、病理类型、临床分期、分化程度及有无淋巴结转移无关(P>0.05)。④宫颈病变组织中,GRP94的表达与HPV感染呈正相关(rs=0.377,P=0.000);CD8的表达与HPV感染呈负相关(rs=-0.395,P=0.000);GRP94与CD8的表达呈负相关(rs=-0.608,P=0.000)。结论:GRP94表达可能是宫颈CIN进展及宫颈癌预后判断的重要预测指标。     

变异性分化抗原簇44（CD44v17）对宫颈癌的临床诊断意义

目的:探讨CD44v17对宫颈癌的临床诊断意义。方法:将CD44v17si RNA、CD44v17、生理盐水转染至传代后的人宫颈癌细胞。检测细胞转染后存活率;检测细胞凋亡率。在裸鼠左肩背部注入人宫颈癌细胞悬液,随机分为CD44v17组、CD44v17si RNA组、对照组。在CD44v17组、CD44v17si RNA组裸鼠瘤体内分别注入CD44v17病毒颗粒、CD44v17si RNA病毒颗粒。检测瘤体的质量与体积。选取疑有宫颈病变患者阴道镜下活检组织80例,正常宫颈组织15例、宫颈上皮内瘤变(CIN)I级组织l5例、CIN II级15例、CIN III级组织15例和宫颈癌组织20例。检测CD44v17在不同组织中的表达量。结果:CD44v17si RNA转染的宫颈癌细胞凋亡率(19.20±2.14%)高于CD44v17转染的宫颈癌细胞凋亡率(6.13±1.08%)(P0.05)。CD44v17组裸鼠瘤体质量(15.9±3.4)g高于对照组裸鼠瘤体质量(11.8±2.7)g(P0.05)。CD44v17在不同组织中的表达量,按正常宫颈、CINⅠ级、CINⅡ级、CINⅢ级、宫颈癌发展过程呈递增趋势(P0.05)。结论:CD44v17能抑制宫颈癌细胞凋亡,促进宫颈癌细胞的生长、增殖。通过降低CD44v17表达量可能是遏制CIN向宫颈癌发展的一个手段。     

Detection of p53 protein and Ki-67 proliferation antigen in human papillomavirus (HPV)-positive and HPV-negative cervical lesions by immunohistochemical double-staining

In HPV-associated genital lesions, low or absent expression of p53 has been attributed to the rapid degradation of p53 through its binding with HPV E6 protein. In this study, we examined p53 protein expression with two antibodies (CM1 polyclonal and PAb 1801 monoclonal antibodies), and Ki-67 proliferation antigen (monoclonal antibody) using an immunohistochemical (IHC) double-staining technique in 77 HPV-positive cervical lesions (HPV6, HPV11, HPV16, HPV18, HPV31, and HPV33) and in 15 HPV-negative cases. p53 protein expression was detected in 36/92 (39.1%) of the specimens. of the p53-positive cases, 80.6% (29/36) were HPV-positive samples, including 10/23 (43.5%) of HPV16- and 3/10 (30%) of HPV18-positive biopsies. In 52.8% of the p53-positive samples, the expression was found in less than 5% of the basal cells which were also positive for Ki-67.
Ki-67 proliferation marker was found in 91/92 specimens, most intensely in those infected by HPV16. p53 was more abundant in progressive or persistent lesions, but no differences were found between HPV-positive and HPV-negative samples. the positive IHC double-staining of both p53 and Ki-67 proliferation antigen in the same basal (and parabasal) cells indicates that these two normal cell-cycle proteins are being expressed while the cells are entering from the G₁ to the S phase of the cell cycle. Since the latter property is only attributed to the wild-type p53 (but not to mutated p53), the p53 protein detected in HPV lesions by IHC is likely to be the wild-type p53 rather than mutated p53, and the result was also confirmed by using p53 mutant specific antibody PAb 240. Accordingly, the concept of HPV inactivating the wild-type p53 protein should be re-examined, and other mechanisms for HPV-mediated carcinogenesis should be considered.     

