microRNAs and esophageal carcinoma
Guo and colleagues were the first to report microRNA
expression profiles in esophageal cancer, in 2008. Microarrays
were used to profile 435 microRNAs in RNA extracted
from fresh-frozen specimens of 31 pairs of ESCC and
corresponding adjacent normal esophageal tissues (70).
One-hundred-ninety-one microRNAs were considered
detectable, and their expression profiles could be used to
discern cancerous from normal tissue with >90% accuracy.
microRNAs miR-25, miR-424 and miR-151 showed
upregulation, and miR-100, miR-99a, miR-29c, and miR-140*
showed reduction in cancerous tissue. Higher expression
of miR-103 and miR-107, known to affect metastatic
potential of cancers by downregulating Dicer levels (58), was
associated with poor prognosis. In a study that was published
in the same year, Feber, et al., used RNA from fresh-frozen
tissue samples from ten cases each of EAC and ESCC,
and five cases of BE, to assay the expression of 328 human
microRNAs (71). Compared to normal esophagus, miR-203 and miR-205 were expressed two-to-ten-fold less in all three
diseases, whereas miR-21 levels were three-to-five-fold higher.
Reduced levels of miR-203 and miR-205 were also observed
in columnar epithelium compared to normal squamous
epithelium in a study that examined 377 microRNAs in 16
individuals using microarrays (72). Levels of miR-205 were
also found to be lower in BE mucosa compared to normal
adjacent epithelium as well as to neosquamous epitheium
generated following ablation of Barrett's epithelium with
Argon plasma coagulation in a study involving nine patients
(73). microRNA miR-21 was also identified as overexpressed
in a study that used RT-PCR to examine 20 cases of ESCC
and seven ESCC cell-lines, and in two other studies, and
it has been shown to be an oncogene that promoted cell
transformation by targeting transcripts for the Programmed cell death 4 (PDCD4) protein ( 72, 74-76). Though some
microRNAs, such as miR-21, miR-100, miR-203 and
miR-205, were identified as being affected in esophageal
carcinoma in more than one of the aforementioned studies,
many, like miR-143, miR-145 and miR-215, whose levels are
increased in EAC as well as BE (74), were not. Characteristics
of patient populations and RNA quantification technologies,
and differences in sample-sizes and data analyses are believed
to be responsible for this, a theme that occurs recurrently in
such biomarker discovery work.
In a large study with a sample-size of 170 (100 EAC and 70
ESCC cases), in which 329 microRNAs were quantified using
microarrays, differences in microRNA expression between the two histological types were clearly identified. Specifically,
miR-194 and miR-375 were found to be expressed 5-6-times
more in EAC compared to ESCC (74). In EAC patients
with Barrett’s, but not in those without, low expression
of miR-375 was associated with worse prognosis (hazard
ratio [HR]=0.3, 95% confidence interval [CI]=0.2-0.7).
Among ESCC patients, increased miR-146b, miR-155 and
miR-188, and decreased miR-21 were associated with poor
prognosis, with HR values ranging from 2 to 4. microRNA
expression differences between BE and EAC were also been
examined by RT-PCR in a cohort of 32 cases, and expression
of miR-143, miR-145 and miR-215 was higher in the former
(72). In a similar study involving 50 and 25 cases of BE and
EAC, respectively, expression of miR-143 and miR-145, but
not of miR-215, was higher in BE than in EAC (77). In the
same study, using microarray-based assays for some of the
cases, alterations in levels of microRNAs between diseased
and adjacent normal tissue were seen for 0, 32 and 39 of 470
quantified microRNAs in BE with low-grade dysplasia (n=5),
BE with high-grade dysplasia (n=5), and EAC (n=6), with
14 and ten up- and down-regulated similarly in the last two
diseases.
