A queilite actínica é uma lesão causada pela exposição excessiva aos raios ultra-violeta (UV). Atingindo mais homens a partir da 5º década de vida e de pele clara, possuindo grande potencial de malignização, quando originará o carcinoma epidermóide de lábio, a malignidade mais comum em boca. Seu diagnóstico na maioria das vezes é tardio e quando isto ocorre sua taxa de sobrevida é de apenas 5 anos. O processo de progressão da carcinogênese está relacionado com a quebra no balanço entre os processos de proliferação/diferenciação celular e apoptose. A survivina é uma proteína com importantes funções na inibição da apoptose e progressão da mitose. Sua expressão desregulada, presente na maioria dos cânceres humanos, está relacionada a um prognóstico pobre e uma diminuição na sobrevida dos pacientes. Acredita-se que ela participe de eventos chaves na carcinogênese. Pode ser gene alvo da b-catenina, uma proteína de adesão com funções de transcrição relacionada com a via Wnt. A b-catenina presente nas junções aderentes da membrana celular junto com a caderina- E, quando livre no citoplasma é translocada para o núcleo onde faz a transcrição de gens reguladores do ciclo celular. O objetivo deste estudo foi avaliar a expressão imunoistoquímica da survivina e b-catenina nas lesões de queilite actínica e carcinoma epidermóide de lábio, e relacionar a expressão das duas proteínas e a participação na carcinogênese dessa lesão. Além disso, as lesões de queilite actínica foram classificadas quanto às alterações morfológicas por duas classificações: a proposta pela OMS, 2005 e por um sistema binário de graduação proposto por Kujan et al. em 2006. Foram realizadas reações de imunoistoquímica para verificação da expressão das duas proteínas. Os resultados mostraram, para b-catenina, expressão de membrana em todos os casos e marcação citoplasmática em 85% os casos de queilite actínica e marcação nuclear em 22%. A survivina foi positiva em 42% dos casos de queilite, com padrão de marcação irregular. Os carcinomas epidermóides foram positivos em 83% dos casos para b-catenina e nenhum deles teve marcação nuclear, e foram 100% positivos para survivina. Os resultados mostram alterações nas lesões de displasia, evidenciando o potencial maligno. Mais estudos são necessários para relacionar a expressão das duas proteínas e para esclarecer o papel da survivina na carcinogênese das lesões de lábio. / The actinic cheilitis is caused by excessive exposure to ultra violet (UV) radiation, most common in men after the 5º decade and fair skin, it has a great potencial of malignization, when it will become the squamous cell carcinoma of the lip, the malignancy most frequent in the mouth. The diagnosis is late in most cases which leads to a decrease of the survival to only 5 years. The progression of carcinogenesis is related to the balance between cell proliferation/ differenciation and apoptosis. Survivin is a protein with important functions on the inhibition of apoptosis and progression of mitosis. It?s desregulated expression, present in most human cancers, is related to a poor prognosis and a decrease of overall survival. Many authors believe that it participates and is key event on early carcinogenesis. Survivin might be a target gene of b-catenin, that is a adhesion protein with transcription functions related with the Wnt pathway. b-catenin is present in the adherens junctions of the cellular membrane in complex with the E-cadherin, and when free on the cytoplasm, it?s translocated to the nucleus, where it?s responsible for the transcription of cell-cycle regulators genes. The aim of the study was to evaluate the immunohystochemical expression of survivin and b-catenin in actinic cheilitis and squamous cell carcinoma lesions, and correlate the expression of the two proteins and the participation on the carcinogenesis of this lesion. Besides, the actinic cheilitis samples were classified as the epithelial changes by two methods: one proposed by the World Health Organization (WHO), in 2005 and the other, a binary system of graduation proposed by Kujan et al. in 2006. The results showed, for the b-catenin, membrane expression in all cases, and cytoplasmatic staining in 85% of the actinic cheilitis lesions, and 22% of nuclear staining. Survivin was positive in 42% of the actinic cheilitis, with an irregular pattern of staining. The squamous cell carcinomas were positives in 83% for b-catenin and none of them had nuclear staining, and were a 100% positive for survivin. The results showed alterations on the dysplasic lesions, proving their malignant potencial. More studies are needed to correlated the expression of the two proteins and to elucidate the role of survivin in the carcinogenesis of lip lesions.

