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Molecular Oncology, Markers, Clinical Correlates |
1 Department of Biochemistry and Molecular Oncology, Institute of Basic Medical Sciences, and 2 Department of Surgery, Institute of Clinical Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan; 3 Department of Molecular, Cell Pharmacology, National Center for Child Health and Development Research Institute, Tokyo, Japan
| ABSTRACT |
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Experimental Design: Gene expression profiles for PTC tissue, normal thyroid tissue, and healthy peripheral blood cells were compared by use of a human 4000-gene cDNA microarray. Protein expressions of the up-regulated genes in PTC were examined in thyroid tissues by immunohistochemistry.
Results: Sixty-four genes were overexpressed in PTC tissue relative to normal thyroid tissue and healthy peripheral blood cells. The genes that were up-regulated in PTC were involved in cell cycle regulation, DNA damage response, angiogenesis, and oncogenesis. Among these genes, basic fibroblast growth factor and platelet-derived growth factor were identified by immunochemical methods as proteins that are specifically expressed at high levels in thyroid neoplasms. Basic fibroblast growth factor, which has been identified as a biomarker for PTC, was overexpressed in 54% of PTC cases, 67% of follicular thyroid carcinomas, and 36% of benign thyroid neoplasms. Platelet-derived growth factor was overexpressed in 81% of PTC cases and 100% of follicular carcinomas, but was immunonegative in normal thyroid tissues and benign thyroid neoplasms.
Conclusions: Platelet-derived growth factor may be a potential biomarker for PTC and follicular carcinoma. Expression profile analysis using a microarray followed by immunohistochemical study can be used to facilitate the development of molecular biomarkers for cancer.
| INTRODUCTION |
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20% of PTC tumors recur (1)
, and some reach advanced stages. Postoperative follow-up for diagnosing recurrence is important for a favorable outcome. Although PTC can be diagnosed by fine-needle aspiration cytology, this method is not sufficiently reliable for predicting postoperative clinical outcome. Serum thyroglobulin (TG) has been monitored by immunoassay to detect the recurrence of differentiated thyroid carcinoma. However, measurement of serum TG is sometimes hindered by the presence of circulating factors, particularly anti-TG antibodies (2)
, and residual normal thyroid (NT) gland tissue that produces TG. Thus, a reliable diagnostic molecular marker for PTC would be extremely valuable for improving cancer detection and the prognosis of patients with PTC. A common approach for identifying circulating cancer cells in peripheral blood is the reverse transcription-PCR (RT-PCR) method for amplifying tumor-specific mRNA (3 , 4) . Another possible approach is to measure abnormal or ectopic tissue-specific gene expression in peripheral blood. Previous studies have investigated the thyroid-specific markers TG, thyroid peroxidase (TPO), Ret/PTC1, and human sodium/iodide symporter (NIS) as diagnostic markers of thyroid carcinomas (5, 6, 7, 8) . However, expression of TG is reportedly not thyroid specific and is not correlated with thyroid cancer (9 , 10) . Although RT-PCR detection of a marker for circulating cancer cells in peripheral blood would be an effective noninvasive method, a reliable marker for PTC has not yet been identified.
Use of a cDNA microarray is a powerful method for the quantitative analysis of cancer-specific gene expression (11 , 12) that can detect altered gene expression associated with the pathology or the altered biology of cancer cells. A cDNA microarray can be used to identify potential diagnostic markers for cancer by measuring tumor-specific expression of thousands of genes in hundreds of tumors. Candidate genes for diagnostic markers can also be characterized by analyzing the gene expression profiles of a small number of cancer tissues in combination with the further large-scale immunohistochemical analysis of protein expression.
In this study we examined potential PTC-specific molecular markers that could be used to identify circulating cancer cells in peripheral blood or tumor-associated proteins in serum.
| MATERIALS AND METHODS |
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Microarray Preparation.
