Tissue Microarray Construction Research Articles

COX2 expression is associated with proliferation and tumor extension in vestibular schwannoma but is not influenced by acetylsalicylic acid intake

Acetylsalicylic acid has been linked to a lower risk for different cancer types, presumably through its inhibitory effect on cyclooxygenase 2. This has also been investigated in vestibular schwannomas with promising results suggesting an antiproliferative effect and recently the intake has been recommended for vestibular schwannomas as a conservative treatment option. We constructed tissue microarrays from paraffin-embedded tissue samples of 1048 vestibular schwannomas and analyzed the expression of cyclooxygenase 2 and the proliferation marker MIB1 (Molecular Immunology Borstel) via immunohistochemistry together with clinical data (age, gender, tumor extension, prior radiotherapy, neurofibromatosis type 2, tumor recurrence, cyclooxygenase 2 responsive medication). Univariate analysis showed that cyclooxygenase 2 expression was increased with age, female gender, prior radiotherapy and larger tumor extension. MIB1 expression was also associated with higher cyclooxygenase 2 expression. Schwannomas of neurofibromatosis type 2 patients had lower cyclooxygenase 2 levels. Use of acetylsalicylic acid, non-steroidal anti-inflammatory drugs, glucocorticoids or other immunosuppressants did not show differences in cyclooxygenase 2 or MIB1 expression. Instead, cyclooxygenase 2 expression increases with tumor extension while MIB1 expression is not associated with tumor size. Overall, cyclooxygenase 2 expression is associated with proliferation but not influenced by regular intake of acetylsalicylic acid or other cyclooxygenase 2-responsive medications. Acetylsalicylic acid intake does not alter cyclooxygenase 2 expression and has no antiproliferative effect in vestibular.

HPV RNA in-situ hybridization as a diagnostic aid in papillary laryngeal lesions.

In the larynx, differentiating squamous papillomas from de-novo papillary squamous dysplasias or squamous cell carcinomas (SCC) has significant consequences for management. Overlapping clinical presentations and cytologic changes across the spectrum of papillary lesions presents diagnostic challenges for otolaryngologists and pathologists. In this study, we evaluate whether ribonucleic acid (RNA) in-situ hybridization (ISH) for low-risk and high-risk human papillomavirus (HPV) can help distinguish these lesions. We constructed tissue microarrays from 97 papillary laryngeal lesions, including 61 squamous papillomas, two papillomas with dysplasia, two SCCs-ex papilloma, 14 papillary squamous dysplasias, and 18 papillary SCCs identified at the Johns Hopkins Hospital between 2000 and 2017. We performed RNA ISH using probes for low-risk and high-risk HPV types. Low-risk HPV RNA was identified in 55 benign papillomas (90%), two papillomas with dysplasia (100%), and two SCCs-ex papilloma (100%) but was absent in de-novo papillary dysplasias and SCCs (0%). High-risk HPV RNA ISH was positive only in four papillary SCC (22%). Overall, low-risk HPV RNA ISH was 90% sensitive and 89% specific for benign papillomas with a positive predictive value of 93% and negative predictive value of 84%. In contrast, high-risk HPV was 20% sensitive for SCC. Low-risk HPV RNA ISH is a useful diagnostic adjunct for distinguishing laryngeal squamous papillomas from papillary squamous dysplasia and SCC. However, it is not entirely specific for benign processes as it is also retained in papillomas with dysplasia and SCCs-ex papilloma. Because high-risk HPV is rare in papillary laryngeal lesions, high-risk HPV RNA ISH has limited utility. Level 4 Laryngoscope, 130:955-960, 2020.

Abstract 3992: Comparison of AKR1B10, 2SC, and FH as biomarkers for HLRCC detection

Abstract HLRCC is an autosomal dominant tumor predisposition syndrome characterized by cutaneous and uterine leiomyomas (ULs), and increased risk for aggressive type 2 papillary renal cell carcinoma (RCC). The syndrome is caused by germline mutations in fumarate hydratase (FH). Loss of FH causes dysfunction of the Crebs cycle and an increase of succinated proteins, which can be detected using anti-2-succinocysteine (2SC) antibody. Recently, we have observed that aldo-keto reductase family 1, member B10 (AKR1B10) is overexpressed in RNA-level in ULs with biallelic loss of FH. Here, we compared anti-AKR1B10, anti-2SC, and anti-FH antibodies in detection of FH loss in protein-level in HLRCC-associated ULs. The study material consisted of 142 formalin-fixed paraffin-embedded (FFPE) UL samples collected at the University hospitals in Finland. The sample series include 77 FH-deficient UL samples from 25 HLRCC patients and 65 sporadic conventional ULs. HLRCC background was verified by detected germline mutation of FH. Four 0.8 mm cores of representative FFPE tumor tissue were used to construct tissue microarrays. Immunohistochemistry (IHC) was executed using an anti-AKR1B10 (1:300, H00057016-M01, Abnova), anti-2SC (1:2000, provided by Dr. Norma Frizzell), and anti-FH (1:1000, sc-100743, Santa Cruz Biotechnology, Inc) antibodies. Expression was detected by BrightVision (Immunologic) and DAB Quanto (Thermo Fisher Scientific) systems. Pathologist specialized in gynecological pathology evaluated the IHC staining from the smooth muscle tumor cells. AKR1B10 and 2SC detected all 77 HLRCC samples. AKR1B10 displayed either mild (12/77, 16%) or strong (65/77, 84%) expression and succination level was strong in all cases. Loss of FH expression was displayed in 68/77 (88%) of the FH-deficient ULs. All conventional ULs displayed negative AKR1B10 and 2SC staining and expressed FH. FH was expressed either mildly (15/65, 23%) or strongly (50/65, 77%) in the samples. Reliable methods for FH-deficient UL detection in the clinics are currently lacking. Here, comparison of AKR1B10, 2SC, and FH showed that all three biomarkers identified HLRCC-ULs with 100% specificity. The sensitivity was 100% with AKR1B10 and 2SC, and 88% with FH. It seems that even with known mutation in FH, in some cases the likely inactive protein is retained in tumor cells and is thus detectable by anti-FH. To conclude, we show that anti-AKR1B10 and anti-2SC detect FH-deficient ULs with 100% specificity and sensitivity. Anti-FH is lacking sensitivity in 12% of HLRCC cases. Reliable detection of FH-deficient ULs enables the patients and their families to be directed to genetic counseling, family planning, and regular renal monitoring. Citation Format: Terhi Ahvenainen, Outi Uimari, Anne Ahtikoski, Kati Kämpjärvi, Ralf Bützow, Pia Vahteristo. Comparison of AKR1B10, 2SC, and FH as biomarkers for HLRCC detection [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 3992.

