Abstract

BackgroundMalignant pleural mesothelioma (MPM) is an aggressive neoplasm of the pleura, mainly related to asbestos exposure. As in other solid tumors, malignant cells exhibit high glucose uptake and glycolytic rates with increased lactic acid efflux into the interstitial space. Lactate transport into and out of cells, crucial to maintaining intracellular pH homeostasis and glycolysis, is carried out by monocarboxylate transporters (MCTs) and the chaperone basigin (CD147). We set out to examine the clinical significance of basigin, MCT1 and MCT4 in the context of MPM and to evaluate their expression in relation to the evolution of the disease.MethodsWe used immunohistochemistry to measure the expression of basigin, MCT1 and MCT4 in a cohort of 135 individuals with MPM compared to a series of 15 non-MPM pleura specimens. Moreover, by Kaplan–Meier and Cox analyses we evaluated whether an expression over the average of these markers could be associated with the patients’ overall survival (OS).ResultsWe detected positive staining of basigin, MCT1, and MCT4 in most MPM specimens. In particular, MCT4 was always positive in malignant tissues but undetectable in the 4 normal pleural specimens incorporated within the tissue microarray. This was confirmed in the additional series of 15 normal pleural samples. Moreover, MCT4 expression was significantly associated with reduced OS.ConclusionIn this study, the tissue expression of basigin did not prove to be exploitable as a diagnostic or prognostic marker for MPM patients. The expression of MCT1 was not informative either, being tightly correlated with that of basigin. However, the expression of MCT4 showed promise as a diagnostic/therapeutic and prognostic biomarker.

Highlights

  • Malignant pleural mesothelioma (MPM) is an aggressive neoplasm of the pleura, mainly related to asbestos exposure

  • In order to evaluate further the expression of basigin, MCT1, and MCT4 in MPM, an IHC evaluation was performed on a tissue microarray (TMA) containing 135 samples

  • High expression of MCT4 was significantly associated with shortened overall survival (OS)

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Summary

Introduction

Malignant pleural mesothelioma (MPM) is an aggressive neoplasm of the pleura, mainly related to asbestos exposure. We set out to examine the clinical significance of basigin, MCT1 and MCT4 in the context of MPM and to evaluate their expression in relation to the evolution of the disease. It is well-known that cancer cells can obtain energy by increasing their rates of glycolysis despite oxygen being available (Warburg effect) [1]. It is conceivable that the expression of basigin, MCT1 and MCT4 could be related to MPM carcinogenesis and aggressiveness To test this hypothesis, we assessed whether the expression of these molecules (evaluated by immunohistochemical staining, IHC) was associated with the malignant state or patients’ prognosis. Histological subtype remains the main prognostic parameter for MPM patients [13, 14], with the epithelioid subtype having a better outcome than the sarcomatoid or biphasic MPM

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