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Vol. 3, 799-804, May 1997 Clinical Expression of the Genes Proteolipid Protein John Golflnos,2 G. Stephen W. Conrad Ballecer, Sylvia Coons, Encoding in Human Myelin Malignant had median Adrienne than (grade Division of Neurosurgery [J. 0. G.], Neuro-Oncology Research [S. A. N., C. B., A. C. S.], and Division of Neuropathology [S. W. C.], Barrow Neurological Institute of St. Joseph’s Hospital and Medical Center, Phoenix, Arizona 85013, and National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Disorders, Phoenix, Arizona [R. A. N.] a 75% 5-year rates of patients survival less C. Scheck3 1 year for reliable tissue-specific been found; thus, these tumors rely Furthermore, ABSTRACT trocytoma. Pathological differentiation of oligodendroglioma and mixed oligoastrocytoma from astrocytoma is difficult, relying on morphological characteristics due to the lack of reliable immunohistochemical stains. Oligodendrocytes, the presumed cell of origin of oligodendrogliomas, highly express the genes encoding myelin basic protein (MBP) and proteolipid protein (PLP). We analyzed the expression of these genes to determine whether they might be useful molecular markers of oligodendrocytic tumors. MBP and PLP were highly expressed in all oligodendrogliomas and minimally expressed in glioblastomas multiforme. MBP was complicated on in mixed oligoastrocytomas, whereas PLP classification statistically as a useful significant. Expression molecular marker of these for some genes may subtypes (5). inherent serve of human term malignant survival of these from gliomas Current (1); tumors tumor accepted (2). The subtypes major oligodendroglioma. cytomas. oligodendrocyte In a recent solid scheme review, tumors with cases of long- for different survival of a reliable for histopathological glioma are and patients the are are less individually reviewed beginning of the review with tumors low-grade of than study, to 69%. Neurological gliomas using the tumors more reclassified ods for identifying of the lack and genetic highly of myelin classified express sheaths and 80-90% of the proteins pre- Therefore, we hypothesized may serve as molecular from oligodendrocytic astro- oligoden- by these mas (grades difference Received 9/20/96; revised 12/23/96; accepted 1/31/97. 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. I This work was supported by NIH Grant CA 50931. 2 Present address: Department of Neurosurgery, New York University Medical Center, 530 First Avenue, New York, NY 10016. 3 To whom requests for reprints should be addressed, at Neuro-Oncology Research, Barrow Neurological Institute of St. Joseph’s Hospital and Medical Center, 350 West Thomas Road, Phoenix, AZ 85013. PLP marker 2 and in the The abbreviations lipid protein. 4 the and used are: MBP, to be prognosis, myelin for myelin (1 1). of these genes arising of tissues and a statistically This The account of tumors analysis genes is likely patient (7-10). system oligoastrocytomas, of the methOligoden- PLP) expression Our mixed for the elaboration markers of gliomas. genes type, methand system nervous 4) demonstrates subtypes of these for tumor (MB!” types. expression 44 (16%) types. nervous biological cell 315 criteria. biological tumor responsible that of neuropathological of these genes mixed in different expression histological to use molecular in central oligodendrogliomas, at the set or oligoastrocytomas. the central encoded after defined, as astrocytomas, the genes within were At the however, oligodendrogliomas markers State and grade. a second of objective grading Ohio neuropathologists defined the samples 52%; reviewed we sought to identify drocytes two in from to be better as oligodendrogliomas oligoastrocytomas, ods was precisely originally were impordifficulty and type of underscored tumor criteria The The Clinic, tumor Institute relative was and forty-four histological rose Barrow contain is uncer- tumor. tumors concordance allowed that The prognosis neuropathologists to determine as- is further tumors as is the the Mayo is not from tumors the of glial hundred this oligoastrocytomas, by four Institute, (6). Two protein, elements. within (4). gliofibrillary of these mixed types proteins grading astrocytoma common a subtypes of patient by the lack Oligodendrogliomas origin few Predictions is hampered of brain produces the prognosis widely. histopathology universally are therapy however, can vary and sumed Neurological University acid alone