Identification of Necrosis-Associated Genes in Glioblastoma by Cdna Microarray Analysis
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212 Vol. 10, 212–221, January 1, 2004 Clinical Cancer Research Identification of Necrosis-Associated Genes in Glioblastoma by cDNA Microarray Analysis Shaan M. Raza,1 Gregory N. Fuller,2 the 26 genes between grade III necrosis GBM and anaplastic Chang Hun Rhee,4 Suyun Huang,1 astrocytoma (AA) samples; all but 1 of the genes had ele- Kenneth Hess,3 Wei Zhang,2 and vated expression when comparing necrosis grade III with 1 AA samples. Two factors, the ephrin type A receptor 1 and Raymond Sawaya the prostaglandin E receptor EP4 subtype, not previously 1 2 3 2 Departments of Neurosurgery, Pathology, and Biostatistics, Brain considered in this context, were highlighted because of their Tumor Center, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, and 4Department of Neurosurgery, Korean particularly high (positive) correlation coefficients; immu- Cancer Center Hospital, Seoul, Korea nostaining showed the products of these two genes to be localized in perinecrotic and necrotic regions and to be overexpressed in grade III GBMs, but not AAs. These two ABSTRACT molecules also showed significant correlation with survival .in a combined model (0.0034 ؍ Purpose: In the field of cancer research, there has been of GBM patients (P a paucity of interest in necrosis, whereas studies focusing on Conclusions: The application of cDNA expression mi- apoptosis abound. In neuro-oncology, this is particularly croarray analysis has identified specific genes and patterns surprising because of the importance of necrosis as a hall- of gene expression that may help elucidate the molecular mark of glioblastoma (GBM), the most malignant and most basis of necrogenesis in GBM. Additional studies will be common primary brain tumor, and the fact that the degree required to further investigate and confirm these findings. of necrosis has been shown to be inversely related to patient survival. It is therefore of considerable interest and impor- tance to identify genes and gene products related to necrosis INTRODUCTION formation. In cancer research, the subject of cell death has been Experimental Design: We used a nylon cDNA microar- extensively studied with the goal of achieving therapeutically ray to analyze mRNA expression of 588 universal cellular induced tumor death. Among the two major forms of cell death genes in 15 surgically resected human GBM samples with encountered in biology, apoptosis has received a proportionately varying degrees of necrosis. Gene expression was correlated greater degree of attention and emphasis than has necrosis (1, 2). with the degree of necrosis using rank correlation coeffi- A large body of recent literature has provided an understanding cients. The expression of identified genes was compared with of the physiological and molecular events that lead to apoptosis; their expression in tissue samples from 5 anaplastic astro- yet similar characterization of necrosis cannot be found. cytomas (AAs). Immunostaining was used to determine In the field of neuro-oncology, this paucity of interest in whether genes showing the most positive correlation with necrosis is surprising because it is a hallmark of the most necrosis were increasingly expressed in tumor tissues, as common and most malignant primary brain tumor—glioblas- grade of necrosis increased. toma (GBM). In fact, GBM is differentially diagnosed from Results: The hybridization results indicated that 26 lower grade astrocytomas based on the histological presence of genes showed significant correlation with the amount of de novo tumor necrosis and associated microvascular prolifer- necrosis. All 26 genes had functions associated with either ation. Clinical studies indicate that of all clinical, neuroimaging, Ras, Akt, tumor necrosis factor ␣, nuclear factor B, apo- and histopathological characteristics (including age), necrosis ptosis, procoagulation, or hypoxia. Nine genes were posi- that is visible on magnetic resonance imaging scans has the tively correlated with necrosis grade, and 17 genes were greatest prognostic value and is inversely related to patient negatively correlated with necrosis grade. There were sig- survival (3). Based on the clinical implications and potential for nificant differences in the median expression levels of 3 of novel therapeutic interventions, the molecular factors mediating necrogenesis in GBM warrant investigation. An initial step in this process would be the identification of specific gene prod- ucts associated with necrosis. Received 1/28/03; revised 9/11/03; accepted 9/16/03. Although there have been a few limited studies of one or Grant support: Texas Higher Education Coordinating Board (to W. Z. two necrosis-associated molecules, there have been no efforts to and G. N. F.) and the Anthony Bullock III Brain Tumor Research Fund characterize global gene expression changes associated with (to R. S.). The costs of publication of this article were defrayed in part by the varying degrees of necrosis in GBM (4). In