Background and aims of the study. Prostate cancer (PCa) is one of the most common hormone-dependent cancers in men in Western and also Asian countries. The standard treatment options for localized PCa include surgery and androgen-deprivation therapy (ADT). However, most patients upon ADT therapy invariably relapse and progress to a more aggressive and metastatic stage termed as castration-resistant PCa (CRPC). Accumulating studies indicate that androgen receptor (AR) transcriptional activity is dysregulated during the advanced progression of CRPC. One important mechanism responsible for the growth of CRPC includes increased intra-tumoral androgen synthesis in PCa. Recently, a novel androgen-responsive fusion gene TMPRSS2:ERG formed by fusion between the transmembrane protein TMPRSS2 and transcription factor ERG, has been identified in approximately 50% PCa samples, which results in the aberrant expression of ERG function as oncogenic factor in PCa. Currently, TMPRSS2:ERG is regarded as a significant potential diagnostic and prognostic biomarker for PCa. Estrogen-related receptor alpha-ERRα, the first identified ligand-independent orphan nuclear receptor, is characterized to be up-regulated in advanced cancers, suggesting that ERRα might play important regulatory roles in the malignant progression of PCa. Previous studies showed that ERRα can functionally cross-talk with AR signaling via co-targeting to AR targets and regulate the expression of some steroidogenic enzymes in breast cancer. Based on this background, it is hypothesized that ERRα could functionally regulate the TMPRSS2:ERG fusion gene and play a regulatory role in the development and progression of CRPC through activation of the intracellular androgen synthesis pathway. / Results. 1) The results obtained in this study showed that suppression of ERRα by its specific inverse agonist XCT790 or shRNA-knockdown could induce down-regulation of TMPRSS2:ERG and also its target genes in AR-positive VCaP PCa cells. 2) Ectopic expression of ERRα and/or its coactivator PGC-1α could increase the expression of TMPRSS2:ERG in AR-negative NCI-H660 PCa cells. 3) Two ERRα-DNA binding elements were identified by ChIP assay and sequence analysis in the promoter of TMPRSS2:ERG and both of these two elements could be transactivated by ERRα and PGC-1α. 4) Ectopic expression of TMPRSS2:ERG under the regulation of ERRα enhanced the prostatic cell invasion capacity as shown in the TMPRSS2:ERG infectants of BPH-1 and PC-3 prostatic cells. 5) ERG expressed by the TMPRSS2:ERG fusion could directly transactivate the ERRα gene in prostatic cells. 6) A positive correlation on the expressions between TMPRSS2:ERG and ERRα was demonstrated in a xenograft model of CRPC (VCaP-CRPC). 7) The expression of TMPRSS2:ERG and ERRα showed significant up-regulation and the transactivation activity of ERRα was also enhanced in castration-resistant VCaP-CRPC cells. 8) Ectopic expression of ERRα could promote resistant growth capacity to androgen-deprivation condition in LNCaP PCa cells, whereas shRNA-mediated silence of ERRα could weaken this resistant capacity. Furthermore, ectopic expression of ERRα in LNCaP-ERRα infectants could promote their in vivo growth resistance to castration in SCID mice. 9) Expression of several androgenic enzyme genes, including CYP11A1, CYP17A1 and ARK1C3, were detected to be up-regulated in castration-resistant VCaP-CRPC cells. Moreover, ectopic expression of ERRα could induce the increased expression of these enzyme genes in LNCaP-ERRα infectants, whereas knockdown of ERRα by shRNA could decrease their expression. 