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Erschienen in: Annals of Surgical Oncology 4/2010

01.04.2010 | Translational Research and Biomarkers

Associations of MDM2 SNP309, Transcriptional Activity, mRNA Expression, and Survival in Stage I Non-Small-Cell Lung Cancer Patients with Wild-Type p53 Tumors

verfasst von: Wen-Pin Chien, PhD, Ruey-Hong Wong, PhD, Ya-Wen Cheng, PhD, Chih-Yi Chen, MD, PhD, Huei Lee, PhD

Erschienen in: Annals of Surgical Oncology | Ausgabe 4/2010

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Abstract

Background

Mouse double minute 2 (MDM2) is a negative regulator of p53. In the present study, we examined MDM2 transcriptional activity and messenger RNA (mRNA) expression in lung tumors with respect to MDM2 SNP309 genotypes and p53 mutation status, and the effects of MDM2 SNP309 genotypes and p53 mutation status on lung cancer prognosis.

Methods

p53-null lung cancer cells were cotransfected with MDM2 P2 reporter construct containing the TT or GG genotype and wild-type or mutant p53 plasmids for luciferase reporter assay. Genomic DNA from 306 lung tumors and adjacent normal tissues was used to determine p53 mutation and MDM2 genotype by direct sequencing and polymerase chain reaction (PCR) restriction fragment length polymorphism. Real-time reverse-transcriptase PCR was applied to determine MDM2 mRNA levels. Overall survival was also calculated.

Results

Transcriptional activity of the MDM2 promoter containing the SNP309 GG genotype was significantly lower than that containing the TT genotype in p53-null lung cancer cells cotransfected with wild-type p53 expression plasmid under mithramycin A treatment. MDM2 mRNA levels in tumors with the SNP309 TG and GG genotypes were higher than those in tumors with the TT genotype, particularly in wild-type p53 tumors. Stage I patients with MDM2 SNP309 GG also had better overall survival than TT carriers, especially wild-type p53 patients (hazard ratio = 0.34; 95% confidence interval 0.15–0.80). Similar results were not observed in late-stage patients.

