Paula Silva

BRAF mutations are associated with some histological types of papillary thyroid carcinoma

Mutations in the BRAF gene have recently been detected in a wide range of neoplastic lesions with a particularly high prevalence in melanoma and papillary thyroid carcinoma (PTC). The hot‐spot mutation BRAFV599E is frequently detected in PTC (36–69%), in contrast to its absence in other benign or malignant thyroid lesions. In order to unravel whether there is any association between the occurrence of the BRAF mutation and the histological pattern of PTC, in this study a previous series of 50 PTCs was extended to 134 cases, including ten cases of PTC‐related entities—hyalinizing trabecular tumour (HTT) and mucoepidermoid carcinoma (MEC). Using PCR/SSCP and sequencing, the BRAFV599E mutation was detected in 45 of the 124 PTCs (36%). No mutations were detected in any case of HTT and MEC. BRAFV599E was present in 75% of Warthin‐like PTCs and 53% of conventional PTCs, whereas no BRAFV599E mutations were detected in any of the 32 cases of the follicular variant of PTC. BRAFV599E was also detected in 6 of 11 cases of the oncocytic variant of PTC that displayed a papillary or mixed follicular–papillary growth pattern and in none of the four oncocytic PTCs with a follicular growth pattern. A distinct mutation in BRAF (codon K600E) was detected in three cases of the follicular variant of PTC. This study has confirmed the high prevalence of BRAFV599E in PTC and has shown that the mutation is almost exclusively seen in PTC with a papillary or mixed follicular–papillary growth pattern, regardless of the cytological features of the neoplastic cells. The results support the existence of an oncocytic variant of PTC that should be separated from the oncocytic variant of follicular carcinoma and suggest that the follicular variant of PTC may be genetically different from conventional PTC. Copyright

Novel and classic myoepithelial/stem cell markers in metaplastic carcinomas of the breast

Metaplastic carcinomas of the breast (MCBs) are unusual neoplasms characterized by an admixture of glandular epithelial components, which frequently exhibit features of squamous differentiation, and mesenchymal malignant components. Regardless of the presence of myoepithelial features in MCB, no consensus concerning their putative histogenesis has yet been achieved. Recently, novel putative myoepithelial markers have been developed, including p63, maspin, and P-cadherin. We assessed the expression of these myoepithelial markers in MCBs and compared their expression with classic myoepithelial markers. Immunohistochemistry using the streptavidin–biotin–peroxidase complex technique with antibodies raised against p63, maspin, P-cadherin, actin (clones CGA7, 1A4 and HHF35), cytokeratin 14 (Ck14), and vimentin was performed on 16 MCBs (7 matrix-producing MCBs, 6 adenosquamous MCBs, and 3 MCBs with heterologous elements). In healthy breast lobules and ducts adjacent to the tumors, myoepithelial cells showed distinctive and consistent immunoreactivity for p63, maspin, P-cadherin, actin, S-100 protein, and Ck14. Matrix-producing MCBs were positive for maspin in all cases, for p63 in 4 of 7 cases, and for P-cadherin in 4 of 7 cases. Adenosquamous MCB showed immunoreactivity for p63, maspin, and P-cadherin in 5 of 6 cases. All novel myoepithelial markers and Ck14 decorated squamous cell islands. MCBs with heterologous elements were positive for p63 in 1 case, for maspin in all 3 cases, and for P-cadherin in 2 cases. All cases showed at least one of the novel myoepithelial markers. Eleven of 16 cases were positive for actin. Eleven of 14 cases reacted with Ck14, and all cases that stained for S-100 protein (9 of 9) and vimentin (13 of 13) were also positive. Based on our findings, the balance of probabilities favors that MCBs may have a basal or myoepithelial cell histogenesis and differentiation.