A 5-µl aliquot of sequence-verified human 3968 cDNA (Invitrogen, Carlsbad, CA) was added to 2.5 ml of Terrific broth (Difco, Detroit, MI) containing ampicillin and incubated at 37°C overnight. Plasmid DNA was extracted from each culture in a 96-well format by use of an alkaline-SDS method with a MultiScreen plate (Millipore, Bedford, MA). The microarray membrane was prepared with human 3968 cDNA, which contains genes named in the UniGene database (National Center for Biotechnology Information, Bethesda, MD). The cDNA insert was diluted and amplified by standard PCR protocols using the primer set GF-FW (5'-CTG CAA GGC GAT TAA GTT GGG TAA C-3') and GF-RV (5'-GTG AGC GGA TAA CAA TTT CAC ACA GGA AAC AGC-3'). The amplification products, including thyroid-specific cDNAs, were purified by use of Multi Screen-PCR plates (Millipore) and spotted on Hybond-N Plus membranes (Amersham, Buckinghamshire, United Kingdom) with a GTMASS arrayer (NLE, Nagoya, Japan).
Hybridization and Data Analysis.
A 2-µg portion of total RNA was dissolved in 8 µl of RNase-free water; 2 µl of oligo(dT) primer (1 µg/µl; Invitrogen) were then added. The sample was heated for 10 min at 70°C and immediately chilled on ice. The following were then added to the sample: 5 µl of first-strand cDNA synthesis buffer, 1 µl of DTT (0.1 M final concentration), 1.5 µl of deoxynucleotide triphosphates (20 mM dATP, dGTP, and dTTP), 1.5 µl of SuperScript (200 units/µl; Invitrogen), and [
-33P]dCTP (3000 Ci/mmol; Amersham). The reaction was incubated at 37°C for 90 min. Labeled cDNA was then purified by use of Bio-Spin 6 chromatography columns (Bio-Rad Laboratories, Hercules, CA) and denatured for 3 min at 95°C. The microarray was prehybridized at 42°C for 2 h in MicroHyb solution (Invitrogen) with 0.5 µg/ml poly(dA) and 1 µg/ml COT1 DNA (Invitrogen). The probes were hybridized at 42°C overnight in the same solution. The membrane microarray was washed twice at 50°C with 2x SSC-1% SDS for 20 min and at room temperature with 0.5x SSC-1% SDS for 15 min. The membrane microarray was exposed to an imaging plate, which was scanned with a BAS 5000 imaging analyzer (Fuji Film, Tokyo, Japan). Spot intensity was quantified with ArrayVision 5.0 software (Imaging Research, Ontario, Canada). GeneSpring 5.0 software (Silicon Genetics, Redwood, CA) was used to normalize values for each gene and each microarray, and for data analysis.
The accuracy of microarray data was determined by six repeat analyses of the same RNA from NT tissue. Probes were stripped by boiling with 0.5% SDS before rehybridization.
Northern Blot Analysis.
Aliquots containing 10 µg of total RNA were electrophoresed on a 1% formaldehyde-agarose gel, transferred to a nylon membrane, and immobilized by baking the filters at 80°C for 2 h. The membrane was prehybridized with Churchs solution (0.5 M sodium phosphate-7% SDS-1 mM EDTA) at 68°C for 2 h. The DNA fragments for adrenergic receptor ß kinase 1, myeloid leukemia factor, TG, TPO, thyroid-stimulating hormone receptor (TSHR), and glyceraldehyde-3-phosphate dehydrogenase were amplified from cDNA and sequenced by a standard protocol. After sequence confirmation, the DNA fragment was labeled with [
-32P]dCTP by a random primer cDNA labeling method with the commercial Megaprime DNA Labeling System (Amersham). The heat-denatured probe was added to the prehybridization solution and incubated at 68°C overnight.
Real-Time Quantitative PCR for Determination of mRNA Levels.
