Mucins (MUC) play crucial roles in carcinogenesis and tumor invasion in pancreatic ductal adenocarcinoma (PDAC) and intraductal papillary mucinous neoplasms (IPMNs). Our immunohistochemistry (IHC) studies have shown a consensus position on mucin expression profiles in pancreatic neoplasms as follows: MUC1-positive but MUC2-negative expression in PDACs; MUC1-negative but MUC2-positive expression in intestinal-type IPMNs (dangerous type); MUC1-negative and MUC2-negative expression in gastric-type IPMNs (safe type); High MUC4 expression in PDAC patients with a poor outcome; and MUC4-positive expression in intestinal-type IPMNs. We also showed that three mucin genes (MUC1, MUC2 and MUC4) expression in cancer cell line was regulated by DNA methylation. We have developed a novel ‘methylation-specific electrophoresis (MSE)’ method to analyze the DNA methylation status of mucin genes by high sensitivity and resolution. By using the MSE method, we evaluated pancreatic juice samples from 45 patients with various pancreatic lesions. The results were compared with final diagnosis of the pancreatic lesions including IHC of mucin expression in the paired pancreatic tissues. The results indicated that the DNA methylation status of MUC1, MUC2 and MUC4 in pancreatic juice matched with the mucin expression in tissue. Analyses of the DNA methylation status of MUC1, MUC2 and MUC4 were useful for differential diagnosis of human pancreatic neoplasms, with specificity and sensitivity of 87% and 80% for PDAC; 100% and 88% for intestinal-type IPMN; and 88% and 77% for gastric-type IPMN, respectively. In conclusion, MSE analysis of human pancreatic juice may provide useful information for selection of treatment for pancreatic neoplasms.
References
[1]
Hruban RH, Boffettta P, Hiraoka N, Iacobuzio-Donaue C, Kato Y, et al. (2010) Ductal adenocarcinoma of the pancreas. In: Bosman FT, Carneiro, F, Hruban, R H., Theise, N D., editor. World Health Organization Classification of Tumours, Pathology and Genetics of Tumours of the Digestive System. Lyon. 281–291.
[2]
Adsay NV, Fukushima N, Furukawa T, Hruban RH, Klimstra DS, et al. (2010) Intraductal neoplasms of the pancreas. In: Bosman FT, Carneiro, F, Hruban, R H., Theise, N D., editor. World Health Organization Classification of Tumours, Pathology and Genetics of Tumours of the Digestive System. Lyon. 304–313.
[3]
Nakamura A, Horinouchi M, Goto M, Nagata K, Sakoda K, et al. (2002) New classification of pancreatic intraductal papillary-mucinous tumour by mucin expression: its relationship with potential for malignancy. J Pathol 197: 201–210. doi: 10.1002/path.1109
[4]
Horinouchi M, Nagata K, Nakamura A, Goto M, Takao S, et al. (2003) Expression of Different Glycoforms of Membrane Mucin(MUC1) and Secretory Mucin (MUC2, MUC5AC and MUC6) in Pancreatic Neoplasms. Acta Histochem Cytochem 36: 443–453. doi: 10.1267/ahc.36.443
[5]
Longnecker DS, Albert G, Hruban RH (2000) Intraductal papillary-mucinous neoplasms of the pancreas. In: Hamilton SA, Aaltonen LA, eds. World Health Organization Classification of Tumors, Pathology and Genetics of Tumors of the Digestive System: 237–241.