10) ERRα could directly transactivate the gene promoters of CYP11A1, CYP17A1 and ARK1C3 which contain ERRE elements prediction by sequence analysis. These results suggested that ERRα could play a role in de novo or intra prostatic androgen synthesis in the PCa cells. / Conclusions. The results obtained in this study suggested that ERRα and TMPRSS2:ERG could form a positive reciprocal loop in PCa cells, and ERRα could also promote the resistant growth capacity of PCa cells resistant to the androgen-deprivation condition in vitro and also castration-resistant growth in vivo via a mechanism of up-regulation of androgenic enzyme genes. The results also suggested that ERRα might play a significant regulatory role in the development and progression of PCa, particularly the advanced CRPC, and also ERRα could be a potential therapeutic target for the treatment of PCa, particularly the advanced PCa-CRPC. / 研究背景與研究目的：前列腺癌作為激素依賴的一種癌症，經常出現在西方和亞洲國家的男性人群中。對於局限性前列腺癌多採用外科手術和去勢的治療。但是大多數病人經過去勢治療后會再次復發並且形成更加惡心幾轉移的前列腺癌，稱之為去勢難治性前列腺癌（CRPC）。越來越多的研究表明在去勢難治性前列腺癌發病過程中，雄激素受體轉錄活性異性增強。其中一個重要機理解釋為前列腺癌細胞自身合成的雄激素增多。進來，在大約50%的前列腺癌病人中新檢測到一個受雄激素受（AR）體調控的融合基因TMPRSS2:ERG，它是由稱為TMPRSS2的一個跨膜蛋白和一個稱為ERG的轉錄因子融合而成，它的出現導致了在前列腺癌中異常的稱為致癌因子的ERG蛋白的高表達。目前，TMPRSS2:ERG已經被作為一個重要的潛在的診斷和預測的標誌物應用在前列腺癌中。作為第一個鑒定的配體不依賴的孤兒受體-ERRα，被證明在晚期的癌症中有很高的表達，預示著ERRα可能在惡性的癌症中起到一個非常重要的調控作用。之前的研究表明通過共同調控AR的下游基因，ERRα同AR信號通路之間有功能性的交叉調控；除此之外，在乳腺癌中，ERRα還可以調控一些類固醇類化合物的合成相關的一些酶的合成。依據上述，我們推定ERRα可能功能性地調控TMPRSS2:ERG融合基因的表達並且通過調控細胞內的雄激素的合成進而在去勢難治性前列腺癌的發生和發展中起到一個非常重要的作用。 / 結果：本論文研究結果總結如下：1）在有AR表達的前列腺癌細胞-VCaP細胞中，通過ERRα特異性的抑制劑XCT790處理或者shRNA介入的干擾ERRα的mRNA的方法來抑制ERRα，下調了TMPRSS2:ERG和它的一些下游調控基因的表達。2）在沒有AR表達的前列腺癌細胞-NCI-H660細胞中，上調ERRα或者它的特異性的共激活因子PGC-1α表達可以提升TMPRSS2:ERG的表達。3）通過ChIP實驗，在TMPRSS2:ERG的啟動子上面，兩個ERRα的DNA結合位點被鑒定出來。並且這兩個位點可以被ERRα和PGC-1α轉錄激活。4）在兩個前列腺細胞BPH-1和PC-3細胞中，在ERRα的調控下高表達TMPRSS2:ERG融合基因可以增強細胞的侵襲能力。5）融合基因TMPRSS2:ERG導致的ERG蛋白的表達可以直接轉錄激活ERRα的表達。6）我們通過VCaP細胞的異種移植建立VCaP-CRPC的體內模型來模擬CRPC過程，在整個過程中，我們發現TMPRSS2:ERG和ERRα有一致性的表達相關性。除此之外，我們根據上述動物模型通建立了VCaP-CRPC細胞系，並且發現在VCaP-CRPC細胞細胞中，TMPRSS2:ERG和ERRα都有被上調並且ERRα的轉錄活性同樣也提升。7）在LNCaP細胞中高表達ERRα可以提升細胞在去除雄激素的環境中生長的能力。但是當在LNCaP細胞中用shRNA干擾掉ERRα可以明顯減弱這種生長的能力。用LNCaP-ERRα穩轉ERRα的細胞異種移植建立SCID老鼠體內腫瘤模型，我們發現和LNCaP-pBABE對照組相比，LNCaP-ERRα細胞生長的更快更大。並且在對老鼠進行睪丸切除術后，LNCaP-ERRα組細胞更快適應這種環境并繼續生長，相比之下，LNCaP-pBABE對照組則持續萎縮減小。8）在上述的VCaP-CRPC細胞中，我們發現一些和雄激素合成相關的關鍵的酶包括CYP11A1，CYP17A1和ARK1C3的表達量有顯著地提升。而且在LNCaP-ERRα細胞中同樣檢測到這些酶的表達量的提升。然而當在LNCaP細胞中用shRNA干擾掉ERRα可以明顯減降低上述酶的表達。9）我們在CYP11A1，CYP17A1和ARK1C3基因的啟動子區域發現有ERRα結合位點，並且發現這些位點可以被ERRα轉錄激活。 / 結論：本論文的研究結果提示在前列腺癌細胞中，ERRα和TMPRSS2:ERG可以形成一個相互正向調控的循環。除此之外，上調ERRα可以促進細胞在去除雄激素的環境中生長的能力，並且在動物體內可以提升細胞在睪丸去除的環境中的適應和生長能力。這種體內和體外的能力的提升是通過一種潛在的上調前列腺癌細胞的雄激素合成相關的關鍵的酶的表達，進而提升雄激素的含量而得以實現的。上述的結果預示著ERRα可能在前列腺癌發生機發展的過程中起到非常重要的調控作用，尤其在晚期的CRPC中。同時，ERRα也可能作為一個潛在的重要的前列腺癌尤其是晚期的CRPC的治療靶點，尤其是一些潛在ERRα的特異性抑制劑，比如XCT790，可能作為將來用以作為治療前列腺癌的特異性靶點藥物。 / Xu, Zhenyu. / Thesis Ph.D. Chinese University of Hong Kong 2014. / Includes bibliographical references (leaves 126-143). / Abstracts also in Chinese. / Title from PDF title page (viewed on 05, October, 2016). / Xu, Zhenyu. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only.

