(CANCER RESEARCH 46,1530-1534, March 1986] Differential Expression of p21rasGene Products among Histológica! Subtypes of Fresh Primary Human Lung Tumors1 Razelle Kurzrock,2 Gary E. Gallick,3 and Jordan U. Gutterman4 Department of Clinical Immunology and Biological Therapy [R. K., J. U. G.J and Department of Tumor Biology, Section of Virology [G. E. G.], M. D. Anderson Hospital and Tumor Institute, Houston, Texas 77030 ABSTRACT Activation of the ras oncogene has been associated with a number of human tumors. In this study, expression of p2Vas in different histological types of fresh primary bronchogenic carci nomas was examined. p21fas products were detected in all lung tissues that were analyzed. Only 1 of 23 tumors demonstrated aberrant migration of p21'as. In contrast, 10 tumors had substan tially elevated levels of p2Vas products with respect to the adjacent normal lung tissues and with respect to the other lung tumors. There was no correlation between increased ras protein expression and tobacco exposure of the patient or extent of disease at the time of diagnosis. However, 9 of 11 tumors with a squamous component as opposed to only 1 of 12 tumors belonging to other histological classifications demonstrated in creased p21ras.These data suggest that, in bronchogenic carci nomas, mutations associated with structural abnormalities and aberrant migration of p21ras occur infrequently as compared to quantitative changes in p21ras. Furthermore, differential expres sion of c-ras products in primary human lung tumors correlates with pathological cell type, and may be a common event in squamous cell carcinomas, but not adenocarcinomas or small cell carcinomas of the lung. ras RNA in colon, lung, and renal tumors (7, 8), and increased ras protein in approximately 50% of colorectal tumors (9, 10) suggests that in vivo quantitative changes in c-ras expression may be important in certain human cancers. Although bronchogenic carcinoma is the most frequently oc curring fatal cancer in the United States (11, 12), studies of oncogene expression in these tumors have been limited. To date, most reports have focused on RNA transcripts as a param eter of gene expression and have usually been restricted to cell lines because of the rapid degradation of RNA in fresh solid tumors (13-15). However, genetic aberrations observed in es tablished cell lines may not always reflect events occurring in unmanipulated tumors (4). Furthermore, studies of the protein products of these genes, which are the molecules to which cellular changes are ultimately attributable, have not been re ported for lung tumors. Therefore, we used a monoclonal anti body that detects the p21 product of the c-Ha-ras, c-Ki-ras, and N-ras genes to investigate ras expression in 23 paired samples of fresh primary human lung tumors and adjacent normal lung tissues. We report differential expression of c-ras which corre lates with histological classification, with increased p21fas de tected in squamous cell carcinomas but not in adenocarcinomas or small cell carcinomas of the lung. INTRODUCTION MATERIALS AND METHODS Aberrant expression of cellular oncogenes belonging to the ras gene family has been observed in several naturally occurring cancers. Activation of these genes by specific point mutations confers the ability to transform NIH-3T3 cells after transfection and is estimated to occur in 10 to 20% of human tumors (1-3). Cell Cultures. Uninfected normal rat kidney cells and normal rat kidney cells infected with Kirsten Sarcoma virus were provided by Dr. E. Scolnick. Cell lines were grown in Dulbecco's modified Eagle's medium, However, such somatic alterations are not seen in, and therefore are unlikely to account for the development of the majority of tumors of any given type (4). Malignant transformation may also result from a change in the level of expression of normal cellular proto-oncogenes. Such tumorigenic potential has been demon strated in vitro for the c-Ha-ras gene by experiments in which transfected molecular clones of this gene ligated to a retroviral long terminal repeat induced high levels of expression of the normal gene product associated with cellular transformation (5). Furthermore, recent work demonstrating hypomethylation of the c-Ha-ras gene in human colon and lung tumors (6), increased Received 7/8/85; revised 11/8/85; accepted 11/11/85. The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked advertisement in accordance with 18 U.S.C. Section 1734 solely to indicate this fact. 1 Research conducted, in part, by the Clayton Foundation for Research and the James E. Lyon Foundation for Research. 