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Determination of Tumor Heterogeneity in Colorectal Cancers Using Heterogeneity Tissue Microarrays

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Pathology & Oncology Research

Abstract

Cancer is often heterogeneous both on a morphological and on a genetic level. Though resected tumors are often large, molecular tumor analysis is usually restricted to one tissue block. In this project we introduce a new tool for a high-throughput heterogeneity analysis of colorectal cancer. A heterogeneity tissue microarray (TMA) was manufactured from tissues of 340 patients with colorectal cancer. For this purpose 8 different tissue spots were taken from as many different cancer blocks per patient as possible (at least 4 different blocks). Additional tissue samples from 1 to 4 corresponding lymph node metastases were added from 134 patients. The system was then validated by analysing one parameter each known for minimal (p53) or substantial (HER2) heterogeneity in colorectal cancer. P53 alterations as detected by immunohistochemistry were seen in 174 (51.3 %) of 339 analyzable primary tumors of which 23 (13.2 % of positive cases) showed a heterogeneous distribution pattern. HER2 overexpression was seen in 18 (5.4 %) of 336 evaluable tumors. HER2 amplification occurred in 6 (33.3 %) of the 18 cases with HER2 overexpression. Genomic heterogeneity was more prevalent for HER2 alterations than for p53 alterations. For immunohistochemical expression analysis, 16 of 18 positive cases were heterogeneous (88.9 %) and for amplification 3 of 6 cases (50 %) were heterogeneous. Large section validation revealed, however a considerable fraction of heterogeneous cases were due to technical artifacts. In summary, our data suggest, that heterogeneity TMAs are a powerful tool to rapidly screen for molecular heterogeneity in colorectal cancer.

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References

  1. Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D (2011) Global cancer statistics. CA Cancer J Clin 61:69–90

    Article  PubMed  Google Scholar 

  2. Lombardi L, Morelli F, Cinieri S et al (2010) Adjuvant colon cancer chemotherapy: where we are and where we’ll go. Cancer Treat Rev 36:S34–S41

    Article  CAS  PubMed  Google Scholar 

  3. Van Cutsem E, Köhne CH, Hitre E et al (2009) Cetuximab and chemotherapy as initial treatment for metastatic colorectal cancer. N Engl J Med 360:1408–1417

    Article  PubMed  Google Scholar 

  4. Fearon ER, Vogelstein B (1990) A genetic model for colorectal tumorigenesis. Cell 61:759–767

    Article  CAS  PubMed  Google Scholar 

  5. Vousden KH, Prives C (2009) Blinded by the light: the growing complexity of p53. Cell 137:413–431

    Article  CAS  PubMed  Google Scholar 

  6. Levine AJ, Oren M (2009) The first 30 years of p53: growing ever more complex. Nat Rev Cancer 9:749–758

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  7. Russo A, Bazan V, Iacopetta B et al (2005) The TP53 colorectal cancer international collaborative study on the prognostic and predictive significance of p53 mutation: influence of tumor site, type of mutation, and adjuvant treatment. J Clin Oncol 23:7518–7528

    Article  CAS  PubMed  Google Scholar 

  8. Munro AJ, Lain S, Lane DP (2005) P53 abnormalities and outcomes in colorectal cancer: a systematic review. Br J Cancer 92:434–444

    PubMed Central  CAS  PubMed  Google Scholar 

  9. Jourdan F, Sebbagh N, Comperat E et al (2003) Tissue microarray technology: validation in colorectal carcinoma and analysis of p53, hMLH1, and hMSH2 immunohistochemical expression. Virchows Arch 443:115–121

    Article  CAS  PubMed  Google Scholar 

  10. Scott N, Sagar P, Stewart J, Blair GE, Dixon MF, Quirke P (1991) p53 in colorectal cancer: clinicopathological correlation and prognostic significance. Br J Cancer 63:317–319

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  11. Rubin I, Yarden Y (2001) The basic biology of HER2. Ann Oncol 12:S3–S8

    Article  PubMed  Google Scholar 

  12. Slamon DJ, Leyland-Jones B, Shak S et al (2001) Use of chemotherapy and a monoclonal antibody against HER2 for metastatic breast cancer that overexpresses HER2. N Engl J Med 344:783–792

    Article  CAS  PubMed  Google Scholar 

  13. Bang YJ, Van Cutsem E, Feyereislova A et al (2010) Trastuzumab in combination with chemotherapy versus chemotherapy alone for treatment of HER2-positive advanced gastric or gastro-oesophageal junction cancer (ToGA): a phase 3, open-label, randomised controlled trial. Lancet 376:687–697, Epub 2010 Aug 19. Erratum in: Lancet. Oct 16;376(9749):1302

    Article  CAS  PubMed  Google Scholar 

  14. Tapia C, Glatz K, Novotny H et al (2007) Close association between HER-2 amplification and overexpression in human tumors of non-breast origin. Mod Pathol 20:192–198

    Article  CAS  PubMed  Google Scholar 

  15. Hu Y, Bandla S, Godfrey TE et al (2011) HER2 amplification, overexpression and score criteria in esophageal adenocarcinoma. Mod Pathol 24:899–907

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  16. Williams MD, Roberts DB, Kies MS, Mao L, Weber RS, El-Naggar AK (2010) Genetic and expression analysis of HER-2 and EGFR genes in salivary duct carcinoma: empirical and therapeutic significance. Clin Cancer Res 16:2266–2274

