Abstract
Retinoic acid (RAR) and retinoid × receptors (RXR) are essential in the transcriptional actions of retinoids. To date, RAR and RXR have not been examined in precancerous lesions and/or ductal carcinoma in situ (DCIS) in human breast. Therefore, we examined RAR and RXR subtypes in DCIS (58 cases), atypical ductal hyperplasia (ADH) (32 cases), and proliferative disease without atypia (PDWA) (32 cases) to study the status of these RARs and RXRs. Immunoreactivities for RAR α, RXR α, RXR β, and RXR γ were all detected in the nuclei of normal ductal epithelia. Immunoreactivity for RAR β was detected exclusively in the nuclei of myoepithelial cells, but not in normal ductal epithelia. Immunoreactivity for RAR γ was not detected in any of the breast tissues examined except for a few cases of PDWA and ADH, and 11 cases of DCIS. The RXR α labeling index (LI) was significantly higher in both DCIS (mean 77.9) and ADH (mean 77.7) than in PDWA (mean 62.8) (P<0.001). RXR β LI was significantly lower in DCIS (mean 81.5) than in both ADH (mean 91.1) and PDWA (mean 91.9) (P=0.0001). Immunoreactivity for RAR α, RXR α, RXR β and RXR γ was widely distributed compared to that of RAR β and RAR γ in DCIS, ADH and PDWA. RAR α LI was significantly correlated with Ki67 LI in DCIS (P=0.0040), especially in estrogen receptor (ER)‐positive DCIS. Our results suggest that RXRs are much more widely distributed than RARs in intraductal proliferative lesions of the human breast, but ER‐positive DCIS cases with high cell proliferative activity are associated with RAR α, suggesting the possible involvement of retinoids through RAR α in tumor cell proliferation in DCIS.
Keywords: RAR, RXR, DCIS, Human breast, Proliferative disease
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REFERENCES
- 1. ) Peto , R. , Doll , R. , Buckley , J. D. and Sporn , M. B.Can dietary beta‐carotene materially reduce human cancer rates ? Nature , 290 , 201 – 208 ( 1981. ). [DOI] [PubMed] [Google Scholar]
- 2. ) De Luca , L. M.Retinoids and their receptors in differentiation, embryogenesis, and neoplasia . FASEB J. , 5 , 2924 – 2933 ( 1991. ). [PubMed] [Google Scholar]
- 3. ) Hong , W. K. , Lippman , S. M. , Hittelman , W. N. and Lotan , R.Retinoid chemoprevention of aerodigestive cancer: from basic research to the clinic . Clin. Cancer Res. , 1 , 677 – 686 ( 1995. ). [PubMed] [Google Scholar]
- 4. ) Lee , P.‐P. H. , Lee , M.‐T. , Darcy , K. M. , Shudo , K. and Ip , M. M.Modulation of normal mammary epithelial cell proliferation, morphogenesis, and functional differentiation by retinoids: a comparison of the retinobenzoic acid derivative RE80 with retinoic acid . Endocrinology , 136 , 1707 – 1717 ( 1995. ). [DOI] [PubMed] [Google Scholar]
- 5. ) Seewaldt , V. L. , Caldwell , L. E. , Johnson , B. S. , Swisshelm , K. , Collins , S. J. and Tsai , S.Inhibition of retinoic acid receptor function in normal human mammary epithelial cells results in increased cellular proliferation and inhibits the formation of a polarized epithelium in vitro . Exp. Cell Res. , 236 , 16 – 28 ( 1997. ). [DOI] [PubMed] [Google Scholar]
- 6. ) Toma , S. , Isnardi , L. , Riccardi , L. and Bollag , W.Induction of apoptosis in MCF‐7 breast carcinoma cell line by RAR and RXR selective retinoids . Anticancer Res. , 18 , 935 – 942 ( 1998. ). [PubMed] [Google Scholar]