and oligodendroglioma are debated, tissue conducted Because prognosis. criteria two study Barrow INTRODUCTION fibrillary to as mixed in the identification a recent Of 275 Human Grading concordance gliomas. dismal referred of identifying minigemistocytes and oligodendrocytic of the joint was minimal. The association between tumor and expression of the MBP and PLP genes was expression tumors, for oligodendrogliomas methods identification from 1 astrocytomas. characteristics by histopathologically these multiforme grade stains glial the glioblastoma with for distinguishing Moreover, astrocytic tance both In contrast, range morphological express both tam with (3). astrocytomas histopathological because marker rate with for patients Few have a useful expressed 799 and survival patients 4) to 3.5 years oligodendrocytes highly Protein Research Gliomas’ drogliomas A. Norman, R. A. Norman, and Basic Cancer encoding finding a useful from astrocytosignificant MBP suggests and that molecular or both. basic protein; PLP, proteo- Downloaded from clincancerres.aacrjournals.org on August 3, 2017. © 1997 American Association for Cancer Research. 800 MBP and PU’ Expression in Human Gliomas Table Tumor codea Agec Diagnosis” F M 31 43 LGA LGA 2 2 Th F 35 AA 4 59 43 70 64 47 67 31 63 49 70 59 68 50 56 55 68 75 51 69 33 33 31 26 31 30 42 60 39 43 42 6 37 43 code assigned by an “R”. b M, male; F, female. C Age at diagnosis. d GBM, glioblastoma multiforme; LGA, e The grading systems used are described AND PATIENTS Gradee GBM GBM GBM GBM GBM GBM GBM GBM GBM GBM GBM GBM GBM GBM GBM GBM GBM GBM GBM Oligo/Astro Oligo/Astro Oligo/Astro Oligo/Astro Oligo Oligo Oligo Oligo Oligo Rec. Oligo Oligo Oligo Oligo Oligo to the tumor. Recurrent L, left; R, right; METHODS Specimens and Histopathology. Tissue samples obtained from patients undergoing resection of malignant All oligodendroglioma, patients with or mixed a diagnosis of received from oligo-astrocytoma neurosurgery, the were frozen and RTO, processed for tumor. system were differentiation consid- evalu- and grade and then facing/opposing paraffin-embedding, was gliomas. the percentage of normal brain tissue admixed Ringertz-Burger 366 D right was used (3, 15). For (12) a tumor geometric a similar classification D A A A A A D A A A A A A A A code followed frontal-temporal; and revised astrocytomas, and to grade oligodendrogliomas or ordinary (large) only minigemistocytes This D NA D D D D D D D D D D D D D D D D RFT, with branching area WHO (13) astrocytoma oligoastrocytoma, we microscopic features: round field of nuclei, X 100 vasculature, For of cells minigemis- a tumor primarily to be called mixed resembling gemistocytes was were considered follows RFP, the Kernohan and oligoas- primarily as mixed protoplasmic astrocytes. of typical oligodendroglioma oligoastrocytoma, 316 NA 408 1 18 80 470 23 1460 37 485 84 362 262 237 158 281 44 233 used to grade halos, and D A oligodendroglioma. to be classified perinuclear tocytes, consisting astrocytes mom with for Oligo, required the presence of at least one cells with typical oligodendroglioma insuring as close as possible similarity between the paraffin and frozen material. Tissue immediately adjacent to the frozen tissue graded The were Status” 377 2071 912 1076 681 1428 498 942 5 1198 3239 170 561 1186 1234 the same 2-letter is given right temporal-occipital; trocytOmas neuropathologist ated the specimens for histopathological type divided the specimens such that corresponding sections oligoastrocytoma; systems (14) (days) 1460 1470 L occ B front L temp L front R RFT R front LTH R pariet L temp L front RTP R pariet Lfront R pariet R temp RTO Lfront P0 L temp L temp front R front R front R front L front R temp Ltemp LiP R temp Rocc NA F pariet from the same patient astrocytoma, ered as sources for tissue specimens; selection was based only on obtaining a range of tumor pathologies. When the samples were B, bilateral; Survival Lfront 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 3 2 2 2 2 3 2 3 2 2 2 2 2 2 tumor with Tissue tumors. Site R front L temp low-grade astrocytoma; Oligo/Astro, in “Patients and Methods.” 1front, frontal; pariet, parietal; temp. temporal; frontal-parietal; LTH, left thalamus. 