RNF8 is associated with radioresistance, nodal stage and extranodal spread in oral cavity squamous-cell carcinoma

Background: Oral cavity cancer has an early metastatic profile and poor adjuvant therapy response when compared with other head and neck cancers, which is reflected in more aggressive clinical management. Accurate prognostic prediction is dependent on histological disease staging and extranodal spread, however these parameters are not available in preoperative clinical decision making. E3-ubiquitin ligase RNF8 is involved in the DNA repair cascade and dysregulation has been shown to promote in vitro genomic instability. Methods: A single-site retrospective series of 53 patients with oral cavity cancer were selected from 2006 to 2012. Clinical data was obtained from chart review, and survival data obtained from the Queensland Cancer Registry. Immunohistochemical analysis for RNF8 was performed against a constructed tissue microarray. Results: Sixteen (30.3%) tumours stained positive for RNF8 expression. RNF8 negative disease showed a significant survival advantage in patients who did not receive radiotherapy, while a non-significant inverse association was suggested in patients who did receive radiotherapy. RNF8 positivity was associated with increased tumour thickness (P=0.021), nodal extracapsular spread (ECS) (P=0.037) and pathological N-stage (P=0.036). Conclusions: RNF8 shows significant correlation with established tumour prognostic features of tumour thickness, ECS and nodal stage.

Differential expression of senescence tumour markers and its implications on survival outcomes of breast cancer patients.

Breast cancer is a heterogeneous disease displaying different histopathological characteristics, molecular profiling and clinical behavior. This study describes the expression patterns of senescence markers P53, DEC1 and DCR2 and assesses their significance on patient survival as a single or combined marker with P16 or P14 using breast cancer progression series. One thousand and eighty (1080) patients with primary invasive ductal carcinoma, no special type, were recruited through an 11-year retrospective study period. We constructed tissue microarrays of normal, benign hyperplasia, ductal carcinoma in situ and invasive ductal carcinoma from each patient and performed immunohistochemical staining to study the protein expression. Statistical analysis includes Pearson chi-square, Kaplan-Meier log ran test and Cox proportional hazard regression were undertaken to determine the associations and predict the survival outcomes. P53, DEC1 and DCR2 expression correlated significantly with normal, benign, premalignant and malignant tissues with (p<0.05). The expression profile of these genes increases from normal to benign to premalignant and plateaued from premalignant to malignant phenotype. There is a significant association between P53 protein expression and age, grade, staging, lymphovascular invasion, estrogen receptor, progesterone receptor and HER2 whereas DCR2 protein expression significantly correlated with tumour grade, hormone receptors status and HER2 (p<0.05 respectively). P53 overexpression correlated with increased risk of relapse (p = 0.002) specifically in patients who did not receive hormone therapy (p = 0.005) or chemotherapy (p<0.0001). The combination of P53+/P16+ is significantly correlated with poor overall and disease-free survival, whereas a combination of P53+/P14+ is associated with worse outcome in disease-free survival (p<0.05 respectively). P53 overexpression appears to be a univariate predictor of poor disease-free survival. The expression profiles of DEC1 and DCR2 do not appear to correlate with patient survival outcomes. The combination of P53 with P16, rather P53 expression alone, appears to provide more useful clinical information on patient survival outcomes in breast cancer.

High expression level of SOX2 is significantly associated with shorter survival in patients with thymic epithelial tumors

