Background
In recent decades, certain prognostic factors and therapeutic targets for cervical cancer have been found. For example, weak pp125FAK expression correlates with pelvic lymph node metastasis and recurrent disease, and is a favorable factor for patients with cervical cancer: the overall survival of patients with high and moderate pp125FAK levels was longer than those with weak PP125FAK expression [
1]. Msi1 is upregulated in patients with cervical cancer, and promotes the proliferation of cervical cancer by directly inhibiting p21, p27, and p53 [
2]. However, cervical cancer remains the fourth most common cancer in women worldwide. Its morbidity has decreased in some countries, probably because of progress in early diagnosis and prevention. In China, the morbidity of cervical cancer is 8.98/100,000 and the mortality is 2.13/100,000, according to data from the 2012 Chinese Cancer Registry Annual Report [
3]. This suggested that new prognostic factors and therapeutic approaches should be developed.
We used publically available gene expression profiles of cervical cancer tissues and normal cervical tissues (GSE9750) to screen for genes that regulate the progression of cervical cancer, and found that
BASP1 (encoding brain abundant membrane attached signal protein 1) was upregulated in cervical cancer tissues. BASP1, which is also known as NAP-22 or CAP-23 [
4], can interact with Wilms tumor 1 (WT1). WT1 is a Wilms’ tumor suppressor protein that plays an important role in nephrogenesis and hematopoiesis [
5]. BASP1 serves as a transcriptional co-suppressor to inhibit transcriptional activity of WT1, suggesting BASP1 regulates the function of WT1 in development [
6,
7]. Further analysis revealed that the N-terminus of BASP1 could be myristoylated; myristoylated BASP1 interacted with oleate-activated transcription factor PIP2, which recruits histone deacetylase histone deacetylase 1 (HDAC1) to the promoter regions of WT1-dependent target genes, causing transcriptional repression [
8]. Toska and colleagues observed that BASP1 also interacted with Prohibitin to recruit BRG1 to the promoter regions of WT1-dependent target genes, causing coactivator p300/CBP to dissociate from the promoter regions to inhibit target gene expression; the interaction between BASP1 and Prohibitin is also critical for the recruitment of PIP2 and HDAC1 to the target genes of WT1 [
9]. These findings suggested BASP1 plays an important role in development. However, the role of BASP1 in cervical cancer has not been reported.
In this study, we analyzed the relationship between BASP1 expression and clinicopathological parameters in patients with cervical cancer, and studied the role of BASP1 in the cervical cancer growth. We found that BASP1 is a new prognostic factor for cervical cancer, and promotes tumor growth.
Discussion
In the present study, we demonstrated that BASP1 plays an important role in cervical cancer. BASP1 was upregulated in cervical cancer, and is a novel unfavorable prognostic factor for patients with cervical cancer. High BASP1 levels correlated with poor clinical outcome. BASP1 also regulates the proliferation and tumorigenicity of cervical cancer; overexpression of BASP1 promoted cellular proliferation and tumorigenicity and knockdown of BASP1 had the opposite effect. These results suggested that BASP1 not only serves as a prognostic factor, but also can function as a target for cervical cancer therapy.
We found BASP1 levels were high in cervical cancer, suggesting that
BASP1 may be an oncogene. However, previous reports have shown that BASP1 is downregulated in v-myc-induced transformed cells, and that overexpression of BASP1 inhibits transformation; further analysis showed that BASP1 inhibits the target genes of c-Myc, such as WS5, Q83 and BRAK, suggesting that BASP1 could be a tumor suppressor [
11]. Moribe and colleagues used a gene microarray and pyrosequencing to screen genes that are methylated specifically in hepatocellular carcinoma (HCC), and found that
BASP1 is aberrantly methylated in HCC; its expression is low in HCC, and it can function as a useful biomarker for the diagnosis of HCC [
12]. MicroRNA miR-191, an onco-miR, is upregulated in transformed human bronchial epithelial cells, and promotes epithelial-mesenchymal transition (EMT) and self-renewal of cancer stem cells of transformed cells. BASP1 is a direct target of miR-191; BASP1 inhibition by miR-191 leads to transactivation of WT1, which activates the Wnt pathway to promote tumor progression [
13]. Many genes have been found to play different roles in different kinds of tumors. For example, inhibitor of DNA binding 2 (ID2) is downregulated in breast cancer, in which it inhibits cellular invasion and is a favorable prognostic factor for patients [
14]. However, ID2 is upregulated in brain cancer, colon cancer, pancreatic cancer, and prostate cancer, in which it promotes tumor progression, making it an unfavorable prognostic factor [
15‐
18].