Conclusions

MDM2 SNP309 was associated with MDM2 transcripts, mRNA levels, and survival in stage I non-small-cell lung cancer patients with wild-type p53 tumors.
Literatur
1.
Zurück zum Zitat Menendez D, Inga A, Jordan JJ, Resnick MA. Changing the p53 master regulatory network: ELEMENTary, my dear Mr Watson. Oncogene. 2007;26:2191–201.CrossRefPubMed Menendez D, Inga A, Jordan JJ, Resnick MA. Changing the p53 master regulatory network: ELEMENTary, my dear Mr Watson. Oncogene. 2007;26:2191–201.CrossRefPubMed
2.
Zurück zum Zitat Tomizawa Y, Kohno T, Fujita T, et al. Correlation between the status of the p53 gene and survival in patients with stage I non-small cell lung carcinoma. Oncogene. 1999;18:1007–14.CrossRefPubMed Tomizawa Y, Kohno T, Fujita T, et al. Correlation between the status of the p53 gene and survival in patients with stage I non-small cell lung carcinoma. Oncogene. 1999;18:1007–14.CrossRefPubMed
3.
Zurück zum Zitat Ahrendt SA, Hu Y, Buta M, et al. p53 mutations and survival in stage I non-small-cell lung cancer: results of a prospective study. J Natl Cancer Inst. 2003;95:961–70.PubMed Ahrendt SA, Hu Y, Buta M, et al. p53 mutations and survival in stage I non-small-cell lung cancer: results of a prospective study. J Natl Cancer Inst. 2003;95:961–70.PubMed
4.
Zurück zum Zitat Nelson HH, Wilkojmen M, Marsit CJ, Kelsey KT. TP53 mutation, allelism and survival in non-small cell lung cancer. Carcinogenesis. 2005;26:1770–3.CrossRefPubMed Nelson HH, Wilkojmen M, Marsit CJ, Kelsey KT. TP53 mutation, allelism and survival in non-small cell lung cancer. Carcinogenesis. 2005;26:1770–3.CrossRefPubMed
5.
Zurück zum Zitat Schiller JH, Adak S, Feins RH, et al. Lack of prognostic significance of p53 and K-ras mutations in primary resected non-small-cell lung cancer on E4592: a Laboratory Ancillary Study on an Eastern Cooperative Oncology Group Prospective Randomized Trial of Postoperative Adjuvant Therapy. J Clin Oncol. 2001;19:448–57.PubMed Schiller JH, Adak S, Feins RH, et al. Lack of prognostic significance of p53 and K-ras mutations in primary resected non-small-cell lung cancer on E4592: a Laboratory Ancillary Study on an Eastern Cooperative Oncology Group Prospective Randomized Trial of Postoperative Adjuvant Therapy. J Clin Oncol. 2001;19:448–57.PubMed
6.
Zurück zum Zitat Harris SL, Levine AJ. The p53 pathway: positive and negative feedback loops. Oncogene. 2005;24:2899–908.CrossRefPubMed Harris SL, Levine AJ. The p53 pathway: positive and negative feedback loops. Oncogene. 2005;24:2899–908.CrossRefPubMed
7.
Zurück zum Zitat Toledo F, Wahl GM. Regulating the p53 pathway: in vitro hypotheses, in vivo veritas. Nat Rev Cancer. 2006;6:909–23.CrossRefPubMed Toledo F, Wahl GM. Regulating the p53 pathway: in vitro hypotheses, in vivo veritas. Nat Rev Cancer. 2006;6:909–23.CrossRefPubMed
8.
Zurück zum Zitat Bond GL, Hu W, Bond EE, et al. A single nucleotide polymorphism in the MDM2 promoter attenuates the p53 tumor suppressor pathway and accelerates tumor formation in humans. Cell. 2004;119:591–602.CrossRefPubMed Bond GL, Hu W, Bond EE, et al. A single nucleotide polymorphism in the MDM2 promoter attenuates the p53 tumor suppressor pathway and accelerates tumor formation in humans. Cell. 2004;119:591–602.CrossRefPubMed
9.
Zurück zum Zitat Koutsodontis G, Tentes I, Papakosta P, Moustakas A, Kardassis D. Sp1 plays a critical role in the transcriptional activation of the human cyclin-dependent kinase inhibitor p21(WAF1/Cip1) gene by the p53 tumor suppressor protein. J Biol Chem. 2001;276:29116–25.CrossRefPubMed Koutsodontis G, Tentes I, Papakosta P, Moustakas A, Kardassis D. Sp1 plays a critical role in the transcriptional activation of the human cyclin-dependent kinase inhibitor p21(WAF1/Cip1) gene by the p53 tumor suppressor protein. J Biol Chem. 2001;276:29116–25.CrossRefPubMed
10.