2To whom requests for reprints should be addressed, at Department of Clinical Immunology and Biological Therapy, Box 41, M. D. Anderson Hospital and Tumor Institute, 6723 Bertner Avenue, Houston, TX 77030. 3 Aided by NIH Grant RR5511 -21. 4 Senior Clayton Foundation Investigator. CANCER RESEARCH supplemented with 15% fetal calf serum. Upon reaching confluency, cell pellets were collected by centrifugation, frozen in liquid nitrogen, and then lyophilized for 12 h. Procurement of Human Tissue. Tissue was removed from patients undergoing pneumonectomy or lobectomy for carcinoma of the lung, in accordance with institutional guidelines. All tissues were obtained im mediately after surgical resection. Lung tumor tissues which showed necrotic areas were carefully trimmed. Normal lung tissues were taken from the far margins of resection of the lung in those patients whose margins of resection were free of tumor. Biopsies of normal skin were also obtained and trimmed to separate the epidermis from the dermis. Tissue was frozen in liquid nitrogen and then lyophilized for 12 h. Tissues stored in this manner have consistently yielded reproducible .results in protein analysis. Patient Data. Data pertaining to patient characteristics were obtained by review of hospital charts. Tumors from patients who had received preoperative radiation therapy were not analyzed in this study. Lung tumors were classified as squamous cell carcinomas, adenocarcinomas, or small cell carcinoma based on histopathological examination. Tumors demonstrating both squamous and glandular elements were classified as adenosquamous carcinoma. In addition, cellularity and proportion of stromal tissue in each tumor was determined, by reviewing pathology slides. Stage of diseasewas designatedaccordingto the criteriaof the VOL. 46 MARCH 1986 1530 Downloaded from cancerres.aacrjournals.org on June 14, 2017. © 1986 American Association for Cancer Research. GENE PRODUCTS IN LUNG TUMOR TISSUES American Joint Committee for Cancer Staging (16). The stages are as follows: Stage I refers to a primary tumor <3 cm in diameter without RESULTS evidence of nodal métastasesoutside the peribronchial or ipsilateral hilar region, or a tumor >3 cm without any nodal métastases. Stage II refers to a primary tumor >3 cm with nodal métastases confined to the peribronchial or ipsilateral hilar region. Stage HI refers to tumors with direct extension into adjacent structures, i.e., parietal pleura or chest wall and/or any tumor with distant nodal or visceral métastases. Immunoprecipitation of Tissue Extracts. A rat monoclonal antibody, Y13-259 (donated by Dr. E. Scolnick), which reacts with the p21 product of c-Ha-ras, c-Ki-ras, and N-ras genes (17) was used in all studies. Lyophilized tissues (2.5 mg) were lysed in 1 ml of detergent-containing The procedure used in these experiments, whereby immunoblotting was performed on immunoprecipitates of p21'8S from relatively large amounts of tissue (2.5 mg) rather than on whole cell extracts (where only about 100 /*g of tissue can be applied to .the gel) has been shown previously by Gallick ef a/. (9) to detect even the small amounts of p21rasfound in NIH-3T3 cells and normal human tissue, with a minimum of spurious bands. In addition, this technique detects migration differences based on structural changes caused by alteration of the 12th amino acid in p21 (9, 24) and accurately reflects quantitative changes in p21 in a normal rat kidney cell line before and after infection with Kirsten sarcoma virus (Fig. 1). The band in the M, 30,000-35,000 buffer as described by Naso