La inestabilidad genómica presente en el tumor determina su evolución. Esta evolución puede ocurrir por diferentes vías de progresión tumoral que comportan unas características moleculares, cromosómicas y clínico-patológicas concretas. El estudio del daño genómico, consecuencia de la inestabilidad genómica, puede ayudar a caracterizar las vías de progresión tumoral y puede permitir la identificación de los grupos de tumores con peor pronóstico.Con el objetivo de caracterizar las distintas formas de daño genómico presentes en el cáncer colorectal y de determinar su relación con el comportamiento biológico del tumor se procedió a analizar el daño genómico de 131 tumores colorectales esporádicos mediante dos técnicas distintas: la citometría de flujo para medir aneuploidía, y la AP-PCR para cuantificar ganancias y pérdidas alélicas. A continuación se realizó la comparación de los dos tipos de daño genómico entre ellos y con las variables clínico-patológicas y moleculares de los tumores y se determinó el valor pronóstico de las medidas de daño genómico. También se analizó el papel de la aneuploidía en la diseminación metastásica.Con la intención de mejorar la cuantificación de la aneuploidía de los tumores decidimos crear un nuevo índice (Aneuploidy Index, AI) que tuviera en cuenta el grado y la extensión de la aneuploidía en el tumor. El AI tiene valor pronóstico independiente del estadío de Dukes y permite identificar un subgrupo de pacientes con tumores en estadíos tempranos, pero con alto riesgo de muerte. Por otra parte, el daño genómico medido por AP-PCR (GDF) cuantifica desequilibrios alélicos y también presenta valor pronóstico independiente. El alto GDF se asocia a mutaciones en p53, lo que indica que la inactivación de este gen podría ser una de las causas de producción de desequilibrios alélicos. Además, el GDF y el AI son independientes y por este motivo la combinación de las dos variables es el mejor predictor de supervivencia en los pacientes con resección quirúrgica radical. En cuanto al análisis de la ploidía en las metástasis, hemos observado que la mayoría presenta una población de células tumorales diploides, lo que indicaría que la diseminación ha sido llevada a cabo por este tipo de células. Además las metástasis reproducen el patrón de ploidía existente en el tumor primario.En base a los distintos tipos de daño genómico observado proponemos que éstos son la manifestación de 4 vías de progresión tumoral con factores pronósticos diferentes: vía de la inestabilidad de microsatélites, vía diploide sin inestabilidad de microsatélites (factor pronóstico: estadío de Dukes), vía aneuploide 'numérica' (factor pronóstico: AI) y vía aneuploide 'numérico-estructural' (factor pronóstico: GDF). / Genomic instability determines tumor evolution. This evolution takes place following different pathways of tumor progression that associate with specific molecular, chromosomic and clinicopathologic characteristics. The study of genomic damage, consequence of genomic instability, could help to characterize the pathways of tumor progression and to identify the subgroups of patients with worse prognosis.To characterize the different forms of genomic damage present in colorectal cancer and to determine their relationship with the biological behaviour of the tumor, we analized the genomic damage of 131 sporadic colorectal tumors using two different techniques: flow cytometry to mesure aneuploidy and AP-PCR to mesure allelic gains and losses. We made the comparison of the two types of genomic damage between them and with tumor molecular and clinicopathologic variables and we determined the prognostic value of genomic damage assessment. Furthermore we analyzed the role of aneuploidy in metastasic dissemination.To quantify tumor aneuploidy in a comprehensive way, we created a new index (Aneuploidy Index, AI) that considers both, the degree and the extension of aneuploidy in the tumor. AI showed prognostic value independent of Dukes stage and identified a subset of patients with early stage tumors but with high risk of death. On the other hand, genomic damage mesured by AP-PCR (GDF) quantified allelic imbalances and also showed independent prognostic value. High GDF associated with p53 mutations, indicating that the inactivation of this gene could be a possible cause of production of allelic imbalances. Furthermore, GDF and AI were independent and, therefore, the combination of both variables was the best predictor of survival in patients with absence of remnant disease. Ploidy analysis in metastasis revealed that most of them show a population of diploid tumoral cells, suggesting that dissemination is accomplished by diploid cells. Furthermore, most metastasis reproduced the ploidy pattern of the primary tumor.In base of the distinct types of genomic damage observed we propose that they are the manifestation of 4 pathways of tumor progression with different prognostic factors: microsatellite instability pathway, diploid without microsatellite instability pathway (prognostic factor: Dukes stage), 'numerical' aneuploid pathway (prognostic factor: AI) and 'numerical-structural' aneuploid pathway (prognostic factor: GDF).