O carcinoma epidermóide de cabeça e pescoço é responsável por 90% das neoplasias malignas, nesta região. Molecularmente, inúmeras vias de sinalização, ainda não muito bem compreendidas, são responsáveis pelo seu crescimento e invasão para tecidos vizinhos, além de metástases para órgãos distantes. Este trabalho destinou-se a avaliar o crosstalk entre as vias de sinalização do Wnt e PI3K, quando células de carcinoma epidermóide (HN6 e HN31) e queratinócitos imortalizados (HaCat), foram estimulados com 50nM Wortmannin (metabólito fúngico que mimetiza a função da PTEN) e 10ng/ml EGF (fator de crescimento epitelial). Para isto, proteínas-chave, pertencentes a estas vias, foram localizadas e quantificadas no interior celular: PTEN, ?-catenina, Akt, pAkt e Ciclina D1. As técnicas de imunofluorescência e western blot foram utilizadas, respectivamente, para observar a localização e os níveis destas proteínas, nos diferentes compartimentos celulares. Os resultados mostraram que a ativação da via do PI3K, pelo EGF, promoveu a proliferação celular, independentemente da via de sinalização do Wnt. Quando as células foram tratadas com wortmannin, houve depleção dos níveis citosólicos e totais de pAkt associada ao acúmulo citoplasmático de ciclina D1. Igualmente, não houve alteração nos níveis da proteína ?-catenina. Ademais, detectou-se a presença de PTEN nuclear em todas as linhagens estudadas. Desta forma, estas células de carcinoma epidermóide de cabeça e pescoço, apresentaram mecanismos de bloqueio e de ativação da proliferação celular, predominantemente, por atividade das proteínas PTEN (atividades citoplasmática e nuclear) e Akt, após o tratamento com wortmannin e EGF. / Head and neck squamous cell carcinoma (HNSCC) represents 90% of all head and neck malignancies. Cancer growth, invasion and metastasis are due to several signaling pathways that, unfortunately, are not completely understood. The aim of this study was the crosstalk evaluation between PI3K and Wnt signaling pathways in two different HNSCC cell lines (HN6 and HN31) and HaCat cell line (immortalized keratinocytes), treated with 50nM wortmannin and 10ng/ml EGF (epidermal growth factor). Western blot and imunofluorescence were performed in order to analyze Wnt, PTEN and PI3K signaling key target proteins: PTEN, Akt, CyclinD1 and ?-catenin. Results showed that ?-cateninindependent cellular proliferation was promoted by PI3K signaling pathway EGF-dependent activation. After wortmannin treatment, correlation between decreased phospho-Akt levels and cytosolic cyclin D1 accumulation was found. Also, all cell lines exhibited nuclear PTEN activity. Taking these results together, we conclude that the Cyclin D1 positive and negative modulations, after EGF and wortmannin treatments, were due to, respectively, Akt and PTEN proteins.