ObjectivesThymic epithelial tumors (TET) are heterogenous tumors which are composed of thymoma (TM) and thymic carcinoma (TC). We attempted to determine differences in gene expression between TM and TC, and to determine the effect of such genes on the prognosis of patients with TET. Materials and methodsGene expression profiles of SOX2, OCT-4, IGF-1, IGF-1R and IR mRNA transcripts in tumor tissues of TM and TC were determined using real-time PCR (RT-PCR). We constructed tissue microarray with 140 paraffin-embedded tumor tissues and performed immunohistochemistry (IHC) for IGF-1R-related signaling molecules, including SOX2, IGF-1, IGF-1R and pAKT. ResultsSOX2 mRNA expression was notably higher (216-fold) in TCs than in TMs. However, there was no significant difference in expression of IGF-1, IGF-1R, OCT-4 or IR between the two tumor types. In IHC results, SOX2 (HR: 7.57, P = 0.001) and IGF-1 (HR: 9.43, P = 0.001) expression levels in TC were significantly higher than those in TM. There was a significant correlation in expression of SOX2 with IGF-1 (P = 0.021) and pAKT (P = 0.026). In univariate analysis, clinical TNM stage, WHO classification, serum LDH, expression of SOX2, IGF-1R, IGF-1 and pAKT, were significantly correlated with overall survival (OS). Multivariate analysis using a forward-selection procedure revealed that clinical N stage (HR: 4.08, P < 0.001), M stage (HR: 3.37, P = 0.001) and SOX2 expression (HR: 4.53, P = 0.010) were significantly associated with OS. ConclusionsSOX2 is expressed significantly higher in TC than in TM. SOX2 expression is also closely related to IGF-1 and pAKT expression. The higher expression of SOX2 is significantly associated with shorter survival in patients with TET.

3089 Clinicopathologic and Prognostic Significance of LGR5, a Cancer Stem cell Marker in Peritoneal Metastasis of a Colorectal Origin

OBJECTIVES/SPECIFIC AIMS: Leucine-rich repeat-containing G-protein-coupled receptor 5 (LGR5) is expressed on Wnt/β-catenin-dependent adult stem cell populations of the colon. Cancer stem cells are hypothesized to be the driving force behind tumor progression and metastasis, making them attractive therapeutic targets. Our aim was to analyze the clinicopathologic and prognostic significance of LGR5 expression in a cohort of colorectal cancer patients with peritoneal metastasis. METHODS/STUDY POPULATION: A total of 49 Formalin-fixed paraffin-embedded (FFPE) tissue blocks of primary or metastatic tumors and their respective normal tissues were collected from the tissue bank for time period 2009-2015. LGR5 expression was assessed at the protein level through immunohistochemical (IHC) staining of tissue microarray (TMA) constructs consisting of pairs of tumor and normal colon tissue. The correlation between LGR5 expression and clinicopathologic parameters and prognosis was assessed by statistical analysis. RESULTS/ANTICIPATED RESULTS: Of the 49 patient sample, 30(61.22%) were female vs. 19 (38.78%) males. Age range at initial diagnosis ranged from 31.7 years to 84.4 years, with a median age of 61.29 years. Duration of follow-up ranged from 1 – 9 years with a median of 5 years.LGR5 expression was higher in colorectal cancer than in normal mucosa. In univariate survival analysis overexpression of LGR5 was significantly associated with improved survival (p=0.002).Of significance, LGR5 positivity was an independent prognostic marker for better prognosis in a multivariate survival analysis adjusting for prognostic variables age, stage, gender, tumor histology and grade (HR 2.67. 95% CI 1.01-7.00, P = 0.046). DISCUSSION/SIGNIFICANCE OF IMPACT: LGR5 was significantly over expressed in colorectal cancer compared to normal tissues. LGR5 was noted to be an independent prognostic variable for an improved survival outcome in colorectal cancer patients with peritoneal metastasis, making LGR5 a potential therapeutic target in colorectal cancer patients with peritoneal metastasis.

Liver Kinase B1-A Potential Therapeutic Target in Hormone-Sensitive Breast Cancer in Older Women.

Background: The role of liver kinase B1 (LKB1), a serine/threonine kinase, has been described in the development of PeutzJagher’s syndrome, where a proportion (~45%) of patients have developed breast cancer in their lifetime. Cell line studies have linked LKB1 with oestrogen receptors (ER) and with the Adenosine monophosphate-activated protein kinase (AMPK) pathway for energy metabolism. However, limited studies have investigated protein expression of LKB1 in tumour tissues and its intracellular relationships. This study aimed to investigate the intracellular molecular relationships of LKB1 in older women with early operable primary breast cancer and its correlation with long-term clinical outcome. Methods: Between 1973 and 2010, a consecutive series of 1758 older (≥70 years) women with T0-2N0-1M0 breast carcinoma were managed in a dedicated facility. Of these, 813 patients underwent primary surgery, and 575 had good quality tumour samples available for tissue microarray construction. LKB1 was assessed in 407 cases by indirect immunohistochemistry (IHC). Tumours with 30% or more of cells with cytoplasmic LKB1 expression were considered positive. LKB1 expression was compared with tumour size, histological grade, axillary lymph node stage, ER, PgR, EGFR, HER2, HER3, HER4, BRCA1&2, p53, Ki67, Bcl2, Muc1, E-Cadherin, CD44, basal (CK5, CK5/6, CK14 and CK17) and luminal (CK7/8, CK18 and CK19) cytokeratins, MDM2 and MDM4, and correlated with long-term clinical outcome. Results: Positive LKB1 expression was seen in 318 (78.1%) patients, and was significantly associated with high tumour grade, high Ki67, over-expression of HER2, VEGF, HER4, BRCA2, MDM2 and negative expression of CD44 (p < 0.05). There was no significant correlation with tumour size, axillary lymph node status, ER, PgR, p53, basal or luminal cytokeratins, Bcl2, Muc1, EGFR, HER3, MDM4, E-cadherin and BRCA1. LKB1 did not show any significant influence on survival in the overall population; however, in those patients receiving adjuvant endocrine therapy for ER positive tumours, those with positive LKB1 had significantly better 5-year breast cancer specific survival when compared to those without such expression (93% versus 74%, p = 0.03). Conclusion: LKB1 expression has shown association with poor prognostic factors in older women with breast cancer. However, LKB1 expression appears to be associated with better survival outcome among those patients receiving adjuvant endocrine therapy. Further research is required to explore its potential role as a therapeutic target.

