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Expression of the zinc-finger transcription factor Snail in adrenocortical carcinoma is associated with decreased survival.

Waldmann J, Feldmann G, Slater EP, Langer P, Buchholz M, Ramaswamy A, Saeger W, Rothmund M, Fendrich V - Br. J. Cancer (2008)

Bottom Line: Survival rates were significantly decreased in Snail-positive tumours compared to Snail-negative tumours: 10 out of 16 vs one out of eight patients succumbed to disease after a median follow up of 14.5 and 28.5 months, respectively (P=0.03).In conclusion, we describe for the first time that Snail is expressed in a large subset of ACCs.Furthermore, Snail expression is associated with decreased survival, advanced disease and higher risk of developing distant metastases.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Philipps-Universit├Ąt Marburg, Marburg, Germany.

ABSTRACT
In this study, we evaluate whether Snail is expressed in adrenocortical cancer (ACC) and if its expression is related to patient outcome. One of the best known functions of the zinc-finger transcription factor Snail is to induce epithelial-to-mesenchymal transition (EMT). Increasing evidence suggests that EMT plays a pivotal role in tumour progression and metastatic spread. Snail and E-cadherin expression were assessed by immunohistochemistry in 26 resected ACCs and real-time quantitative RT-PCR expression analysis was performed. Data were correlated with clinical outcome and in particular with overall patient survival. Seventeen of 26 (65%) ACC tumour samples expressed Snail when assessed by immunohistochemistry. Snail expression was neither detected in normal adrenocortical tissue, nor in benign adrenocortical adenomas. Expression levels were confirmed on the mRNA level by Real-Time-PCR. Survival rates were significantly decreased in Snail-positive tumours compared to Snail-negative tumours: 10 out of 16 vs one out of eight patients succumbed to disease after a median follow up of 14.5 and 28.5 months, respectively (P=0.03). Patients with Snail-expressing ACCs presented in advanced disease (11 out of 12 vs 6 out of 14, P=0.01) and tend to develop distant metastases more frequently than patients with negative staining (7 out of 11 vs two out of eight, P=0.19). In conclusion, we describe for the first time that Snail is expressed in a large subset of ACCs. Furthermore, Snail expression is associated with decreased survival, advanced disease and higher risk of developing distant metastases.

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IHC for Snail and E-cadherin in an adrenocortical adenoma and Snail expression in normal adrenal cortex. (A) Adrenal cortical adenoma showed no Snail expression. Arrow indicates the border between normal adrenal cortex and adenoma (*). (B) Nor normal adrenocortical tissue neither adenoma showed any E-cadherin expression in this consecutive section. (C) Normal adrenocortical tissue was predominantly negative for Snail, but some single Snail-positive cells within the zona glomerulosa closed to the capsule and some Snail-positive mesenchymal cells (not shown) could be detected.
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fig3: IHC for Snail and E-cadherin in an adrenocortical adenoma and Snail expression in normal adrenal cortex. (A) Adrenal cortical adenoma showed no Snail expression. Arrow indicates the border between normal adrenal cortex and adenoma (*). (B) Nor normal adrenocortical tissue neither adenoma showed any E-cadherin expression in this consecutive section. (C) Normal adrenocortical tissue was predominantly negative for Snail, but some single Snail-positive cells within the zona glomerulosa closed to the capsule and some Snail-positive mesenchymal cells (not shown) could be detected.

Mentions: We analysed E-cadherin and Snail expression in 10 adrenocortical adenomas. Clinical data are shown in Table 2. None of these 10 functioning adenomas (five patients with Cushing and five patients with Conn syndrome) revealed Snail expression by IHC, and in only 3 out of 10 we detected E-cadherin expression (see Figure 3A and B).


Expression of the zinc-finger transcription factor Snail in adrenocortical carcinoma is associated with decreased survival.

Waldmann J, Feldmann G, Slater EP, Langer P, Buchholz M, Ramaswamy A, Saeger W, Rothmund M, Fendrich V - Br. J. Cancer (2008)

IHC for Snail and E-cadherin in an adrenocortical adenoma and Snail expression in normal adrenal cortex. (A) Adrenal cortical adenoma showed no Snail expression. Arrow indicates the border between normal adrenal cortex and adenoma (*). (B) Nor normal adrenocortical tissue neither adenoma showed any E-cadherin expression in this consecutive section. (C) Normal adrenocortical tissue was predominantly negative for Snail, but some single Snail-positive cells within the zona glomerulosa closed to the capsule and some Snail-positive mesenchymal cells (not shown) could be detected.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2600683&req=5

fig3: IHC for Snail and E-cadherin in an adrenocortical adenoma and Snail expression in normal adrenal cortex. (A) Adrenal cortical adenoma showed no Snail expression. Arrow indicates the border between normal adrenal cortex and adenoma (*). (B) Nor normal adrenocortical tissue neither adenoma showed any E-cadherin expression in this consecutive section. (C) Normal adrenocortical tissue was predominantly negative for Snail, but some single Snail-positive cells within the zona glomerulosa closed to the capsule and some Snail-positive mesenchymal cells (not shown) could be detected.
Mentions: We analysed E-cadherin and Snail expression in 10 adrenocortical adenomas. Clinical data are shown in Table 2. None of these 10 functioning adenomas (five patients with Cushing and five patients with Conn syndrome) revealed Snail expression by IHC, and in only 3 out of 10 we detected E-cadherin expression (see Figure 3A and B).

Bottom Line: Survival rates were significantly decreased in Snail-positive tumours compared to Snail-negative tumours: 10 out of 16 vs one out of eight patients succumbed to disease after a median follow up of 14.5 and 28.5 months, respectively (P=0.03).In conclusion, we describe for the first time that Snail is expressed in a large subset of ACCs.Furthermore, Snail expression is associated with decreased survival, advanced disease and higher risk of developing distant metastases.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Philipps-Universit├Ąt Marburg, Marburg, Germany.

ABSTRACT
In this study, we evaluate whether Snail is expressed in adrenocortical cancer (ACC) and if its expression is related to patient outcome. One of the best known functions of the zinc-finger transcription factor Snail is to induce epithelial-to-mesenchymal transition (EMT). Increasing evidence suggests that EMT plays a pivotal role in tumour progression and metastatic spread. Snail and E-cadherin expression were assessed by immunohistochemistry in 26 resected ACCs and real-time quantitative RT-PCR expression analysis was performed. Data were correlated with clinical outcome and in particular with overall patient survival. Seventeen of 26 (65%) ACC tumour samples expressed Snail when assessed by immunohistochemistry. Snail expression was neither detected in normal adrenocortical tissue, nor in benign adrenocortical adenomas. Expression levels were confirmed on the mRNA level by Real-Time-PCR. Survival rates were significantly decreased in Snail-positive tumours compared to Snail-negative tumours: 10 out of 16 vs one out of eight patients succumbed to disease after a median follow up of 14.5 and 28.5 months, respectively (P=0.03). Patients with Snail-expressing ACCs presented in advanced disease (11 out of 12 vs 6 out of 14, P=0.01) and tend to develop distant metastases more frequently than patients with negative staining (7 out of 11 vs two out of eight, P=0.19). In conclusion, we describe for the first time that Snail is expressed in a large subset of ACCs. Furthermore, Snail expression is associated with decreased survival, advanced disease and higher risk of developing distant metastases.

Show MeSH
Related in: MedlinePlus