Background & Aims: By whole genome sequencing, we identified for the first time that solute carrier family 12 member 5 (SLC12A5) gene located on chromosome 20q13.12 was amplified in colorectal cancer (CRC). We aimed to determine the amplification status of SLC12A5 and its clinical implication in CRC, and characterize the functional mechanisms of SLC12A5 in colorectal carcinogenesis. / Materials and Methods: Protein expression level of SLC12A5 was evaluated by immunohistochemistry. SLC12A5 amplification was verified by fluorescence in situ hybridization (FISH). The correlations between SLC12A5 expression and clinicopathologic parameters as well as the prognosis impact of SLC12A5 were analyzed in 195 CRC patients. The biological function of SLC12A5 in CRC cell lines were determined by cell viability, colony formation, invasion, migration, flow cytometry and in vivo tumorigenicity assays. Standard tail vein metastatic assay was performed to examine the effect of SLC12A5 in lung metastasis in nude mice. Western blot, luciferase reporter assays and human tumor metastasis PCR array were performed to evaluate SLC12A5 downstream effectors and related pathways. / Results: RT-PCR showed SLC12A5 was readily expressed in 7 of 9 CRC cell lines, but was absent in normal colorectal tissues. The mean protein expression level of SLC12A5 was significantly higher in primary CRCs as compared to their adjacent normal tissues. Amplification of SLC12A5 was detected in 40.8% (78/191) of primary CRCs by FISH, which was positively correlated with its protein overexpression (P < 0.001). Overexpression of SLC12A5 was positively associated with a more advanced TNM stage (P < 0.05). Multivariate Cox regression analysis showed that SLC12A5 overexpression was an independent predictor of poorer survival of CRC patients (P = 0.018). We further tested the biological function of SLC12A5 in human colon cancer cells. Ectopic expression of SLC12A5 in colon cancer cells SW480 and SW1116 increased proliferation and colony formation. Silencing SLC12A5 expression in HCT116 by siRNA had the opposite effects in vitro, and knockdown of SLC12A5 by shRNA significantly inhibited xenograft tumor growth in nude mice. We further revealed that SLC12A5 inhibited apoptosis of colon cancer cells by mediating apoptosis-inducing factor (AIF) and endonuclease G (EndoG) -dependent apoptotic signaling pathway. Moreover, gain-and loss-of-function experiments showed that SLC12A5 enhanced cell invasion and migration in vitro. Knockdown of SLC12A5 by shRNA significantly inhibited lung metastasis in nude mice. SLC12A5 promoted tumor metastasis through regulating key elements of the matrix architecture, such as matrix metallopeptidase and fibronectin. / Conclusion: We have identified a novel amplification gene SLC12A5 which is overexpressed in CRC. SLC12A5 may be an independent prognostic marker for CRC and may play a pivotal oncogenic role in colorectal carcinogenesis by inhibiting apoptosis and promoting metastasis. / 背景和目的：通過對結直腸癌進行全基因組測序，我們首次發現位於染色體20q13.12的SLC12A5基因在結直腸中擴增。本研究旨在探索SLC12A5在結直腸癌中的擴增情況和臨床意義，并進一步研究SLC12A5在結直腸癌發生發展中的作用機制。 / 材料和方法：採用免疫组化方法檢測SLC12A5的蛋白表达水平。應用熒光原位雜交方法驗證SLC12A5基因的擴增情況。在195例結直腸癌患者中对SLC12A5表达與临床病理關係及其對預後的影響其进行分析。通过檢測細胞活力、細胞集落形成實驗、侵襲實驗、遷移實驗、流式細胞術和體內成瘤實驗以研究SLC12A5在結直腸癌中的生物学功能。進而通過免疫印跡、熒光素酶報告實驗和人腫瘤轉移的PCR陣列，探索SLC12A5調控的基因和相关途径。 / 结果：我們採用RT-PCR方法檢測SLC12A5在9株結直腸癌細胞株的表達情況，SLC12A5在7株結直腸癌細胞株中穩定表達，但是在正常大腸組織中表達沉默。SLC12A5在結直腸中的平均蛋白表達水平顯著高於其鄰近的正常組織。通過熒光原位雜交方法，在40.8% （78/ 191）的結直腸癌中檢測到SLC12A5的擴增，該基因的擴增與其蛋白高表達水平呈正相關關係。SLC12A5高表達水平跟晚期TNM分期密切相關（P <0.05）。多因素Cox回歸分析表明，SLC12A5高表達是結直腸癌患者較差的生存的獨立預測因子（P = 0.018）。我們進一步在人結腸癌細胞株中檢測SLC12A5的生物功能。在結腸癌細胞SW480和SW1116中過度表達SLC12A5促進細胞增殖和集落形成。siRNA敲低HCT116 細胞SLC12A5的表達在體外實驗中有相反的效果。