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MDM-2 Oncoprotein Overexpression, p53 Gene Mutation, and VEGF Up-Regulation in Angiosarcomas

Identifieur interne : 00BD15 ( Ncbi/Merge ); précédent : 00BD14; suivant : 00BD16

MDM-2 Oncoprotein Overexpression, p53 Gene Mutation, and VEGF Up-Regulation in Angiosarcomas

Auteurs : Christian Zietz ; Matthias Rössle ; Christian Haas ; Andrea Sendelhofert ; Astrid Hirschmann ; Michael Stürzl ; Udo Löhrs

Source :

RBID : PMC:1876718

Abstract

The endothelium is one of the largest cellular compartments of the human body and has a high proliferative potential. However, angiosarcomas are among the rarest malignancies. Despite this interesting contradiction, data on growth and angiogenesis control mechanisms of angiosarcomas are scarce. In this study of 19 angiosarcomas and 10 benign vascular control lesions we investigated the sequence and expression of the p53 tumor suppressor gene and the expression of the mdm-2 proto-oncogene, which is a negative regulator of p53 activity and of the vascular endothelial growth factor (VEGF), whose expression, among other factors, is regulated by the p53/MDM-2 pathway. Ten sarcomas (53%) exibited clear nuclear p53 protein accumulation. Two of these cases revealed mutations in the sequence-specific DNA binding domain of the p53 gene. Thirteen angiosarcomas (68%) showed an increased amount of MDM-2 protein. Elevated expression of p53 and MDM-2 protein correlated with increased VEGF expression, which was found in nearly 80% of the angiosarcoma cases. Negative or clearly lower immunostaining was obtained in cases from the benign control collective. Only one case of a juvenile hemangioma reached the cutoff value of p53 positivity coincidentally with high VEGF expression. Our data suggest that the p53/MDM-2 pathway is impaired in about two-thirds (14/19) of the angiosarcomas. This may be a key event in the pathogenesis of human angiosarcomas. The increased VEGF expression observed supports this hypothesis.


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PubMed: 9811333
PubMed Central: 1876718

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PMC:1876718

Le document en format XML

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<title xml:lang="en">MDM-2 Oncoprotein Overexpression,
<italic>p53</italic>
Gene Mutation, and VEGF Up-Regulation in Angiosarcomas</title>
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<name sortKey="Zietz, Christian" sort="Zietz, Christian" uniqKey="Zietz C" first="Christian" last="Zietz">Christian Zietz</name>
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<name sortKey="Haas, Christian" sort="Haas, Christian" uniqKey="Haas C" first="Christian" last="Haas">Christian Haas</name>
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<name sortKey="Sendelhofert, Andrea" sort="Sendelhofert, Andrea" uniqKey="Sendelhofert A" first="Andrea" last="Sendelhofert">Andrea Sendelhofert</name>
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<name sortKey="Hirschmann, Astrid" sort="Hirschmann, Astrid" uniqKey="Hirschmann A" first="Astrid" last="Hirschmann">Astrid Hirschmann</name>
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Gene Mutation, and VEGF Up-Regulation in Angiosarcomas</title>
<author>
<name sortKey="Zietz, Christian" sort="Zietz, Christian" uniqKey="Zietz C" first="Christian" last="Zietz">Christian Zietz</name>
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<name sortKey="Rossle, Matthias" sort="Rossle, Matthias" uniqKey="Rossle M" first="Matthias" last="Rössle">Matthias Rössle</name>
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<author>
<name sortKey="Haas, Christian" sort="Haas, Christian" uniqKey="Haas C" first="Christian" last="Haas">Christian Haas</name>
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<name sortKey="Sendelhofert, Andrea" sort="Sendelhofert, Andrea" uniqKey="Sendelhofert A" first="Andrea" last="Sendelhofert">Andrea Sendelhofert</name>