Zurück zum Zitat Hirata H, Hinoda Y, Kikuno N, Kawamoto K, Suehiro Y, Tanaka Y, Dahiya R. MDM2 SNP309 polymorphism as risk factor for susceptibility and poor prognosis in renal cell carcinoma. Clin Cancer Res. 2007;13:4123–9.CrossRefPubMed Hirata H, Hinoda Y, Kikuno N, Kawamoto K, Suehiro Y, Tanaka Y, Dahiya R. MDM2 SNP309 polymorphism as risk factor for susceptibility and poor prognosis in renal cell carcinoma. Clin Cancer Res. 2007;13:4123–9.CrossRefPubMed
11.
Zurück zum Zitat Cattelani S, Defferrari R, Marsilio S, et al. Impact of a single nucleotide polymorphism in the MDM2 gene on neuroblastoma development and aggressiveness: results of a pilot study on 239 patients. Clin Cancer Res. 2008;14:3248–53.CrossRefPubMed Cattelani S, Defferrari R, Marsilio S, et al. Impact of a single nucleotide polymorphism in the MDM2 gene on neuroblastoma development and aggressiveness: results of a pilot study on 239 patients. Clin Cancer Res. 2008;14:3248–53.CrossRefPubMed
12.
Zurück zum Zitat Gryshchenko I, Hofbauer S, Stoecher M, et al. MDM2 SNP309 is associated with poor outcome in B-cell chronic lymphocytic leukemia. J Clin Oncol. 2008;26:2252–7.CrossRefPubMed Gryshchenko I, Hofbauer S, Stoecher M, et al. MDM2 SNP309 is associated with poor outcome in B-cell chronic lymphocytic leukemia. J Clin Oncol. 2008;26:2252–7.CrossRefPubMed
13.
Zurück zum Zitat Ohmiya N, Taguchi A, Mabuchi N, Itoh A, Hirooka Y, Niwa Y, Goto H. MDM2 promoter polymorphism is associated with both an increased susceptibility to gastric carcinoma and poor prognosis. J Clin Oncol. 2006;24:4434–40.CrossRefPubMed Ohmiya N, Taguchi A, Mabuchi N, Itoh A, Hirooka Y, Niwa Y, Goto H. MDM2 promoter polymorphism is associated with both an increased susceptibility to gastric carcinoma and poor prognosis. J Clin Oncol. 2006;24:4434–40.CrossRefPubMed
14.
Zurück zum Zitat Heist RS, Zhou W, Chirieac LR, et al. MDM2 polymorphism, survival, and histology in early-stage non-small-cell lung cancer. J Clin Oncol. 2007;25:2243–7.CrossRefPubMed Heist RS, Zhou W, Chirieac LR, et al. MDM2 polymorphism, survival, and histology in early-stage non-small-cell lung cancer. J Clin Oncol. 2007;25:2243–7.CrossRefPubMed
15.
Zurück zum Zitat Sanchez-Carbayo M, Socci ND, Kirchoff T, Erill N, Offit K, Bochner BH, Cordon-Cardo C. A polymorphism in HDM2 (SNP309) associates with early onset in superficial tumors, TP53 mutations, and poor outcome in invasive bladder cancer. Clin Cancer Res. 2007;13:3215–20.CrossRefPubMed Sanchez-Carbayo M, Socci ND, Kirchoff T, Erill N, Offit K, Bochner BH, Cordon-Cardo C. A polymorphism in HDM2 (SNP309) associates with early onset in superficial tumors, TP53 mutations, and poor outcome in invasive bladder cancer. Clin Cancer Res. 2007;13:3215–20.CrossRefPubMed
16.
Zurück zum Zitat Galic V, Willner J, Wollan M, et al., Common polymorphism in TP53 and MDM2 and relationship to TP53 mutations and clinical outcomes in women with ovarian and peritoneal carcinomas. Genes Chromosomes Cancer. 2007;46:239–47.CrossRefPubMed Galic V, Willner J, Wollan M, et al., Common polymorphism in TP53 and MDM2 and relationship to TP53 mutations and clinical outcomes in women with ovarian and peritoneal carcinomas. Genes Chromosomes Cancer. 2007;46:239–47.CrossRefPubMed
17.
Zurück zum Zitat Ko JL, Cheng YW, Chang SL, Su JM, Chen CY, Lee H. MDM2 mRNA expression is a favorable prognostic factor in non-small-cell lung cancer. Int J Cancer. 2000;89:265–70.CrossRefPubMed Ko JL, Cheng YW, Chang SL, Su JM, Chen CY, Lee H. MDM2 mRNA expression is a favorable prognostic factor in non-small-cell lung cancer. Int J Cancer. 2000;89:265–70.CrossRefPubMed
18.
Zurück zum Zitat Higashiyama M, Doi O, Kodama K, et al. MDM2 gene amplification and expression in non-small-cell lung cancer: immunohistochemical expression of its protein is a favourable prognostic marker in patients without p53 protein accumulation. Br J Cancer. 1997;75:1302–8.PubMed Higashiyama M, Doi O, Kodama K, et al. MDM2 gene amplification and expression in non-small-cell lung cancer: immunohistochemical expression of its protein is a favourable prognostic marker in patients without p53 protein accumulation. Br J Cancer. 1997;75:1302–8.PubMed