此外，shRNA敲低SLC12A5的表達顯著抑制裸鼠移植瘤的生長。我們進一步發現，SLC12A5通過介導凋亡誘導因子（AIF）和核酸內切酶G（EndoG）-依賴的細胞凋亡信號轉導通路抑制結腸癌細胞的凋亡。此外，功能獲得性和功能缺失性的體外實驗表明，SLC12A5促進腫瘤細胞的侵襲和遷移。尾靜脈注射實驗表明shRNA敲低SLC12A5的表達顯著抑制裸鼠肺轉移。SLC12A5通過調節基質結構的關鍵因子，如基質金屬蛋白酶和纖維連接蛋白，促進腫瘤轉移。 / 结论：我們發現了一個新的擴增基因SLC12A5，該基因在結直腸癌中高表達。SLC12A5是結直腸癌的一個獨立的預後標誌物。SLC12A5通過抑制細胞凋亡和促進腫瘤轉移，在結直腸癌的發生發展中起了舉足輕重的致癌作用。 / Xu, Lixia. / Thesis Ph.D. Chinese University of Hong Kong 2014. / Includes bibliographical references (leaves 107-120). / Abstracts also in Chinese. / Title from PDF title page (viewed on 05, October, 2016). / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only.

Leung, Kin Chung. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2011. / Includes bibliographical references (leaves 148-164). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstract also in Chinese.

Tsang, Chi Keung. / "November 2011." / Thesis (M.Phil.)--Chinese University of Hong Kong, 2012. / Includes bibliographical references (leaves 103-116). / Abstracts in English and Chinese. / Abstract --- p.I / 摘要 --- p.III / Acknowledgement --- p.IV / Table of content --- p.V / List of Figures --- p.VIII / List of Tables --- p.XI / Abbreviations --- p.XII / Chapter Chapter 1: --- INTRODUCTION --- p.1 / Chapter 1.1. --- Hepatocellular carcinoma --- p.2 / Chapter 1.1.1. --- Etiological factors --- p.11 / Chapter 1.1.1.1. --- Chronic Hepatitis and Liver Cirrhosis --- p.13 / Chapter 1.1.1.2. --- HBV --- p.13 / Chapter 1.1.1.3. --- HCV --- p.17 / Chapter 1.1.1.4. --- Male gender --- p.20 / Chapter 1.1.1.5. --- Aflatoxin B1 exposure --- p.21 / Chapter 1.2. --- Genomic abnormalities in HCC --- p.23 / Chapter 1.3. --- GEF-H1 --- p.24 / Chapter 1.4. --- RhoA --- p.26 / Chapter 1.5. --- Epithelial-Mesenchymal Transition (EMT) --- p.29 / Chapter 1.6. --- Aims of Thesis --- p.31 / Chapter Chapter 2: --- MATERIALS AND METHODS --- p.32 / Chapter 2.1. --- Materials --- p.33 / Chapter 2.1.1. --- Chemicals and Reagents --- p.33 / Chapter 2.1.2. --- Buffers --- p.35 / Chapter 2.1.3. --- Cell Culture --- p.37 / Chapter 2.1.4. --- Nucleic Acids --- p.38 / Chapter 2.1.5. --- Enzymes --- p.39 / Chapter 2.1.6. --- Equipments --- p.40 / Chapter 2.1.7. --- Kits --- p.41 / Chapter 2.1.8. --- Antibodies --- p.42 / Chapter 2.1.9. --- Software and Web Resources --- p.43 / Chapter 2.2. --- Fluorescence In Situ Hybridization (FISH) --- p.44 / Chapter 2.2.1. --- Probe Preparation --- p.44 / Chapter 2.2.1.1. --- Human Bacterial Artificial Chromosome (BAC) probe preparation --- p.44 / Chapter 2.2.1.2. --- Nick translation --- p.44 / Chapter 2.2.2. --- Hybridization --- p.45 / Chapter 2.3. --- Genomic DNA extraction --- p.47 / Chapter 2.4. --- Copy number analysis --- p.48 / Chapter 2.5. --- Exon Sequencing analysis --- p.49 / Chapter 2.5.1. --- PCR amplification of GEF-H1 exons --- p.49 / Chapter 2.5.2. --- Cycle sequencing --- p.49 / Chapter 2.6. --- Ectopic expression of GEF-H1 in immortalized hepatocyte cell line --- p.52 / Chapter 2.6.1. --- Construction of GEF-H1 expressing vector --- p.52 / Chapter 2.6.2. --- Sub-cloning --- p.52 / Chapter 2.6.3. --- Transfection and clonal selection --- p.53 / Chapter 2.7. --- Gene Expression Analysis by Quantitative RT-PCR --- p.55 / Chapter 2.7.1. --- Total RNA extraction --- p.55 / Chapter 2.7.2. --- qRT-PCR analysis for gene expression --- p.55 / Chapter 2.8. --- Western blot --- p.58 / Chapter 2.9. --- Functional Analysis --- p.60 / Chapter 2.9.1. --- Cell viability (MTT) assay --- p.60 / Chapter 2.9.2. --- Cell proliferation assays (BrdU-incorporation) --- p.60 / Chapter 2.9.3. --- Mitomycin C treatment --- p.61 / Chapter 2.9.4. --- Migration and Invasion assays --- p.63 / Chapter 2.9.5. --- Wound healing assay --- p.65 / Chapter 2.9.6. --- Transient knock-down