The relevance of prelamin A and RAD51 as molecular biomarkers in cervical cancer
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Simona Leonardi1,*, Marianna Buttarelli2,*, Ilaria De Stefano3, Gabriella Ferrandina2, Marco Petrillo2, Gabriele Babini4, Giovanni Scambia2, Carmela Marino1, Mariateresa Mancuso1 and Daniela Gallo2
1Department of Sustainability, Agenzia Nazionale per le Nuove Tecnologie, l’Energia e lo Sviluppo Economico Sostenibile (ENEA), Rome, Italy
2Department of Obstetrics and Gynecology, Catholic University of the Sacred Heart, Rome, Italy
3Department of Radiation Physics, Guglielmo Marconi University, Rome, Italy
4Department of Physics, University of Pavia, Pavia, Italy
*These authors have contributed equally to this work
Mariateresa Mancuso, email: firstname.lastname@example.org
Daniela Gallo, email: daniela.gallo@ unicatt.it
Keywords: cervix; LACC; chemoradiotherapy; DNA repair; lamin A/C
Received: April 21, 2017 Accepted: September 18, 2017 Published: October 09, 2017
Along with their role in the maintenance of nuclear architecture, nuclear lamins also control genomic stability, DNA damage repair, transcription, cell proliferation, differentiation and senescence. Recent reports reveal that prelamin A–processing defects play a role in cancer development by impacting on transcription of key players in the maintenance of the genome stability, including RAD51. Here, we performed a ‘proof of concept’ study evaluating the role of prelamin A and RAD51 expression in clinical outcome of cervical cancer patients. We analyzed biomarker expression by immunohistochemistry in tumor material from locally advanced cervical cancer (LACC) patients (n=66) and correlated data with clinicopathological parameters and with response to neoadjuvant chemoradiation (CT/RT). In LACC patients who underwent neoadjuvant CT/RT the percentage of cases showing high prelamin A levels was greater in patients who completely responded to treatment (25 of 40, 62.5%) than in patients with macroscopic residual tumor (6 of 26, 26.1%, p=0.0024). Conversely, patients showing high RAD51 expression were less likely to respond to treatment (14 of 26, 53.8%) than were those with low protein levels (12 of 40, 30%, p=0.072). Only prelamin A retained an independent role in predicting response to treatment (p=0.003), while RAD51 approached statistical significance (p=0.07). Notably, high RAD51 expression highly significantly predicted poor outcome, emerging as an independent prognostic factor for disease free survival (p=0.038), while approaching statistical significance for overall survival (p=0.09). Our findings provide a framework for future prospective studies investigating molecular predictors of response to neoadjuvant chemoradiotherapy in LACC patients.
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