Sanz-Ortega J, Roig F, Al-Mousa M M, Saez M C, Muñoz A, Sanz-Esponera J, Callol L
Hospital San Carlos, Madrid, Spain.
Histol Histopathol. 2007 May;22(5):541-5. doi: 10.14670/HH-22.541.
Molecular cytogenetic and LOH analyses of non-small cell lung cancer (NSCLC) have shown frequent allelic deletions in a variety of chromosomes where tumour suppressor genes are located. Allelic loss at 9p21 (p16 locus), 17p13 (p53) and 5q21(APC) has been frequently described in NSCLC and has also been described in premalignant epithelial lesions of the bronchus and normal bronchial cells. These findings suggest that a tissue field of somatic genetic alterations precedes the histopathological phenotypic changes of carcinoma. Similar changes have been described in oral and laryngeal epithelial tumours associated with smoke exposure. We previously reported frequent LOH at 5q21, 9p21 and TP53 in tumor cells and peritumoral normal bronchial cells from surgically resected NSCLC. We now analyze 96 cases of normal oral exfoliative cytology in which normal epithelial cells were obtained: 43 cases from smoker patients with NSCLC diagnosis, 33 smoker patients with no evidence of malignancy and 20 non-smoker patients with no evidence of tumour. All groups had a similar age and sex distribution. PCR amplification was performed utilising the specific markers D5S346, D9S157 and TP53. In normal oral mucosae cells from patients with NSCLC, we found that 21% of the informative cases showed LOH at any of the three analyzed loci distributed as follows: 14.3% of the informative cases showed LOH at 5q21, 7.7% at 9p21 and 22.2% at TP53. Within the smoker risk group only one case (4% of the informative cases) showed LOH at TP53, while no LOH was found at 5q21 or 9p21. No LOH was found in non-smokers. In conclusion, our results show that a significant number of patients with NSCLC have LOH at TP53, 5q21 and 9p21 in normal oral mucosae, while LOH at these loci is unusual in similar cells obtained from patients with no evidence of malignancy. Our study demonstrates that LOH studies can detect smoker patients with a mutated genotype in normal epithelial cells. Further prospective studies may confirm whether LOH studies can detect patients with a higher risk of NSCLC.
非小细胞肺癌(NSCLC)的分子细胞遗传学和杂合性缺失(LOH)分析显示,在多种存在肿瘤抑制基因的染色体上频繁出现等位基因缺失。9p21(p16位点)、17p13(p53)和5q21(APC)处的等位基因缺失在NSCLC中经常被描述,在支气管的癌前上皮病变和正常支气管细胞中也有报道。这些发现表明,体细胞遗传改变的组织区域先于癌的组织病理学表型变化。在与吸烟相关的口腔和喉上皮肿瘤中也描述了类似的变化。我们之前报道,在手术切除的NSCLC的肿瘤细胞和瘤旁正常支气管细胞中,5q21、9p21和TP53处频繁出现LOH。我们现在分析了96例获得正常上皮细胞的正常口腔脱落细胞学样本:43例来自诊断为NSCLC的吸烟患者,33例无恶性肿瘤证据的吸烟患者,以及20例无肿瘤证据的非吸烟患者。所有组的年龄和性别分布相似。利用特异性标记D5S346、D9S157和TP53进行PCR扩增。在NSCLC患者的正常口腔黏膜细胞中,我们发现21%的信息性病例在三个分析位点中的任何一个位点出现LOH,分布如下:14.3%的信息性病例在5q21处出现LOH,7.7%在9p21处出现LOH,22.2%在TP53处出现LOH。在吸烟风险组中,只有1例(占信息性病例的4%)在TP53处出现LOH,而在5q21或9p21处未发现LOH。在非吸烟者中未发现LOH。总之,我们的结果表明,相当数量的NSCLC患者在正常口腔黏膜中TP53、5q21和9p21处存在LOH,而在无恶性肿瘤证据的患者获得的类似细胞中,这些位点的LOH并不常见。我们的研究表明,LOH研究可以检测出正常上皮细胞中具有突变基因型的吸烟患者。进一步的前瞻性研究可能会证实LOH研究是否能够检测出NSCLC风险较高的患者。