8 Survival is in days postsurgery. ‘I A, alive; D, deceased. I This tumor was analyzed in two regions. J NA, not available. brain data Sex” F M M F F M F F F F M F F M F M F F M M M P0 , M QK’ F KF F LI M PK F QM F RD M SD M ST M SU F SV M SW F a Tumor code is a random 2-letter were Patient LHR 01 IM KE KS KV Ia LB LH LT ME MI NO’ NN NS OF OH OJ OK RA TK LC PM right 1 the criteria fibrillary required. Tuoligodendro- developed Downloaded from clincancerres.aacrjournals.org on August 3, 2017. © 1997 American Association for Cancer Research. in our Clinical - A nucleotide DM20 splice I variant . Cancer Research . E c’ QLL 0>1 oC c-aa I4I5II7)_ I I I I MBP I , PLP Histone J; 2 Reverse transcription-PCR sion in human malignant glioma for RNA quantity and integrity. analysis of MBP and PLP exprestissue. Histone was used as a control Fig. 422-441 T *___ B !. nucleotide I1 I splice variant I t1 I I4i5i6I7F- 3 the I4I617I- 3 Primer 1 location for the genes encoding to allow A 5-mm for full extension 80#{176}C incubation through a 2% agarose fluorescence. A quantitation PLP (A) and MBP (B). was photographic gel and Polaroid performed negative expression age, study (6). Clinical gender, surgical data collected procedures, on the patients radiation included treatment, (control) patients undergoing intracerebral gray and liquid Biotecx brain nitrogen All RNA were chemo- were (16, taken 85#{176}C for subsequent Reverse lowed by PCR and PLP genes PCR reaction (16). Primers one intron mg of frozen immediately used Reverse to determine in a semiquantitative were have been described designed and (Fig. run amplified controls transcription details in a previous for exons fol- of the MBP The 8 and of the in a Perkin-Elmer Histone previously GeneAmp 9600 MBP, thermal cycler using and 26 to 28 cycles 3 1 cycles for histone. sisted of95#{176}Cfor I mm and 15 s, followed 1 mm at 72#{176}C. A 6-mm 72#{176}C incubation Inc., (Invitrogen burg, Sequencing MD) was a gift used from for the MBP Dr. Alan PCR were subcloned Diego, CA) fragments into prior PCR-amplified analysis using Technologies, DNA fragthe dsDNA Inc., Gaithers- State Primer was used forward Ml3/pUC reactions. (Ohio the to Se- by the manufacturer. sequencing Yates tempera- chromatography NH). San (Life of gene NC). a low-melting column Keene, specified signifi- scores The PCR fragwere isolated for primers System Differences statistical Cary, JO4 (Fig. I ; 5’-GGCGACTACAAGACCACCAT-3’) for the PLP sequencing reactions, and the was PLP. DNA. primers Elutip Corp., and conditions Our PCR amplification ers generated to span at an internal 3.3 was used (16, 18). PCR PCR System by 30 s at 55#{176}C, and used Schuell, RNA Results or no Primer JO4 University). RESULTS for PLP, 33 cycles for Cycle conditions conwas Cycle without publication 3 (5’-GAAAACCCCG- 17) to provide by and of the System, through followed MBP-specific vector primer 6 (5’-TGCCTCCGTAGCCAAATC-3’) 1; Refs. and using for Analysis by electrophoresis gel and tested of Amplified PLP-specific gel, each experiment. trace expression, test on the Wilcoxon (Statistical bromide the analysis MBP were quencing. The identities of these ments were confirmed by sequence tumor tissue. was stored at expression manner. control for genomic DNA contamination. as a RNA loading control as described reactions (Schleicher in RNAzol B (Cinna/ was used to isolate for MBP and for exons 2 (5’-CCAAAAACTACCAAGACTATG-3 ‘) and 4 (5’-CAAACACCAGGAGCCACACAA-3’) for PLP. These primer pairs were specifically selected least of analysis. was TAGTCCAC-3’) stored encoding Analysis using agarose pCRII Transcription-PCR. were and level sequencing ture genes of densitometric 19). Negative classifications Sequence ments amplified isolation. 80-200 not used DNA at the beginning by ethidium was by by the Kruskal-Wallis expression from of a mixture frozen tumor cance or spontaneous consisted tissues Isolation of Total Cellular RNA. Laboratories, Inc., Houston, TX) from was obtained for trauma and typically matter. until specimens resection hemorrhage white total cellular RNA Isolated RNA that - tissue brain of the among therapeutic treatment, and survival from time of first operation (Table 1). Patient confidentiality was maintained by assigning random two-letter codes to each specimen for identification. Normal amplified used visualized picture and normal brain were included with were ranked as normal, half-normal, recent of was of the reaction to provide a “hot start” for reducing nonspecific annealing. Reaction products were analyzed by electrophoresis I I Fig. reaction fragments. at the end of The was l09-bp l42-bp verified fragments product was MBP-specific (Figs. identified encoding < 0.0007 by sequencing primI and 2). size (8) and product. The as corresponding (Fig. 1 ; Refs. 9 and 20). The PLP-specific a 348-bp fragment from the normal transcript and a 243-bp fragment icant differences among x2; p using 109 bp in size fragment corresponds to the expected as MBP by sequencing the PCR to a splice variant primers amplified of the genes reactions 142 and from the DM-20 splice variant. Signiftumor classifications in the expression MBP and 0.0005, and PLP were found (approximate respectively). Downloaded from clincancerres.aacrjournals.org on August 3, 2017. © 1997 American Association for Cancer Research. 