Exocrine pancreatic cancer is the fifth leading cause of death from malignant disease in Western society and it is one of the most aggressive human tumors. Once diagnosed, the 12-month patient survival is less than 5%. More than 90% of human exocrine tumors are classified as "ductal adenocarcinomas" on the basis of their microscopic appearance. The plasminogen system plays a critical role in intravascular thrombolysis as well as in other biological processes that require cellular migration, such as angiogenesis, inflammatory reactions, tissue remodelling, and tumor progression. There are two types of plasminogen activators that catalyze plasmin generation from plasminogen: tissue-type (tPA) and urokinase-type (uPA). Activation of plasminogen to plasmin results in progressive degradation of fibrin and other extracellular matrix components and may also lead to activation of metalloproteases, latent growth factors, and proteolysis of membrane glycoproteins. All these processes may contribute to tumor development and metastasis. There is extensive evidence supporting the notion that the uPA system, including its receptor and plasminogen activator inhibitor PAI-1, can contribute to tumorigenesis in a variety of tissue types but there is less evidence for such a role regarding tPA and annexin A2 (AnxA2), a putative tPA receptor. Previous studies of our group have shown that tPA is commonly expressed in pancreas cancer tissues and cell lines and appears to be selectively associated with the neoplastic phenotype. Using neutralizing antibodies or chemical inhibitors leads to reduced in vitro tumor invasion. Our results support that - in the pancreas - the tPA system plays an important role in tumor development and/or progression whereas the uPA system may play a more dominant role in pancreatitis. More recent studies have shown that tPA stimulates cell proliferation and angiogenesis in exocrine pancreatic tumors. These results allow new approaches to improve the treatment of this disease, but to do so it is necessary to use of mouse models of disease. In attempt to explore the role of tPA and its receptor, annexin A2, in pancreatic tumorigenesis, we have taken advantage of two well established transgenic mouse models: Ela1-TAg (1-127) and Ela1-myc. In these mice, transgenes are targeted to acinar cells using the Elastase-1 enhancer/promoter. We have also analyzed the pancreas of Ela1-CCK2 and MT-TGFa transgenic mice, as models of acinar-ductal transdifferentiation and ductal complex formation. Our results show that expression of tPA is undetectable in the non-neoplastic pancreatic epithelium and in metaplastic ducts and in acinar tumors. By contrast, tPA is overexpressed in neoplastic pancreatic ducts. This pattern expression is in agreement with the results described in humans, indicating that mouse models of pancreatic cancer may be useful for the study of human pathology. On the other hand, AnxA2 is undetectable in acinar tumors but it is detected in the apical membrane of normal and metaplastic duct epithelium. In addition, AnxA2 is strongly expressed in ductal tumor cells where it shows a non-polarized distribution. These results suggest that different molecular events may participate in the activation of tPA and its receptor, AnxA2, in non-neoplastic ducts. In order to analyze the role of tPA in the progression of pancreatic tumors, we mated Ela1-TAg and Ela1-myc transgenic mice to tPA-deficient mice. The proportion of tumors displaying pure acinar differentiation or mixed acinar/ductal components was similar in both mouse strains, indicating that tPA is not required for in acinar-ductal transdifferentiation. However, it was observed an increased survival in hybrid mice Ela1-myc:tPA-/- supporting a critical role for tPA in the progression of pancreatic ductal tumors. To get insight into the mechanism by wich tPA participates in this process we have analyzed factors related to tumor progression: tumors arising in a tPA-/- genetic background show a lesser vessel density and proliferation rate than those arising in wild type mice. These results indicate that tPA could play a role in angiogenesis stimulation and cell proliferation and suggest that the increase in survival observed in Ela1-myc tPA-/- mice could be a consequence of the inhibition of tumor angiogenesis and cell proliferation. In addition, we have analyzed the differential gene expression between Ela1-myc and Ela1-myc tPA-/- mice by microarrays. This analysis has led to the identification of related genes with tumor progression and invasion that can be a target for the action of tPA, although more work is necessary to determined their role. Finally, we have studied the direct effects of the expression of tPA in the pancreas, by the generation of two transgenic mice which tPA expression is targeted to acinar cells, using the Elastase-1 enhancer/promoter (Ela1-tPA), or to ductal cells using the Citokeratin 19 promoter (CK19-tPA). The results in Ela1-tPA mice show that overexpression of tPA in acinar cells does not affect normal mouse development. The effects on the pancreas analysed are currently being analyzed in greater detail. Altogether, the data described here support the relevant role of tPA in pancreas cancer progression and indicate that mouse models of pancreatic cancer may be useful for the preclinical evaluation of drugs targeting the tPA system.