Expression of c-met Tyrosine Kinase Receptor Is Biologically and Prognostically Relevant for Primary Cutaneous Malignant Melanomas

Objectives: The c-met tyrosine-kinase receptor and its ligand hepatocyte growth factor are involved in cell survival, proliferation, motility, and invasion. Experimental data have suggested a putative role in melanomagenesis and progression of cutaneous malignant melanoma (CMM). We sought to evaluate c-met expression in a cohort of 62 primary CMM patients diagnosed and primarily treated at the same institution. Methods: Sixty-two cases of CMM were retrospectively retrieved from the archives of the Department of Pathology, Hospital São João, Porto, Portugal. All classical clinicopathological features were reviewed. Only those patients in whom representative paraffin blocks were available and the diagnosis of primary CMM was confirmed, and who were followed up after the primary diagnosis were included in the study. Immunohistochemistry for c-met was performed in 59 cases, and semiquantitatively and qualitatively (membranous and cytoplasmic, M+C, or cytoplasmic) evaluated. Statistical analysis was performed using χ2, ANOVA and Kaplan-Meier/log-rank tests. Results: M+C pattern of c-met expression was significantly associated with presence of vertical growth phase (p = 0.0198), thick tumors (p = 0.0006), ulceration (p = 0.0386), high mitotic index (p = 0.0008), lymphatic (p = 0.0086) and vascular (p = 0.0080) invasion, and nodal (p = 0.0422) and combined (nodal and/or visceral) metastases (p = 0.0234). M+C pattern of c-met expression also proved to be a significant prognostic factor for overall survival in univariate analysis (p = 0.0125). Conclusions: Our findings suggest that the pattern of c-met expression is a relevant prognostic factor for overall survival and is associated with more aggressive behavior of primary CMMs.

Telomerase expression and proliferative activity suggest a stem cell role for thyroid solid cell nests.

Solid cell nests of the human thyroid gland are composed of main cells and C cells. In order to investigate the putative stem cell nature of the role for solid cell nests, we evaluated the histological features, and the immunohistochemical expression of p63, bcl-2, telomerase catalytic subunit, and two proliferative markers (Ki-67 and minichromosome maintenance protein 2), in a series of 24 cases of solid cell nests. Proliferative indices were determined in (a) solid cell nests, (b) thyroid follicular cells in the vicinity of solid cell nests within a low-power field, and (c) distant thyroid tissue, at a distance of at least three low-power fields from solid cell nests. In 15 cases of solid cell nests (62.5%), mixed follicles were observed; papillary formations were observed in four cases (16.6%), and ciliated cells were observed in the lining of microcysts associated with two cases (8.3%). Salivary gland-type tissue, cartilage islands, adipose and fibrous tissues, and small nerves were also associated with some cases of solid cell nests. We observed that the main cells of the solid cell nests express consistently telomerase, although at lower levels than p63, and show strong cytoplasmic immunoreactivity for bcl-2, which is associated with an increased differentiation potential. We also observed that despite their relative low proliferative index, main cells of the solid cell nests display higher proliferation than follicular cells in the vicinity and follicular cells in more distant thyroid tissue. We conclude that main cells of the solid cell nests apparently harbor the minimal properties of a stem cell phenotype (capacity for both self-renewal, conferred by telomerase activity, and differentiation to one or more than one type of specialized cells, given by the high expression of p63 and bcl-2) and may thus represent a pool of stem cells of the adult thyroid.

Maspin Expression in Myoepithelial Tumors of the Breast

Maspin is a mammary inhibitory serine protease that harbors tumor suppressor, tumor invasiveness-suppression and anti-angiogenic properties. It is consistently expressed by mammary myoepithelial cells. However, to the best of our knowledge, no assessment of maspin immunoexpression in myoepithelial cell lesions of the breast has been reported so far. We evaluated maspin expression by immunohistochemistry in five normal breast samples, one sclerosing papilloma (SP), one tubular adenomyoepithelioma (TA), one adenoid cystic carcinoma (ACC), one epithelial-myoepithelial carcinoma of the breast (EMC), and one malignant adenomyoepithelioma (MA). We also compared maspin expression with the expression of other classic myoepithelial markers in myoepithelial and secretory cells, as well as in stromal components of all samples. In normal breast samples, maspin expression was restricted to myoepithelial cell nuclei and cytoplasm. A strong nuclear and cytoplasmic maspin immunoreactivity was observed in the myoepithelial components of SP, TA, ACC, and EMC. In MA, maspin immunoreactivity was confined to the nucleus and cytoplasm of the cells lining tubular-like and papillary structures, as well as in squamous cells. The myoepithelial nature of maspin-positive cells was further confirmed by classic myoepithelial cell markers, including alpha-actin and S-100 protein. No stromal, neural or vascular components were immunostained by maspin. In spite of the small number of myoepithelial lesions here assessed, we suggest that maspin should be used in surgical pathology practice either as an additional marker in immunohistochemical panels defining a myoepithelial histogenesis in odd breast neoplasms, or in those cases in which the definite diagnosis relies on the myoepithelial cell layer identification.