Expression of p53, bcl-2 and Ki-67 in cervical intraepithelial neoplasia and invasive squamous cell carcinoma of the uterine cervix

OBJECTIVE: To assess the expression of p53, bcl-2 and Ki-67 in the progression of cervical neoplasia. STUDY DESIGN: A total of 131 cervical specimens, consisting of normal cervical epithelium (n = 43), cervical intraepithelial neoplasia (CIN) lesions (n =40) and cervical squamous cell carcinomas (SCCs) (n = 48) were examined immunohistochemically in paraffin sections for expression of p53, bcl-2 and Ki-67. RESULTS: Immunoreactivity of p53 was found in 27% of SCC cases, but it had no significant relationship with SCC staging (p = 0.791). Immunoreactivity of bcl-2 was observed in 33% of CIN 3 cases. We found a significant relationship (chi2 test: p = 0.009) between the expression of bcl-2 and CIN grading. Ki-67 index was higher in high grade CIN (HGCIN: CIN 2 and 3) and SCC lesions compared to normal cervices. Ki-67 index showed a correlation with bcl-2 protein expression (p = 0.030), but not with p53 protein expression (p = 0.239). CONCLUSION: HGCIN is an early stage to demonstrate the alteration of bcl-2 and Ki-67 expressions. Progression of neoplasia in the uterine cervix is accompanied by an increase of antiapoptotic protein, bcl-2 as well as cellular proliferation.     

Guest Lecture 8.45–9.30 Monday 15 September 2003 Endocervical Adenocarcinoma and its Precursors

The incidence of malignant and pre‐malignant endocervical glandular lesions is increasing. Part of this is an apparent increase due to a reduction in the number of invasive cervical squamous carcinomas but there is evidence that there is a real increase in malignant and pre‐malignant endocervical glandular lesions. Different terminologies are in use in the UK where the term cervical glandular intraepithelial neoplasia (CGIN) is commonly used and the rest of the world where pre‐malignant lesions are classified as glandular dysplasia and adenocarcinoma in situ (AIS) (WHO classification). It is well established that high‐grade CGIN (AIS in WHO terminology) is a precursor lesion of cervical adenocarcinoma but it is controversial whether a recognizable precursor to high grade CGIN (namely low‐grade CGIN) exists and criteria for diagnosing this are poorly established and poorly reproducible. Most cases of CGIN are of usual or endocervical type but other morphological subtypes described include endometrioid, intestinal, tubal and stratified mucinous intraepithelial lesion (SMILE). The presence of skip lesions and lesions high up the endocervical canal has been overemphasised in CGIN with most cases occurring close to the transformation zone. Treatment is on an individualized basis but local excision with negative margins and close cytological follow‐up may be employed. There is evidence in the literature that early invasive adenocarcinomas behave in a similar fashion to early invasive squamous carcinomas and that, on selected occasions, conservative therapy can be safely undertaken. However, further studies are needed to ascertain the behaviour and natural history of early invasive cervical adenocarcinoma. In 10%–15% of cases it may be impossible to ascertain whether a malignant endocervical glandular lesion is invasive or in situ. There are many benign mimics of CGIN and adenocarcinoma, including tuboendometrial metaplasia (TEM), endometriosis and microglandular hyperplasia (MGH). Although careful morphological examination usually allows confident distinction of these lesions, a panel of immunohistochemical stains including MIB1, bcl2 and p16 may assist.     

Quantitative cell-cycle protein expression in oral cancer assessed by computer-assisted system

The knowledge of cell-cycle control has shown that the capacity of malignant growth is acquired by the stepwise accumulation of defects in specific genes regulating cell growth. Histologic diagnosis might be improved by a quantitative evaluation of more specific diagnosis biomarkers, which could help to precisely identify pre-malignant and malignant oral lesions. The aim of the present study is to evaluate whether computer-based quantitative assessment of p53, PCNA and Ki-67 immunohistochemical expression, could be used clinically to foresee the risk of oral malignant transformation. This retrospective study was carried out in ninety-five oral biopsies, 27 were classified as fibrous inflammatory hyperplasia, 40 as leukoplakia and 28 as oral squamous cell carcinoma. Sixteen out of the 40 leukoplakia were diagnosed as non-dysplastic leukoplakia, the other 24 being dysplastic leukoplakia, of which 50.0% were classified as moderate to severe dysplasia. Comparison of the four groups of oral tissues showed significant rises in p53 and Ki-67 positivity index, which increased steadily in the order benign, pre-malignant, and malignant. In contrast, it was not possible to relate higher PCNA levels with pre-malignant and malignant oral lesions. We therefore conclude that PCNA immunohistochemistry expression is probably an inappropriate marker to identify oral carcinogenesis, whereas joint quantitative evaluation of p53 and Ki-67, appears to be useful as a tumor marker, providing a pre-diagnostic estimate of the potential for cell-cycle deregulation of the oral proliferate status.     