O carcinoma epidermóide de cabeça e pescoço é responsável por 90% das neoplasias malignas, nesta região. Molecularmente, inúmeras vias de sinalização, ainda não muito bem compreendidas, são responsáveis pelo seu crescimento e invasão para tecidos vizinhos, além de metástases para órgãos distantes. Este trabalho destinou-se a avaliar o crosstalk entre as vias de sinalização do Wnt e PI3K, quando células de carcinoma epidermóide (HN6 e HN31) e queratinócitos imortalizados (HaCat), foram estimulados com 50nM Wortmannin (metabólito fúngico que mimetiza a função da PTEN) e 10ng/ml EGF (fator de crescimento epitelial). Para isto, proteínas-chave, pertencentes a estas vias, foram localizadas e quantificadas no interior celular: PTEN, ?-catenina, Akt, pAkt e Ciclina D1. As técnicas de imunofluorescência e western blot foram utilizadas, respectivamente, para observar a localização e os níveis destas proteínas, nos diferentes compartimentos celulares. Os resultados mostraram que a ativação da via do PI3K, pelo EGF, promoveu a proliferação celular, independentemente da via de sinalização do Wnt. Quando as células foram tratadas com wortmannin, houve depleção dos níveis citosólicos e totais de pAkt associada ao acúmulo citoplasmático de ciclina D1. Igualmente, não houve alteração nos níveis da proteína ?-catenina. Ademais, detectou-se a presença de PTEN nuclear em todas as linhagens estudadas. Desta forma, estas células de carcinoma epidermóide de cabeça e pescoço, apresentaram mecanismos de bloqueio e de ativação da proliferação celular, predominantemente, por atividade das proteínas PTEN (atividades citoplasmática e nuclear) e Akt, após o tratamento com wortmannin e EGF. / Head and neck squamous cell carcinoma (HNSCC) represents 90% of all head and neck malignancies. Cancer growth, invasion and metastasis are due to several signaling pathways that, unfortunately, are not completely understood. The aim of this study was the crosstalk evaluation between PI3K and Wnt signaling pathways in two different HNSCC cell lines (HN6 and HN31) and HaCat cell line (immortalized keratinocytes), treated with 50nM wortmannin and 10ng/ml EGF (epidermal growth factor). Western blot and imunofluorescence were performed in order to analyze Wnt, PTEN and PI3K signaling key target proteins: PTEN, Akt, CyclinD1 and ?-catenin. Results showed that ?-cateninindependent cellular proliferation was promoted by PI3K signaling pathway EGF-dependent activation. After wortmannin treatment, correlation between decreased phospho-Akt levels and cytosolic cyclin D1 accumulation was found. Also, all cell lines exhibited nuclear PTEN activity. Taking these results together, we conclude that the Cyclin D1 positive and negative modulations, after EGF and wortmannin treatments, were due to, respectively, Akt and PTEN proteins.

A queilite actínica é uma lesão causada pela exposição excessiva aos raios ultra-violeta (UV). Atingindo mais homens a partir da 5º década de vida e de pele clara, possuindo grande potencial de malignização, quando originará o carcinoma epidermóide de lábio, a malignidade mais comum em boca. Seu diagnóstico na maioria das vezes é tardio e quando isto ocorre sua taxa de sobrevida é de apenas 5 anos. O processo de progressão da carcinogênese está relacionado com a quebra no balanço entre os processos de proliferação/diferenciação celular e apoptose. A survivina é uma proteína com importantes funções na inibição da apoptose e progressão da mitose. Sua expressão desregulada, presente na maioria dos cânceres humanos, está relacionada a um prognóstico pobre e uma diminuição na sobrevida dos pacientes. Acredita-se que ela participe de eventos chaves na carcinogênese. Pode ser gene alvo da b-catenina, uma proteína de adesão com funções de transcrição relacionada com a via Wnt. A b-catenina presente nas junções aderentes da membrana celular junto com a caderina- E, quando livre no citoplasma é translocada para o núcleo onde faz a transcrição de gens reguladores do ciclo celular. O objetivo deste estudo foi avaliar a expressão imunoistoquímica da survivina e b-catenina nas lesões de queilite actínica e carcinoma epidermóide de lábio, e relacionar a expressão das duas proteínas e a participação na carcinogênese dessa lesão. Além disso, as lesões de queilite actínica foram classificadas quanto às alterações morfológicas por duas