Expression of p-AMPK in colorectal cancer revealed substantial diverse survival patterns.

Objective:Several cancers have showed differences in the role of p- AMPK in cancer growth, progression and prognosis, and little is identified regarding the significance of p-AMPK expression in colorectal adenocarcinoma. Therefore, this report will define p-AMPK phenotype in a panel of colorectal carcinomas and explore the relationship between this phenotype and tumor clinicopathological features.Methods:A total of 228 cases comprising 155 large intestine cancers and 73 controls (40 benign tumors and thirty three non-cancerous tissues) were employed in tissue microarray construction. Immunohistochemistry (IHC) staining was applied to reveal p-AMPK expression. This study was carried out in the pathology lab of King Abdulaziz University Hospital over a duration of 15 months and was completed on 7th July 2018.Results:Phosphorylated AMPK was identified in 133 (85.8%) of colorectal cancers and 73 (100%) control cases. Histologic type was noticeably correlated with p-AMPK immunostaining (P= 0.001), high score of p-AMPK immunostaining is more frequent in control cases. Considerable varied survival models were observed with neoplasm size, metastatic tumor, recurrence and disease relapse (P-values<0.01). Survival estimates are considerably healthier in positive cases which have one of the following features size less than 5 cm, absence of metastatic tumor, no reoccurrence or disease relapse.Conclusions:The present study showed a reduction in the IHC staining of p-AMPK in colorectal cancer compared with controls. IHC staining of p-AMPK can be a supportive marker in predicting prognosis and survival estimates of colorectal tumors with specific clinical factors.

EGFR as a biomarker of smoking status and survival in oropharyngeal squamous cell carcinoma

BackgroundThis study aims to investigate EGFR as a prognostic biomarker in oropharyngeal squamous cell carcinoma (OPSCC).MethodsOPSCC patients from retrospective (1998–2009) and prospective cohorts (2014–2017) were included. Retrospectively collected tumors were used to construct tissue microarrays (TMAs), which were stained with EGFR, p16, DAPI and Pan-cytokeratin, and digitally quantified. EGFR, CDKN2A and HPV E6/7 levels from prospectively collected OPSCC was measured by droplet digital PCR (ddPCR). Biomarkers were compared to patient covariates, factors and survival outcomes.ResultsA total of 249 patients were included retrospectively and 64 patients were enrolled prospectively. p16 status (p < 0.001), smoking above 10 pack years (p = 0.04), smoking above 20 pack years (p < 0.001), total EGFR tumor levels (p = 0.016), and high EGFR within high or low Ki67 tumor nuclear staining (p = 0.03) were found to be significant predictors of 5-year disease specific survival (DSS). A Cox proportional hazard model of DSS showed smoking status and eGFR expression to be dependent of each other on predicting 5-year DSS. ddPCR analysis showed a significant association between smoking status and EGFR levels.ConclusionsTotal EGFR tumor levels are predictive of 5-year DSS. EGFR levels correlate with.smoking and could be an objective marker for this disease etiology.

PI3-kinase pathway biomarkers in oral cancer and tumor immune cells.

This study investigated the hypothesis that phosphoinositide 3-kinase (PI3-kinase) pathway dysregulation in either head and neck cancer cells and/or tumor infiltrating immune cells would influence outcomes of patients with surgically treated oral tongue squamous cell carcinomas (SCC). We constructed tissue microarrays containing 123 oral tongue SCC samples and performed immunohistochemistry using antibodies against 7 PI3-kinase pathway markers: phosphatase and tensin homolog (PTEN), Akt, p-Akt, mammalian target of rapamycin (mTOR), phosphorylated-mammalian target of rapamycin (p-mTOR), survivin, and Ki-67). Expression levels in cancer cells or tumor infiltrating immune cells were correlated with outcomes. Higher levels of PTEN expression in immune cells were significantly associated with improved recurrence-free survival (heart rate (HR) = 0.45, 95% confidence interval (CI) 0.23-0.90, P = .03), and overall survival (HR = 0.34, 95% CI 0.15-0.76, P = .01) on univariate and multicovariate models. We identified a novel, negative prognostic role of PI3-kinase activation (as determined by PTEN loss) in oral SCC infiltrating immune cells. These findings could be relevant for clinical development of PI-3 kinase inhibitors for this disease.

Making a Tissue Microarray.

Tissue microarray (TMA) is a widely used, high-throughput, cost-effective, and tissue and reagent-conserving method of performing molecular analysis. Multiple donor tissue cores are procured and transferred into a recipient TMA block for simultaneous differential and comparative molecular profiling under theoretically identical performance conditions. Described herein is a discussion of the theory behind the TMA, an overview of the concepts and principles of TMA design and construction, a brief summary of its advantages and disadvantages, and a sample protocol of TMA construction.