Evaluation of the mTOR pathway in ocular (uvea and conjunctiva) melanoma.

Ocular melanoma is the most common eye malignancy in adults. It usually arises in the uvea, mostly in the choroid and less frequently in the conjunctiva. There is no curative therapy available when it becomes metastatic. The etiopathogenesis of uvea and conjunctiva melanomas is still poorly understood. The mammalian target of rapamycin (mTOR) pathway is involved in many biological processes and has been implicated in the development of cutaneous melanoma tumours. The mTOR pathway is an important target for anticancer drug development, and an inhibitor of this pathway has already been approved for use in humans to treat advanced renal cell carcinoma. The aim of this study was to evaluate the contribution of the mTOR pathway in uvea and conjunctiva melanomas. We analysed specific mTOR pathway effectors using immunohistochemical analysis of 30 uvea and eight conjunctiva melanoma samples. We assessed the association with prognostic clinical-pathological features, and performed mutational analysis on the BRAF and NRAS genes. None of the cases had mutations in either BRAF or NRAS. Expression of phospho-AKT Thr308 was associated with metastatic uvea melanomas. In conjunctiva melanomas, overactivation of the mTOR pathway, as confirmed by high phospho-AKT Ser473 and Thr308, S6 and p4EBP1 Thr37/46 levels, was associated with adverse prognostic parameters (mitotic index and tumour thickness). Conjunctiva melanomas displayed high expression of phospho-mTOR effectors in contrast with uvea melanomas, in which PTEN seemed to downregulate the mTOR pathway. Characterizing the expression of PTEN, AKT and pS6 Ser235/236 might be a useful predictive tool for deciding whether to use mTOR inhibitors to treat conjunctiva melanomas.

Genomic approach in evaluating the role of androgens on the growth of Atlantic cod (Gadus morhua) previtellogenic oocytes

Previous studies have suggested that androgens may play an integral role in early oocyte development in fish. This study evaluated the effects of androgens (11-ketotestosterone: 11-KT and testosterone: T) on gene expression patterns and growth of cod previtellogenic oocytes. cDNA libraries of androgen-responsive genes were generated using suppressive subtractive hybridization (SSH) of clones containing differentially expressed genes in oocytes separately exposed to different concentrations of 11-KT and T, in addition to a solvent control. Secondly, a targeted microarray was developed based on differentially expressed genes. In the experimental setup, tissue was cultured in vitro with different concentrations of 11-KT and T (0, 10 and 100 muM). The array analyses showed 0.5-3.5-fold significant alterations in transcript levels for a number of genes. Real-time PCR and in -situ hybridization were also used to analyze the changes in expression for selected genes. Quantitative histological analyses showed a consistent stereological validation of oocyte growth and development after exposure to androgens. The present study reveals novel roles of androgens on the development of previtellogenic oocytes, suggesting androgen control of early oocyte growth in cod. The strong effects of 11-KT on oocyte growth support our hypothesis that non-aromatizable androgens may exert direct hormonal effects in previtellogenic oocytes, with possible consequences for overt fecundity.

