Citations

Abstract The terminology for human papillomavirus (HPV)–associated squamous lesions of the lower anogenital tract has a long history marked by disparate diagnostic terms derived from multiple specialties. It often does not reflect current knowledge of HPV biology and pathogenesis. A consensus process was convened to recommend terminology unified across lower anogenital sites. The goal was to create a histopathologic nomenclature system that reflects current knowledge of HPV biology, optimally uses available biomarkers, and facilitates clear communication across different medical specialties. The Lower Anogenital Squamous Terminology (LAST) Project was cosponsored by the College of American Pathologists and the American Society for Colposcopy and Cervical Pathology and included 5 working groups; 3 work groups performed comprehensive literature reviews and developed draft recommendations. Another work group provided the historical background and the fifth will continue to foster implementation of the LAST recommendations. After an open comment period, the draft recommendations were presented at a consensus conference attended by LAST work group members, advisors, and representatives from 35 stakeholder organizations including professional societies and government agencies. Recommendations were finalized and voted on at the consensus meeting. The final, approved recommendations standardize biologically relevant histopathologic terminology for HPV-associated squamous intraepithelial lesions and superficially invasive squamous carcinomas across all lower anogenital tract sites and detail the appropriate use of specific biomarkers to clarify histologic interpretations and enhance diagnostic accuracy. A plan for disseminating and monitoring recommendation implementation in the practicing community was also developed. The implemented recommendations will facilitate communication between pathologists and their clinical colleagues and improve accuracy of histologic diagnosis with the ultimate goal of providing optimal patient care.

Abstract MUC1 is over expressed and aberrantly glycosolated in >60% of pancreatic ductal adenocarcinomas. Over expression of MUC1 in pancreatic cancer is known, however the functional role has yet to be fully elucidated due to a dearth of appropriate models. In the present study, we have generated mouse models that spontaneously develop pancreatic ductal adenocarcinoma (KC), which are either Muc1 null (KCKO) or express human MUC1 as a self antigen (KCM). We show that PDA mice lacking Muc1 have significantly slower tumor progression, with tumor weight reaching up to a third of the KCM tumor and half of KC tumor. One out of 10 KCKO mice developed secondary metastasis versus 6 out of 10 and 3 out of 10 KCM and KC respectively. Cell lines derived from KCKO tumors have significantly lower tumorigenic capacity compared to cells derived from KCM tumors. Therefore, mice with KCKO tumors had a significant survival benefit compared to mice bearing the KCM tumors. In vitro, the KCKO cells have reduced proliferation and invasion compared to KCM cells and failed to respond to exogenous epidermal growth factor (EGF), platelet-derived growth factor (PDGF), or matrix metalloproteinase-9 (MMP9) stimuli. Further, significantly fewer KCKO cells entered the G2M phase of the cell cycle compared to the KCM cells, consequently more KCKO cells were observed at the S-phase of the cell cycle. Proteomics and western blotting analysis revealed a complete loss of cdc-25c expression, phosphorylation of MAPK, as well as a significant decrease in Nestin and Tubulin α-2 chain expression in KCKO cells. Treatment of the KCM cells with a MEK1/2 inhibitor, U0126, completely abrogated the enhanced proliferation of the KCM cells but had minimal effect on KCKO cells, strongly suggesting that MUC1 is necessary for MAPK activity and downstream oncogenic signaling. This is the first study to utilize a Muc1-null PDA mouse in order to fully elucidate the oncogenic role of MUC1, both in vivo and in vitro. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 1070. doi:10.1158/1538-7445.AM2011-1070

