State Key Laboratory of Oncology in South China, Cancer Center, Sun Yat-Sen University, Guangzhou, China.
J Pathol. 2013 Apr;229(5):765-74. doi: 10.1002/path.4163. Epub 2013 Feb 22.
Chemoradiotherapy (CRT) is a standard treatment for oesophageal squamous cell carcinoma (ESCC) in its advanced stages. The telomerase/telomere interacting protein PinX1 contributes to telomere maintenance, tumourigenicity, and influences the DNA damage agent-induced apoptotic response in telomerase-positive cancer cells. However, the clinical and biological significance of PinX1 in human ESCCs remains unclear. We examined the expression dynamics of PinX1 by immunohistochemistry in a learning cohort (n = 98) and a validation cohort (n = 59) of ESCC patients treated with definite chemoradiotherapy (CRT). A series of in vivo and in vitro assays were performed to elucidate the effect of PinX1 on ESCC cells' CRT response and underlying mechanisms. Knockdown of PinX1 did not affect ESCC cells' chemosensitivities to 5-fluorouracil and cisplatin, but substantially increased ESCC cells' therapeutic efficacy of radiation both in vitro and in vivo. Ectopic overexpression of PinX1 dramatically enhanced ESCC cells' resistance to radiotherapy. Furthermore, we demonstrated that PinX1 resistance to radiotherapy (RT) was attributed to PinX1 maintaining telomere stability, reducing ESCC cell death by RT-induced mitosis catastrophe (MC). High expression of Pinx1 correlated positively with ESCC's resistance to CRT, and was a strong and independent predictor for short disease-specific survival (DSS) of ESCC patients. Our data suggest that PinX1 could serve as a novel predictor for a CRT response to ESCC patients, and the pathway of PinX1-mediated telomere stability might represent a new target to improve the RT effect of ESCC.
放化疗(CRT)是治疗晚期食管鳞状细胞癌(ESCC)的标准方法。端粒酶/端粒相互作用蛋白 PinX1 有助于端粒维持、肿瘤发生,并影响端粒酶阳性癌细胞中 DNA 损伤剂诱导的凋亡反应。然而,PinX1 在人 ESCC 中的临床和生物学意义尚不清楚。我们通过免疫组织化学检测了接受明确 CRT 治疗的 ESCC 患者的学习队列(n=98)和验证队列(n=59)中 PinX1 的表达动态。进行了一系列体内和体外实验,以阐明 PinX1 对 ESCC 细胞 CRT 反应的影响及其潜在机制。敲低 PinX1 不影响 ESCC 细胞对 5-氟尿嘧啶和顺铂的化学敏感性,但显著增加了 ESCC 细胞在体外和体内对辐射的治疗效果。PinX1 的过表达显著增强了 ESCC 细胞对放疗的抵抗力。此外,我们证明了 PinX1 对放疗(RT)的抵抗力归因于 PinX1 维持端粒稳定性,通过 RT 诱导的有丝分裂灾难(MC)减少 ESCC 细胞死亡。Pinx1 的高表达与 ESCC 对 CRT 的耐药性呈正相关,是 ESCC 患者疾病特异性生存(DSS)短的强烈且独立的预测因子。我们的数据表明,PinX1 可作为 ESCC 患者 CRT 反应的新型预测因子,PinX1 介导的端粒稳定性途径可能代表改善 ESCC RT 效果的新靶点。