[6]
Furukawa T, Hatori T, Fujita I, Yamamoto M, Kobayashi M, et al. (2011) Prognostic relevance of morphological types of intraductal papillary mucinous neoplasms of the pancreas. Gut 60: 509–516. doi: 10.1136/gut.2010.210567
[7]
Cheever MA, Allison JP, Ferris AS, Finn OJ, Hastings BM, et al. (2009) The prioritization of cancer antigens: a national cancer institute pilot project for the acceleration of translational research. Clin Cancer Res 15: 5323–5337. doi: 10.1158/1078-0432.ccr-09-0737
[8]
Yonezawa S, Higashi M, Yamada N, Yokoyama S, Goto M (2010) Significance of mucin expression in pancreatobiliary neoplasms. J Hepatobiliary Pancreat Sci 17: 108–124. doi: 10.1007/s00534-009-0174-7
[9]
Yonezawa S, Higashi M, Yamada N, Yokoyama S, Kitamoto S, et al. (2011) Mucins in human neoplasms: clinical pathology, gene expression and diagnostic application. Pathol Int 61: 697–716. doi: 10.1111/j.1440-1827.2011.02734.x
[10]
Osako M, Yonezawa S, Siddiki B, Huang J, Ho JJ, et al. (1993) Immunohistochemical study of mucin carbohydrates and core proteins in human pancreatic tumors. Cancer 71: 2191–2199. doi: 10.1002/1097-0142(19930401)71:7<2191::aid-cncr2820710705>3.0.co;2-x
[11]
Yonezawa S, Taira M, Osako M, Kubo M, Tanaka S, et al. (1998) MUC-1 mucin expression in invasive areas of intraductal papillary mucinous tumors of the pancreas. Pathol Int 48: 319–322. doi: 10.1111/j.1440-1827.1998.tb03913.x
[12]
Saitou M, Goto M, Horinouchi M, Tamada S, Nagata K, et al. (2005) MUC4 expression is a novel prognostic factor in patients with invasive ductal carcinoma of the pancreas. J Clin Pathol 58: 845–852. doi: 10.1136/jcp.2004.023572
[13]
Kitazono I, Higashi M, Kitamoto S, Yokoyama S, Horinouchi M, et al. (2013) Expression of MUC4 mucin is observed mainly in the intestinal type of intraductal papillary mucinous neoplasm of the pancreas. Pancreas 42: 1120–1128. doi: 10.1097/mpa.0b013e3182965915
[14]
Yamada N, Nishida Y, Tsutsumida H, Hamada T, Goto M, et al. (2008) MUC1 expression is regulated by DNA methylation and histone H3 lysine 9 modification in cancer cells. Cancer Res 68: 2708–2716. doi: 10.1158/0008-5472.can-07-6844
[15]
Yamada N, Hamada T, Goto M, Tsutsumida H, Higashi M, et al. (2006) MUC2 expression is regulated by histone H3 modification and DNA methylation in pancreatic cancer. Int J Cancer 119: 1850–1857. doi: 10.1002/ijc.22047
[16]
Yamada N, Nishida Y, Tsutsumida H, Goto M, Higashi M, et al. (2009) Promoter CpG methylation in cancer cells contributes to the regulation of MUC4. Br J Cancer 100: 344–351.
[17]
Yamada N, Kitamoto S, Yokoyama S, Hamada T, Goto M, et al. (2011) Epigenetic regulation of mucin genes in human cancers. Clin Epigenet: published online.
[18]
Yokoyama S, Kitamoto S, Yamada N, Houjou I, Sugai T, et al. (2012) The application of methylation specific electrophoresis (MSE) to DNA methylation analysis of the 5′ CpG island of mucin in cancer cells. BMC Cancer 12: 67. doi: 10.1186/1471-2407-12-67
[19]
Shinozuka N, Okada K, Torii T, Hirooka E, Tabuchi S, et al. (2007) Endoscopic pancreatic duct drainage and stenting for acute pancreatitis and pancreatic cyst and abscess. J Hepatobiliary Pancreat Surg 14: 569–574. doi: 10.1007/s00534-006-1203-4
[20]
Hara T, Ikebe D, Odaka A, Sudo K, Nakamura K, et al. (2013) Preoperative histological subtype classification of intraductal papillary mucinous neoplasms (IPMN) by pancreatic juice cytology with MUC stain. Ann Surg 257: 1103–1111. doi: 10.1097/sla.0b013e318281b824
[21]
Ihaka R, Gentleman R (1996) R: A Language for Data Analysis and Graphics. Journal of Computational and Graphical Statistics 5: 16. doi: 10.2307/1390807
[22]
Venables WN, Ripley BD (2002) Modern Applied Statistics with S: Springer.