19.
Zurück zum Zitat Slack A, Chen Z, Tonelli R, Pule M, Hunt L, Pession A, et al. The p53 regulatory gene MDM2 is a direct transcriptional target of MYCN in neuroblastoma. Proc Natl Acad Sci USA. 2005;102:731–6.CrossRefPubMed Slack A, Chen Z, Tonelli R, Pule M, Hunt L, Pession A, et al. The p53 regulatory gene MDM2 is a direct transcriptional target of MYCN in neuroblastoma. Proc Natl Acad Sci USA. 2005;102:731–6.CrossRefPubMed
20.
Zurück zum Zitat Ko JL, Chiao MC, Chang, SL, Lin P, Lin JC, Sheu GT, Lee H. (2002) A novel p53 mutant retained functional activity in lung carcinomas. DNA Repair (Amst). 1:755–62.CrossRef Ko JL, Chiao MC, Chang, SL, Lin P, Lin JC, Sheu GT, Lee H. (2002) A novel p53 mutant retained functional activity in lung carcinomas. DNA Repair (Amst). 1:755–62.CrossRef
21.
Zurück zum Zitat Bond GL, Hirshfield KM, Kirchhoff T, et al. MDM2 SNP309 accelerates tumor formation in a gender-specific and hormone-dependent manner. Cancer Res. 2006;66:5104–10.CrossRefPubMed Bond GL, Hirshfield KM, Kirchhoff T, et al. MDM2 SNP309 accelerates tumor formation in a gender-specific and hormone-dependent manner. Cancer Res. 2006;66:5104–10.CrossRefPubMed
22.
Zurück zum Zitat Huang CC, Cheng YW, Chen MC, Lin YS, Chou MC, Lee H. Different p53 mutation patterns in colorectal tumors from smokers and nonsmokers. Environ Mol Mutagen. 2006;47:527–32.CrossRefPubMed Huang CC, Cheng YW, Chen MC, Lin YS, Chou MC, Lee H. Different p53 mutation patterns in colorectal tumors from smokers and nonsmokers. Environ Mol Mutagen. 2006;47:527–32.CrossRefPubMed
23.
Zurück zum Zitat Phelps M, Darley M, Primrose JN, Blaydes JP. p53-independent activation of the hdm2-P2 promoter through multiple transcription factor response elements results in elevated hdm2 expression in estrogen receptor alpha-positive breast cancer cells. Cancer Res. 2003;63:2616–23.PubMed Phelps M, Darley M, Primrose JN, Blaydes JP. p53-independent activation of the hdm2-P2 promoter through multiple transcription factor response elements results in elevated hdm2 expression in estrogen receptor alpha-positive breast cancer cells. Cancer Res. 2003;63:2616–23.PubMed
24.
Zurück zum Zitat Zhang X, Miao X, Guo Y, et al. Genetic polymorphisms in cell cycle regulatory genes MDM2 and TP53 are associated with susceptibility to lung cancer. Hum Mutat. 2006;27:110–7.CrossRefPubMed Zhang X, Miao X, Guo Y, et al. Genetic polymorphisms in cell cycle regulatory genes MDM2 and TP53 are associated with susceptibility to lung cancer. Hum Mutat. 2006;27:110–7.CrossRefPubMed
25.
Zurück zum Zitat Hu Z, Ma H, Lu D, et al. Genetic variants in the MDM2 promoter and lung cancer risk in a Chinese population. Int J Cancer. 2006;118:1275–8.CrossRefPubMed Hu Z, Ma H, Lu D, et al. Genetic variants in the MDM2 promoter and lung cancer risk in a Chinese population. Int J Cancer. 2006;118:1275–8.CrossRefPubMed
26.
Zurück zum Zitat Bond GL, Levine AJ. A single nucleotide polymorphism in the p53 pathway interacts with gender, environmental stresses and tumor genetics to influence cancer in humans. Oncogene. 2007;26:1317–23.CrossRefPubMed Bond GL, Levine AJ. A single nucleotide polymorphism in the p53 pathway interacts with gender, environmental stresses and tumor genetics to influence cancer in humans. Oncogene. 2007;26:1317–23.CrossRefPubMed
27.
Zurück zum Zitat Bond GL, Menin C, Bertorelle R, Alhopuro P, Aaltonen LA, Levine AJ. MDM2 SNP309 accelerates colorectal tumour formation in women. J Med Genet. 2006;43:950–2.CrossRefPubMed Bond GL, Menin C, Bertorelle R, Alhopuro P, Aaltonen LA, Levine AJ. MDM2 SNP309 accelerates colorectal tumour formation in women. J Med Genet. 2006;43:950–2.CrossRefPubMed
28.
Zurück zum Zitat Royds JA, Iacopetta B. p53 and disease: when the guardian angel fails. Cell Death Differ. 2006;13:1017–26.CrossRefPubMed Royds JA, Iacopetta B. p53 and disease: when the guardian angel fails. Cell Death Differ. 2006;13:1017–26.CrossRefPubMed
29.