e? al. (18) and then homogenized. The resulting suspension was cleared by centrifuging at 10,000 rpm for 10 min. The lysates were then incubated for 3 h with 10 /¿\ of the monoclonal antibody (1.7 mg/ml) at 4°C.Lysates were next reacted for 2 h with 10 6 ni of rabbit antibodies against rat IgG (Cappel Laboratories, Cochranville, PA), which had been reconstituted according to the manufacturer's 7 instructions. Antigen-antibody complexes were then reacted with 60 M! of formalin-inactivated Staphylococcus aureus (Cowan strain) for 30 min at 4°C(19). The immune precipitates were collected by centrifugation, and the cell pellets were then washed 3 times. Immunoprecipitated proteins were released by resuspending the samples in SDS5-polyacryl- LC- amide gel electrophoresis buffer (1% SDS, 1% 2-mercaptoethanol, 0.001 M EDTA, 0.005 M bromophenol blue, 5% glycerol, and 0.01 M Tris-HCI, pH 8.0) and boiling for 5 min. Samples were then cooled to room temperature and centrifugea at 6,000 rpm for 10 min, and the Cowan pellets were discarded. Immunoprecipitation of tubulin was performed with a sheep antiserum to human tubulin (20) (donated by Dr. B. Brinkley) as described above, except that S. aureus protein A was added imme diately after 4 h of incubation with the anti-tubulin serum. Fig. 1. Comparison of p21 and tubulin levels in primary human squamous cell carcinomas of the lung and adjacent normal lung tissue. Immunoblotting of immunoprecipitates was performed as described in "Materials and Methods." A, reactivity of p21 was determined by reaction of immunoprecipitates with 125Isheep anti-rat Western Blotting. Western blotting of proteins was done by a modi fication of the method of Anderson ef al. (21). Immunoprecipitated proteins were resolved by SDS polyacrylamide gel electrophoresis by using a 10.5% acrylamide gel. The gels were calibrated according to the following molecular weight standards: Phosphorylase B (M, 92,500); bovine serum albumin (M, 66,200); ovalbumin (M, 45,000); carbonic anhydrase (M, 31,000); soybean trypsin inhibitor (M, 21,500); and lysozyme (M, 14,400). Electrophoretic transfer of proteins from the gel onto nitrocellulose filter paper (22) was then accomplished at 100 V for 45 min. Blotted protein molecular weight standards were separated from the rest of the nitrocellulose and stained in a 0.1% amido black solution for direct visualization. The remaining nitrocellulose filter was rinsed in TNE/NP40 buffer (0.15 M NaCI, 0.002 M EDTA, 0.1% NP40, 0.05 M Tris, pH 7.5) and then preblocked for 3 h at 37°C in a plastic bag containing IgG. Lane 1, NRK cells; Lane 2, NRK cells infected with Kirsten sarcoma virus; Lanes 3 and 4, lung tumor and normal tissues, respectively, (patient M,) (Table 1); Lanes 5 and 6, lung tumor and normal tissues (patient Ci); Lanes 7 and 8, lung tumor and normal tissues (patient P,). LC denotes light chain of IgG. B, reactivity of tubulin was determined by reaction of immunoprecipitates with 125IStaphylococ cus aureus protein A. Lanes 1 and 2, lung tumor and normal tissues, respectively (patient M,); Lanes 3 and 4, lung tumor and normal tissues, respectively (patient Ci); Lanes 5 and 6, lung tumor and normal tissues, respectively (patient P,); Lane 7, no cell extract. 8 456 9 45K- Mini. 2 ml per gel lane TNE/NP40 with 3% bovine serum albumin on a rocking platform. After blocking, a 1:100 ratio of anti-p21 sera to fresh buffer was added and then incubated at 4°Cfor 12 h on a rocking platform. Filters were then washed five times with TNE/NP40 buffer, placed in a plastic bag, and incubated with rocking for 1 h with 1 ^Ci per gel lane 125l-sheep anti-rat IgG (specific activity, 5-20 ¿iCi/mg;Amersham, Chi 22K- h M . »' » •-P21 cago, IL), diluted in 2 ml per gel lane TNE/NP40 buffer containing 3% bovine serum albumin. Filters were washed 4 times with TNE/NP40 and then once in TNE/NP40 containing 1.2% glycerol. After drying, filters were autoradiographed at -70°C with Kodak Lightning-Plus intensifying screens (23). Quantitation of differences in the level of p21ras was performed by densitometry analysis. Immunoblotting of tubulin