Abstract Introduction: Pancreatic cancer is the fourth leading cause of cancer-related death in United States. Most human pancreatic cancers overexpress MUC1, which is associated with high metastasis and poor prognosis of the disease. We have recently shown that MUC1 initiates the process of epithelial to mesenchymal transition (EMT) and promotes metastasis in pancreatic cancer cells via signaling through the seven tyrosines present in its cytoplasmic tail (CT) motif. When the 7 tyrosines were mutated to phenylalanine, EMT was completely abrogated. Since TGF-β has been extensively studied as a mediator of EMT and invasion in pancreatic cancer, we hypothesized that MUC1 may be inducing its effect through regulating TGF-β production and signaling. We also aimed at identifying the specific tyrosine residue(s) responsible for MUC1 induced EMT. Method: We made the following plasmids containing a) full length MUC1 (MUC1), b) all 7 tyrosine residues of MUC1 CT were mutated to Phenylalanine (Y0), c) Y6 (Tyrosine 6 present, the rest replaced by Phenylalanine), d) Y7 (Tyrosine 7 present, the rest replaced by Phenylalanine), e) Y2,5 (Tyrosine 2 and 5 present, the rest replaced by Phenylalanine), f) Y3,6,7 (Tyrosine3, 6 and 7 present, the rest replaced by Phenylalanine) and g) empty vector (Neo). These plasmids were stably expressed in human pancreatic cancer cell lines, BxPC3 and Su86.86 that express low levels of endogenous MUC1. We first assessed the levels of functional TGF-β secreted by BxPC3 Neo, MUC1 and Y0 cells as well as the levels of TGF-βI and II receptors. We then treated these cells with exogenous human recombinant TGF-β and assessed both, the process of EMT and the capacity to invade through growth-reduced matrigel. Results: We found that BxPC3.MUC1 cells produced strikingly larger amounts of TGF-β compared to BxPC3 Neo and Y0 cells. We also found that MUC1-expressing cells became more invasive in response to exogenous TGF-β while the Y0 cells did not respond to exogenous TGF-β although the receptor levels were similar in all three cell lines. However, none of the mutants of MUC1 CT could rescue the function of full length MUC1, in the context of induction of EMT. Conclusion: 1) We believe that TGF-β mediated EMT and TGF-β signal propagation requires the tyrosine residue of MUC1, which is evident from the data that mutating the tyrosine residues in MUC1CT abrogates TGF-β mediated EMT in these cells. 2) Induction of EMT by MUC1 is a complex process, which involves a particular combination of tyrosine residues of MUC1. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 2910. doi:10.1158/1538-7445.AM2011-2910

Abstract Background: Preliminary results from the Success and Remagus trials showed that CTC detection by CellSearch® has adverse prognostic value in non-metastatic breast cancer. Moreover, several investigators have characterized HER2 expression on CTCs in early breast cancer. Since the majority of CTC-positive women with non-metastatic breast cancer have only 1 CTC detected / blood volume analyzed, we wanted to evaluate the inter-reader variability in this setting. This is a crucial step before moving forward with multi-lab/multi-center prospective testing of the clinical utility of the CellSearch® technology in non-metastatic breast cancer. Methods: Five galleries of CellSearch® images from 3 European and one US institution (a total of 307 images) were mailed to 22 independent readers from 14 European and US academic laboratories and 8 readers from two CellSearch® Veridex laboratories in a blinded fashion. These images came mainly from studies on CTC and/or HER2−positive CTC detection in breast cancer and included healthy women (negative controls), women with metastatic (positive controls) and non-metastatic disease (Pierga et al SABCS 2010, Pierga et al ASCO 2011, Riedthorf et al CCR 2010, Ignatiadis et al PLoS ONE 2011). Each reader reported the images as either CTC-negative or CTC-positive/HER2−negative or CTC-positive/HER2−positive. Kappa statistics were used to assess inter-reader agreement. The 8 Veridex readers were summarized by a majority voting system to derive a gold standard in order to compare each independent reader using discordance rates. Results: Kappa statistics showed moderate to good agreement between independent readers depending on the gallery evaluated (gallery 1 K: 0.55, gallery 2 K:0.57 gallery 3 K:0.64, gallery 4 K:0.72, gallery 5 K:0.85). These differences were attributed to differences in scoring difficulty of each gallery. Discordances in CTC-positive vs CTC-negative events between each reader and the gold standard ranged from 2.3%-31.3% with 7 readers showing discordance rates <5%, 11 readers between 5–10%, 10 readers between 10–14% and only 2 readers showing discordance rates >14% as compared to the gold standard (median discordance rate: 9.3%). Image analysis showed that investigators with high discordance rates compared to the Veridex gold standard were not always taking into account “morphological characteristics” for defining an event as CTC-positive. Discordant results between readers were mainly due to discordance in CTC definition and to a lesser extent in the definition of HER2−positivity. Indeed, discordances in assigning a CTC-positive event as either HER2−negative or HER2−positive ranged from 0.3−13.7% with 19 readers showing discordance rates <5%, 7 readers between 5–10% and 4 readers with discordance rates >10% (median discordance rate: 3.9%). Conclusion: In non-metastatic breast cancer, we observed low discordance between most independent readers and the gold standard for defining a CellSearch® event as CTC with very few readers showing high discordance rates. Concordance can be improved through appropriate training and the use of all the tools provided by the CellSearch® system for image interpretation. Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P4-07-14.