classificações: a proposta pela OMS, 2005 e por um sistema binário de graduação proposto por Kujan et al. em 2006. Foram realizadas reações de imunoistoquímica para verificação da expressão das duas proteínas. Os resultados mostraram, para b-catenina, expressão de membrana em todos os casos e marcação citoplasmática em 85% os casos de queilite actínica e marcação nuclear em 22%. A survivina foi positiva em 42% dos casos de queilite, com padrão de marcação irregular. Os carcinomas epidermóides foram positivos em 83% dos casos para b-catenina e nenhum deles teve marcação nuclear, e foram 100% positivos para survivina. Os resultados mostram alterações nas lesões de displasia, evidenciando o potencial maligno. Mais estudos são necessários para relacionar a expressão das duas proteínas e para esclarecer o papel da survivina na carcinogênese das lesões de lábio. / The actinic cheilitis is caused by excessive exposure to ultra violet (UV) radiation, most common in men after the 5º decade and fair skin, it has a great potencial of malignization, when it will become the squamous cell carcinoma of the lip, the malignancy most frequent in the mouth. The diagnosis is late in most cases which leads to a decrease of the survival to only 5 years. The progression of carcinogenesis is related to the balance between cell proliferation/ differenciation and apoptosis. Survivin is a protein with important functions on the inhibition of apoptosis and progression of mitosis. It?s desregulated expression, present in most human cancers, is related to a poor prognosis and a decrease of overall survival. Many authors believe that it participates and is key event on early carcinogenesis. Survivin might be a target gene of b-catenin, that is a adhesion protein with transcription functions related with the Wnt pathway. b-catenin is present in the adherens junctions of the cellular membrane in complex with the E-cadherin, and when free on the cytoplasm, it?s translocated to the nucleus, where it?s responsible for the transcription of cell-cycle regulators genes. The aim of the study was to evaluate the immunohystochemical expression of survivin and b-catenin in actinic cheilitis and squamous cell carcinoma lesions, and correlate the expression of the two proteins and the participation on the carcinogenesis of this lesion. Besides, the actinic cheilitis samples were classified as the epithelial changes by two methods: one proposed by the World Health Organization (WHO), in 2005 and the other, a binary system of graduation proposed by Kujan et al. in 2006. The results showed, for the b-catenin, membrane expression in all cases, and cytoplasmatic staining in 85% of the actinic cheilitis lesions, and 22% of nuclear staining. Survivin was positive in 42% of the actinic cheilitis, with an irregular pattern of staining. The squamous cell carcinomas were positives in 83% for b-catenin and none of them had nuclear staining, and were a 100% positive for survivin. The results showed alterations on the dysplasic lesions, proving their malignant potencial. More studies are needed to correlated the expression of the two proteins and to elucidate the role of survivin in the carcinogenesis of lip lesions.

Der Wnt/β-catenin Signalweg reguliert zusammen mit anderen Signalkaskaden die Embryogenese sowie auch die Homöostase und die Proliferation der Stammzellen im adulten Organismus. Mutationen in Komponenten dieses Signaltransduktionsweges führen zu einer aberranten Aktivierung von β-catenin und wurden in vielen verschieden Krebsarten einschließlich Darmkrebs beobachtet. Die transkriptionelle Akivität von β-catenin wird von verschiedenen nukleären Kofaktoren beeinflusst. Hierzu zählen insbesondere die Proteine der Pygopus Familie, die in Drosophila eine essentielle Rolle im kanonischen Wnt-Signalweg spielen, in Vertebraten allerdings vielmehr Kontext abhängig agieren. Insbesondere Pygo2 ist hierbei vermutlich auch an der malignen Transformation verschiedener Zelltypen mit anschließender Ausbildung von Tumoren beteiligt. Auch wenn bereits gezeigt werden konnte, dass Pygo2 in Darmtumoren überexprimiert wird, ist bisher unbekannt, ob es tatsächlich eine Rolle bei der Entstehung von intestinalen Tumoren spielt. Anhand von genetischen Experimenten in der Maus zeigt diese Arbeit zum ersten Mal in vivo, dass Pygo2 für die normale Homöostase des Darms