of RhoA --- p.65 / Chapter 2. --- 10. Immuno-fluorescent imaging --- p.66 / Chapter 2. --- 11. In vivo tumorigenic study of GEF-H1 by subcutaneous injection --- p.68 / Chapter 2. --- 12. Statistical analysis --- p.69 / Chapter Chapter 3: --- RESULTS --- p.70 / Chapter 3.1. --- Verifying copy number gain of GEF-H1 in high GEF-H1 expressing HCC --- p.71 / Chapter 3.2. --- Verifying if there is any GEF-H1 exon point mutation in HCC --- p.75 / Chapter 3.3. --- Functional roles of GEF-H1 in HCC --- p.77 / Chapter 3.4. --- GEF-Hl-induced functions were RhoA independent --- p.83 / Chapter 3.5. --- GEF-H1 Induction of Epithelial-mesenchymal transition in HCC --- p.88 / Chapter 3.6. --- GEF-H1 induced tumorigenicity of MIHA cells --- p.95 / Chapter Chapter 4: --- DISCUSSIONS --- p.96 / Chapter 4.1. --- GEF-H1 in HCC and other cancers --- p.97 / Chapter 4.2. --- GEF-H1 promotes cell motility --- p.98 / Chapter 4.3. --- GEF-H1 induced tumorigenicity --- p.100 / Chapter Chapter 5: --- CONCLUSIONS AND PROPOSED FUTURE INVESTIGATIONS --- p.101 / Chapter Chapter 6: --- REFERENCES --- p.103

Uveal Melanoma (UM) is the most common malignant intra-ocular tumor in adults. Despite the high accuracy of clinical diagnosis and advances in local treatment, more than 50% of UM patients develop metastasis within ten years of initial diagnosis. NM23 is a human metastasis suppressor gene. Reduced Nm23-H1 expression is correlated with high metastatic potential in a variety of different cancers including melanoma. C-Met is a receptor tyrosine kinase (RTK) that has been known to stimulate the invasive growth and increase the metastatic potential of cancer cells. Expression of c-Met is correlated with high mortality rate in UM patients. Treatment with CQX-2 inhibitors showed promise as an adjuvant therapy in adenocarcinoma of the colon. A previous report from our laboratory showed that topical treatment with Nepafenac (a CQX-2 inhibitor) delayed the progression of the primary tumor and the formation of metastasis in the experimental rabbit model of UM. / The purpose of this thesis is to investigate the expression levels ofNm23-H1 in UM cell lines with different metastatic potentials, in paraffin embedded tissues from primary tumors of UM patients, and in an experimental rabbit model. In addition, the aim of this thesis is to determine whether treating human uveal melanoma cell lines with Nepafenac would increase the expression levels of Nm23-H1 and decrease the expression levels of c-Met in vitro (UM cell lines) and in vivo (experimental rabbit model). / To achieve our goal, we used several types of assays in our UM cell lines and paraffin embedded tissues from patient samples and experimental rabbit model, including quantitative immunostaining, quantitative Real-time PCR, and small interference RNA (siRNA). / The Real-time PCR results of five human uveal melanoma cell lines showed that expression of Nm23-HI is higher in cell lines with low metastatic potential compared to those with high metastatic potential. The invasive ability of the uveal melanoma cell lines increased after silencing Nm23-H1 expression with siRNA. The increased immunostaining intensity of Nm23-H1 in patient samples is associated with better survival rate. Moreover, treatment with Nepafenac resulted in increase of Nm23-H1 levels and decrease of c-Met levels in both the UM cell lines and the experimental rabbit model. / In conclusion, Nm23-H1 is a potent prognostic marker to predict the survival rate of UM patients and it has the potential to identify high-risk patients. To the best of our knowledge, this is the first study to show that treatment with COX-2 inhibitor causes an upregulation of Nm23-H1 and downregulation of c-Met in UM. Therefore, treatment with COX-2 inhibitors may be a useful strategy as an adjuvant therapy for UM patients.