Zurück zum Zitat Lianes P, Orlow I, Zhang ZF, Oliva MR, Sarkis AS, Reuter VE, Cordon-Cardo C. Altered patterns of MDM2 and TP53 expression in human bladder cancer. J Natl Cancer Inst. 1994;86:1325–30.CrossRefPubMed Lianes P, Orlow I, Zhang ZF, Oliva MR, Sarkis AS, Reuter VE, Cordon-Cardo C. Altered patterns of MDM2 and TP53 expression in human bladder cancer. J Natl Cancer Inst. 1994;86:1325–30.CrossRefPubMed
30.
Zurück zum Zitat Saito H, Tsujitani S, Oka S, Ikeguchi M, Maeta M, Kaibara N. The expression of murine double minute 2 is a favorable prognostic marker in esophageal squamous cell carcinoma without p53 protein accumulation. Ann Surg Oncol. 2002;9:450–6.CrossRefPubMed Saito H, Tsujitani S, Oka S, Ikeguchi M, Maeta M, Kaibara N. The expression of murine double minute 2 is a favorable prognostic marker in esophageal squamous cell carcinoma without p53 protein accumulation. Ann Surg Oncol. 2002;9:450–6.CrossRefPubMed
31.
Zurück zum Zitat Courjal F, Cuny M, Rodriguez C, et al. DNA amplifications at 20q13 and MDM2 define distinct subsets of evolved breast and ovarian tumours. Br J Cancer. 1996;74:1984–9.PubMed Courjal F, Cuny M, Rodriguez C, et al. DNA amplifications at 20q13 and MDM2 define distinct subsets of evolved breast and ovarian tumours. Br J Cancer. 1996;74:1984–9.PubMed
32.
Zurück zum Zitat Tanner B, Hengstler JG, Laubscher S, et al. mdm 2 mRNA expression is associated with survival in ovarian cancer. Int J Cancer. 1997;74:438–42.CrossRefPubMed Tanner B, Hengstler JG, Laubscher S, et al. mdm 2 mRNA expression is associated with survival in ovarian cancer. Int J Cancer. 1997;74:438–42.CrossRefPubMed
33.
Zurück zum Zitat Bond GL, Hu W, Levine A. A single nucleotide polymorphism in the MDM2 gene: from a molecular and cellular explanation to clinical effect. Cancer Res. 2005;65:5481–4.CrossRefPubMed Bond GL, Hu W, Levine A. A single nucleotide polymorphism in the MDM2 gene: from a molecular and cellular explanation to clinical effect. Cancer Res. 2005;65:5481–4.CrossRefPubMed
34.
Zurück zum Zitat Oda K, Arakawa H, Tanaka T, et al. p53AIP1, a potential mediator of p53-dependent apoptosis, and its regulation by Ser-46-phosphorylated p53. Cell. 2000;102:849–62.CrossRefPubMed Oda K, Arakawa H, Tanaka T, et al. p53AIP1, a potential mediator of p53-dependent apoptosis, and its regulation by Ser-46-phosphorylated p53. Cell. 2000;102:849–62.CrossRefPubMed
35.
Zurück zum Zitat Menin C, Scaini MC, De Salvo GL, et al. Association between MDM2-SNP309 and age at colorectal cancer diagnosis according to p53 mutation status. J Natl Cancer Inst. 2006;98:285–8.PubMedCrossRef Menin C, Scaini MC, De Salvo GL, et al. Association between MDM2-SNP309 and age at colorectal cancer diagnosis according to p53 mutation status. J Natl Cancer Inst. 2006;98:285–8.PubMedCrossRef
36.
Zurück zum Zitat Polsky D, Melzer K, Hazan C, et al. HDM2 protein overexpression and prognosis in primary malignant melanoma. J Natl Cancer Inst. 2002;23:1803–6. Polsky D, Melzer K, Hazan C, et al. HDM2 protein overexpression and prognosis in primary malignant melanoma. J Natl Cancer Inst. 2002;23:1803–6.
37.
Zurück zum Zitat Tammemagi MC, McLaughlin JR, Bull SB. Meta-analyses of p53 tumor suppressor gene alterations and clinicopathological features in resected lung cancers. Cancer Epidemiol Biomarkers Prev. 1999;8:625–34.PubMed Tammemagi MC, McLaughlin JR, Bull SB. Meta-analyses of p53 tumor suppressor gene alterations and clinicopathological features in resected lung cancers. Cancer Epidemiol Biomarkers Prev. 1999;8:625–34.PubMed
Metadaten
Titel
Associations of MDM2 SNP309, Transcriptional Activity, mRNA Expression, and Survival in Stage I Non-Small-Cell Lung Cancer Patients with Wild-Type p53 Tumors
verfasst von
Wen-Pin Chien, PhD
Ruey-Hong Wong, PhD
Ya-Wen Cheng, PhD
Chih-Yi Chen, MD, PhD
Huei Lee, PhD
Publikationsdatum
01.04.2010
Verlag
Springer-Verlag
Erschienen in
Annals of Surgical Oncology / Ausgabe 4/2010
Print ISSN: 1068-9265
Elektronische ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-009-0853-2

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