nicht essentiell ist, aber an der Ausbildung von Darmtumoren, welche durch eine Stabilisierung von β-catenin induziert werden, beteiligt ist. Weder im embryonalen noch im adulten Darm beeinflusste der konditionale Villin-Cre bedingte Knock-out von Pygo2 in epithelialen Zellen die normale embryonale Entwicklung oder die Homöostase im adulten Darm. Auch für die Regulation von Zielgenen des Wnt/β-catenin Signalweges unter physiologischen Bedingungen scheint Pygo2 funktionell redundant zu sein. Im Gegensatz dazu verhinderte der Verlust von Pygo2 die Entstehung von β-catenin induzierten intestinalen Tumoren und normalisierte die damit verbundene Hyperproliferation sowie die erhöhte Expression von Wnt/β-catenin Zielgenen und intestinalen Stammzellmarkern. Überraschenderweise konnte die Ausbildungen von Adenomen in ApcMin/+ Mäusen durch Deletion von Pygo2 nicht verhindert werden. Der Vergleich beider Mausmodelle ergab eine erhöhte Expression von BCL9-2 in den Adenomen der ApcMin/+ Mäuse aber nicht in den Hyperplasien, die durch aktiviertes β-catenin induziert wurden. Dies könnte darauf hinweisen, dass in Apc mutierten epithelialen Zellen BCL9-2 für die Tumorprogression verantwortlich ist. Weiterhin konnte gezeigt werden, dass sowohl der knock-down von Pygo2 als auch von BCL9-2 in human Kolonkarzinomzellen die Proliferation reduzierte. Anhand von immunohistochemischen Analysen des Phosphorylierungsstatus von ERK1/2, einem „downstream“ Effektor von K-ras, konnten außerdem pERK1/2 positive Zellen in den intestinalen Adenomen von ApcMin/+ Mäusen, nicht aber in hyperproliferierenden Zellen mit stabilisierten β-catenin nachgewiesen werden. Zusammenfassend weisen die Ergebnisse dieser Arbeit daraufhin, dass die Funktion von Pygo2 im Darm Kontext abhängig ist. Während in normalen epithelialen Zellen des Darms Pygo2 offensichtlich funktionell redundant ist, scheint es für die Ausbildung von intestinalen Tumoren, welche durch dereguliertes Wnt/β-catenin induziert werden, essentiell zu sein. Daher könnte Pygo2 ein idealer Angriffspunkt für die zielgerichtete Therapie von Darmtumoren mit β-catenin Mutation sein.

Biological information processing in living systems like cells, tissues and organs critically depends on the physical interactions of molecular signaling components in time and space. How endocytic transport of signaling molecules contributes to the regulation of developmental signaling in the complex in vivo environment of a developing organism is not well understood. In a previously performed genome-wide screen on endocytosis, several genes have been identified, that selectively regulate transport of signaling molecules to different types of endosomes, without disrupting endocytosis. My PhD thesis work provides the first functional in vivo characterization of one of these candidate genes, the novel, highly conserved Rab5 effector protein P95 (PPP1R21). Cell culture studies suggest that P95 is a novel endocytic protein important to maintain the balance of distinct endosomal sub-populations and potentially regulates the sorting of signaling molecules between them (unpublished work, Zerial lab). The scientific evidence presented in this study demonstrates that zebrafish P95 is essential for early zebrafish embryogenesis. Both, knockdown and overexpression of zebrafish P95 compromise accurate morphogenetic movements and patterning of the zebrafish gastrula, showing that P95 functions during zebrafish gastrulation. P95 is functionally required to maintain signaling activity of signaling pathways that control embryonic patterning, in particular for WNT/β-catenin signaling activity. Knockdown of zebrafish P95 amplifies the recruitment of β-catenin to early endosomes, which correlates with the limitation of β-catenin to translocate to the nucleus and function as transcriptional activator. The obtained results suggest that zebrafish P95 modulates the cytoplasmic pools of β-catenin in vivo, via endosomal transport of β-catenin. In conclusion, the data presented in this thesis work provides evidence that the cytoplasm-to-nucleus shuttling of β-catenin is modulated by endocytic trafficking of β-catenin in vivo. We propose the endocytic modulation of β-catenin cytoplasm-to-nucleus trafficking as potential new mechanism to fine-tune the functional output of WNT/β-catenin signaling during vertebrate gastrulation.