Uveal melanoma is the most common primary intraocular malignant tumour in adults. Despite improvements in the diagnosis and treatment of the primary tumour, patients continue to have the same mortality rate as several decades ago, reflecting our poor understanding of the mechanisms behind the formation of metastases in this disease. The purpose of this study was therefore to characterize an animal model of uveal melanoma and use this model to study the transcriptional changes that cells undergo from culture to intraocular tumour, to circulation and finally to the formation of a metastatic nodule. / Using microarrays we identified 314 changes in transcript abundance between the intraocular tumour and metastatic lesions. Principal Components Analysis was used to cluster these transcripts into four distinct groups. A further 61 gene transcripts showed statistically significant changes between re-cultured cells isolated from the model, with the circulating malignant cells representing an intermediate step between cells isolated from intraocular tumours and metastatic lesions. We have produced a detailed analysis of the molecular changes that take place as human uveal melanoma cells evolve from a primary tumour to metastasis in an animal model, including the decrease in expression of specific melanoma markers. These changes were verified using quantitative real time polymerase chain reaction and three different functional assays. / In addition we sought to describe the genetic changes that are present in these cells. Using comparative genomic hybridization arrays we were able to successfully describe the deletions and amplifications that are present in genomic DNA extracted from paraffin embedded sections of the primary tumour. This represents the first time that archival tissue has successfully been used for this sort of analysis in uveal melanoma. We identified several genomic amplifications and deletions including an area of amplification of Wnt2, which is involved in beta-catenin regulation and C-Met, which plays a role in tumour cell homing to the liver in patients. / To the best of our knowledge, this is the first time that a detailed genetic analysis has been carried out on the progression of uveal melanoma from intraocular tumour, to circulation, to the formation of metastases.

Uveal Melanoma is the most common primary intraocular tumor in adults. Despite the advances in numerous ophthalmic techniques leading to the increased accuracy of diagnosing this malignancy, the ten-year mortality rate for patients has remained unchanged at approximately fifty percent. Knowing this, further understanding of the specific steps that occur within the metastatic cascade of uveal melanoma is required. / Our laboratory utilizes five human uveal melanoma cell lines (92.1, SP6.5, MKT-BR, OCM-1, UW-1) of known proliferative, invasive, and metastatic potential. We used four methods to characterize the presence and roles of the chemotactic factors CXCL12, CXCL8, CXCL1 and HGF in these five cell lines. We also used a novel peptide inhibitor (TN14003) to block the biological action of CXCL12 on its receptor CXCR4. / With the results obtained from this thesis, we were able to establish the novel presence and importance of the four chosen factors for this malignancy. We were also able to display the positive effects TN14003 had on inhibiting uveal melanoma cell migration in vitro. This may lead to a future therapeutic target, which ultimately may delay or inhibit the metastatic process in uveal melanoma patients, improving the present unaffected ten-year mortality rate.

