Correlation of NEDD4-1 and PTEN Expression with the Invasive Capacity of Pituitary Adenomas
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96 MOLECULAR AND CLINICAL ONCOLOGY 6: 96-100, 2017 Correlation of NEDD4-1 and PTEN expression with the invasive capacity of pituitary adenomas JING ZHANG1, XIN LI2 and YANYAN ZHANG1 1Department of Neurosurgery, Heze Municipal Hospital, Heze, Shandong 274000; 2Department of Neurosurgery, Liaocheng �eople's Hospital and Liaocheng Clinical School of Taishan Medical University, Liaocheng, Shandong 252000, �.R. China Received December 21, 2015; Accepted November 3, 2016 DOI: 10.3892/mco.2016.1092 Abstract. The aim of the present study was to correlate the have advanced the current knowledge on the pathogenesis expression of neural precursor cell expressed developmentally of pituitary adenoma, the precise mechanisms and causes downregulated 4-1 (NEDD4-1) and phosphatase and tensin have remained elusive. �hosphatase and tensin homolog homolog deleted on chromosome 10 (���������������������TEN) with the inva- deleted on chromosome 10 (PTEN), the first known tumor sive capacity of pituitary adenomas. A total of 50 pituitary suppressor gene with phosphatase activity, was first cloned adenoma tissues and 10 normal pituitary tissues were divided and named in 1997 (2,3). In 2007, neural precursor cell into the invasive group (26 cases), the non-invasive group expressed developmentally down regulated 4-1 (NEDD4-1) (24 cases) and the normal group (10 cases). The expression of was identified by Wang et al (4). NEDD4-1 has an important NEDD4-1 and �TEN was determined by immunohistochem- role in downregulating the levels of �TEN. It can promote istry. NEDD4-1 was revealed to be located in the nucleus and the degradation of �TEN in the proteasome by adding a cytoplasm, whereas �TEN was only located in the cytoplasm. molecular marker, ubiquitin (4-8). To the best of our knowl- Furthermore, expression of NEDD4-1 was higher in pituitary edge, no previous studies have assessed whether NEDD4-1 adenomas compared with normal pituitary tissues (�<0.05), is expressed in pituitary adenomas or whether its expression and higher in the invasive group compared with the non-inva- is associated with their invasiveness or with �TEN. In the sive group, whereas the opposite trend was observed for �TEN. present study, the expression of NEDD4-1 and �TEN in There was a strong negative correlation between NEDD4-1 and invasive and non-invasive pituitary adenomas and normal �TEN expression, indicating a dependency between the two pituitary tissues were analyzed using immunohistochem- and an association with invasiveness. In conclusion, NEDD4-1 istry, and their correlation was assessed. The present study may serve as a diagnostic and prognostic factor, and as a novel aimed to investigate the possible molecular mechanisms of therapeutic target, in pituitary adenomas. the genesis and invasiveness of pituitary adenomas, and to identify biomarkers for early detection as well as character- Introduction ization of the biological behavior of pituitary adenomas. �ituitary adenoma is a common type of neurological Materials and methods neoplasm and the third most common type of intracranial tumors. While pituitary adenomas are classified as benign Patients and reagents. The specimens for immunohistochem- tumors, a proportion of them exhibit invasive growth towards ical analysis were collected from 50 patients with pituitary the surrounding normal structures, including the skull, adenomas who underwent treatment at the Department of cavernous sinus, dura, sphenoid bone, the third ventricle, and Neurosurgery of Heze Municipal Hospital (Heze, China) even the pharyngonasal cavity (1). Although recent studies from July 2012 to May 2015. The patient cohort comprised 27 males and 23 females, with a male-to-female ratio of 1.17:1. The average age of the patients was 38.7 years (range, 18-78 years). According to the presence or absence of inva- sion of the tumors to the surrounding bones and cavernous Correspondence to: Dr Jing Zhang, Department of Neurosurgery, sinus, patients were divided into the invasive group Heze Municipal Hospital, 2888 Caozhou Road, Heze, Shandong 274000, �.R. China (26 cases) and the non‑invasive group (24 cases) (Table Ⅰ). E-mail: [email protected] Furthermore, 10 samples of normal pituitary tissues were obtained through normal autopsy. Rabbit anti-human Key words: invasion, neural precursor cells, developmentally NEDD4-1 polyclonal antibody (cat. no. bs-3506R-AF350; downregulated 4-1, phosphatase and tensin homolog deleted on 1:200 dilution) and rabbit anti-human �TEN polyclonal anti- chromosome 10, pituitary adenomas, immunohistochemistry body (cat. no. DM-0748R,1:300 dilution) were from Santa Cruz Biotechnology, Inc. (Dallas, TX, USA), and secondary antibodies were from a designated immunohistochemistry ZHANG et al: EX�RESSION AND CORRELATION OF NEDD4-1 AND �TEN IN �ITUITARY ADENOMAS 97 kit for rabbit antibodies (Beijing Zhongshan Golden Bridge Table I. Clinical data of patients with pituitary adenoma. Biotechnology Co., Ltd., China). All experiments and use of the specimens