Abstract

BackgroundDifferential diagnosis between malignant pleural mesothelioma (MPM) and benign mesothelial conditions is still challenging and there is a lack of useful markers. Programmed cell death 4 (PDCD4) is a well-known tumor suppressor gene in several cancers, its post-transcriptional activity is directly controlled by miR-21, whose over-expression has been recently reported in MPM compared to normal mesothelium. Aim of this study was to test this suppressor gene as a possible new marker of malignant transformation in mesothelial cells, as well as a new prognostic marker.MethodsPDCD4 nuclear expression was assessed by immunohistochemistry (IHC) in 40 non-neoplastic pleural (NNP) and 40 MPM formalin-fixed and paraffin-embedded specimens. PDCD4 and miR-21 expressions were analyzed by qRT-PCR in all cases. In situ hybridization (ISH) of miR-21 was performed in 5 representative cases of both groups. The prognostic relevance of PDCD4 was assessed in a public available gene expression dataset.ResultsIHC showed that PDCD4 nuclear expression was significantly lower in MPM than in NNP. PDCD4 was down-regulated, whereas miR-21 was over-expressed in MPM cases compared to NNP ones. ISH detected miR-21 only in MPM specimens. Down-expression of PDCD4 was found significantly associated with short overall survival in publicly available data.ConclusionsThese findings highlighted a switch between PDCD4 and miR-21 expression in MPM. Further studies should assess the diagnostic reliability of these two markers for MPM in biopsy and effusion specimens.

Highlights

  • Malignant pleural mesothelioma (MPM) is the most lethal tumor arising from the mesothelial cells that line the serosal cavities and it is strongly associated to the longterm inhalation of asbestos fibers

  • Programmed cell death 4 (PDCD4) was down-regulated, whereas miR-21 was over-expressed in malignant pleural mesothelioma (MPM) cases compared to non-neoplastic pleural (NNP) ones

  • These findings highlighted a switch between PDCD4 and miR-21 expression in MPM

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Summary

Introduction

Malignant pleural mesothelioma (MPM) is the most lethal tumor arising from the mesothelial cells that line the serosal cavities and it is strongly associated to the longterm inhalation of asbestos fibers. Asbestos fibers may trigger the transformation of mesothelial cells through the generation of reactive oxygen species, inducing a genomic damage and causing the release of different pro-inflammatory and carcinogenetic cytokines by the mesothelial and inflammatory cells (e.g. tumor necrosis factor-α, several interleukins, transforming growth factor-β, and platelet-derived growth factor) [4] All these mechanisms are linked to the inactivation of oncosuppressor genes, such as the complex cyclindependent kinase inhibitor 2A (CDKN2A)/alternative reading frame (ARF), retinoblastoma, and p53 [5]. Programmed cell death 4 (PDCD4) is a well-known tumor suppressor gene in several cancers, its post-transcriptional activity is directly controlled by miR21, whose over-expression has been recently reported in MPM compared to normal mesothelium. Aim of this study was to test this suppressor gene as a possible new marker of malignant transformation in mesothelial cells, as well as a new prognostic marker

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