The gene expression levels of NIS, TPO, and the Ret proto-oncogene (RET) were examined by real-time quantitative PCR. A 1-µg aliquot of total RNA for each sample was reverse-transcribed in a 100-µl reaction volume with a commercial High-Capacity cDNA Archive Kit (Applied Biosystems PE) according to manufacturers protocol. The quantitative PCR reaction was carried out in 96-well microtiter plates on the ABI Prism Sequence Detector 7900 (Applied Biosystems) with a commercial Assays-on-Demand kit (Applied Biosystems). The probe sequences for PCR were as follows: 5'-GGC GCT CTG CAC CAG ATC ATC ACC C-3' for TPO; 5'-GGC TCC TGG GAG GGT GAG GGT CTG CC-3' for RET; and 5'-AGC TGC CTG ACA GGC CCC ACC AAG C-3' for NIS. For each sample of each gene, PCR amplification was performed in triplicate with 18S rRNA used as an endogenous control. The mRNA content of each target was determined simultaneously in three paired normal/tumoral samples studied by DNA array analysis.
Immunohistochemistry.
Archival formaldehyde-fixed, paraffin-embedded blocks were obtained from Tsukuba University Hospital. Sections were cut 5-µm thick, deparaffinized, and rehydrated. Antigen retrieval for platelet-derived growth factor (PDGF) antibody staining was performed with 0.01 M citrate buffer. Endogenous peroxidase activity was inactivated with a blocking agent. After washing, the sections were exposed to a 1:100 solution of antihuman basic fibroblast growth factor (bFGF) monoclonal antibody (WAKO Pure Chemical Industries, Osaka, Japan) or PDGF polyclonal antibody (WAKO Pure Chemical Industries) at 4°C overnight and incubated with peroxidase-labeled dextran polymer (Envision Plus System; DAKO, Kyoto, Japan) for 1 h. Staining without primary antibodies was used as a negative control. For visualization, tissue sections were soaked in medium containing 3,3-diaminobenzidine tetrahydrochloride and H2O2 and were counterstained with hematoxylin. Cytoplasmic staining was assessed by identifying and scoring 100 cells within a randomly selected light microscopic field (x400 magnification). The cytoplasm of those cells was scored as 0 (no staining), 1 (mild staining), 2 (moderate staining), or 3 (heavy staining) by two independent observers. The results are presented as proportions of 1000 cells (fields from multiple slides were examined) from which the histochemical score for determining the level of expression was then calculated (13)
. Expression was considered to be positive when the histochemical score was >75.
Cytological specimens were obtained intraoperatively by fine-needle aspiration. Cells were smeared on the slide and fixed in formaldehyde. The PDGF protein expression was examined as described above.
| RESULTS |
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Hierarchical Clustering Analysis.
Expression profiles were analyzed for seven PTC samples and seven NT samples, including three pairs of normal/tumoral thyroid tissues. The cutoff for differential expression associated with PTC was set at 2.0-fold. Clustering analysis was performed with the model-based approach with GeneSpring software and showed a similar expression pattern among PTC samples (Fig. 1)
. Most of the NT tissue samples were clustered in one group, and the tumors were clustered in another group. The NT and PTC groups were separated by the differential expression of genes; these differences were determined to be statistically significant by the t test (<0.05). Several genes showed up-regulated expression patterns in PTC (Table 1)
. The proteins encoded by the altered genes are associated with cell cycle regulators, growth regulators, oncogenes, and DNA damage regulators.
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PTC-Specific Gene Expression.
Genes that were differentially expressed in PTC compared with paired normal tissue obtained from the same patients were also detected. We focused on those genes that showed up-regulated expression in at least one NT/PTC pair and statistically different expression from other NT samples. This screening identified 64 genes showing a >2-fold increase in expression. Table 2
summarizes the tumor-related genes that showed PTC-specific expression (PTC/NT ratio).