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<name sortKey="Hirschmann, Astrid" sort="Hirschmann, Astrid" uniqKey="Hirschmann A" first="Astrid" last="Hirschmann">Astrid Hirschmann</name>
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<name sortKey="Sturzl, Michael" sort="Sturzl, Michael" uniqKey="Sturzl M" first="Michael" last="Stürzl">Michael Stürzl</name>
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<name sortKey="Lohrs, Udo" sort="Lohrs, Udo" uniqKey="Lohrs U" first="Udo" last="Löhrs">Udo Löhrs</name>
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<series>
<title level="j">The American Journal of Pathology</title>
<idno type="ISSN">0002-9440</idno>
<idno type="eISSN">1525-2191</idno>
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<date when="1998">1998</date>
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<front>
<div type="abstract" xml:lang="en">
<p>The endothelium is one of the largest cellular compartments of the human body and has a high proliferative potential. However, angiosarcomas are among the rarest malignancies. Despite this interesting contradiction, data on growth and angiogenesis control mechanisms of angiosarcomas are scarce. In this study of 19 angiosarcomas and 10 benign vascular control lesions we investigated the sequence and expression of the
<italic>p53</italic>
tumor suppressor gene and the expression of the
<italic>mdm-2</italic>
proto-oncogene, which is a negative regulator of p53 activity and of the vascular endothelial growth factor (VEGF), whose expression, among other factors, is regulated by the p53/MDM-2 pathway. Ten sarcomas (53%) exibited clear nuclear p53 protein accumulation. Two of these cases revealed mutations in the sequence-specific DNA binding domain of the
<italic>p53</italic>
gene. Thirteen angiosarcomas (68%) showed an increased amount of MDM-2 protein. Elevated expression of p53 and MDM-2 protein correlated with increased VEGF expression, which was found in nearly 80% of the angiosarcoma cases. Negative or clearly lower immunostaining was obtained in cases from the benign control collective. Only one case of a juvenile hemangioma reached the cutoff value of p53 positivity coincidentally with high VEGF expression. Our data suggest that the p53/MDM-2 pathway is impaired in about two-thirds (14/19) of the angiosarcomas. This may be a key event in the pathogenesis of human angiosarcomas. The increased VEGF expression observed supports this hypothesis.</p>
</div>
</front>
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<pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
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<journal-meta>
<journal-id journal-id-type="nlm-ta">Am J Pathol</journal-id>
<journal-title>The American Journal of Pathology</journal-title>
<issn pub-type="ppub">0002-9440</issn>
<issn pub-type="epub">1525-2191</issn>
<publisher>
<publisher-name>American Society for Investigative Pathology</publisher-name>
</publisher>
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<article-meta>
<article-id pub-id-type="pmid">9811333</article-id>
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<article-id pub-id-type="publisher-id">1485</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Regular Articles</subject>
</subj-group>
</article-categories>
<title-group>
<article-title>MDM-2 Oncoprotein Overexpression,
<italic>p53</italic>
Gene Mutation, and VEGF Up-Regulation in Angiosarcomas</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname>Zietz</surname>
<given-names>Christian</given-names>
</name>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Rössle</surname>
<given-names>Matthias</given-names>
</name>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Haas</surname>
<given-names>Christian</given-names>
</name>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Sendelhofert</surname>
<given-names>Andrea</given-names>