was done by the same procedure, except that immunoprecipitated proteins were resolved by SDS polyacrylamide gel electrophoresis using an 8% acryl amide gel. Reactivity of tubulin in Western analyses was determined by reactivity with 0.1 ftC\ per gel lane 125l-labeledS. aureus protein A (specific Fig. 2. Comparison of p21 levels in primary human lung carcinoma of different histological subtypes with adjacent normal lung tissue and normal skin tissue. Immunoblotting of immunoprecipitates was performed as described in "Materials and Methods." Reactivity of p21 was determined by reaction of immunoprecipitates with 125Isheep anti-rat IgG. Lane 7, no cell extract; Lanes 2 and 3, small cell carcinoma of the lung and adjacent normal lung tissue, respectively (patient Z,) (Table 1). Lanes 4 and 5, squamous cell carcinoma of the lung and adjacent normal lung tissue, respectively (patient Wi). Lanes 6 and 7, adenocarcinoma of the lung and adjacent normal lung tissue, respectively (patient X,); Lanes 8 and 9. normal skin tissues; LC denotes light chain of IgG. activity, >30 mCi/mg; Amersham). 5 The abbreviations used are: SDS, sodium dodecyl sulfate; EGF, epidermal growth factor; TNE, Tris-NaCI-EDTA; NP40, Nonidet P-40. CANCER RESEARCH VOL. 46 MARCH 1986 1531 Downloaded from cancerres.aacrjournals.org on June 14, 2017. © 1986 American Association for Cancer Research. p21"s GENE PRODUCTS IN LUNG TUMOR TISSUES Table 1 Selected properties of primary lung tumors of history ratio: tumor/ disease8IIIIII11IIillII1illinIIilllillill1IIII11II1IISmoking (pack/yr)6301203003060453030501335450905007050120503050p21 normal lungc>10.0>10.04.1>10.05.15.04.25.04.3 diagnosisAdenosquamous (yr)/sex57/F68/M56/M76/M58/F65/M63/M46/M68/M64/M49/M49/F56/F65/F49/F58/M58/F65/M55/M62/M58/F56/M54/FHistological PatientM,C,JiP,s,S2w,0,Y,T,E,P*P.E,T,S3W2H,N,X,K,Z,D,Age carcinomaAdenosquamous carcinomaAdenosquamous carcinomaSquamous carcinomaSquamous carcinomaSquamous carcinomaSquamous carcinomaSquamous carcinomaSquamous carcinomaSquamous carcinomaSquamous carcinomaAdenocarcinomaAdenocarcinomaAdenocarcinomaAdenocarcinomaAdenocarcinomaAdenocarcinomaAdenocarcinomaAdenocarcino carcinomaSmall cell carcinomaSmall cell cell carcinomaStage " Criteria of the American Joint Committee for Cancer Staging (16). 6 Pack/yr = number of 20-cigarette packages smoked per day x number of years of smoking. c Quantitation was done by densitometry. molecular weight region of the gel, seen in all lanes, including the lane in which no cell extract was immunoprecipitated (Fig. 2, lane 1), represents reactivity of 125l-sheep anti-rat IgG with light chain of the rat monoclonal antisera. Examples of immunoblotting of immunoprecipitates of human lung tumors and adjacent normal lung tissue are shown in Figs. 1 and 2. To date, ras gene expression has been analyzed in samples of both fresh primary lung cancers and normal lung tissue from each of 23 patients (Table 1). The tumor tissues were histologically classified as squamous cell carcinomas (8 samples), adenosquamous carcinomas (3 samples), adenocar- Fig. 2 shows examples of p21'as levels in a small cell carcinoma (lanes 2 and 3), squamous cell carcinoma (lanes 4 and 5), and adenocarcinoma (lanes 6 and 7). In contrast to the results observed in squamous carcinomas, only 1 of 9 bronchogenic adenocarcinomas and none of 3 small cell carcinomas demon strated enhanced ras expression in tumor relative to normal tissue. As determined by densitometry, the median ratio of p21ras in the 11 squamous tumors analyzed, relative to adjacent normal tissue, was 5.1 (range, 0.5 to >10). The median ratio of p21'as in the 12 nonsquamous lung tumors analyzed as compared to adjacent normal tissue was 0.95 (range, 0.5 to 4.0). When equal amounts of protein were immunoprecipitated (in contrast to equal dry weights) similar differences between tumors were observed (data not shown). In addition, when densitometry comparisons of p2Vas levels between different histological types of tumors were performed, the 9 squamous tumors with increased p2Tas tumor/normal ratio also showed elevation of p21rasranging