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| DISCUSSION |
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Cytological specimens from fine-needle aspirates were also immunoreactive for PDGF. Physicians make their diagnosis of PTC on the basis of morphology from fine-needle aspirate biopsy samples, but not immunochemistry. Immunostaining these samples for PDGF may be helpful for identifying PTC. On the basis of our results for fine-needle aspirate cytology, thyroid tumors could be more accurately diagnosed by a combination of morphological diagnosis and detection of PDGF expression.
Microarray analysis was performed on 4000 human cDNA arrays and RNA from 7 PTC samples and 7 normal samples, including 3 PTC/NT pairs. The reproducibility of the microarray data was confirmed. Clustering analysis classified samples as PTC or NT and identified 64 genes whose expression is up-regulated in PTC but low or undetectable in NT and PBCs. Although more clinical cases need to be studied, the expression profiles of selected genes in these PTC samples may be representative of this type of cancer cell.
Of the 64 genes with up-regulated expression, several genes may be candidates as diagnostic markers for thyroid carcinoma. Such markers could be particularly useful for monitoring patients postoperatively. An ideal biomarker for cancer in its early diagnosis should have both tumor and tissue specificity. Our microarray screening did not give any information about tissue specificity. Although a protein that shows both tumor and tissue specificities might be rare, a detailed study of the candidate genes detected by the microarray in this study might successfully find such biomarkers.
Previous studies have similarly identified genes up-regulated in PTC [i.e., fibronectin 1 (18) , galectin-3 (19) , S100 calcium-binding proteins (20 , 21) , and insulin receptor (22) ], indicating that these genes may be involved in the development of thyroid carcinogenesis. From previous microarray studies (23 , 24) , it is difficult to identify common up-regulated genes in PTC. Overlapping gene expression among microarray studies may depend on the microarray probe design, which may explain some of the overlap between studies. However, several of the genes related to cell cycle, carcinogenesis, oncogene, and growth factors showed similar expression patterns in our and other studies.
The thyroid follicular cell is a highly differentiated cell that responds to thyroid-stimulating hormone, traps iodine, and synthesizes TG and TPO. Thus, TG, TPO, and TSHR can be used as markers for the differentiation of follicular cells. In this study, TG was expressed at a high level in PTC. However variable levels of TG expression have been observed in thyroid malignancies (25, 26, 27, 28, 29, 30) . Some studies reported that the expression was not thyroid specific (9 , 10) ; in fact, we found TG expression in healthy PBCs. We selected three thyroid-related genes for additional analysis to validate the microarray expression data. In this study, we found that the gene expression levels of TPO and NIS were decreased; this supports previous findings (28 , 30, 31, 32) . The gene RET, a tyrosine kinase receptor, may be a major proto-oncogene in thyroid carcinogenesis: RET rearrangement is the most common genetic alternation found in PTC (33, 34, 35) . In this study we did not detect RET gene expression in NT tissue and found different levels of expression in PTC samples. These data coincide with previous reports using RT-PCR (36) .
In summary, this study demonstrates that microarray technology can be used to develop molecular markers for cancer diagnosis. Some of the genes shown to have strong expression might be used as serum tumor markers of thyroid cancers. In particular, gene expression profiling was used to identify genes differentially regulated in PTC. From this set of genes, PDGF was identified as a strong candidate diagnostic marker for PTC because it was highly expressed in 81% of PTC cases at the protein level. Antibodies to PDGF could be extremely useful in future studies to evaluate the clinical potential of PDGF as a diagnostic marker for PTC. The expression profiling data presented here may also improve our understanding of thyroid carcinogenesis.
| FOOTNOTES |
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The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked advertisement in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.
Requests for reprints: Kazuhiko Uchida, Department of Biochemistry and Molecular Oncology, Institute of Basic Medical Sciences, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba, Ibaraki 305-8575, Japan. Phone: 81-29-853-3115/3070; Fax: 81-29-853-3271; E-mail: yanoyuki{at}rg7.so-net.ne.jp
Received 5/27/03; revised 11/ 5/03; accepted 11/ 5/03.
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