京都大学 / 0048 / 新制・課程博士 / 博士(生命科学) / 甲第21224号 / 生博第393号 / 新制||生||52(附属図書館) / 京都大学大学院生命科学研究科統合生命科学専攻 / (主査)教授 西田 栄介, 教授 米原 伸, 教授 上村 匡 / 学位規則第4条第1項該当 / Doctor of Philosophy in Life Sciences / Kyoto University / DFAM

Patients on peritoneal dialysis (PD) are reliant on the peritoneum to provide a semi-permeable barrier to allow for dialysis (solute clearance), salt and water removal (ultrafiltration). PD patients are at risk of developing peritoneal fibrosis and angiogenesis which can lead to a decline in peritoneal membrane function. Specifically, PD patients develop increased solute transport and decreased osmotic conductance leading to ultrafiltration failure. Peritoneal angiogenesis is the leading factor that results in augmented peritoneal membrane solute transport which is associated with worse outcomes – increased risk of mortality and PD technique failure. Transforming growth factor beta (TGFB) is one of the primary cytokines involved in inducing epithelial to mesenchymal transition (EMT) and fibrosis. We hypothesize that PD leads to injury of the epithelial lining of the peritoneum – the mesothelial cells. These cells undergo a transition process and transitioned mesothelium are a source for angiogenic and fibrogenic growth factors. Matrix Metalloproteinase (MMP) 9 is an angiogeneic factor and has been observed to correlate with increased expression of vascular endothelial growth factor (VEGF). MMP9 has the ability to cleave and activate membrane bound factors such as E-cadherin and b-catenin respectively. There is substantial evidence that the canonical WNT/b-catenin pathway is active during fibrosis, and angiogenesis in different biological contexts. Thus, we investigated the role of MMP9 and WNT signaling in peritoneal angiogenesis. Limited evidence exists describing the role of noncanonical WNT signaling but some reports suggest that non-canonical WNT signaling inhibits WNT/b-catenin signaling. Non-canonical WNT5A has differential effects based on receptor context and has been shown to block WNT/b-catenin signaling in the presence of Receptor Tyrosine Kinase Like Orphan Receptor 2 (Ror2). The overall hypothesis of this PhD thesis is that MMP9 and WNT signaling play a key role in inducing peritoneal angiogenesis and are associated with changes in peritoneal membrane function. We expect WNT5A and Ror2 to protect against peritoneal membrane injury. From the overnight effluent of stable PD patients, we cultured mesothelial cells and assayed these for expression of MMP and WNT related genes. MMP9 and WNT1 gene expression were observed to be strongly correlated with peritoneal membrane solute transport in patients on PD. WNT2 mRNA was also positively correlated with peritoneal solute transport. We overexpressed MMP9 in the mouse peritoneum to demonstrate its role in angiogenesis and confirmed these findings using MMP9 -/- mice. In addition to this, we have shown a novel mechanism by which MMP9 induces angiogenesis by E-cadherin cleavage and b-catenin mediated signaling. The observed cross-talk between MMP9 and b-catenin prompted investigation of the activation of canonical WNT/b-catenin signaling in development of peritoneal membrane injury. In an experimental model of TGFB induced pertioneal injury, we confirmed the activation of WNT/b-catenin signaling. In addition to this we, we blocked the WNT pathway and observed that WNT/b-catenin signaling is required to induce peritoneal angiogenesis. WNT5A mRNA was downregulated during TGFB induced injury suggesting a more protective role. Furthermore, several studies have demonstrated its ability to antagonize the WNT/b-catenin signaling pathway. We demonstrated that WNT5A protected against angiogenesis by blocking the canonical WNT pathway. WNT5A is thought to antagonize the WNT/b-catenin signaling pathway by signaling through receptor Ror2. In cell culture, we overexpressed TGFB and blocked Ror2. This resulted in elevated levels of VEGF and fibronectin suggesting that Ror2 is involved in mediating protection. Therefore, Ror2 possesses the ability to regulate VEGF and may be a potential candidate by which WNT5A mediates its protective effects. In conclusion, our findings identified MMP9 and WNT1 as potential biomarkers of increased peritoneal solute transport in patients that are on PD. We have also found a novel mechanism by which MMP9 interacts with b-catenin to induce peritoneal angiogenesis and have provided a first look at WNT/b-catenin signaling in peritoneal angiogenesis. Lastly, we have shown WNT5A to protect against peritoneal angiogenesis. Taken together, our findings are not only significant to the realm of PD research but hold wide applicability to research in the biomedical sciences. / Thesis / Doctor of Philosophy (PhD)