801 802 MBP and PU’ Expression in Human Gliomas Table 2 Tumor code’ Diagnosis” LHR 01-A 01-B Th IM KE KS KV KZ LB LH LT ME MI NGAh NO-B” NN NS OF OH OJ OK RA TK LC PM PG QK QK2h LI PK QM RD SD ST SU SV SW a Tumor by an “R”. b LGA Grader LGA LGA LGA AA GBM GBM GBM GBM GBM GBM GBM GBM GBM GBM GBM OBM GBM GBM GBM GBM OBM GBM GBM GBM Oligo/Astro Oligo/Astro Oligo/Astro Oligo/Astro Oligo/Astro Oligo Oligo Oligo Oligo Oligo Rec.Oligo Oligo Oligo Oligo Oligo is a random KY code = low-grade Expression of the MBP and PU’ % nonneoplastic 2 2 2 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 3 2 2 2 2 2 3 2 3 2 2 2 2 2 2 code assigned 2-letter astrocytoma; cellsd genes Sival PLP, The oligodendrogliomas although there were these genes were expressed. was not typically analyzed mal solely (Table in only samples, due D 118 80 470 23 1460 37 485 84 362 362 262 237 158 281 D D D D D D D D D D D D D D +/- + +1+1+/+/+/- +1+/+/- +1+1+/- 44 +/- 233 +/- 366 +1+ ++ ++ +/- + +/+/+/+/- + +/+/- +1++ to the tumor. Recurrent astrocytoma; GBM glioblastoma and Twenty-four 25% barely 10 oligo detectable tumors approximately + was 2). In contrast, 5 of brain; normal normal or less PLP samples, brain because of the tissue gene normal or half-normal in the 3). This expression expression half-normal normal specimens was in 4 of northe in 1 sample. of astrocytic origin analyzed for - + + + - - + ++ ++ - - - - - - - - + - + - - - + +/- - - - - - +/- - +/- D - - D + + + + +/- - A A A A A A A D A A A A A A A A patient - + + + + + +1- ++ - - ++ ++ ++ + ++ + + +/- ++ ++ + + ++ ++ ++ + ++ ++ ++ is given tissue from - ++ ++ the same 2-letter Oligo/Astro half of normal; The majority of the genes encoding samples), and immediately adjacent both genes. sion in these by normal samples sion had little used no - and PLP. Expression 12% of the samples. or no expression of the either MBP (12 of 24 samples) or PIP (20 of 24 only two samples had near-normal expression of As in the oligodendrogliomas, samples cells. from Oligo to the tissue less than half of normal; +/- samples code followed = oligoastrocytoma; the expression of the genes encoding MBP of MBP or PLP was near-normal in only of the gene the observed is not attributable The the mixed oligodendrogliomas were + + +/- multiforme; were made PLP expression ++ D 6 1533 862 686 681 681 1428 498 511 5 1198 3239 170 561 1186 1234 tumor from the same +/- Expression to admixed represented MBP expression8 408 NA’ of MBP StatuI ++ + + +/- both MBP and in the amount and at least 2; Figs. 2 and (daysY +/- ++ analyzed expressed distinct differences almost so in 8 of 10 specimens remaining two samples (Table cells in gliomas D A A D NA oligodendroglioma; rec = recurrent. C The grading systems used are described in the Materials and Methods. d = 25-50%; + approximately 25%; +/= minimal. Determinations for RT-PCR analysis. e Survival is in days post-surgery. 1A = alive; D = deceased. S = expression equal to that observed detectable expression. h This tumor was analyzed in two regions. ‘ NA, not available. and mixed 1460 1470 858 316 NA ++ AA = anaplastic in gliomas expression of MBP oligoastrocytomas and astrocytomas. encoding solely MBP was Not expres- to contamination and PIP in tissue had elements of both surprisingly, expres- somewhat random Downloaded from clincancerres.aacrjournals.org on August 3, 2017. © 1997 American Association for Cancer Research. in that Clinical A . Additionally, cells that lation 12 a. E (22). PLP have specimens from statistically significant tumor I- 0 z normal 15 The 12 that in each E in these *2 PLP (A) and MBP (B) expression in human malignant glioma tissue. Expression was quantitated by densitometric analysis and normalized to the expression of histone to control for RNA quantity and integrity. Results are expressed compared with the expression in normal brain tissue (Table 2). (2 of 5) of the showed trast, none samples showed near-normal