from 3 to >10-fold as compared to adenocarcinomas or small cell carcinomas analyzed on the same gel. Therefore, p21ras levels cinomas (9 samples), and small cell carcinomas (3 samples). As expected, p21'as was present in all lung tissues examined. A p21'as which migrated more slowly than the normal was detected in only one of the lung tumors examined. This tumor was classified as an adenocarcinoma, and the aberrant migration pattern was not seen in the normal lung tissue adjacent to this tumor. Ten tumors demonstrated a greater than four-fold eleva tion in p21'as with respect to adjacent normal lung tissue (Table 1). Interestingly, 9 of the tumors with increased p21'as had a were increased in squamous tumors as compared to other lung tumors or as compared to adjacent normal lung tissue. Review of pathology slides revealed that the stromal compo not have a squamous component was the adenocarcinoma nent of both the adenocarcinomas and squamous cell carcino (mentioned above), which demonstrated an aberrant migration mas constituted approximately 45 to 55% of the tumor tissue. pattern. Three examples of the increased p2Vas levels in squa The small cell carcinomas appeared somewhat more cellular mous or adenosquamous lung carcinomas are shown in Fig. ÃŒA than the other tumor types, with the stromal component consti (lanes 3 to 8). In contrast, Fig. 1ß(lanes 1 to 6) illustrates that tuting 30 to 40% of the tumor tissue. Therefore, variations in the although there is some patient to patient variability when tissue amount of stromal tissue between tumor types cannot account for the increased levels of p21ras in squamous carcinomas as extracts identical to those in A were blotted and reacted with antiserum to human tubulin, the levels of this protein are similar compared to adenocarcinomas or small cell carcinomas. To determine the expression of p2Vas in normal squamous between tumor and normal tissue in each of these patients. Thus, variations in the extent of nonspecific proteolysis occurring epithelium, the epidermal layer of normal skin derived from 2 additional patients was obtained. The level of p21ras in normal in tumor versus normal tissue are unlikely to account for the dramatically increased levels of p21ras seen in these squamous skin epidermal tissue was equivalent to that in normal lung tissue squamous cell component on histological examination (Table 1). Furthermore, the single tumor with increased p21ras which did (Fig. 2, lanes 8 and 9). This is consistent with our previously lung tumors relative to adjacent normal lung tissue. CANCER RESEARCH VOL. 46 MARCH 1986 1532 Downloaded from cancerres.aacrjournals.org on June 14, 2017. © 1986 American Association for Cancer Research. p21'as GENE PRODUCTS IN LUNG TUMOR TISSUES reported results (9) showing about a two-fold variation in p21ras adenocarcinoma. expression among various normal tissues, including lung, liver, and colon. These data suggest that increased p21rasis a property adenocarcinoma may have occurred because of previous acti vation of the c-ras gene by a point mutation, since this tumor was the one in which slowed migration of p21 was detected. Elevation of p21ras was not observed in normal squamous epi of malignant but not of normal squamous epithelium. Alternatively, elevation of p21'as in this one DISCUSSION thelium derived from skin biopsies, suggesting that increased p21'as is a property of squamous cell carcinoma but not of normal Activation of cellular oncogenes has been implicated in induc tion of In vitro malignant transformation of NIH-3T3 cells and may be related in vivo to several human cancers (1-3, 5-10). In particular, transfection experiments have revealed that altered p21 products of the c-ras gene seem to be responsible for the mous cell carcinoma but not of normal keratinocytes. Recent work suggests that the autonomous growth of malig nant cells may be due to aberrant expression of controlling growth factors, growth factor receptors, or their intracellular messenger system, any of which may be encoded directly by oncogenes or may interact with oncogene protein products (28). In particular, experiments demonstrating that EGF stimulates the guanine nucleotide binding of the c-Ha-ras and v-Ha-ras protein (29) suggest a functional link between p21ras and the receptor transforming potential of individual lung cancer cell lines (25) and fresh lung tumors (26). Quantitative changes in oncogene expression may also be associated with bronchogenic cancers. In small cell lung cancer cell lines, elevated expression of the cmyc (14) and c-myb (15) genes have been observed, with the former correlating with progression. Hypomethylation of the cHa-ras gene and enhanced expression of c-Ki-ras and c-Ha-ras mRNA have also been described in individual lung tumors (6, 8). However, to date, systematic comparison of oncogene expres sion in fresh lung tumors of different histological types has not been performed. Therefore, in this study, fresh tissues from bronchogenic carcinomas classified as squamous cell, adenosquamous, adenocarcinomas, and small cell carcinomas were analyzed for expression of the p21 product of the ras gene by immunoblotting with a broadly reactive monoclonal antisera to p21'as. Although this technique has been shown previously to detect migration differences caused by a point mutation at the 12th amino acid of p21 (9), only 1 of 23 (4.3%) lung tumors demonstrated such a migration difference. These results in fresh lung tumor tissue are in accord with previous work in lung cancer cell lines suggesting that this point mutation occurs infrequently and therefore probably does not play a role in the development of most lung cancers (4). In contrast, quantitative changes in p2Vas were commonly observed in this study, with 10 of 23 (44%) lung tumor tissues analyzed showing a greater than four fold elevation of p21 in the tumor with respect to the adjacent normal tissue. Increased p2Vas was not associated with age or sex of patient, history of tobacco use, or stage of disease (Table 1). We have reported previously that p21'as expression in colorectal cancer corresponds with stage of disease, with higher levels of expression detected in intermediate stage primary tu mors as compared with metastatic lesions, or with late stage primary disease in which métastasesare present (9). Therefore, it is possible that differential expression of p21'as may be asso ciated with progression of colorectal carcinoma but not of lung carcinoma. However, it is important to bear in mind that the total of 3 different gene products are being assayed, i.e., c-Ha-ras, cKi-ras, and N-ras, and the same one may not be increased in colon and lung tumors. Interestingly, differential expression of c-ras did correlate with the histological classification of the lung tumors (Table 1). Nine of 11 (82%) tumors with a squamous component as opposed to only 1 of 12 (8.3%) nonsquamous cell carcinomas of the lung demonstrated increased p21ras.There is a large body of evidence suggesting that the major histological subtypes of lung carci noma may be developmentally related with some tumors exhib iting characteristics of more than one subtype (27), possibly accounting for the elevated p21'as in a single apparently "pure" system stimulated by EGF. The structure of the ras proteins is homologous to the a-subunit of the G-regulatory proteins (30) that transduce signals from certain receptor-ligand systems into changes in the intracellular levels of adenylate cyclase, in part, by binding to guanine nucleotides (31, 32). Studies performed with yeast further support the concept that Aas proteins are controlling elements of adenylate cyclase (33). Therefore, it is possible that overexpression of the ras gene may be involved in the genesis of squamous cell carcinomas by acting as a signal transducer on cyclic AMP in a similar fashion to G-proteins and/ or by its interaction with the EGF receptor system. Furthermore, amplification of the EGF receptor gene has been described in squamous carcinoma cell lines (34-36), and recent work indi cates that increased EGF receptor is a consistent feature of squamous cell carcinomas (37). 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