in the present study were approved by Invasive Non-invasive the Ethics Committee of Heze Municipal Hospital (Heze, Characteristic group (n) group (n) China), and all patients provided written informed consent prior to enrollment. Cases 26 24 Age (years) Immunohistochemical staining procedures. ≥40 20 15 �araffin-embedded specimens were cut into 4-µm thick <40 6 9 sections, which were deparaffinized in turpentine, rehy- Gender drated in an ascending ethanol series and incubated in citrate Male 13 14 buffer (0.01 mol/l, pH 6.0) with water bath heating (~98˚C) Female 13 10 for 15 min for antigen recovery. Following a general strep- tavidin-biotin complex immunohistochemical protocol (9), Endocrine type immunoreactivity was visualized with diaminobenzidine and ACTH 2 5 the nuclei were counterstained with hematoxylin. Sections GH 6 3 were then subsequently dehydrated in a series of graded alco- �RL 8 10 hols, cleared in xylene and mounted. �rostate cancer samples Others 10 6 were used as the positive control and slides incubated with Operative method phosphate-buffered saline without antibody were used as the Transcranial 21 6 negative control. Trans-sphenoidal 5 18 Evaluation of immunohistochemical staining. For each ACTH, adrenocorticotropic hormone; GH, growth hormone; �RL, sample, 10 microscopic fields (magnification, x200) were prolactin. selected from the tissue sections with the strongest immune response. A total of 100 cells per field were counted and averaged. The percentage of positively stained cells was recorded. Staining was rated according to the color intensity and the percentage of positive cells. �ositive staining was and/or the nucleus (Fig. 1). The positive rate of NEDD4-1 defined as the staining intensity being markedly higher than expression in the normal control group [10.0% (1/10)] was that of the background. Staining was classified into four significantly lower compared with that in the experimental categories according to the number of stained cells and the group [52.0% (26/50); P<0.05] (Table II). The positive rate staining intensity: Negative [- (i.e., the staining intensity was of NEDD4-1 was 37.5% (9/24) in the non-invasive pituitary not significantly different from the background)]; weakly adenomas group and 65.3% (17/26) in the invasive adenomas positive [+ (i.e., the percentage of positively stained cells group, thereby revealing a significantly increasing trend with was <10%, or the staining intensity was weakly positive or the increasing degree of tumor invasiveness (�<0.05); the only individual cells were positive to strongly positive)]; differences were also significant compared with the control moderately positive [++ (i.e., the percentage of positive cells group (�<0.05). was 10‑60%)]; strongly positive [+++ (i.e., the percentage of positively stained cells was >60%, or the staining intensity PTEN protein expression in pituitary tissues/adenoma was moderately to strongly positive and only a few cells were decreases with increasing degree of malignancy. Immuno- weakly positive]. The known positive prostate section was histochemistry revealed that �TEN was mainly expressed in selected as the positive control. the cytoplasm, displaying as a brownish-yellow stain (Fig. 2). The rate of �TEN expression in the normal control group Statistical analysis. S�SS 18.0 software was used for statis- [100.0% (10/10)] was significantly higher compared with that in tical analysis. The two-samples t-test and analysis of variance the experimental group [54.0% (27/50); P<0.05] (Table III). were used to assess differences between groups. The χ2 test The positive rate of �TEN was 83.3% (20/24) in the non-inva- and exact test on a four-fold table were used to determine sive pituitary adenoma group and 26.9% (7/26) in the invasive differences in the positive staining rate between normal pitu- pituitary adenoma group, thereby revealing a significantly itary tissues and invasive, as well as non-invasive, pituitary decreasing trend with the increasing degree of tumor invasive- adenomas. The Line x List χ2 test and the one-sided test were ness (P<0.05); the differences were also significant compared used for correlation analyses. α=0.05 was considered as the with the control group (�<0.05). level of significance. P<0.05 was considered to indicate a statistically significant difference. Inverse correlation of NEDD4‑1 and PTEN protein expres‑ sion in pituitary adenomas. Among the 26 cases of pituitary Results adenomas which stained positive for NEDD4-1, four were posi- tive for �TEN. Furthermore, among the 27 cases of pituitary NEDD4‑1 expression in pituitary tissues/adenoma increases adenomas which stained positive for �TEN, 24 were negative with the degree of malignancy. Immunohistochemistry for NEDD4-1. Statistical analysis revealed a negative correla- revealed that NEDD4-1 was expressed in the cytoplasm tion between the two proteins (γ=-0.711, �<0.05) (Table IV). 98 MOLECULAR AND CLINICAL ONCOLOGY 6: 96-100, 2017 A B C Figure 1. NEDD4‑1 expression in normal pituitary tissue and pituitary adenomas (magnification, x200). NEDD4‑1 was expressed in the cytoplasm and/or the nucleus.