Single-stranded DNA binding protein 2 expression is associated with patient survival in hepatocellular carcinoma

BackgroundSSBP2, single-stranded DNA binding protein 2, is a subunit of the ssDNA-binding complex that is involved in the maintenance of genome stability. The majority of previous studies have suggested a tumor-suppressive role of SSBP2, which is silenced by promoter hypermethylation in several human malignancies, such as hematologic malignancies, prostate cancer, esophageal squamous cell carcinoma, ovarian cancer, and gallbladder cancer. However, an oncogenic role of SSBP2 has been suggested in glioblastoma patients. We investigated the clinicopathologic significance of SSBP2 expression in hepatocellular carcinoma.MethodsWe constructed tissue microarrays consisting of 21 normal liver parenchyma and 213 hepatocellular carcinoma tissues with corresponding adjacent non-neoplastic tissues. SSBP2 expression was investigated by immunohistochemistry, and positive expression was defined as more than 10% of the tumor cells to show nuclear staining. We then analyzed the correlations between SSBP2 expression and various clinicopathologic characteristics, and further studied the role of SSBP2 in cell growth and migration.ResultsHepatocytes were negative for SSBP2 immunohistochemistry in all normal liver samples, whereas the nuclei of normal bile duct epithelium and sinusoidal endothelium were immunoreactive. Positive immunoreactivity was found in one (0.6%) out of 180 non-neoplastic liver tissue samples adjacent to the tumor and in 16 (8.5%) out of 189 hepatocellular carcinomas. Positive SSBP2 expression was significantly correlated with tumor multifocality (P = 0.027, chi-square test), high histologic grade (P = 0.003, chi-square test), and frequent vascular invasion (P = 0.001, chi-square test). Kaplan-Meier survival curves revealed that patients with SSBP2 expression had poor prognosis in both disease-free and overall survival (P = 0.004 and P = 0.026, respectively, log-rank test). SSBP2-positive tumors also had a higher Ki-67 proliferation index (P < 0.001, t-test). Furthermore, downregulation of SSBP2 in the Huh7 cell line inhibited cell migration (P = 0.022, t-test) with altered expression of epithelial-mesenchymal transition markers.ConclusionsThe minority of hepatocellular carcinomas expressed SSBP2 by immunohistochemistry, whereas normal hepatocytes were negative. SSBP2-positive hepatocellular carcinomas were significantly associated with aggressive phenotypes and poor clinical outcome.

Quantitative Multiplex Immunohistochemistry Identifies Immunosuppression in the AML Bone Marrow and NK-Cells As Prognostic Biomarker in Intermediate-Risk Patients

BACKGROUNDA complex interaction between blasts and surrounding cells in the acute myeloid leukemia (AML) bone marrow (BM) microenvironment sustains blast proliferation and confers chemoresistance. T- and NK-cells have been shown to be dysfunctional in AML, which might be associated with immune evasion and poor prognosis. Here, we present a comprehensive analysis of the immune contexture of the AML BM at diagnosis and study its interaction with clinicopathological variables.METHODSDiagnostic BM biopsies (n=69) were collected from AML patients treated in the Helsinki University Hospital during 2005-2017 and age and gender-matched controls (n=12) to construct tissue microarrays (TMA). Using 8-plex immunohistochemistry (mIHC) and computerized image analysis, we determined cell abundance and immunophenotypic states of millions of immune cells. Immunoprofiles were integrated with a total of 120 clinicopathological variables including cytogenetics and molecular genetics, ELN (European Leukemia Net) risk classification, disease burden parameters, and patient demographics.RESULTSUnsupervised hierarchical clustering of the immunologic contexture defined by mIHC analysis grouped AML patients distinctly from control subjects (Fig 1a). By extracting significant differences (Mann-Whitney U test, q<0.05) and annotating immunologic markers as either anti-cancer or immunosuppression drivers based on literature, we observed an interesting polarization of increased immunosuppression in AML compared to control BM (Fig 1b). In AML patients, lower fraction of granzyme B expressing (GrB+) cells was noted both in CD3+CD4+ helper T-cells (10.9% vs 24.3%, q=0.002, in AML vs control BM) and CD3+CD8+ cytotoxic T-cells (23.5% vs 33.5%, q=0.02). Moreover, we observed pronounced T-cell inhibition features, such as higher proportion of regulatory T-cells (1.5% vs 0.0% FOXP3+ of helper T-cells, q<0.001), and lower expression of class I HLA in BM cells (89.1% vs 100.0%, q<0.001). Putative exhausted PD1+ T-cells were also markedly enriched in the AML BM (15.7% vs 1.7% PD1+ of helper T-cells and 13.2% vs 2.0% PD1+ of cytotoxic T-cells, q<0.001).Among the high interpatient heterogeneity, we discovered two main immune profiles. Cluster 1 was characterized with higher proportion (Log2 fold change >0.5, q<0.05) of cytotoxic T-cells and expression of CD57, CD27, and CD25 in T-cells, as well as higher expression of PD-L1 in the BM. Moreover, lower expression (Log2 fold change <0.5, q<0.05) of OX40 and CD45RO in T-cells and proportion of CD11c+BDCA1+ (type 1 myeloid dendritic cells) were observed. Patients of Cluster 1 were associated with longer event-free survival (EFS; HR 1.9, p=0.049) as well as lower age (median 53.6 vs 64.4 years, p=0.001). No connection between immunologic clusters and FLT3 or NPM1 genotype, complex karyotype, ELN risk class, blast proportion or leukocyte count was found.To support clinical decision-making in ELN 2017 intermediate-risk patients, we developed a risk stratification model focusing on this particular subgroup (n=28) using L1-penalized Cox regression. Patient age over 60 years (HR 8.1, CI95% 2.5-26.6 p<0.001) and low proportion of CD45+CD2+CD3- NK-cells (HR 0.92, CI95% 0.85-0.99 p=0.03) predicted worse EFS.In intermediate-risk patients (n=68) of a separate validation cohort (n=145) analyzed with flow cytometry, low NK cell proportion and high age predicted worse EFS (HR 2.7 CI95% 1.6-4.6 p<0.001) and OS (HR 3.9 CI95% 2.1-7.3 p<0.001) after adjusting with induction therapy protocol. Lower NK-cell proportion was associated with FLT3-ITD genotype (0.45% vs 1.1% NK-cells/all cells in FLT3-ITD+ vs FLT3-ITD- AML patients, p=0.01), and higher than median PB leukocyte (WBC) count (0.50% vs 1.9% NK-cells/all cells in patients with PB WBC ≥7.8x10E9/L vs <7.8x10E9/L, p<0.001).CONCLUSIONSUsing TMA cytometrics with mIHC and automated image analysis for detailed characterization of the immune contexture, we discovered pronounced immune exhaustion and suppression in AML BM. An aging-related immune profile was identified and was associated with poor prognosis. Furthermore, survival prediction of intermediate-risk patients might be enhanced by considering patient age and NK-cell proportion. Taken together, immunophenotyping of AML patients might improve risk stratification and identify a subgroup benefiting from immunomodulatory treatments. [Display omitted] DisclosuresPallaud:Novartis: Employment. Marques Ramos:Novartis: Employment. Porkka:Novartis: Honoraria, Research Funding; Celgene: Honoraria, Research Funding. Mustjoki:Ariad: Research Funding; Novartis: Honoraria, Research Funding; Celgene: Honoraria; Bristol-Myers Squibb: Honoraria, Research Funding; Pfizer: Honoraria, Research Funding.

