Kibel A S, Faith D A, Bova G S, Isaacs W B
Department of Urology, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA.
J Urol. 2000 Jul;164(1):192-6.
Our laboratory has recently identified a 1 to 2 Mb homozygous deletion at 12p12-13 in a prostate cancer specimen and determined that the p27/kip1 gene lies within the deletion. While immunohistochemical analysis has implicated p27/kip1 in prostate carcinoma, no previous studies had identified genetic abnormalities at this locus. Here, we examined primary and metastatic prostate tumors to determine if allelic loss occurs at this locus in localized disease and if it increases the risk of metastatic, high stage or high-grade disease.
DNA was extracted from prostate tumors and normal tissue of 99 patients. 60 tumors were primary, 20 were metastatic pelvic lymph nodes, and 19 were distant metastases. Multiple metastases were analyzed from 11 of 19 patients with metastatic disease. Polymorphic markers spanning our region of interest were PCR amplified from tumor and normal DNA. PCR products were then scored for allelic loss.
Loss of heterozygosity (LOH) was identified in 14/60 (23%) primary tumors, 6/20 (30%) lymph node metastasis, and 9/19 (47%) distant metastases. The difference between primary and distant metastatic disease was statistically significant (p = 0.045, Fisher's exact test). The pattern of LOH was identical in all metastatic sites obtained from individual patients, indicating that genetic loss occurred prior to metastasis. Subset analysis of the 60 primary tumors demonstrated no association between LOH and adverse pathological feature [nodal involvement, seminal vesicle invasion, margin positivity, high Gleason score (7-10)].
Demonstrating that 12p12-13 LOH is a prominent feature of primary prostate tumors and that multiple metastatic foci have an identical LOH pattern, provides evidence that gene inactivation in this region occurs prior to metastasis. In addition, the strong association between LOH and distant metastasis raises the possibility that mutational inactivation of a gene at 12p12-13, possibly p27/kip1, plays a pivotal role in the development of metastatic disease.
我们实验室最近在一份前列腺癌标本中发现12p12 - 13区域存在1至2 Mb的纯合缺失,并确定p27/kip1基因位于该缺失区域内。虽然免疫组化分析表明p27/kip1与前列腺癌有关,但此前尚无研究发现该位点的基因异常。在此,我们检测了原发性和转移性前列腺肿瘤,以确定在局限性疾病中该位点是否发生等位基因缺失,以及它是否会增加转移性、高分期或高分级疾病的风险。
从99例患者的前列腺肿瘤和正常组织中提取DNA。60例肿瘤为原发性,20例为转移性盆腔淋巴结,19例为远处转移灶。对19例转移性疾病患者中的11例的多个转移灶进行了分析。从肿瘤和正常DNA中PCR扩增跨越我们感兴趣区域的多态性标记。然后对PCR产物进行等位基因缺失评分。
在14/60(23%)的原发性肿瘤、6/20(30%)的淋巴结转移灶和9/19(47%)的远处转移灶中发现杂合性缺失(LOH)。原发性和远处转移性疾病之间的差异具有统计学意义(p = 0.045,Fisher精确检验)。从个体患者获得的所有转移部位的LOH模式相同,表明基因缺失发生在转移之前。对60例原发性肿瘤的亚组分析表明,LOH与不良病理特征[淋巴结受累、精囊侵犯、切缘阳性、高Gleason评分(7 - 10)]之间无关联。
证明12p12 - 13 LOH是原发性前列腺肿瘤的一个显著特征,且多个转移灶具有相同的LOH模式,这为该区域的基因失活发生在转移之前提供了证据。此外,LOH与远处转移之间的强关联增加了12p12 - 13处基因(可能是p27/kip1)的突变失活在转移性疾病发展中起关键作用的可能性。