[23]
Fawcett T (2006) An introduction to ROC analysis. Pattern Recognition Letters 27: 4. doi: 10.1016/j.patrec.2005.10.010
[24]
Yonezawa S, Kitajima S, Higashi M, Osako M, Horinouchi M, et al. (2012) A novel anti-MUC1 antibody against the MUC1 cytoplasmic tail domain: use in sensitive identification of poorly differentiated cells in adenocarcinoma of the stomach. Gastric Cancer.
[25]
Moniaux N, Varshney GC, Chauhan SC, Copin MC, Jain M, et al. (2004) Generation and characterization of anti-MUC4 monoclonal antibodies reactive with normal and cancer cells in humans. J Histochem Cytochem 52: 253–261. doi: 10.1177/002215540405200213
[26]
Begum S, Brait M, Dasgupta S, Ostrow KL, Zahurak M, et al. (2011) An epigenetic marker panel for detection of lung cancer using cell-free serum DNA. Clin Cancer Res 17: 4494–4503. doi: 10.1158/1078-0432.ccr-10-3436
[27]
Carvalho AL, Jeronimo C, Kim MM, Henrique R, Zhang Z, et al. (2008) Evaluation of promoter hypermethylation detection in body fluids as a screening/diagnosis tool for head and neck squamous cell carcinoma. Clin Cancer Res 14: 97–107. doi: 10.1158/1078-0432.ccr-07-0722
[28]
Nagata S, Hamada T, Yamada N, Yokoyama S, Kitamoto S, et al. (2012) Aberrant DNA methylation of tumor-related genes in oral rinse: a noninvasive method for detection of oral squamous cell carcinoma. Cancer 118: 4298–4308. doi: 10.1002/cncr.27417
[29]
Matsubayashi H, Canto M, Sato N, Klein A, Abe T, et al. (2006) DNA methylation alterations in the pancreatic juice of patients with suspected pancreatic disease. Cancer Res 66: 1208–1217. doi: 10.1158/0008-5472.can-05-2664
[30]
Yao F, Sun M, Dong M, Jing F, Chen B, et al. (2013) NPTX2 hypermethylation in pure pancreatic juice predicts pancreatic neoplasms. Am J Med Sci 346: 175–180. doi: 10.1097/maj.0b013e31827b94b6
[31]
Yonezawa S, Goto M, Yamada N, Higashi M, Nomoto M (2008) Expression profiles of MUC1, MUC2, and MUC4 mucins in human neoplasms and their relationship with biological behavior. Proteomics 8: 3329–3341. doi: 10.1002/pmic.200800040
[32]
Yonezawa S, Sueyoshi K, Nomoto M, Kitamura H, Nagata K, et al. (1997) MUC2 gene expression is found in noninvasive tumors but not in invasive tumors of the pancreas and liver: its close relationship with prognosis of the patients. Hum Pathol 28: 344–352.
[33]
Yonezawa S, Horinouchi M, Osako M, Kubo M, Takao S, et al. (1999) Gene expression of gastric type mucin (MUC5AC) in pancreatic tumors: its relationship with the biological behavior of the tumor. Pathol Int 49: 45–54. doi: 10.1046/j.1440-1827.1999.00823.x
[34]
Yonezawa S, Higashi M, Yamada N, Goto M (2008) Precursor lesions of pancreatic cancer. Gut Liver 2: 137–154. doi: 10.5009/gnl.2008.2.3.137
[35]
Adsay NV, Conlon KC, Zee SY, Brennan MF, Klimstra DS (2002) Intraductal papillary-mucinous neoplasms of the pancreas: an analysis of in situ and invasive carcinomas in 28 patients. Cancer 94: 62–77. doi: 10.1002/cncr.10203
[36]
Tanaka M, Fernandez-del Castillo C, Adsay V, Chari S, Falconi M, et al. International consensus guidelines 2012 for the management of IPMN and MCN of the pancreas. Pancreatology 12: 183–197. doi: 10.1016/j.pan.2012.04.004
[37]
Ideno N, Ohtsuka T, Kono H, Fujiwara K, Oda Y, et al. (2013) Intraductal papillary mucinous neoplasms of the pancreas with distinct pancreatic ductal adenocarcinomas are frequently of gastric subtype. Ann Surg 258: 141–151. doi: 10.1097/sla.0b013e31828cd008