Les lésions tumorales cortico-surrénaliennes sont majoritairement des adénomes bénins et très rarement des carcinomes. Les altérations génétiques impliquées dans le développement des tumeurs cortico-surrénaliennes sporadiques, plus particulièrement au stade malin, demeurent à ce jour très peu connues. Lors de travaux récents menant à l’identification d’altérations génétiques de β-CATÉNINE nous avons constaté que plusieurs tumeurs présentaient une accumulation nucléo/cytoplasmique de la protéine β-CATÉNINE sans toutefois contenir de mutations pour ce gène. Nous avons donc émis l’hypothèse que, comme pour d’autres types de cancers, d’autres composants de la voie de signalisation Wnt/β-CATÉNINE, tel qu’AXIN2, pourrait être impliqués dans le développement des tumeurs du cortex surrénalien. De plus, plusieurs aberrations dans l’expression d’AXIN2 et de β-CATÉNINE sont associées à des tumeurs présentant de l’instabilité microsatellite dans d’autres types de cancer, notamment le cancer gastrique et colorectal. Nous avons donc étudié une cohorte de 30 adénomes, 6 carcinomes, 5 AIMAH, 3 hyperplasies ACTH-dépendante et 5 PPNAD ainsi que les lignées cellulaires de carcinomes cortico-surrénaliens humains H295R et SW13. Une étude préliminaire du statut MSI a également été réalisée sur 10 tumeurs contenant une mutation pour AXIN2 et/ou β-CATÉNINE. Nous avons trouvé des mutations d’AXIN2 dans 7% des adénomes (2/30) et 17% des carcinomes (1/6) cortico-surrénaliens. L’analyse fonctionnelle des mutations par immunohistochimie, analyse western blot et analyse de RT-PCR en temps réel a révélé une diminution de l’expression d’AXIN2 associée à cette mutation. L’analyse préliminaire MSI a démontré 1 échantillon AIMAH MSI-H, c’est-à-dire instable pour le locus BAT-25 et BAT-26 et 3 autres adénomes sécrétant de l’aldostérone instables seulement pour le locus BAT-26. Ainsi, ces travaux permirent d’identifier une nouvelle altération génétique associée au développement des tumeurs du cortex surrénalien en plus de rapporter pour la première fois la présence de MSI-H dans ce type de tumeurs. / Adrenocortical lesions are mostly benign tumors and rarely carcinomas. From now on, genetic alterations implicated in sporadic adrecocortical tumour development remains largely unknown. In our previous work leading to identification of genetic alterations in β-catenin, we observed that many tumors presented a nucleo/cytoplasmic accumulation of β-catenin protein without β-catenin mutations. Thus, we hypothesised that, as for many others cancers, others components of the Wnt/ β-catenin signalling pathway, as AXIN2, are implicated in development of adrenocortical tumors. Also, many aberrations in AXIN2 and β-catenin expression have been reported in association with microsatellite instability in other types of cancers like gastroinstestinal and colorectal cancer. We have studied 30 adenomas, 6 carcinomas, 5 AIMAH, 3 ACTH-dependant hyperplasias and 5 PPNAD as well as the human carcinoma cancer cells lines H295R and SW13. Preliminary study for MSI was also realised on 10 tumors harbouring AXIN2 and/or Β-CATENIN mutations. We have found AXIN2 mutations in 7% of adrenocortical adenomas (2/30) and 17% of adrenocortiocal carcinomas. Functional analysis of this mutation by immunohistochemical, western blot and real-time RT-PCR analysis revealed a down-regulation of AXIN2 expression associated with this mutation. Preliminary analysis of MSI results in 1 AIMAH sample MSI-H, which means instable for BAT-25 and BAT-26 locus, and 2 aldosterone adenomas were unstable for BAT-26 locus. This work identified a new genetic alteration involved in adrenocortical tumour development and report for the first time MSI-H in this type of tumor.