AXL phosphorylates and up-regulates TNS2 and its implications in IRS-1-associated metabolism in cancer cells

BackgroundTNS2 is a focal adhesions protein and a binding partner for many proteins, including the receptor tyrosine kinase Axl. Although TNS2 can bind with Axl, the details of their interactions have not been elucidated. TNS2 is involved in IRS-1 signaling pathway. In this study, we confirmed the relationship between TNS2 expression and the expression of Axl, IRS-1, PDK1 and Glut4 in pancreatic cancer patients.MethodsThe expression levels of TNS2, Axl, IRS-1, PDK1 and Glut4 in human cancer cells were measured by Western blot and/or IP-Western blot assays. Paired samples of pancreatic cancer and non-cancer tissues were obtained from 33 patients and were used to construct tissue microarrays. The expression levels of these markers in the tissue microarrays were measured by enzyme-linked Immunohistochemistry assay, and the relationships were analyzed by Pearson’s chi-square test and two-tailed t-test analysis.ResultsWe demonstrated for the first time that TNS2 is a phosphorylation substrate of Axl. Moreover, we found a positive relationship between TNS2 expression and the expression of Axl, IRS-1, PDK1 and Glut4 in pancreatic cancer patients. Based on these results, we suggest that Axl modulates glucose metabolism potentially through TNS2 and IRS-1. We hypothesize that there exists a novel mechanism whereby Axl binds to and phosphorylates TNS2, releasing TNS2 from interaction with IRS-1 and resulting in increased stability of IRS-1. The two key enzymes of aerobic glycolysis (Glut4 and PDK1) were found to be up-regulated by Axl/TNS2/IRS-1 cross-talk and may play a critical role in glucose metabolism of cancer cells.ConclusionsOur results revealed for the first time that Axl binds to and phosphorylates TNS2 and that Axl/TNS2/IRS-1 cross-talk may potentially play a critical role in glucose metabolism of cancer cells.

Loss of PTEN Expression Detected by Fluorescence Immunohistochemistry Predicts Lethal Prostate Cancer in Men Treated with Prostatectomy

BackgroundPTEN deletion is associated with relapse after therapy for localized prostate cancer. There are limited data on PTEN loss as detected by immunohistochemistry (IHC) and the risk of lethal disease after surgery. ObjectiveTo determine whether PTEN loss as detected by quantitative fluorescence IHC (FIHC) predicts lethal disease outcomes after surgery for prostate cancer. Design, setting and participantsWe used formalin-fixed, paraffin-embedded radical prostatectomy specimens to construct tissue microarrays and perform dual FIHC for PTEN and AMACR for masking tumor epithelium, plus semi-quantitative multispectral imaging analysis. Outcome measurements and statistical analysisThe association of PTEN status analyzed continuously and dichotomously (low [expression in the lowest quartile] vs higher [expression >lowest quartile]) with disease outcomes (metastasis and death) was assessed with adjustment for age, Gleason score, and stage in multivariable analyses. The prognostic ability of PTEN was assessed using logistic regression models. Results and limitationsLow PTEN expression was associated with a higher risk of metastatic disease as both a continuous (hazard ratio [HR] 1.49, 95% confidence interval [CI] 1.14–1.92; p<0.003) and dichotomous (HR 1.92, 95% CI 1.02–3.63; p=0.04) variable. A significant association between low PTEN expression and poorer overall survival was observed (continuous: HR 1.89, 95% CI 1.37–2.63; p<0.001; dichotomous: HR 2.66, 95% CI 1.34–5.28; p=0.005). Addition of PTEN status to clinicopathologic factors (age, Gleason score, and stage) incrementally improved a prognostic model assessing 10-yr outcomes for metastatic disease (area under the curve [AUC] 0.76 vs 0.80) and death (AUC 0.70 vs 0.75). ConclusionsLow PTEN expression detected by FIHC in primary prostate cancer is an independent prognostic biomarker for metastatic disease and death after definitive therapy. FIHC for PTEN is a viable clinical diagnostic assay in this context. Patient summaryWe looked at loss of the PTEN protein in prostate tumors from men treated with surgery. Men with PTEN loss were at higher risk of metastasis and death. Assessing PTEN status may be useful in better determination of the risk of poorer outcomes.