- 7. ) Weber , E. , Ravi , R. K. , Knudsen , E. S. , Williams , J. R. , Dillehay , L. E. , Nelkin , B. D. , Kalemkerian , G. P. , Feramisco , J. R. and Mabry , M.Retinoic acid‐mediated growth inhibition of small cell lung cancer cells is associated with reduced myc and increased p27Kip1 expression . Int. J. Cancer , 80 , 935 – 943 ( 1999. ). [DOI] [PubMed] [Google Scholar]
- 8. ) Huang , M.‐E. , Ye , Y.‐C. , Chen , S.‐R. , Chai , J.‐R. , Lu , J.‐X. , Zhoa , L. , Gu , L.‐J. and Wang , Z.‐Y.Use of all‐trans retinoic acid in the treatment of acute promyelocytic leukemia . Blood , 724 , 567 – 572 ( 1988. ). [PubMed] [Google Scholar]
- 9. ) Kogan , S. C. and Bishop , J. M.Acute promyelocytic leukemia: from treatment to genetics and back . Oncogene , 18 , 5261 – 5267 ( 1999. ). [DOI] [PubMed] [Google Scholar]
- 10. ) Petkovich , M. , Brand , N. J. , Krust , A. and Chambon , P.A human retinoic acid receptor which belongs to the family of nuclear receptors . Nature , 330 , 444 – 450 ( 1987. ). [DOI] [PubMed] [Google Scholar]
- 11. ) Giguere , V. , Ong , E. S. , Segui , P. and Evans , R. M.Identification of a receptor for the morphogen retinoic acid . Nature , 330624 – 629 ( 1987. ). [DOI] [PubMed] [Google Scholar]
- 12. ) de Thé , H. , Marchio , A. , Tiollais , P. and Dejean , A.A novel steroid thyroid hormone receptor‐related gene inappropriately expressed in human hepatocellular carcinoma . Nature , 330 , 667 – 670 ( 1987. ). [DOI] [PubMed] [Google Scholar]
- 13. ) Brand , N. , Petkovich , M. , Krust , A. , Chambon , P. , de Thé , H. , Marchio , A. , Tiollais , P. and Dejean , A.Identification of a second human retinoic acid receptor . Nature , 332 , 850 – 853 ( 1988. ). [DOI] [PubMed] [Google Scholar]
- 14. ) Krust , A. , Kastner , P. , Petkovich , K. M. , Zelent , A. and Chambon , P.A third human retinoic acid receptor, hRAR‐γ . Proc. Natl. Acad. Sci. USA , 86 , 5310 – 5314 ( 1989. ). [DOI] [PMC free article] [PubMed] [Google Scholar]
- 15. ) Hamada , K. , Gleason , S. L. , Levi , B.‐Z. , Hirschfeld , S. , Appella , E. and Ozato , K.H‐2R II BP, a member of the nuclear hormone receptor superfamily that binds to both the regulatory element of major histocompatibility class I genes and the estrogen response element . Proc. Natl. Acad. Sci. USA , 86 , 8289 – 8293 ( 1989. ). [DOI] [PMC free article] [PubMed] [Google Scholar]
- 16. ) Mangelsdorf , D. J. , Ong , E. S. , Dyck , J. A. and Evans , R. M.Nuclear receptor that identifies a novel retinoic acid response pathway . Nature , 345 , 224 – 229 ( 1990. ). [DOI] [PubMed] [Google Scholar]
- 17. ) Mangelsdorf , D. J. , Borgmeyer , U. , Heyman , R. A. , Zhou , J. Y. , Ong , E. S. and Oro , A. E.Characterization of three RXR genes that mediate the action of 9‐cis‐retinoic acid . Genes Dev. , 6 , 329 – 344 ( 1992. ). [DOI] [PubMed] [Google Scholar]
- 18. ) Leid , M. , Kastner , P. and Chambon , P.Multiplicity generates diversity in the retinoic acid signaling pathways . Trends Biochem. Sci. , 17 , 427 – 433 ( 1992. ). [DOI] [PubMed] [Google Scholar]
- 19. ) Chambon , P.A decade of molecular biology of retinoic acid receptors . FASEB J. , 10 , 940 – 954 ( 1996. ). [PubMed] [Google Scholar]
- 20. ) Marth , C. , Mayer , I. and Daxenbichler , G.Effect of retinoic acid and 4‐hydroxytamoxifen on human breast cancer cell lines . Biochem. Pharmacol. , 33 , 2217 – 2221 ( 1984. ). [DOI] [PubMed] [Google Scholar]