</name>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Hirschmann</surname>
<given-names>Astrid</given-names>
</name>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Stürzl</surname>
<given-names>Michael</given-names>
</name>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Löhrs</surname>
<given-names>Udo</given-names>
</name>
</contrib>
</contrib-group>
<aff id="N0x1c2e6b0N0x1d01600">From the Department of Pathology,* Ludwig Maximilians University of Munich, 80337 München, and the Department of Virology,† Max Planck Institute for Biochemistry, 82152 Martinsried, Federal Republic of Germany</aff>
<pub-date pub-type="ppub">
<month>11</month>
<year>1998</year>
</pub-date>
<volume>153</volume>
<issue>5</issue>
<fpage>1425</fpage>
<lpage>1433</lpage>
<history>
<date date-type="accepted">
<day>6</day>
<month>8</month>
<year>1998</year>
</date>
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<permissions>
<copyright-statement>Copyright © 1998, American Society for Investigative Pathology</copyright-statement>
</permissions>
<abstract>
<p>The endothelium is one of the largest cellular compartments of the human body and has a high proliferative potential. However, angiosarcomas are among the rarest malignancies. Despite this interesting contradiction, data on growth and angiogenesis control mechanisms of angiosarcomas are scarce. In this study of 19 angiosarcomas and 10 benign vascular control lesions we investigated the sequence and expression of the
<italic>p53</italic>
tumor suppressor gene and the expression of the
<italic>mdm-2</italic>
proto-oncogene, which is a negative regulator of p53 activity and of the vascular endothelial growth factor (VEGF), whose expression, among other factors, is regulated by the p53/MDM-2 pathway. Ten sarcomas (53%) exibited clear nuclear p53 protein accumulation. Two of these cases revealed mutations in the sequence-specific DNA binding domain of the
<italic>p53</italic>
gene. Thirteen angiosarcomas (68%) showed an increased amount of MDM-2 protein. Elevated expression of p53 and MDM-2 protein correlated with increased VEGF expression, which was found in nearly 80% of the angiosarcoma cases. Negative or clearly lower immunostaining was obtained in cases from the benign control collective. Only one case of a juvenile hemangioma reached the cutoff value of p53 positivity coincidentally with high VEGF expression. Our data suggest that the p53/MDM-2 pathway is impaired in about two-thirds (14/19) of the angiosarcomas. This may be a key event in the pathogenesis of human angiosarcomas. The increased VEGF expression observed supports this hypothesis.</p>
</abstract>
</article-meta>
</front>
<floats-wrap>
<table-wrap position="float" id="t1">
<label>Table 1.</label>
<caption>
<p>Angiosarcoma Group: Patient Characteristics, Results of Immunohistochemical Staining, and
<italic>p53</italic>
Gene Sequence Analysis (Exons 5–9)</p>
</caption>
<table frame="hsides" rules="groups">
<thead>
<tr>
<th colspan="1" rowspan="1" align="left" valign="bottom">Case No.</th>
<th colspan="1" rowspan="1" align="center" valign="bottom">Age (Years)</th>
<th colspan="1" rowspan="1" align="center" valign="bottom">Sex</th>
<th colspan="1" rowspan="1" align="center" valign="bottom">Tumor Location</th>
<th colspan="1" rowspan="1" align="center" valign="bottom">Histol. Grad (Coindre)</th>
<th colspan="1" rowspan="1" align="center" valign="bottom">Immunohistochemistry Percentage of positive cells (PP
<sup>*</sup>
)/Staining intensity (SI
<sup></sup>
)</th>
<th colspan="1" rowspan="1" align="center" valign="bottom"></th>
<th colspan="1" rowspan="1" align="center" valign="bottom"></th>
</tr>
</thead>
<tbody>
<tr>
<td colspan="1" rowspan="1" align="left" valign="bottom"></td>
<td colspan="1" rowspan="1" align="center" valign="bottom"></td>
<td colspan="1" rowspan="1" align="center" valign="bottom"></td>
<td colspan="1" rowspan="1" align="center" valign="bottom"></td>