Testing the effects of ethinylestradiol and of an environmentally relevant mixture of xenoestrogens as found in the Douro River (Portugal) on the maturation of fish gonads—A stereological study using the zebrafish (Danio rerio) as model

In natural environments fish populations are exposed to many potential xenoestrogens, whereby understanding the impacts of mixtures continue to be of great interest. The main objective of this study was, therefore, to understand whether and how an environmentally relevant mixture of xenoestrogens found in the Douro River estuary can disrupt the normal gametogenesis in fish. For this purpose, adult zebrafish of both sexes were exposed for 21 days to an environmental mixture (MIX) of 11 xenoestrogens from diverse sources. A 100 ng/L ethinylestradiol (EE2) positive control was added. A quantitative (stereological) analysis with systematic sampling was made in the gonads, and using light microscopy both the relative and the absolute volumes of the gametogenic stages were estimated. Data point that the EE2 stimulus induced changes in structural compartments; with decreasing trends for the advanced maturation stages both in males and females. There was also a trend for a greater amount of interstitial tissue in males. Along with an interstitial fibrosis increase detected, the presence of a proteinaceous fluid was observed in both sexes and experimental groups (EE2 and MIX). Other histopathologic alterations were observed in the EE2 female group, such as the presence of foci of granulomatous inflammation and follicular mineralization in the germinal parenchyma and luminal areas. The most interesting finding of this study was that the exposure to the MIX caused a decrease of the relative volume of spermatozoa in zebrafish. This kind of estrogenic effect has not earlier been structurally quantified in such a fine detail with unbiased stereology in fish gonads. Despite the ultimate consequences of such disruptions being unknown, it could be logically argued that reduction or slowing-down of the appearance of the most mature cohorts and/or eventual interstitial fibrosis and other pathologic changes can adversely affect breeding. The findings add further explanatory bases for understanding the negative impacts of xenoestrogens.

DNA copy number profiles of gastric cancer precursor lesions

BackgroundChromosomal instability (CIN) is the most prevalent type of genomic instability in gastric tumours, but its role in malignant transformation of the gastric mucosa is still obscure. In the present study, we set out to study whether two morphologically distinct categories of gastric cancer precursor lesions, i.e. intestinal-type and pyloric gland adenomas, would carry different patterns of DNA copy number changes, possibly reflecting distinct genetic pathways of gastric carcinogenesis in these two adenoma types.ResultsUsing a 5K BAC array CGH platform, we showed that the most common aberrations shared by the 11 intestinal-type and 10 pyloric gland adenomas were gains of chromosomes 9 (29%), 11q (29%) and 20 (33%), and losses of chromosomes 13q (48%), 6(48%), 5(43%) and 10 (33%). The most frequent aberrations in intestinal-type gastric adenoma were gains on 11q, 9q and 8, and losses on chromosomes 5q, 6, 10 and 13, whereas in pyloric gland gastric adenomas these were gains on chromosome 20 and losses on 5q and 6. However, no significant differences were observed between the two adenoma types.ConclusionThe results suggest that gains on chromosomes 8, 9q, 11q and 20, and losses on chromosomes 5q, 6, 10 and 13, likely represent early events in gastric carcinogenesis. The phenotypical entities, intestinal-type and pyloric gland adenomas, however, do not differ significantly (P = 0.8) at the level of DNA copy number changes.

Molecular alterations of KIT and PDGFRA in GISTs: evaluation of a Portuguese series

Aim: To assess KIT and PDGFRA mutations frequencies in a Portuguese series of gastrointestinal stromal tumours (GISTs). Methods: 78 GISTs were evaluated for CD117 expression and screened for mutations in KIT (exons 9, 11, 13, 14 and 17) and PDGFRA (exons 12, 14 and 18) genes. Results: KIT activating mutations were identified in 44 (56%) of the 78 GISTs. Forty cases (91%) presented a mutation in KIT exon 11, and 4 (9%) in exon 9. One case showed a 4 bp deletion in intron 14. PDGFRA mutations were observed in 5 cases (6%): 2 (3%) in exon 12 and 3 (4%) in exon 18. Survival analysis was performed in 63 of the 78 GISTs. The presence of mutated KIT was significantly correlated with shorter survival of patients (p = 0.0460), and inversely associated with epithelioid histological type of GISTs (p = 0.0064). Conclusions: Overall, the incidence of both KIT and PDGFRA mutations in these Portuguese series was 63%, being in agreement with other studies, mainly of Iberian populations. The great majority of mutations were located in KIT exon 11, statistically associated with worse prognosis and indicative of favourable response to imatinib-based therapy in this Portuguese series of GISTs.