The ability to predict a cancer patient’s response to
chemotherapy or radiotherapy is a major goal of current
translational research. Such predictability can be particularly
applicable and relevant in esophageal cancer because of the
ease with which pre-treatment cancer tissue can be sampled
by endoscopy, and the current norm of administering chemoor
radiotherapy before surgery, in spite of limited pathologic
response to it. microRNA profiling of the NCI-60 cell-lines
has demonstrated associations between microRNA expression
and sensitivity to chemotherapeutic drugs, suggesting that
microRNAs might be usable as predictors, and possibly even
modulators, of chemosensitivity (e.g., 78, 79). Recently, Hong, et
al, showed that miR-296, high levels of which were associated
with poor prognosis in ESCC, targets transcripts of the
MDR1 drug-resistance gene and affects sensitivity of many
esophageal cancer cell-lines to a variety of anti-cancer drugs
(80). Targeting of MDR1 by another microRNA, miR-27a, to
alter esophgeal cancer cell-line chemosensitivity has also been
observed (81).
A few studies have examined the association of esophageal
cancer with other molecular determinants of microRNA
biology, besides microRNA levels per se. In a study involving
71 cases of esophageal cancer, post-operative survival was
negatively associated with increased levels of RNASENmRNA, while levels of transcripts for Dicer and DGCR8 had
no correlation (82). The HR was 4.6 (95% CI=1.5-13.8).
Further, RNASEN knockdown reduced proliferation of
esophageal cancer cell-lines in vitro. The RNASEN protein
interacts with DGCR8 and affects pre- microRNA processing (83). Genetic variations in a number of microRNA-related
genes were identified as associated with susceptibility
to the disease in a study of 346 Caucasian patients in
whom 41 variations in 26 genes, including those encoding
Dicer, DGCR8 and Ago 1, were examined (84). Certain
polymorphisms in the genes for miR-196a-2 and miR-631 were associated with an increased risk for the disease
(odds ratio [OR] of 1.7 in both cases), whereas a particular
polymorphism in the gene for miR-423 was associated with
a reduced risk (OR=0.6). Polymorphisms in the gene for
miR-196a-2 have also been linked with risks for cancers of
the liver, lung, breast, stomach, and head and neck ( 27, 28,
85-87). In a cohort of 11 patients, miR-196a was found to
mark the progression of BE to low-grade dysplasia, highgrade
dysplasia, and EAC, with rising levels (88). Some of
these findings on miR-196a might be explained through its
targeting of the transcript for Annexin A1, an anti-proliferative
and apoptosis-mediating protein (88). The microRNA has
also been shown to target transcripts for the S100A9 protein,
also referred to as MRP14 (migration inhibitory factorrelated
protein 14), reduction of whose product has been
associated with poorly differentiated ESCC (89). In a study
of 444 sporadic ESCC cases among the Chinese Han, a
single nucleotide polymorphism in the gene for miR-146a was found to be associated with an increased risk for the
disease (OR=2.4, 95% CI=1.4-4.2), with risk being higher
for smokers (OR=3.2, 95% CI=1.7-4.5) (90). A separate
polymorphism was associated significantly with higher
clinical tumor-node-metastasis (TNM) staging (OR=1.6,
95% CI=1.2-2.2).
In vitro studies using esophageal cancer cell-lines have
helped identify roles for certain microRNAs in the biology
of esophageal carcinoma. For example, miR-373 has been
shown to target transcripts for LATS2 (large tumor suppressor
homolog 2) protein, whose gene-locus for which loss of heterozygosity has been
reported for esophageal cancer, to stimulate proliferation of
cells (91). microRNA miR-10b was found to cause increased
invasiveness and motility of cells by targeting transcripts
for KLF4 (Krueppel-like factor 4) protein (92). Elevated
expression of the microRNAs in esophageal cancer tissues
was shown in both studies. Similarly, miR-145, miR-133a and miR-133b, all of which are downregulated in ESCC, have
been shown to target transcripts for FSCN1 (actin-binding
protein, Fascin homolog 1) that is associated with esophageal
squamous cell carcinogenesis (93).
|
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Cite this article as:
Patnaik S, Mallick R, Yendamuri S. MicroRNAs and esophageal cancer. J Gastrointest Oncol. 2010;1(1):55-63. DOI:10.3978/j.issn.2078-6891.2010.011
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