905P - CD103+ tissue-resident CD8+ T Cells correlate with protective anti-tumoral immune responses in muscle-invasive bladder cancer patients

Background: CD103+ Tissue-resident CD8+ T cells are previously reported as memory CD8+ T cells and thus could promote adaptive immune response. While immunotherapy shows a great potential in muscle-invasive bladder cancer (MIBC) treatment, it is urgent to discover which subgroup MIBC patients could benefit most from immunotherapy. We here tried to explore the prognostic and predictive value of CD103+ tissue-resident CD8+ T cells, and provide possible molecular explanations. Methods: We selected 259 MIBC patients who underwent radical cystectomy between 2002 and 2014. CD103+ tissue-resident CD8+ T Cells were evaluated via immunofluorescence of CD103 and CD8 performed in our constructed tissue microarrays. Prognostic value of CD103+ CD8+ T cells in MIBC was assessed, and was further validated in TCGA-BLCA cohort using tissue-resident CD8+ T cell core signatures. 10 fresh MIBC specimens were analyzed by flow cytometry to explore the anti-tumoral immune response and immune check-point expression of tissue-resident CD8+ T cell. Results: Patients with higher CD103+ tissue-resident CD8+ T cells infiltration had a significant better overall survival in both our study population and TCGA-BLCA cohort (HR = 0.504, 95%CI: 0.312-0.816; P = 0.005 and HR = 0.637, 95%CI: 0.444-0.913; P = 0.014). Further Cox regression indicated that CD103+ tissue-resident CD8+ T cells was an independent prognosticator in MIBC patients. Flow cytometry results revealed that CD103+ CD8+ T cells tended to express more IFN-γ and granzyme B than CD103- CD8+ T cells (P < 0.001 and P = 0.007, respectively) (n = 10). However, expression of perforin did not show significant differences between CD103+ CD8+ T cells and CD103- CD8+ T cells. We then analyzed PD-L1 and TIM3 expression in CD103+ tissue-resident CD8+ T cells. Surprisingly, there was no significant differences of PD-L1 expression between CD103+ CD8+ T cells and CD103- CD8+ T cells. Nonetheless, CD103+ CD8+ T cells had more TIM3+ phenotypes than CD103- CD8+ T cells (P = 0.034). Conclusions: High CD103+ tissue-resident CD8+ T cells could predict better prognosis in MIBC patients. Patients with high infiltration of CD103+ tissue-resident CD8+ T cells might benefit most from anti-TIM3 immunotherapy. Legal entity responsible for the study: Dai, Bo. Funding: National Natural Science Foundation of China; Shanghai Municipal Natural Science Foundation; Shanghai Municipal Commission of Health and Family Planning Program; Guide Project of Science and Technology Commission of Shanghai Municipality; Shanghai Cancer Research Charity Center. Disclosure: All authors have declared no conflicts of interest.

Abstract A014: Raman microscopy to assess biochemical recurrence risk after radical prostatectomy

Abstract Background: There is an urgent need for pathologists to better define patients with high-risk prostate cancer. One of the promising tools is Raman micro-spectroscopy, also known as Raman microscopy, a nondestructive and label-free imaging technique based on light scattered after reflection. Our group has recently developed a rapid standardized protocol for the preparation of formalin-fixed, paraffin-embedded (FFPE) diagnostic tissues suitable for Raman microscopy. The objective of this study was to evaluate the potential of Raman microscopy to assess the prognosis of prostate cancer patients with FFPE tissues from radical prostatectomy. Methods: Patients treated by first-line radical prostatectomy between 1994 and 2004 at Centre hospitalier de l’Université de Montréal (CHUM) were included in this study. FFPE prostate cancer tissues from surgery were used for the construction of tissue microarrays (TMAs). To enable Raman microscopy, TMA sections of 4 µm were placed on low-cost aluminum slides. The rapid dewaxing protocol of the hospital was used (8 minutes), followed by 20 minutes of vacuum drying. All Raman spectra were acquired with the Renishaw inVia confocal Raman microscope equipped with a 785-nm line focus laser. After removing background contributions (e.g., autofluorescence) for each spectrum with Wire 4.4 software, a custom toolbox in MATLAB was used to predict biochemical recurrence. Chemometric methods and calculated ratios were used for the analysis of Raman microscopy images. Results: A total of 320 Raman spectra from 80 patients were analyzed from prostate cancer TMAs, representing 25 patients with biochemical recurrence within 18 months after radical prostatectomy and 55 without. Using a Support Vector Machine (SVM) technique and correlation feature selection for classification, our results with Raman microscopy identified biochemical recurrence with an accuracy of 83.7%, a sensitivity of 84.0% and a specificity of 83.6%. Raman peak assignment of features was used to investigate the molecular differences between these two patient groups. We found that the molecular constituents of RNA and phosphorylated proteins were more important in prostate cancer with biochemical recurrence. In contrast, Raman peaks of the phospholipid head of cell membranes, DNA, and collagen were more intense in prostate cancer without biochemical recurrence. For the visualization of these different molecular constituents of prostate cancer, we developed two methods of Raman microscopy imaging. The first method involved analysis of chemometric data (i.e., extraction of chemical information) to identify the whole tissue (phenylalanine), nuclei (DNA), and red blood cells (hemoglobin), followed by background removal. The images of our chemometric analysis created a virtual staining of hematoxylin and eosin (H&amp;E). The second method involved testing several ratios of Raman peaks associated with proteins, lipids, DNA and RNA. Calculated ratios distinguished specific structures of the prostate tissue, such as the cancerous and normal glands, by different colors. Conclusions: This is the first study demonstrating the potential of Raman microscopy for the prediction of biochemical recurrence within 18 months following radical prostatectomy for prostate cancer. Raman microscopy imaging of tissues is a promising method for the recognition of specific structures, which could help pathologists in the accuracy of diagnosis. The accessibility of this technology to clinicians could be useful for patient follow-up and treatment strategies. Citation Format: Andrée-Anne Grosset, Catherine St-Pierre, Karl St-Arnaud, Kelly Aubertin, Michael Jermyn, Frédéric Leblond, Dominique Trudel. Raman microscopy to assess biochemical recurrence risk after radical prostatectomy [abstract]. In: Proceedings of the AACR Special Conference: Prostate Cancer: Advances in Basic, Translational, and Clinical Research; 2017 Dec 2-5; Orlando, Florida. Philadelphia (PA): AACR; Cancer Res 2018;78(16 Suppl):Abstract nr A014.

