Lin S R, Lee Y J, Tsai J H
Department of Internal Medicine and Clinical Pathology, Kaohsiung Medical College, Taiwan, Republic of China.
J Clin Endocrinol Metab. 1994 Feb;78(2):483-91. doi: 10.1210/jcem.78.2.8106638.
To clarify gene alterations in functional human adrenal tumors, we performed molecular analysis for p53 abnormalities in 23 cases with adrenal neoplasms. The immunohistochemical study with anti-p53 monoclonal antibody pAb1801 demonstrated that 10 of 23 (43.5%) cases overexpressed p53 protein in the tumor cells. Using a polymerase chain reaction-single strand conformation polymorphism study, 5 of 6 (83.3%) pheochromocytoma tissues (1 malignant and 5 benign) and 11 of 15 (73.3%) adrenocortical adenomas (2 with Cushing's syndrome and 13 with primary aldosteronism, all benign) showed an apparent electrophoretic mobility shift between the tumor and its paired adjacent normal adrenal tissue. Such differences were detected in exon 4 (12 cases), exon 5 (2 cases), and exon 7 (3 cases). The types of these mutations in exon 4 were a substitution from threonine (ACC) to isoleucine (ATC) at codon 102 in 5 cases, from glutamine (CAG) to histidine (CAC) at codon 104 in 1 case, from glycine (GGG) to alanine (CGG) at codon 117 in 1 case, from glutamate (GAG) to glutamine (CAG) at codon 68 in 1 case, and single base changes resulting in a premature stop codon at codon 100 in 2 cases. A 2-basepair deletion at codon 175 in exon 5 resulting in a frame shift was identified in 1 case. A single point mutation was identified, resulting in the substitution of glutamine (CAG) for arginine (CGG) at codon 248 of exon 7 in 1 case. A single basepair deletion at codon 249 resulted in a frame shift in 2 cases. There was 1 case with malignant pheochromocytoma that combined a single point mutation in exon 4 and a single base deletion in exon 7. Only 2 of 23 cases showed a loss of a normal allele encoding in the p53 gene. Northern blot analysis with 1.8-kilobase p53 cDNA revealed that p53 mRNA was overexpressed in 6 cases. Our results indicate that high frequencies of p53 gene mutation, especially in exon 4, exist in functional adrenal tumors. As p53 protein is a regulator of guanine nucleotide synthesis, the loss of normal inhibitory regulation by the p53 mutation would serve to increase the availability of GTP for the transduction of signals essential for increased cell growth and hormone expression in the adrenal tumors. These findings suggest that the p53 gene mutation may play a role in the tumorigenesis of benign and functional human adrenal tumors.
为阐明功能性人肾上腺肿瘤中的基因改变,我们对23例肾上腺肿瘤患者进行了p53异常的分子分析。用抗p53单克隆抗体pAb1801进行免疫组化研究表明,23例中有10例(43.5%)肿瘤细胞中p53蛋白过表达。利用聚合酶链反应-单链构象多态性研究,6例嗜铬细胞瘤组织(1例恶性和5例良性)中的5例(83.3%)以及15例肾上腺皮质腺瘤(2例库欣综合征和13例原发性醛固酮增多症,均为良性)中的11例(73.3%)在肿瘤及其配对的相邻正常肾上腺组织之间显示出明显的电泳迁移率改变。这种差异在第4外显子(12例)、第5外显子(2例)和第7外显子(3例)中被检测到。第4外显子中这些突变的类型包括:5例在密码子102处由苏氨酸(ACC)替换为异亮氨酸(ATC);1例在密码子104处由谷氨酰胺(CAG)替换为组氨酸(CAC);1例在密码子117处由甘氨酸(GGG)替换为丙氨酸(CGG);1例在密码子68处由谷氨酸(GAG)替换为谷氨酰胺(CAG);2例单碱基改变导致密码子100处出现提前终止密码子。1例在第5外显子密码子175处发生2个碱基对缺失导致移码。1例在第7外显子密码子248处发生单点突变,导致谷氨酰胺(CAG)替换为精氨酸(CGG)。2例在密码子249处发生单碱基对缺失导致移码。有1例恶性嗜铬细胞瘤合并第4外显子单点突变和第7外显子单碱基缺失。23例中仅2例显示p53基因正常等位基因缺失。用1.8千碱基的p53 cDNA进行Northern印迹分析显示,6例中p53 mRNA过表达。我们的结果表明,功能性肾上腺肿瘤中存在高频率的p53基因突变,尤其是在第4外显子中。由于p53蛋白是鸟嘌呤核苷酸合成的调节因子,p53突变导致正常抑制调节丧失将有助于增加GTP的可用性,用于肾上腺肿瘤中细胞生长和激素表达增加所必需的信号转导。这些发现提示p53基因突变可能在人良性功能性肾上腺肿瘤的肿瘤发生中起作用。