<td colspan="1" rowspan="1" align="center" valign="bottom"></td>
<td colspan="1" rowspan="1" align="center" valign="bottom">p53 (PP/SI)</td>
<td colspan="1" rowspan="1" align="center" valign="bottom">MDM-2 (PP/SI)</td>
<td colspan="1" rowspan="1" align="center" valign="bottom">VEGF (PP/SI)</td>
</tr>
<tr>
<td colspan="1" rowspan="1" align="char" char="." valign="top">1</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">58</td>
<td colspan="1" rowspan="1" align="center" valign="top">M</td>
<td colspan="1" rowspan="1" align="center" valign="top">head</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">3</td>
<td colspan="1" rowspan="1" align="center" valign="top">5/3 mutant
<sup></sup>
</td>
<td colspan="1" rowspan="1" align="center" valign="top">5/3</td>
<td colspan="1" rowspan="1" align="center" valign="top">5/3</td>
</tr>
<tr>
<td colspan="1" rowspan="1" align="char" char="." valign="top">2</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">68</td>
<td colspan="1" rowspan="1" align="center" valign="top">F</td>
<td colspan="1" rowspan="1" align="center" valign="top">upper arm</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">2</td>
<td colspan="1" rowspan="1" align="center" valign="top">3/2 wild-type</td>
<td colspan="1" rowspan="1" align="center" valign="top">3/3 C+
<sup></sup>
</td>
<td colspan="1" rowspan="1" align="center" valign="top">5/2</td>
</tr>
<tr>
<td colspan="1" rowspan="1" align="char" char="." valign="top">3</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">25</td>
<td colspan="1" rowspan="1" align="center" valign="top">F</td>
<td colspan="1" rowspan="1" align="center" valign="top">breast</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">3</td>
<td colspan="1" rowspan="1" align="center" valign="top">4/3 wild-type</td>
<td colspan="1" rowspan="1" align="center" valign="top">5/3</td>
<td colspan="1" rowspan="1" align="center" valign="top">5/2</td>
</tr>
<tr>
<td colspan="1" rowspan="1" align="char" char="." valign="top">4</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">54</td>
<td colspan="1" rowspan="1" align="center" valign="top">F</td>
<td colspan="1" rowspan="1" align="center" valign="top">breast</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">3</td>
<td colspan="1" rowspan="1" align="center" valign="top">1/2 wild-type</td>
<td colspan="1" rowspan="1" align="center" valign="top">1/1</td>
<td colspan="1" rowspan="1" align="center" valign="top">2/1</td>
</tr>
<tr>
<td colspan="1" rowspan="1" align="char" char="." valign="top">5</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">70</td>
<td colspan="1" rowspan="1" align="center" valign="top">M</td>
<td colspan="1" rowspan="1" align="center" valign="top">lower leg</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">2</td>
<td colspan="1" rowspan="1" align="center" valign="top">2/3 wild-type</td>
<td colspan="1" rowspan="1" align="center" valign="top">2/3 C+</td>
<td colspan="1" rowspan="1" align="center" valign="top">5/2</td>
</tr>
<tr>
<td colspan="1" rowspan="1" align="char" char="." valign="top">6</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">37</td>
<td colspan="1" rowspan="1" align="center" valign="top">F</td>
<td colspan="1" rowspan="1" align="center" valign="top">(U/L) leg</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">3</td>
<td colspan="1" rowspan="1" align="center" valign="top">2/2 wild-type</td>
<td colspan="1" rowspan="1" align="center" valign="top">2/1</td>
<td colspan="1" rowspan="1" align="center" valign="top">5/2</td>
</tr>
<tr>
<td colspan="1" rowspan="1" align="char" char="." valign="top">7</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">88</td>
<td colspan="1" rowspan="1" align="center" valign="top">F</td>
<td colspan="1" rowspan="1" align="center" valign="top">breast</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">3</td>
<td colspan="1" rowspan="1" align="center" valign="top">1/2 wild-type</td>