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  17. Burandt E, Schreiber M, Stein A et al (2014) Continuous tissue microarray based identification of cancers with homogeneous target expression for successful targeted therapy in clinical routine practice. Genes Chromosomes Cancer 53:228–239

    Article  CAS  PubMed  Google Scholar 

  18. Ramanathan RK, Hwang JJ, Zamboni WC et al (2004) Low overexpression of HER-2/neu in advanced colorectal cancer limits the usefulness of trastuzumab (Herceptin) and irinotecan as therapy. A phase II trial. Cancer Investig 22:858–865

    Article  CAS  Google Scholar 

  19. Saunders NA, Simpson F, Thompson EW et al (2012) Role of intratumoural heterogeneity in cancer drug resistance: molecular and clinical perspectives. EMBO Mol Med 4:675–684

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  20. Minner S, Gärtner R, Freudenthaler F et al (2013) Marked heterogeneity of ERG expression in large primary prostate cancers. Mod Pathol 26(1):106–116

    Article  CAS  PubMed  Google Scholar 

  21. Simon R, Mirlacher M, Sauter G (2005) Tissue microarrays. Methods Mol Med 114:257–268

    CAS  PubMed  Google Scholar 

  22. Rosen DG, Huang X, Deavers MT, Malpica A, Silva EG, Liu J (2004) Validation of tissue microarray technology in ovarian carcinoma. Mod Pathol 17:790–797

    Article  CAS  PubMed  Google Scholar 

  23. Graham AD, Faratian D, Rae F, Thomas JS (2008) Tissue microarray technology in the routine assessment of HER-2 status in invasive breast cancer: a prospective study of the use of immunohistochemistry and fluorescence in situ hybridization. Histopathology 52:847–855

    Article  CAS  PubMed  Google Scholar 

  24. Bhargava R, Lal P, Chen B (2004) Feasibility of using tissue microarrays for the assessment of HER-2 gene amplification by fluorescence in situ hybridization in breast carcinoma. Diagn Mol Pathol 13:213–216

    Article  CAS  PubMed  Google Scholar 

  25. Sauter G, Lee J, Barlett JM, Slamon DJ, Press MF (2009) Guidelines for human epidermal growth factor receptor 2 testing: biologic and methodologic considerations. J Clin Oncol 27:1323–1333

    Article  CAS  PubMed  Google Scholar 

  26. Fernebro E, Dictor M, Bendahl PO, Fernö M, Nilbert M (2002) Evaluation of the tissue microarray technique for immunohistochemical analysis in rectal cancer. Arch Pathol Lab Med 126:702–705

    PubMed  Google Scholar 

  27. Kountourakis P, Pavlakis K, Psyrri A et al (2006) Clinicopathologic significance of EGFR and Her-2/neu in colorectal adenocarcinomas. Cancer J 12:229–236

    Article  CAS  PubMed  Google Scholar 

  28. Nathanson DR, Culliford AT, Shia J et al (2003) HER 2/neu expression and gene amplification in colon cancer. Int J Cancer 105:796–802

    Article  CAS  PubMed  Google Scholar 

  29. Marx AH, Burandt EC, Choschzick M et al (2010) Heterogenous high-level HER-2 amplification in a small subset of colorectal cancers. Hum Pathol 41:1577–1585

    Article  CAS  PubMed  Google Scholar 

  30. McKay JA, Loane JF, Ross VG et al (2002) c-erbB-2 is not a major factor in the development of colorectal cancer. Br J Cancer 86:568–573

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  31. Maurer CA, Friess H, Kretschmann B et al (1998) Increased expression of erbB3 in colorectal cancer is associated with concomitant increase in the level of erbB2. Hum Pathol 29:771–777

    Article  CAS  PubMed  Google Scholar 

  32. Seidal T, Balaton AJ, Battifora H (2001) Interpretation and quantification of immunostains. Am J Surg Pathol 25:1204–1207

    Article  CAS  PubMed  Google Scholar 

  33. Prat A, Parera M, Reyes V et al (2008) Successful treatment of pulmonary metastatic salivary ductal carcinoma with trastuzumab-based therapy. Head Neck 30:680–683

    Article  PubMed  Google Scholar 

  34. Cappuzzo F, Bemis L, Varella-Garcia M (2006) HER2 mutation and response to trastuzumab therapy in non-small-cell lung cancer. N Engl J Med 354:2619–2621

    Article  CAS  PubMed  Google Scholar 

  35. Santin AD, Bellone S, Roman JJ, McKenney JK, Pecorelli S (2008) Trastuzumab treatment in patients with advanced or recurrent endometrial carcinoma overexpressing HER2/neu. Int J Gynaecol Obstet 102:128–131

    Article  CAS  PubMed  Google Scholar 

  36. Karam A, Berek JS, Stenson A, Rao J, Dorigo O (2008) HER-2/neu targeting for recurrent vulvar Paget’s disease A case report and literature review. Gynecol Oncol 111:568–571

    Article  CAS  PubMed  Google Scholar 

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Correspondence to Phillip R. Stahl.

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Phillip R. Stahl and Jessica Schnellert contributed equally to this work.

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Stahl, P.R., Schnellert, J., Koop, C. et al. Determination of Tumor Heterogeneity in Colorectal Cancers Using Heterogeneity Tissue Microarrays. Pathol. Oncol. Res. 21, 1183–1189 (2015). https://doi.org/10.1007/s12253-015-9953-4

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  • DOI: https://doi.org/10.1007/s12253-015-9953-4

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