- 21. ) Fontana , J. A. , Miranda , D. and Mezu , A. B.Retinoic acid inhibition of human breast carcinoma proliferation is accompanied by inhibition of the synthesis of a Mr 39,000 protein . Cancer Res. , 50 , 1977 – 1982 ( 1990. ). [PubMed] [Google Scholar]
- 22. ) van der Burg , B. , van der Leede , B. M. , Kwakkenbos‐Isbrucker , L. , Salverda , S. , de Laat , S. W. and van der Saag , P. T.Retinoic acid resistance of estradiol‐independent breast cancer cell lines coincides with diminished expression of functional retinoic acid receptors . Mol. Cell. Endo-crinol. , 91 , 149 – 157 ( 1993. ). [DOI] [PubMed] [Google Scholar]
- 23. ) Anzano , M. A. , Byers , S. W. , Smith , J. M. , Peer , C. W. , Mullen , L. T. , Brown , C. C. , Roberts , A. B. and Sporn , M. B.Prevention of breast cancer in the rat with 9‐cis‐retinoic acid as a single agent and in combination with tamoxifen . Cancer Res. , 54 , 4614 – 4617 ( 1994. ). [PubMed] [Google Scholar]
- 24. ) van der Leede , B. M. , Geertzema , J. , Vroom , T. M. , Dècimo , D. , Lutz , Y. , van der Saag , P. T. and van der Burg , B.Immunohistochemical analysis of retinoic acid receptor‐ α in human breast tumors: retinoic acid receptor‐ α expression correlates with proliferative activity . Am. J. Pathol. , 148 , 1905 – 1914 ( 1996. ). [PMC free article] [PubMed] [Google Scholar]
- 25. ) Xu , X.‐C. , Sneige , N. , Liu , X. , Nandagiri , R. , Lee , J. J. , Lukmanji , F. , Hortobagyi , G. , Lippman , S. M. , Dhingra , K. and Lotan , R.Progressive decrease in nuclear retinoic acid receptor β messenger RNA level during breast carcinogenesis . Cancer Res. , 57 , 4992 – 4996 ( 1997. ). [PubMed] [Google Scholar]
- 26. ) Pastorino , U. , Infante , M. , Maioli , M. , Chiesa , G. , Buyse , M. , Firket , P. , Rosmentz , N. , Clerici , M. , Soresi , E. , Valente , M. , Belloni , P. A. and Ravasi , G.Adjuvant treatment of stage I lung cancer with high‐dose vitamin A . J. Clin. Oncol. , 11 , 1216 – 1222 ( 1993. ). [DOI] [PubMed] [Google Scholar]
- 27. ) Sun , S.‐Y. , Kurie , J. M. , Yue , P. , Dawson , M. I. , Shroot , B. , Chandraratna , R. A. S. , Hong , W. K. and Lotan , R.Differential responses of normal, premalignant, and malignant human bronchial epithelial cells to receptor‐selective retinoids . Clin. Cancer Res. , 5 , 431 – 437 ( 1999. ). [PubMed] [Google Scholar]
- 28. ) Lawrence , J. A. , Merino , M. J. , Simpson , J. F. , Manrow , R. E. , Page , D. L. and Steeg , P. S.A high‐risk lesion for invasive breast cancer, ductal carcinoma in situ, exhibits frequent overexpression of retinoid × receptor . Cancer Epidemiol. Biomarkers Prev. , 7 , 29 – 35 ( 1998. ). [PubMed] [Google Scholar]
- 29. ) Roman , S. D. , Ormandy , C. J. , Manning , D. L. , Blamey , R. W. , Nicholson , R. I. , Sutherland , R. L. and Clarke , C. L.Estradiol induction of retinoic acid receptors in human breast cancer cells . Cancer Res. , 53 , 5940 – 5945 ( 1993. ). [PubMed] [Google Scholar]
- 30. ) Rosenauer , A. , Nervi , C. , Davison , K. , Lamph , W. W. , Mader , S. and Miller , W. H. , Jr.Estrogen receptor expression activates the transcriptional and growth‐inhibitory response to retinoids without enhanced retinoic acid receptor α expression . Cancer Res. , 58 , 5110 – 5116 ( 1998. ). [PubMed] [Google Scholar]