<td colspan="1" rowspan="1" align="center" valign="top">2/2 C+</td>
<td colspan="1" rowspan="1" align="center" valign="top">5/3</td>
</tr>
<tr>
<td colspan="1" rowspan="1" align="char" char="." valign="top">8</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">31</td>
<td colspan="1" rowspan="1" align="center" valign="top">F</td>
<td colspan="1" rowspan="1" align="center" valign="top">breast</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">3</td>
<td colspan="1" rowspan="1" align="center" valign="top">5/3 mutant
<sup>§</sup>
</td>
<td colspan="1" rowspan="1" align="center" valign="top">3/2</td>
<td colspan="1" rowspan="1" align="center" valign="top">5/3</td>
</tr>
<tr>
<td colspan="1" rowspan="1" align="char" char="." valign="top">9</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">44</td>
<td colspan="1" rowspan="1" align="center" valign="top">M</td>
<td colspan="1" rowspan="1" align="center" valign="top">heart/aorta</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">3</td>
<td colspan="1" rowspan="1" align="center" valign="top">4/2 wild-type</td>
<td colspan="1" rowspan="1" align="center" valign="top">4/2</td>
<td colspan="1" rowspan="1" align="center" valign="top">5/3</td>
</tr>
<tr>
<td colspan="1" rowspan="1" align="char" char="." valign="top">10</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">41</td>
<td colspan="1" rowspan="1" align="center" valign="top">M</td>
<td colspan="1" rowspan="1" align="center" valign="top">upper leg</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">3</td>
<td colspan="1" rowspan="1" align="center" valign="top">5/3 wild-type</td>
<td colspan="1" rowspan="1" align="center" valign="top">5/3</td>
<td colspan="1" rowspan="1" align="center" valign="top">5/3</td>
</tr>
<tr>
<td colspan="1" rowspan="1" align="char" char="." valign="top">11</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">42</td>
<td colspan="1" rowspan="1" align="center" valign="top">F</td>
<td colspan="1" rowspan="1" align="center" valign="top">thyroid</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">2</td>
<td colspan="1" rowspan="1" align="center" valign="top">2/2 wild-type</td>
<td colspan="1" rowspan="1" align="center" valign="top">3/3 C+</td>
<td colspan="1" rowspan="1" align="center" valign="top">5/2</td>
</tr>
<tr>
<td colspan="1" rowspan="1" align="char" char="." valign="top">12</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">60</td>
<td colspan="1" rowspan="1" align="center" valign="top">M</td>
<td colspan="1" rowspan="1" align="center" valign="top">thyroid</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">3</td>
<td colspan="1" rowspan="1" align="center" valign="top">2/3 wild-type</td>
<td colspan="1" rowspan="1" align="center" valign="top">3/3</td>
<td colspan="1" rowspan="1" align="center" valign="top">5/2</td>
</tr>
<tr>
<td colspan="1" rowspan="1" align="char" char="." valign="top">13</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">59</td>
<td colspan="1" rowspan="1" align="center" valign="top">F</td>
<td colspan="1" rowspan="1" align="center" valign="top">thyroid</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">3</td>
<td colspan="1" rowspan="1" align="center" valign="top">3/2 wild-type</td>
<td colspan="1" rowspan="1" align="center" valign="top">5/3</td>
<td colspan="1" rowspan="1" align="center" valign="top">4/2</td>
</tr>
<tr>
<td colspan="1" rowspan="1" align="char" char="." valign="top">14</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">67</td>
<td colspan="1" rowspan="1" align="center" valign="top">F</td>
<td colspan="1" rowspan="1" align="center" valign="top">lung</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">3</td>
<td colspan="1" rowspan="1" align="center" valign="top">1/2 wild-type</td>
<td colspan="1" rowspan="1" align="center" valign="top">4/2</td>
<td colspan="1" rowspan="1" align="center" valign="top">3/2</td>
</tr>
<tr>