The relationship between colorectal cancer (CRC) and folate metabolism is complex. Dietary folate, depending on the timing and dose, may either prevent or enhance tumour initiation and/or growth, and polymorphisms in the genes encoding folate-metabolising enzymes may also modulate risk. In this thesis, the Apcmin/+ mouse model of CRC was used to investigate the effect of nutritional and genetic disturbances in folate metabolism on tumourigenesis and to examine various mechanisms. / The reduced folate carrier I (RFC1) is responsible for the cellular uptake and intestinal absorption of folate, primarily the 5-methyltetrahydrofolate (5-methylTHF) derivative. Methionine synthase (MTR) uses 5-methylTHF to remethylate homocysteine to methionine, which may be activated and used to methylate substrates such as DNA. 5-MethylTHF is also the product of the methylenetetrahydrofolate reductase (MTHFR)-catalysed reduction of 5,10-methyleneTHF, which is also used to convert dUMP to dTMP. / Adenoma number and load were reduced in Rfc1+/-Apc min/+ mice, compared with Rfc1+/+Apc min/+ mice, but were similar in Mtr+/-Apc min/+ and Mtr+/+ Apcmin/+ mice. Neither Rfc1 nor Mtr genotype affected global DNA methylation, apoptosis or plasma homocysteine (tHcy) levels. In the experiments involving Mtr mice, dietary folate deficiency increased adenoma number, plasma tHcy, and apoptosis, and decreased global DNA methylation. Neither Mtr nor Rfc1 genotype affected the dUTP/dTTP ratio in the intestine of mice not predisposed to adenoma formation. / Adenoma number was decreased in Mthfr+/-Apc min/+ mice (compared with Mthfr+/+Apc min/+ mice) and in Mthfr+/+Apc min/+ offspring of Mthfr+/- mothers (compared with Mthfr+/+Apcmin/+ offspring of Mthfr+/+ mothers). A folate-deficient diet, when initiated prior to conception, significantly decreased adenoma number and decreased global DNA methylation. Overall, adenoma number was inversely correlated with plasma tHcy, dUTP/dTTP ratio and apoptosis. When initiated at three weeks of age, a folate-enriched diet significantly increased adenoma number in Apcmin/+ mice. In the intestines of mice not predisposed to adenoma formation, Mthfr deficiency decreased, and folic acid deficiency increased, the dUTP/dTTP ratio. / These results support the evidence that MTHFR polymorphisms are protective in CRC tumourigenesis and that depending on stage or predisposition, folate may inhibit or enhance tumour growth.

Diss. (sammanfattning) Stockholm : Karol. inst. / Härtill 5 uppsatser.

Introdução: A identificação de mecanismos genéticos envolvidos no processo de carcinogênese do câncer colorretal levou ao surgimento de novas estratégias terapêuticas como a terapia gênica. Através do bloqueio ou estímulo de determinados alvos genéticos ou moleculares seria possível interromper o ciclo celular de células transformadas. Uma das estratégias sugeridas foi a utilização de seqüências anti-sense do gene da ciclina G que revelou resultados iniciais clínicos e experimentais promissores em diversas neoplasias, inclusive na colorretal. Assim seria esperado que a expressão da ciclina G estivesse freqüentemente alterada de maneira seletiva nas células do câncer colorretal quando comparado às células normais. Por estas razões, decidiu-se estudar a expressão da ciclina G em pacientes com câncer do reto. Métodos: Dados clínicos, epidemiológicos, anátomo-patológicos e de sobrevivência de 36 pacientes com câncer do reto foram obtidos e correlacionados com os resultados de expressão imunohistoquímica da ciclina G. O tecido neoplásico e normal distante da lesão primária foram submetidos a reação imunohistoquímica com anticorpo monoclonal anti-ciclina G e quantificados através de três métodos: (1) quantitativo, obtido a partir da contagem de células determinando a razão entre o número de células positivas e o número total de células contadas em 10 campos; (2) semi-quantitativo (cruzes), obtido a partir da pontuação em sistema de cruzes conforme a intensidade e quantidade de células positivas em áreas de maior impregnação do corante; (3) semi-quantitativo (escore), obtido a partir da pontuação em sistema de escore (alto ou baixo) conforme a intensidade e quantidade de células positivas em áreas de maior impregnação do corante. O estudo estatístico incluiu teste T de student, Qui-quadrado, exato de Fisher, teste t pareado, Wilcoxon, log-rank e curva ROC sendo considerados significativos quando o valor de p<0,05. Resultados: A expressão da ciclina G foi positiva em 76,5±30% da células contadas, com média de 3,2±1,1 cruzes e escore alto em 32 pacientes no tecido tumoral. No tecido normal dos pacientes a positividade foi de 42,2±27,4%, com