We found the opposite role of BASP1 in cervical cancer. Gene set enrichment analyses (GSEA) demonstrated that
BASP1 expression correlated significantly with progression and development of cervical cancer (Additional file
4: Figure S2), revealing that BASP1 is an oncogene in cervical cancer. We further studied whether BASP1 is an unfavorable prognostic factor. Statistical analysis of BASP1 levels in 136 paraffin-embedded cervical cancer tissues suggested a positive correlation between BASP1 levels and clinical stage, T classification, N classification and survival or mortality. Cox regression analysis demonstrated that BASP1 is an independent prognostic factor for patients with cervical cancer, and thus could be used to predict their prognosis.
We also determined the role of BASP1 in the proliferation and tumorigenicity of cervical cancer; overexpression of BASP1 promoted proliferation, colony formation, cell cycle progression, and tumorigenicity. Knockdown of BASP1 had the opposite effects. These results suggested that BASP1 regulates the proliferation and tumorigenicity of cervical cancer, making a potential therapeutic target. However, the mechanism by which BASP1 promotes the proliferation and tumorigenicity of cervical cancer requires further study; for example, a chromatin immunoprecipitation assay could identify the target genes of BASP1 associated with cervical cancer.
Methods and materials
Cell culture and transfection
Human cervical cancer cell lines Ca Ski, MS751, ME-180, SiHa, HT-3, HeLa, C4-I and SW756 were cultured in Dulbecco’s modified Eagle’s medium (DMEM) (Natocor) supplemented with 10% fetal bovine serum (FBS) (GIBCO). Ectocervical Ect1/E6E7 and endocervical End1/E6E7 cells were cultured in Keratinocyte-Serum Free medium (GIBCO-BRL, 17005-042, USA) supplemented with 0.1 ng/mL human recombinant EGF, 0.05 mg/mL bovine pituitary extract (BPE, Sigma) and 0.4 mM CaCl2 (Natocor). The cells were maintained in 5% CO2 at 37 °C.
The full-length BASP1 cDNA was cloned into vector pMSCV-puro; pMSCV-empty vector was used as the negative control. pMSCV-BASP1 and pMSCV-empty vector were cotransfected with the IK packaging plasmid into 293T cells using the calcium phosphate transfection method. Supernatants were collected at 48 h after transfection, and infected with cervical cells for 12 h in the presence of polybrene (2.5 μg/mL). Puromycin was used to select the transfected cell lines.
For BASP1 knockdown experiments, two siRNAs for BASP1 and one scrambled siRNA were synthesized by Guangzhou RiboBio Co (Guangzhou, China). The sequences used to downregulate BASP1 were: siBASP1#1: 5′CGGGATCCATGGGA3′, siBASP1#2: 5′CGGAATTCTCACTCT3′. 50 nM of the siRNA was transfected into ME-180 and HT-3 cells using the Lipofectamine RNAiMAX Transfection Reagent (Life Technologies).
Patients and tissue samples
Six cervical cancer tissues and matched adjacent normal cervical epithelium tissues were obtained from the First Affiliated Hospital of Sun Yat-sen University. Guangzhou. These samples were snap-frozen immediately and stored in liquid nitrogen until use. To further analyze the relationship between BASP1 expression and the clinicopathological parameters, a cohort of 136 paraffin-embedded cervical cancer tissues was used. These tissues were diagnosed histopathologically and clinically at the First Affiliated Hospital of Sun Yat-sen University. For the use of above clinical samples for research purposes, prior patient’s consent and approval from the Institute Research Ethics Committee of the First Affiliated Hospital of Sun Yat-sen University were obtained. The detailed clinicopathological parameters are shown in Additional file
5: Table S1.