Mixed gastric- and intestinal-type metaplasia is formed by cells with dual intestinal and gastric differentiation.

We have proposed to divide intestinal metaplasia (IM) into two categories, i.e., a mixed gastric and intestinal (GI) type, and a solely intestinal (I) type, based on the residual gastric phenotype cells. The GI-mixed-type IM can be identified by the presence of both cells with either gastric or intestinal phenotypes in a single gland. This study is conducted to elucidate whether cells in the GI-mixed-type IM glands can simultaneously present both gastric and intestinal phenotypes. MUC5AC, MUC2, CD10 and villin expressions were investigated in 20 samples from five gastric cancer cases, directly using either AlexaFluor 488- or 568-labeled specific monoclonal antibodies and observed by fluorescent microscopy and confocal laser-scanning microscopy. GI-mixed IM glands comprise a population expressing MUC5AC and MUC2, MUC5AC and villin, and MUC5AC and CD10. MUC2 and villin expressions were reciprocally increased with decreasing MUC5AC expression, while CD10 expression was limited to cells with only a residual MUC5AC expression or no expression. These results suggest that a heterogeneous cell population with both gastric and intestinal phenotypes would develop into a single intestinal phenotype, as reflected in the progression of intestinal metaplasia from GI-mixed-type- to I-type IM-type glands.     

Immunohistochemical staining patterns of MUC1, MUC2, MUC4, and MUC5AC mucins in hyperplastic polyps, serrated adenomas, and traditional adenomas of the colorectum.

We studied the distribution of the four human apomucins MUC1, MUC2, MUC4, and MUC5AC in hyperplastic polyps, serrated adenomas, and traditional adenomas of the colorectum using immunohistochemical techniques, with the aim of comparing and contrasting their patterns of expression. A series of 12 hyperplastic polyps, 27 serrated adenomas, and 20 traditional adenomas was studied. No significant change in apomucin expression was observed in traditional adenomas compared with normal colorectal epithelium, except for MUC5AC, which was present in 12 of the adenomas (60%) and only 20% of the normal samples. In both hyperplastic polyps and serrated adenomas, MUC2 and MUC5AC mucin expression was consistently and markedly increased. In 50% of the hyperplastic polyps, MUC4 was reduced but in the remaining cases was similar to normal. Loss of MUC4 expression was observed in all serrated adenomas. MUC1 was not increased in the hyperplastic polyps but increased expression was seen in 17 of the serrated adenomas (63%). Similar altered distribution patterns of MUC2, MUC4, and MUC5AC were seen in hyperplastic polyps and serrated adenomas, whereas traditional adenomas showed little change from normal patterns of expression. Although hyperplastic polyps are commonly defined as benign lesions without neoplastic potential, the similar phenotypes of hyperplastic and serrated adenomas and the existence of mixed polyps suggest that these lesions may represent a histogenetic continuum.     

P-cadherin expression in glandular lesions of the uterine cervix detected by liquid-based cytology

OBJECTIVE: To study P-cadherin aberrant expression as a possible marker for cervical adenocarcinomas in cytological samples. METHODS: We studied P-cadherin immunoexpression in liquid-based cervical cytology samples of biopsy-proven cervical lesions. RESULTS: We found a statistically significant correlation between P-cadherin expression and a cytological diagnosis of malignancy, either glandular or squamous (P < 0.0001). Twenty-two of 33 malignant cases showed P-cadherin membrane staining. None of the 30 benign cases tested showed membrane staining, but three of them displayed an aberrant nuclear P-cadherin expression. CONCLUSIONS: We concluded that P-cadherin can be used to discriminate between malignant and benign cervical cytological specimens, but not to discriminate glandular from squamous lesions.     

