Abstract

Nijmegen breakage syndrome (NBS) with NBS1 germ-line mutation is a human autosomal recessive disease characterized by genomic instability and enhanced cancer predisposition. The NBS1 gene codes for a protein, Nbs1(p95/Nibrin), involved in the processing/repair of DNA double-strand breaks. Hepatocellular carcinoma (HCC) is a complex and heterogeneous tumor with several genomic alterations. Recent studies have shown that heterozygous NBS1 mice exhibited a higher incidence of HCC than did wild-type mice. The objective of the present study is to assess whether NBS1 mutations play a role in the pathogenesis of human primary liver cancer, including HBV-associated HCC and intrahepatic cholangiocarcinoma (ICC). Eight missense NBS1 mutations were identified in six of 64 (9.4%) HCCs and two of 18 (11.1%) ICCs, whereas only one synonymous mutation was found in 89 control cases of cirrhosis and chronic hepatitis B. Analysis of the functional consequences of the identified NBS1 mutations in Mre11-binding domain showed loss of nuclear localization of Nbs1 partner Mre11, one of the hallmarks for Nbs1 deficiency, in one HCC and two ICCs with NBS1 mutations. Moreover, seven of the eight tumors with NBS1 mutations had at least one genetic alteration in the TP53 pathway, including TP53 mutation, MDM2 amplification, p14ARF homozygous deletion and promoter methylation, implying a synergistic effect of Nbs1 disruption and p53 inactivation. Our findings provide novel insight on the molecular pathogenesis of primary liver cancer characterized by mutation inactivation of NBS1, a DNA repair associated gene.

Highlights

  • IntroductionPrimary liver cancer comprises mainly hepatocellular carcinoma (HCC; about 90%) and intrahepatic cholangiocarcinoma (ICC; 5–15%) [1,2,3]

  • Primary liver cancer is the second most common cancer in Asia and the fourth most common cancer in Africa

  • High rate of NBS1 mutations identified in hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICC) but not in cirrhosis or chronic hepatitis B

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Summary

Introduction

Primary liver cancer comprises mainly hepatocellular carcinoma (HCC; about 90%) and intrahepatic cholangiocarcinoma (ICC; 5–15%) [1,2,3]. Hepatitis B virus (HBV) infection is widely recognized as an extremely high risk factor for HCC and ICC progression [3,4]. It is known that multiple risk factors, including HBV and hepatitis C virus infection, aflatoxin contamination, alcohol abuse, ionizing radiation and human metabolic products toxic to the human genome, can cause DNA damage such as double-strand breaks (DSBs), single-strand breaks and point mutation in hepatocytes [5]. HBV DNA was found in the genome of almost all cases of HBV-associated HCC, and the efficiency of integration is enhanced when DSBs or oxidative DNA damage occurs [7,8]. Accumulation of damaged DNA due to impaired DNA damage repair can become an important molecular mechanism in the carcinogenesis of HCC, especially HBV-associated HCC

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