this study, we used payment of page charges. This article must therefore be hereby marked cDNA expression microarrays to identify the molecular finger- advertisement in accordance with 18 U.S.C. Section 1734 solely to prints of 15 GBM samples with differing degrees of necrosis; indicate this fact. this was done with the goal of identifying genes whose mRNA Requests for reprints: Raymond Sawaya, Department of Neurosur- gery–442, The University of Texas M. D. Anderson Cancer Center, expression is correlated with the formation of necrosis. In hopes 1515 Holcombe Boulevard, Houston, Texas 77030. Phone: (713) 792- of establishing a relationship between necrosis and the identified 2400; Fax: (713) 794-4950; E-mail: [email protected]. genes, their expression levels in anaplastic astrocytomas (AAs), Downloaded from clincancerres.aacrjournals.org on September 28, 2021. © 2004 American Association for Cancer Research. Clinical Cancer Research 213 which by definition (St. Anne/Mayo criteria) are tumors that are Table 1 Necrosis grades of human glioblastoma samplesa and not associated with necrosis, were determined and compared survival time of patients with expression levels in grade III necrosis GBM samples, Necrosis Sample Median survival which are tumors characterized by extensive amounts of necrosis. grade no. (weeks) 04 64 MATERIALS AND METHODS I 2 116 II 5 53 Primary Glioma Tissues. All human tumor samples III 4 25 were obtained from the Brain Tumor Center Tissue Bank at The a The following grading system (see Ref. 3) was used: grade 0, no University of Texas M. D. Anderson Cancer Center (Houston, necrosis apparent on the magnetic resonance imaging scan; grade I, TX). After surgical removal, tissue samples were quickly frozen amount of necrosis is less than 25% of the tumor volume; grade II, at Ϫ80°C. All tissue samples used for cDNA analysis were amount of necrosis is between 25% and 50% of the tumor volume; grade evaluated by a neuropathologist; all specimens selected were III, amount of necrosis is greater than 50% of the tumor volume. In all characterized by dense tumor cellularity and the presence of cases, the extent of necrosis was confirmed at surgery. Ͻ10% normal brain tissue. A second neuropathologist con- firmed all diagnoses. Grading of astrocytic neoplasms was per- formed according to the St. Anne/Mayo criteria. A total of 5 AAs and 15 GBM samples were analyzed. The 15 GBM sam- volume (Ref. 3; Fig. 1). The extent of necrosis was confirmed in ples obtained were further graded based on the amount of all cases during surgery. Within our sample population, four necrosis observed on magnetic resonance imaging scans. Ne- tumors were grade 0, two were grade I, five were grade II, crosis on magnetic resonance imaging scans appears as a and four were grade III. The sample distribution is shown in hypointense region of T1 signal surrounded by a contrast- Table 1. enhanced region representing viable tumor. Necrosis was graded Isolation of Total RNA and mRNA from Tissue Sam- according to the following previously described system: grade 0, ples. The frozen tissue samples were ground to a powder in no necrosis apparent on the magnetic resonance imaging scan; liquid nitrogen using a mortar and pestle and then treated with grade I, amount of necrosis is Ͻ25% of the tumor volume; grade lysis buffer, TRI Reagent (Molecular Research Center, Cincin- II, amount of necrosis is between 25% and 50% of the tumor nati, OH), to extract nucleic acids and prevent their degradation. volume; grade III, amount of necrosis is Ͼ50% of the tumor Total RNA was isolated as described previously (5). The quality of this RNA was checked by electrophoresis on a denaturing formaldehyde agarose gel. The presence of high-quality unde- graded RNA was verified by the observation of a lack of streaking on the lower (anodal) part of the sample lane on the gel. A further indication that high-quality RNA was obtained was the presence on the gel of a 28S rRNA band twice as intense as that of the 18S rRNA band. A poly(dT) mRNA isolation column (Qiagen, Inc., Chatsworth, CA) was used to separate mRNA from high-quality total RNA. With this column, we recovered 1–2 g of mRNA from approximately 200 g of total RNA, but only 0.5–1.0 g of mRNA was required for analysis in the cDNA array. In this study, we obtained high-quality RNA from Ͼ90% of the resected samples. Because undegraded RNA is scarce within regions of necrosis, total RNA and mRNA were predominantly isolated from viable nonnecrotic tumor regions. Hybridization to Human Atlas cDNA Expression Array Blots. cDNA fragments, approximately 200- to 500-bp long, representing 588 human genes with known functions and tight transcriptional controls were immobilized in duplicate on a nylon membrane (Clontech Laboratories, Inc.). To minimize cross-hybridization and nonspecific binding of cDNA probes, each fragment was selected as a unique sequence without a poly(A) tail, highly homologous sequences, or repetitive ele- ments. 32P-labeled cDNA probes were generated through re- verse transcription of 0.5–1.0 g of each analyzed poly(A)ϩ Fig.