<td colspan="1" rowspan="1" align="char" char="." valign="top">15</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">61</td>
<td colspan="1" rowspan="1" align="center" valign="top">F</td>
<td colspan="1" rowspan="1" align="center" valign="top">breast</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">2</td>
<td colspan="1" rowspan="1" align="center" valign="top">1/2 wild-type</td>
<td colspan="1" rowspan="1" align="center" valign="top">1/1</td>
<td colspan="1" rowspan="1" align="center" valign="top">0/0</td>
</tr>
<tr>
<td colspan="1" rowspan="1" align="char" char="." valign="top">16</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">29</td>
<td colspan="1" rowspan="1" align="center" valign="top">M</td>
<td colspan="1" rowspan="1" align="center" valign="top">sternum</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">2</td>
<td colspan="1" rowspan="1" align="center" valign="top">5/2 wild-type</td>
<td colspan="1" rowspan="1" align="center" valign="top">2/3 C+</td>
<td colspan="1" rowspan="1" align="center" valign="top">5/3</td>
</tr>
<tr>
<td colspan="1" rowspan="1" align="char" char="." valign="top">17</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">35</td>
<td colspan="1" rowspan="1" align="center" valign="top">M</td>
<td colspan="1" rowspan="1" align="center" valign="top">trunk</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">2</td>
<td colspan="1" rowspan="1" align="center" valign="top">3/3 wild-type</td>
<td colspan="1" rowspan="1" align="center" valign="top">4/3</td>
<td colspan="1" rowspan="1" align="center" valign="top">5/3</td>
</tr>
<tr>
<td colspan="1" rowspan="1" align="char" char="." valign="top">18</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">37</td>
<td colspan="1" rowspan="1" align="center" valign="top">M</td>
<td colspan="1" rowspan="1" align="center" valign="top">upper leg</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">3</td>
<td colspan="1" rowspan="1" align="center" valign="top">4/3 wild-type</td>
<td colspan="1" rowspan="1" align="center" valign="top">4/3</td>
<td colspan="1" rowspan="1" align="center" valign="top">5/3</td>
</tr>
<tr>
<td colspan="1" rowspan="1" align="char" char="." valign="top">19</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">33</td>
<td colspan="1" rowspan="1" align="center" valign="top">F</td>
<td colspan="1" rowspan="1" align="center" valign="top">breast</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">2</td>
<td colspan="1" rowspan="1" align="center" valign="top">2/1 wild-type</td>
<td colspan="1" rowspan="1" align="center" valign="top">5/3</td>
<td colspan="1" rowspan="1" align="center" valign="top">5/2</td>
</tr>
</tbody>
</table>
<table-wrap-foot>
<fn>
<p>*PP: 0 = negative; 1 = 1–20%; 2 = 21–40%; 3 = 41–60%; 4 = 61–80%; 5 = 81–100%.</p>
</fn>
<fn>
<p>
<sup></sup>
SI: 0 = negative, 1 = light, 2 = intermediate, 3 = intense staining.</p>
</fn>
<fn>
<p>
<sup></sup>
sequence data: exon 6, codon 197, nucleotide change: GTG → GGG, amino acid change Val → Gly.</p>
</fn>
<fn>
<p>
<sup>§</sup>
sequence data: exon 8, codon 274, nucleotide change: GTT → CTT, amino acid change Val → Leu.</p>
</fn>
<fn>
<p>
<sup></sup>
cytoplasmic staining.</p>
</fn>
</table-wrap-foot>
</table-wrap>
<table-wrap position="float" id="t2">
<label>Table 2.</label>
<caption>
<p>Control Group: Patient Characteristics and Results of Immunohistochemical Staining</p>
</caption>
<table frame="hsides" rules="groups">
<thead>
<tr>
<th colspan="1" rowspan="1" align="left" valign="bottom">Case No.</th>
<th colspan="1" rowspan="1" align="center" valign="bottom">Age</th>
<th colspan="1" rowspan="1" align="center" valign="bottom">Sex</th>
<th colspan="1" rowspan="1" align="center" valign="bottom">Diagnosis</th>
<th colspan="1" rowspan="1" align="center" valign="bottom">Tumor Location</th>
<th colspan="1" rowspan="1" align="center" valign="bottom">Immunohistochemistry Percentage of positive cells (PP
<sup>*</sup>
)/Staining intensity (SI
<sup></sup>
)</th>