média de 1,9±1,1 cruzes e escore alto em 16 casos. Quando comparados os tecidos tumoral e normal de cada paciente, o resultado tumor>normal foi obtido em 28 (77,8%) pacientes (quantitativa), 27 (75%) pacientes (semi-quantitativa/cruzes) e 18 (50%) pacientes (semi-quantitativa/escore). A diferença de expressão entre tecido tumoral e tecido normal maior que 10% apresentou correlação com ausência de metástases sistêmicas enquanto que a diferença maior que 38% apresentou correlação com a ausência de metástases linfonodais (área da curva 0,69 nos dois casos). Houve correlação entre o resultado tumor>normal e a ausência de metástases linfonodais quando o método de quantificação foi semi-quantitativo (cruzes e escore;p=0,02 e 0,04). Não houve correlação entre o resultado tumor>normal e as demais características. Não houve influência do resultado tumor>normal nas curvas de sobrevivência (3 anos). Conclusões: A expressão da ciclina G é maior no tecido neoplásico do câncer colorretal quando comparada ao tecido normal. Apesar disso, a expressão da ciclina G é raramente nula no tecido normal. A expressão de ciclina G tumor>normal esteve associada a ausência de metástases linfonodais quando mensurada através de métodos semi-quantitativos. Apesar disso, a expressão alterada da ciclina G não tem influência sobre sobrevivência precoce em pacientes com câncer do reto. / Introduction: Identification of genetic mechanisms involved in colorectal cancer carcinogenesis led to the development of new treatment strategies such as gene therapy. The aim of this strategy is to interrupt cell-cycle of transformed malignant cells by blocking or stimulating specific gene expression. Utilization of cyclin G antisense constructs has been suggested with clinical and experimental promising results in various neoplasias, including colorectal cancer. In this setting, one would expect that cyclin G would be selectively overexpressed in colorectal cancer cells as opposed to normal tissue. For this reason, we decided to study cyclin G expression in patients with rectal cancer. Methods: Clinical, epidemiological, pathological and survival data from 36 patients with rectal cancer was collected and correlated with Cyclin G immunohistochemical expression. Neoplastic and non-adjacent normal tissue were stained with monoclonal anti-Cyclin G antibody and quantified according to 3 different methods: (1) quantitative, obtained from cell count and determined by the ratio between positive counted cells and total number of counted cells observed in 10 microscopic fields; (2) semi-quantitative (crosses), obtained from a scoring system that takes into account both quantity and intensity of most strongly stained areas; (3) semi-quantitative (score), obtained from a scoring system that takes into account both quantity and intensity of most strongly stained areas. Statistical analysis included ROC curves, student\'s T, Chi-square, Fisher\'s exact, log rank, Wilcoxon, and paired t test. Significant differences were considered for p<0.05. Results: In tumor-tissue, positive Cyclin G expression was observed in 76.5±30% of counted cells, with a mean number of 3.2±1.1 crosses and high expression score in 32 patients (89%). In normal tissue, positive cyclin G expression was observed in 42.2±27.4% of counted cells, with a mean of 1.9±1.1 crossed and high expression score in 16 patients. When comparing tumor and normal tissue within each patient, a result of tumor>normal cyclin G expression was observed in 28 (77.8%) patients (quantitative method), 27 (75%) patients (semi-quantitative crosses) and 18(50%) patients (semi-quantitative score). A difference of cyclin G expression between tumor and normal tissue greater than 10% was associated with the absence of metastatic disease. A difference of cyclin G expression between tumor and normal tissue greater than 38% was associated with the absence of lymph node metastases (ROC curve area of 0.69 in both cases). There was significant association between cyclin G expression tumor>normal result and the absence of lymph node metastases when using semi-quantitative quantification methods (p=0.02 for crosses; p=0.04 for score). There was no association between cyclin G expression and other patient\'s characteristics or survival. Conclusion: Cyclin G expression is greater in tumor tissue when compared to normal tissue in patients with rectal cancer. However, cyclin G expression in normal tissue is rarely absent. Tumor>normal cyclin G expression is significantly associated with absence of lymph node metastases when quantified using semiquantitative methods. However, cyclin G expression had no influence in short-term survival.