- 31. ) Zhu , W.‐Y. , Jones , C. S. , Amin , S. , Matsukuma , K. , Haque , M. , Vuligonda , V. , Chandraratna , R. A. S. and De Luca , L. M.Retinoic acid increases tyrosine phosphorylation of focal adhesion kinase and paxillin in MCF‐7 human breast cancer cells . Cancer Res. , 59 , 85 – 90 ( 1999. ). [PubMed] [Google Scholar]
- 32. ) Hanna , W. M. , Kahn , H. J. and Chapman , J.‐A. W.The correlation of Ki67 growth factor and ERICA in breast cancer . Mod. Pathol. , 5 , 220 – 223 ( 1992. ). [PubMed] [Google Scholar]
- 33. ) Leal , C. B. , Schmitt , F. C. , Bento , M. J. , Maia , N. C. and Lopes , C. S.Ductal carcinoma in situ of the breast: histologic categorization and its relationship to ploidy and immunohistochemical expression of hormone receptors, p53, and c‐erbB‐2 protein . Cancer , 75 , 2123 – 2131 ( 1995. ). [DOI] [PubMed] [Google Scholar]
- 34. ) Moreno , A. , Lloveras , B. , Figueras , A. , Escobedo , A. , Ramon , J. M. , Sierra , A. and Febra , A.Ductal carcinoma in situ of the breast: correlation between histologic classification and biologic markers . Mod. Pathol. , 10 , 1088 – 1092 ( 1997. ). [PubMed] [Google Scholar]
- 35. ) Dupont , W. D. and Page , D. L.Risk factors for breast cancer in women with proliferative breast disease . N. Engl. J. Med. , 312 , 146 – 151 ( 1985. ). [DOI] [PubMed] [Google Scholar]
- 36. ) Ottesen , G. L. , Graverson , H. P. , Blichert‐Toft , M. , Zedeler , K. and Andersen , J. A.Ductal carcinoma in situ of the female breast: short‐term results of a prospective nationwide study . Am. J. Surg. Pathol. , 16 , 1183 – 1196 ( 1992. ). [DOI] [PubMed] [Google Scholar]
- 37. ) The Consensus Conference Committee . Consensus conference on the classification of ductal carcinoma in situ . Cancer , 80 , 1798 – 1802 ( 1997. ). [DOI] [PubMed] [Google Scholar]
- 38. ) Sugawara , A. , Yen , P. M. , Qi , Y. , Lehcan , R. M. and Chin , W. W.Isoform‐specific retinoid‐X receptor (RXR) antibodies detect differential expression of RXR proteins in the pituitary gland . Endocrinology , 136 , 1766 – 1774 ( 1995. ). [DOI] [PubMed] [Google Scholar]
- 39. ) Poller , D. N. , Roberts , E. C. , Bell , J. A. , Elston , C. W. , Blamey , R. W. and Ellis , I. O.p53 protein expression in mammary ductal carcinoma in situ: relationship to immunohistochemical expression of estrogen receptor and c‐erbB‐2 protein . Hum. Pathol. , 24 , 463 – 468 ( 1993. ). [DOI] [PubMed] [Google Scholar]
- 40. ) Sun , S.‐Y. , Yue , P. , Mao , L. , Dawson , M. I. , Scroot , B. , Lamph , W. W. , Heyman , R. A. , Chandraratna , R. A. S. , Shudo , K. , Hong , W. K. and Lotan , R.Identification of receptor‐selective retinoids that are potent inhibitors of the growth of human head and neck squamous cell carcinoma cells . Clin. Cancer Res. , 6 , 1563 – 1573 ( 2000. ). [PubMed] [Google Scholar]
- 41. ) Keller , H. , Givel , F. , Perroud , M. and Wahli , W.Signaling cross‐talk between peroxisome proliferator‐activated receptor/retinoid × receptor and estrogen receptor through estrogen response elements . Mol. Endocrinol. , 9 , 794 – 804 ( 1995. ). [DOI] [PubMed] [Google Scholar]
- 42. ) Tsibris , J. C. , Porter , K. B. , Jazayeri , A. , Tzimas , G. , Nau , H. , Huang , H. , Kuparadze , K. , Porter , G. W. , O'Brien , W. F. and Spellacy , W. N.Human uterine leiomyomata express higher levels of peroxisome proliferator‐activated receptor γ, retinoid × receptor α, and all‐trans retinoic acid than myometrium . Cancer Res. , 59 , 5737 – 5744 ( 1999. ). [PubMed] [Google Scholar]