O carcinoma ex-adenoma pleomórifoco (CXAP) é a contraparte maligna do Adenoma pleomórfico (AP), sendo sua malignização descrita em 10% dos AP. Histológicamente o CXAP apresenta grande variação morfológica vista a capacidade do componente maligno se originar de diferentes estruturas do componente misto do AP. Nota-se que grande parte dos CXAP apresentam caráter infiltrativo, metástase linfonodal e metástase tardia. Para que as células neoplásicas adquiram um fenótipo com maior capacidade infiltrava é necessário que passem por um processo de transição de um fenótipo epitelial para mesenquimal. Este processo é conhecido como Transição epitélio-mesênquima (TEM). Tal processo é visto em situações fisiológicas, tais quais, migração de células ectodérmicas durante o período embriológico, reparação e cicatrização e também em processos neoplásicos. O objetivo deste trabalho é avaliar a presença de proteínas inerentes ao processo de transição epitélio mesênquima e comparar a expressão destas proteínas com achados histopatológicos sugestivos de invasão e mestástase. A análise das proteínas E-caderina e Beta-catenina em células neoplásicas de CXAP foi realizada de forma semi-quantitativa conforme sugerido pela literatura. Os casos foram subdividos de acordo com a positividade da reação de imunohistoquímica. Onde houve ausência de células positivas o caso recebeu escore 0, casos onde houve <10% de células positivas o escore foi 1, casos onde 10- 75% de células positivas escore 2 e consequentemente 3 para casos em que >75% das células eram positivas. Tais achados foram relacionados com presença de invasão angiolinfática, perineural, metástase tardia, recorrência e metástase linfonodal. De um total de 16 casos de CXAP, o sitio mais acometido foi a parótida e 53% da nossa amostra era composta por homens, a idade média foi de 52,9 anos e a parótida foi o sitio mais acometido. A análise histopatológica demonstrou que quando havia marcação para E-caderina a mesma se dava em membrana celular. 12,5% ausência de marcação, 50% dos casos com marcação fraca 31,25% dos casos com expressão moderada e 6,25% dos casos com marcação intensa. Já para Beta-catenina um caso apresentou marcação citoplasmática e os restantes em membrana celular.18,75% ausente de marcação, 25 % com marcação fraca, 50% dos casos com marcação moderada e 6,25 dos casos com marcação intensa. A imuno-marcação estava distribuída de forma difusa tanto no front de invasão quanto no parênquima do carcinoma. Casos com maior presença de E-caderina apresentaram mais metástases linfonodais, p=0,035. Para outros critérios de invasão nenhuma relação estatística significante foi observada. Sugere-se que E-caderina e Beta-catenina não fazem parte do processo de invasão e metástase de CXAP nem são fatores relacionados a invasão dos tecidos adjacentes. / Carcinoma ex-pleomorphic adenoma (CXAP) is the malignant counterpart of pleomorphic adenoma(PA), although malignant transformation of PA is unusual occurring in 10% of the PA cases. The CXAP histologically presents an intense morphologic variation due to the ability of the malignant tissue to originate from any structure of de mixed component. A significant number of CXAPs show an infiltrative behavior, lymph node metastasis and late metastasis. The cell component must undergo a morphologic alteration changing the epithelial phenotype to a mesenchymal one. That development process is known as epithelial-mesenchymal transiction (MET). This process is seen in physiologic situations, like cell migration on embryologic ectodermal evolution, tissue repair and int neoplastic processes. The main objective of this study was to evaluate immunohistochemical expression of epithelial-mesenchymal transiction proteins, e-caderin and beta-catenin in malignant areas of CXAP and correlate with pathologic parameters that indicates migration, like perineural and angiolymphatic invasion and metastasis as suggested by the literature. Immunohistochemical analysis was performed semiquantitatively according to the scores 0 (no positive cell), 1 (<10% positive cells), 2 (10-75% of cells positive, and 3 (>75% positive cells). These results were also correlated with pathological parameters of neoplastic aggressiveness using the Fisher\'s exact test. Of the16 cases, the parotid gland was the most involved site and men were affected in 53.8 % of our sample. The mean age was 52.9 year. The histopathological analysis showed that in all cases in which e-caderin was positive, the immunoreaction was of the cell membrane 12,5% of the cases showed absent of e-caderin expression, 50% showed weak expression, 31,25% showed moderate expression and 6,25 show strong one. In the other hand, b-catenin showed cytoplasmic expression in one case, all other cases showed protein in cell membrane. 18,75 showed absent expression, 25% showed weak expression, 50% showed moderate and 6,25% showed intense one. The immunohistochemical reaction was diffuse and presented itself in invasion front as well as in the carcinoma parenchyma. Cases presenting high expression of e-caderin developed more lymph node metastasis, p=0,035. For the others invasion parameters there was no statistic summary observed. This work suggest that e-caderin and b-catenin have no relation to CXAP carcinogenesis or invasion process