Expression of leptin in colorectal adenocarcinoma showed significant different survival patterns associated with tumor size, lymphovascular invasion, distant metastasis, local recurrence, and relapse of disease in the western province of Saudi Arabia.

Leptin phenotype has been suggested to be a possible biomarker for the diagnosis and prognosis of different neoplasms. Nonetheless, there are conflicts among the outcomes found in several tumors, and little is proven concerning the correlation between the phenotype of leptin and its clinical significance in colorectal carcinomas. This study will describe the phenotype of leptin in colorectal adenocarcinomas, and investigate its correlation with clinicopathological factors.Two hundred and twenty eight tissue samples include 155 colorectal carcinomas, 40 adenomas, and 33 noncancerous cases were utilized in constructing tissue microarrays which have been used in the revealing of leptin expression using leptin monoclonal antibody and immunohistochemistry staining protocol.Immunoexpression of leptin was recognized in 145 (93.5%) of colorectal tumors and 56 (76.7%) cases of control group. Histotype was considerably associated with leptin phenotype (P = .000), there is up regulation in leptin expression in colorectal carcinoma cases. Significantly higher proportion of negative leptin immunostaining cases were observed in tumors which have size more than 5 cm (P = .045). Whereas, significant different survival patterns were observed in positive cases regarding tumor size, lymphovascular invasion, distant metastasis, local recurrence and relapse of disease (P-values .046, .011, .000, .013, and .001, respectively). On the other hand, positive leptin staining colorectal tumors with size <5 cm, and with no distant metastases, local recurrence, or disease relapse had significantly better survival estimates. However, leptin immunostaining did not show noteworthy associations with age, gender, differentiation, tumor location, stage, margins involvement, lymphovascular invasion, and lymph node metastasis.The current study shows up regulation in leptin expression in colorectal adenocarcinoma compared with noncancerous control cases. Thus, immunohistochemical staining of leptin in colorectal cancer could be a helpful tool in the prediction of prognosis and survival pattern of colorectal cancer with certain clinicopathological factors (tumor size, lymphovascular invasion, distant metastasis, local recurrence, and relapse of disease).

Differential expression of E-cadherin and P-cadherin in pT3 prostate cancer: correlation with clinical and pathological features.

Cadherins seem to play and important role in prostate cancer (PCa) progression. E-cadherin loss of expression has been associated with poor prognosis; P-cadherin's role is still elusive. Although pT3 PCa is often considered "high-risk cancer," it does not exhibit an uniformly poor prognosis. Herein, we assessed the prognostic value and survival impact of E-cadherin and P-cadherin immunoexpression in pT3 PCa. Radical prostatectomy (RP) specimens from 102 pT3 PCa patients treated between 1991 and 2014 in a single institution were designated for E-cadherin and P-cadherin immunoexpression analysis. A representative block from each specimen was selected for tissue micro-array (TMA) construction, using 3 cores per case. E-cadherin immunoexpression was assessed via a digital image analysis system. For P-cadherin, scoring criteria for HER2 in gastric cancer were used. Clinical records of all patients were reviewed for baseline clinical/pathologic characteristics and follow-up data. E-cadherin-low PCa patients displayed worse disease-specific survival (DSS), although not reaching statistical significance (HR 2.65, 95%CI 0.81-7.88). However, considering the pT3b group only, those with low E-cadherin immunoexpression displayed significantly worse overall-survival (OS) and DSS (HR 3.69, 95%CI 1.18-11.50; HR 5.90, 95%CI 1.40-24.81). No significant differences in survival were found for P-cadherin differential immunoexpression. Furthermore, an association between E-cadherin and P-cadherin immunoexpression (p = 0.019) was found, as among E-cadherin-low PCa, 96.6% were P-cadherin negative. We demonstrated that low E-cadherin immunoexpression discriminates among pT3b PCa patients those with poorer survival and which might benefit from specific therapy. The role of P-cadherin in PCa seems context-dependent deserving further investigation.