<th colspan="1" rowspan="1" align="center" valign="bottom"></th>
<th colspan="1" rowspan="1" align="center" valign="bottom"></th>
</tr>
</thead>
<tbody>
<tr>
<td colspan="1" rowspan="1" align="left" valign="bottom"></td>
<td colspan="1" rowspan="1" align="center" valign="bottom"></td>
<td colspan="1" rowspan="1" align="center" valign="bottom"></td>
<td colspan="1" rowspan="1" align="center" valign="bottom"></td>
<td colspan="1" rowspan="1" align="center" valign="bottom"></td>
<td colspan="1" rowspan="1" align="center" valign="bottom">p53 (PP/SI)</td>
<td colspan="1" rowspan="1" align="center" valign="bottom">MDM-2 (PP/SI)</td>
<td colspan="1" rowspan="1" align="center" valign="bottom">VEGF (PP/SI)</td>
</tr>
<tr>
<td colspan="1" rowspan="1" align="left" valign="top">C1</td>
<td colspan="1" rowspan="1" align="left" valign="top">10 days</td>
<td colspan="1" rowspan="1" align="center" valign="top">M</td>
<td colspan="1" rowspan="1" align="center" valign="top">Cystic lymphangioma</td>
<td colspan="1" rowspan="1" align="center" valign="top">Head</td>
<td colspan="1" rowspan="1" align="center" valign="top">0/0</td>
<td colspan="1" rowspan="1" align="center" valign="top">1/1</td>
<td colspan="1" rowspan="1" align="center" valign="top">2/1</td>
</tr>
<tr>
<td colspan="1" rowspan="1" align="left" valign="top">C2</td>
<td colspan="1" rowspan="1" align="left" valign="top">57 years</td>
<td colspan="1" rowspan="1" align="center" valign="top">F</td>
<td colspan="1" rowspan="1" align="center" valign="top">Granulation tissue</td>
<td colspan="1" rowspan="1" align="center" valign="top">Oropharynx</td>
<td colspan="1" rowspan="1" align="center" valign="top">1/1</td>
<td colspan="1" rowspan="1" align="center" valign="top">2/1</td>
<td colspan="1" rowspan="1" align="center" valign="top">2/2</td>
</tr>
<tr>
<td colspan="1" rowspan="1" align="left" valign="top">C3</td>
<td colspan="1" rowspan="1" align="left" valign="top">31 years</td>
<td colspan="1" rowspan="1" align="center" valign="top">F</td>
<td colspan="1" rowspan="1" align="center" valign="top">Granulation tissue</td>
<td colspan="1" rowspan="1" align="center" valign="top">Oropharynx</td>
<td colspan="1" rowspan="1" align="center" valign="top">2/2</td>
<td colspan="1" rowspan="1" align="center" valign="top">1/1</td>
<td colspan="1" rowspan="1" align="center" valign="top">2/2</td>
</tr>
<tr>
<td colspan="1" rowspan="1" align="left" valign="top">C4</td>
<td colspan="1" rowspan="1" align="left" valign="top">69 years</td>
<td colspan="1" rowspan="1" align="center" valign="top">F</td>
<td colspan="1" rowspan="1" align="center" valign="top">Granulation tissue</td>
<td colspan="1" rowspan="1" align="center" valign="top">Trunk</td>
<td colspan="1" rowspan="1" align="center" valign="top">1/1</td>
<td colspan="1" rowspan="1" align="center" valign="top">2/2</td>
<td colspan="1" rowspan="1" align="center" valign="top">2/1</td>
</tr>
<tr>
<td colspan="1" rowspan="1" align="left" valign="top">C5</td>
<td colspan="1" rowspan="1" align="left" valign="top">38 years</td>
<td colspan="1" rowspan="1" align="center" valign="top">M</td>
<td colspan="1" rowspan="1" align="center" valign="top">Hemangioma</td>
<td colspan="1" rowspan="1" align="center" valign="top">Upper leg</td>
<td colspan="1" rowspan="1" align="center" valign="top">1/2</td>
<td colspan="1" rowspan="1" align="center" valign="top">3/1</td>
<td colspan="1" rowspan="1" align="center" valign="top">3/1</td>
</tr>
<tr>
<td colspan="1" rowspan="1" align="left" valign="top">C6</td>
<td colspan="1" rowspan="1" align="left" valign="top">6 months</td>
<td colspan="1" rowspan="1" align="center" valign="top">M</td>
<td colspan="1" rowspan="1" align="center" valign="top">Juvenile hemangioma</td>
<td colspan="1" rowspan="1" align="center" valign="top">Head</td>
<td colspan="1" rowspan="1" align="center" valign="top">3/2</td>
<td colspan="1" rowspan="1" align="center" valign="top">2/1</td>