Chromosomal translocations involving the MALT1 gene are hallmarks of mucosa-associated lymphoid tissue (MALT) lymphoma. To date, targeting these translocations to mouse B cells has failed to reproduce human disease. Here, we induced MALT1 expression in mouse Sca1 + Lin − hematopoietic stem/progenitor cells, which showed NF-κB activation and early lymphoid priming, being selectively skewed toward B-cell differentiation. These cells accumulated in extranodal tissues and gave rise to clonal tumors recapitulating the principal clinical, biological, and molecular genetic features of MALT lymphoma. Deletion of p53 gene accelerated tumor onset and induced transformation of MALT lymphoma to activated B-cell diffuse large-cell lymphoma (ABC-DLBCL). Treatment of MALT1-induced lymphomas with a specific inhibitor of MALT1 proteolytic activity decreased cell viability, indicating that endogenous Malt1 signaling was required for tumor cell survival. Our study shows that human-like lymphomas can be modeled in mice by targeting MALT1 expression to hematopoietic stem/progenitor cells, demonstrating the oncogenic role of MALT1 in lymphomagenesis. Furthermore, this work establishes a molecular link between MALT lymphoma and ABC-DLBCL, and provides mouse models to test MALT1 inhibitors. Finally, our results suggest that hematopoietic stem/progenitor cells may be involved in the pathogenesis of human mature B-cell lymphomas.

Case-control studies suggest that increased erythrocyte sodium-lithium countertransport may predict increased susceptibility to the development of essential hypertension. To characterize interindividual variation in sodium-lithium countertransport and its relation to blood pressure levels in the general population, we studied 1,475 Caucasians between 5 and 89 years of age (711 males and 764 females) ascertained through 266 households with children in the schools of Rochester, Minnesota. Individuals who were taking antihypertensive agents or combinations of estrogen and progesterone were not included in the sample. A third-order polynomial regression on age accounted for only a small fraction of variability in sodium-lithium countertransport (2.8% in males, p less than 0.001; 2.1% in females, p less than 0.01), whereas a fourth-order regression on age accounted for a large proportion of variability in systolic blood pressure (45.7% in males, p less than 0.001; 52.5% in females, p less than 0.001) and diastolic blood pressure (39.8% in males, p less than 0.001; 33.0% in females, p less than 0.001). Mean sodium-lithium countertransport was higher in males than females at all ages; but the rank order of male and female means for systolic and diastolic blood pressure was age dependent. Positively skewed distributions for age-, height-, and weight-adjusted sodium-lithium countertransport in male and female cohorts between 5-19.9, 20-49.9, and 50-89.9 years of age were explained significantly better by postulating a mixture of two partially overlapping sodium-lithium countertransport distributions rather than a single normal distribution (p less than 0.01). Among men in the 20-49.9-year-old cohort, adjusted sodium-lithium countertransport values in the upper distribution were associated with higher systolic and diastolic blood pressure (mean +/- SD) than values in the lower distribution (for systolic blood pressure: 115 +/- 11 vs. 111 +/- 11 mm Hg, p less than 0.07; for diastolic blood pressure: 71.2 +/- 8.0 vs. 68.4 +/- 8.6 mm Hg, p less than 0.08). Among females in the 50-89.9-year-old cohort, adjusted sodium-lithium countertransport values in the upper distribution were associated with significantly greater diastolic blood pressure than values in the lower distribution (77 +/- 10 vs. 70 +/- 9 mm Hg, p less than 0.03).(ABSTRACT TRUNCATED AT 400 WORDS)