Glycoprotein CD44 expression in benign, premalignant and malignant epithelial lesions of the larynx: an immunohistochemical study including correlation with Rb, p53, Ki-67 and PCNA.

CD44 is an integral membrane glycoprotein that has diverse functions in cell-cell and cell-substrate interactions. It has been suggested that it may be a determinant of metastatic and invasive behavior in carcinomas. The immunohistochemical expression of CD44 was examined in a series of 34 squamous cell carcinomas, 13 in situ carcinomas, 35 cases with various degrees of epithelial dysplasia, 10 papillomas and 17 cases of keratosis. We used the monoclonal mouse anti-human phagocytic glycoprotein-1 CD44 (clone DF 1485), on formalin-fixed, paraffin-embedded tissue. CD44 expression was correlated with the expression of Rb and p53 proteins, with the proliferative indices Ki-67 and PCNA as well as with conventional clinicopathological data. The mean value of CD44 expression was 78.84 in squamous cell carcinomas, 78.04 in situ carcinomas, 54.93 in dysplasia, 26.8 in papillomas and 24.97 in keratosis. There was no significant difference of CD44 expression between in situ and invasive carcinomas. However, a strong difference of reaction between carcinomas and the other cases was observed. CD44 expression was statistically higher in dysplastic lesions than the cases of keratosis (p < 0.0001) and papillomas (p = 0.01). In the group of invasive carcinomas, CD44 expression was statistically correlated with pRb (p = 0.011), while in preinvasive lesions it was correlated with PCNA (p = 0.016). The relationship with the degree of dysplasia or grade of carcinoma and p53 protein expression was insignificant. These observations suggest that CD44 expression may be involved in the multiple mechanism of the development and progression of laryngeal lesions and may help to predict the risk of transformation of the benign or precancerous lesions to cancer.     

Molecular characterization of sessile serrated adenoma/polyps with dysplasia/carcinoma based on immunohistochemistry,next-generation sequencing,and microsatellite instability testing: a case series study

Background

Colorectal sessile serrated adenoma/polyps (SSA/Ps) are considered early precursor lesions in the serrated neoplasia pathway. Recent studies have shown associations of SSA/Ps with lost MLH1 expression, a CpG island methylator phenotype, and BRAF mutations. However, the molecular biological features of SSA/Ps with early neoplastic progression have not yet been fully elucidated, owing to the rarity of cases of SSA/P with advanced histology such as cytologic dysplasia or invasive carcinoma. In this study, we aimed to elucidate the molecular biological features of SSA/Ps with dysplasia/carcinoma, representing relatively early stages of the serrated neoplasia pathway.

Methods

We performed immunostaining for β-catenin, MLH1, and mucins (e.g., MUC2, MUC5AC, MUC6, and CD10); targeted next-generation sequencing; and microsatellite instability (MSI) testing in 8 SSA/P lesions comprised of 4 SSA/Ps with high-grade dysplasia and 4 SSA/Ps with submucosal carcinoma.

Results

Lost MLH1 expression was found in 5 cases. All lesions studied were positive for nuclear β-catenin expression. Regarding phenotypic mucin expression, all lesions were positive for MUC2, but negative for CD10. MUC5AC and MUC6 positivity was observed in 7 cases. Genetically, the most frequently mutated gene was BRAF (7 cases), and other mutations were detected in FBXW7 (3 cases); TP53 (2 cases), and KIT, PTEN, SMAD4, and SMARCB1 (1 case each). Furthermore, 4 of 8 lesions were MSI-high and the remaining 4 lesions were microsatellite-stable (MSS). Interestingly, all 4 MSI-high lesions displayed MLH1 loss, 3 of which harbored a FBXW7 mutation, but not a TP53 mutation. However, 2 MSS lesions harbored a TP53 mutation, although none harbored a FBXW7 mutation.

Conclusions

SSA/Ps with dysplasia/carcinoma frequently harbored BRAF mutations. Activation of the WNT/β-catenin signaling pathway may facilitate the development of dysplasia in SSA/Ps and progression to carcinoma. Furthermore, our results suggested that these lesions might be associated with both MSI-high and MSS colorectal cancer, which might be distinguished by distinct molecular biological features such as lost MLH1 expression, FBXW7 mutations, and TP53 mutations.