Western blotting and immunohistochemistry (IHC)
Western blotting was performed according to standard methods, as described previously [
19], using anti-BASP1 (ab101855, Abcam), anti-Ki67 (sc-7846, Santa Cruz) antibodies. The membranes were stripped and reprobed with anti-β-actin antibodies as a loading control. The band intensity was analyzed using Image J software.
IHC was performed as described previously [
20] using the anti-BASP1 antibody (ab101855, Abcam). The results of staining were scored independently by two pathologists blinded to the clinical outcome, and were based on both the proportion of positively stained tumors cells and the intensity of staining. The proportion of stained tumor cells was scored as follows: score 0, no positive cells; score 1, up to 25% positive cells; score 2, 26–50% positive cells; score 3, 51–75% positive cells; score 4, over 75% positive cells. The intensity of staining was determined as: 0 (no staining), 1 (light yellow = weak staining), 2 (yellow brown = moderate staining), and 3 (brown = strong staining). The staining index (SI) was determined as the product of staining intensity × percentage of positive tumor cells. Cutoff values for high and low expression of BASP1 were chosen based on a measurement of heterogeneity using the log-rank test with respect to overall survival. An SI score of greater than or equal to 6 was considered to be high expression, and an SI score of less than 6 was considered low expression.
Cell proliferation and cell cycle assay
To examine the role of BASP1 in the proliferation of cervical cancer cells, an MTT assay and colony formation assay were performed using previous described methods [
21].
Cell cycle analysis was performed using a previously described method [
21]. Briefly, cells were harvested and washed in cold PBS followed by fixation in 70% alcohol overnight at 4 °C. After washing with cold PBS three times, the cells were resuspended in PBS solution with 20 μg/mL propidium iodide (Sigma) and μg/mL RNase A for 30 min at 37 °C. Samples were then analyzed using a FACSCalibur cytometer (Becton–Dickinson).
Anchorage-independent growth assay
An anchorage-independent growth assay was performed according to a previously described method [
21,
22]. Briefly, 500 cells were suspended in 2 mL of complete medium containing 0.3% agar (Sigma). The agar–cell mixture was plated on top of a solid bottom layer containing 1% complete medium agar mixture. After 10 days, colonies that contained more than 50 cells or were larger than 0.1 mm in diameter were counted. The experiment was performed in triplicate.
Growth of tumor xenografts in nude mice
Animal studies were performed according to institutional guidelines. BALB/c nude mice (4–5 weeks old) were used to make a xenograft model using ME-180 cervical cancer cell lines. Five mice were assigned randomly to each group and injected with ME-180 transfected with pMSCV-BASP1, pMSCV-empty, scramble siRNA, or BASP1 siRNA, and used to determine the role of BASP1 in tumor progression. 1 × 106 cells were injected into the subcutaneous sites of nude mice. The tumor volume was calculated every 2 days for 1 month. The tumors were excised and subjected to protein extraction to determine Ki67 levels using western blotting.
Statistical analysis
All statistical analyses were performed using the SPSS 19.0 statistical software package. Results are presented as the mean ± standard deviation (SD) for at last three repeated individual experiments for each group. Chi square and Fisher’s exact tests were used to analyze the relationship between BASP1 levels and clinicopathological parameters. Bivariate correlations between variables were calculated using Spearman’s rank correlation coefficients. The survival curve was plotted using Kaplan–Meier survival analysis and compared using a log-rank test. Univariate and multivariate Cox regression analyses were used to estimate the significance of various variables for survival. A value of p < 0.05 was considered significant in all cases.
Authors’ contributions
HRT, GST, and HPL designed the experiments. HRT and BZ collected clinical data. SQX, LSL, and WC performed experiments and data collection. HRT and HPL analyzed the data. HRT, GST, and HPL interpreted of the data and drafted the manuscript. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. All authors read and approved the final manuscript.
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