expression, and 20% had no expression. In con- of the samples had near-normal expression of PLP, 60% had approximately half-normal expression, samples had little or no PLP expression. During this representing study, we also different regions analyzed from two the differences of normal did brain the separate low-grade 0! and two from the mixed oligoastrocytoma differences in gene expression in various these and lineage astrocytoma not solely reflect tissue found in the tumor differences their ability to produce encoding MBP cal identification drogliomas, ing results. tumors for mature through in poor (7, 2 1). Some oligodendrogliomas, is of genes at immunohistochemiin gliomas, oligodenhave yielded myelin proteins authors whereas have found others Whether There is evidence, however, in vitro in cell lines obtained that from nuclei exami- of MBP gene regulation and found underscores the need for in addition to analysis of to a higher absence of MBP with other In all cases, grade and PLP the patterns a higher indicate tumors than of tumor gene astroas the in which astrocytes. Interest- of tumor QK astrocytic compo- alterations found also and PLP gene MBP or PLP. is unclear. expression that cell such tumors grade genetic The Ex- may stem regions undergoing greater of PLP. in their levels of MBP did not express either contained cells correlates sample. tumors in neighboring different with that be oligodendrocytic from intermediate controversial. a pluripotent is induced region than remains by these may an typically MBP tumors from differences Region QK-2 this genes, to the oligodendroglial arise samples or contained Our MBP leading to However, the in region QK-2 studies we have done using this same gene expression in region QK-2 has fol- set by more absence lihood conflictin these demonstrate subtype and PLP. malignant expression a statistically and High the expression expression for a diagnosis of expression of an astrocytic examined, gliomas, data tumor evidence be useful astrocytic tumors ( I 6, significant association of the genes of both of oligodendroglioma, of either of these tumor. Although of the genes MBP encoding MBP PLP and the genes suggests more samples as an adjunct to histologically based particularly when the histopathological encodand a likemust be and PLP may diagnoses of features alone are inconclusive. staining have only found MBP staining in normal white matter (7). This work may have been hampered by difficulties in obtaining reliable immunohistochemical staining because of the paucity of good antibodies. pressed of the specimen displayed transcripts change two between oligodendrocytes genes It is un- of normal expression and encoding mixed or they in the sample. the expression Prior attempts gene products and mixed oligoastrocytomas Tissue staining for the has been MBP myelin and PLP. of these of as 25). DISCUSSION characteristic gene (24), cell provides salient tumors of the myelin 02A ing The the the chaotic oligoastrocytomas may lowed QK. In both cases, regions were noted, of these by histopathological examination is closer progression samples is intriguing. with reflect malignant They nent other correlate cytomas. demonstrated expression. half-normal, or both determined may of myelin ingly, 40% not of these malignant 40% was of the pression their of one contamination mixed histogenesis 3 oligo- as much tumors the proportion of expression expression 15 large whereas often a and express or PLP, genes, was markers. The I expression these expression histopathological degree IS- There gene because result molecular iranin tissue tumors. reflected highly careful 0 reverse genes brain tissue did This used to MBP between finding brain and PLP. we MBP to express trans- antibodies of these 803 in cultured without did not typically encoding multiforme specimen nation 156 U) done Research tissue. this by normal 10 tumors genes glioblastoma likely B to obtain, malignant near-normal in two reliable correlation tend brain work be present the expression Astrocytic of the dendrogliomas ! 0 z difficult human subtype. from may Because to analyze amounts i#{224}Ilgo” . amount been II.. z and (23). to 0 is evidence transcription scription-PCR 0 Fig. gene of the message and 15 there PLP Cancer these genes are oligodendrogliomas ex- ACKNOWLEDGMENTS We acknowledge the excellent technical assistance of Susan N. Rhodes and the editorial assistance of Dr. Shelley A. Kick. We thank Drs. Peter C. 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