<td colspan="1" rowspan="1" align="center" valign="top">5/3</td>
</tr>
<tr>
<td colspan="1" rowspan="1" align="left" valign="top">C7</td>
<td colspan="1" rowspan="1" align="left" valign="top">15 years</td>
<td colspan="1" rowspan="1" align="center" valign="top">F</td>
<td colspan="1" rowspan="1" align="center" valign="top">Angiofibroma</td>
<td colspan="1" rowspan="1" align="center" valign="top">Nasopharynx</td>
<td colspan="1" rowspan="1" align="center" valign="top">1/1</td>
<td colspan="1" rowspan="1" align="center" valign="top">2/1</td>
<td colspan="1" rowspan="1" align="center" valign="top">3/1</td>
</tr>
<tr>
<td colspan="1" rowspan="1" align="left" valign="top">C8</td>
<td colspan="1" rowspan="1" align="left" valign="top">20 years</td>
<td colspan="1" rowspan="1" align="center" valign="top">M</td>
<td colspan="1" rowspan="1" align="center" valign="top">Skin</td>
<td colspan="1" rowspan="1" align="center" valign="top">Lower leg</td>
<td colspan="1" rowspan="1" align="center" valign="top">0/0</td>
<td colspan="1" rowspan="1" align="center" valign="top">0/0</td>
<td colspan="1" rowspan="1" align="center" valign="top">1/1</td>
</tr>
<tr>
<td colspan="1" rowspan="1" align="left" valign="top">C9</td>
<td colspan="1" rowspan="1" align="left" valign="top">50 years</td>
<td colspan="1" rowspan="1" align="center" valign="top">M</td>
<td colspan="1" rowspan="1" align="center" valign="top">Skin</td>
<td colspan="1" rowspan="1" align="center" valign="top">Upper leg</td>
<td colspan="1" rowspan="1" align="center" valign="top">0/0</td>
<td colspan="1" rowspan="1" align="center" valign="top">1/1</td>
<td colspan="1" rowspan="1" align="center" valign="top">2/1</td>
</tr>
<tr>
<td colspan="1" rowspan="1" align="left" valign="top">C10</td>
<td colspan="1" rowspan="1" align="left" valign="top">28 years</td>
<td colspan="1" rowspan="1" align="center" valign="top">F</td>
<td colspan="1" rowspan="1" align="center" valign="top">Skin</td>
<td colspan="1" rowspan="1" align="center" valign="top">Arm</td>
<td colspan="1" rowspan="1" align="center" valign="top">0/0</td>
<td colspan="1" rowspan="1" align="center" valign="top">0/0</td>
<td colspan="1" rowspan="1" align="center" valign="top">1/1</td>
</tr>
</tbody>
</table>
<table-wrap-foot>
<fn>
<p>*PP: 0 = negative; 1 = 1–20%; 2 = 21–40%; 3 = 41–60%; 4 = 61–80%; 5 = 81–100%.</p>
</fn>
<fn>
<p>
<sup></sup>
SI: 0 = negative, 1 = light, 2 = intermediate, 3 = intense staining.</p>
</fn>
</table-wrap-foot>
</table-wrap>
<table-wrap position="float" id="t3">
<label>Table 3.</label>
<caption>
<p>Primers for PCR Amplification of the
<italic>p53</italic>
Gene (Exons 5–9)</p>
</caption>
<table frame="hsides" rules="groups">
<thead>
<tr>
<th colspan="1" rowspan="1" align="left" valign="bottom">Exon</th>
<th colspan="1" rowspan="1" align="center" valign="bottom">Primer</th>
<th colspan="1" rowspan="1" align="center" valign="bottom">Oligonucleotide sequences</th>
<th colspan="1" rowspan="1" align="center" valign="bottom">Product size (basepairs)</th>
</tr>
</thead>
<tbody>
<tr>
<td colspan="1" rowspan="1" align="left" valign="top">5</td>
<td colspan="1" rowspan="1" align="left" valign="top">sense</td>
<td colspan="1" rowspan="1" align="left" valign="top">5′-CTGACTTTCAACTCTG-3′</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">253</td>
</tr>
<tr>
<td colspan="1" rowspan="1" align="left" valign="top"></td>
<td colspan="1" rowspan="1" align="left" valign="top">antisense</td>
<td colspan="1" rowspan="1" align="left" valign="top">5′-AGCCCTGTCGTCTCT-3′</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top"></td>
</tr>
<tr>
<td colspan="1" rowspan="1" align="left" valign="top">6</td>
<td colspan="1" rowspan="1" align="left" valign="top">sense</td>
<td colspan="1" rowspan="1" align="left" valign="top">5′-CTCTGATTCCTCACTG-3′</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">166</td>
</tr>
<tr>
<td colspan="1" rowspan="1" align="left" valign="top"></td>
<td colspan="1" rowspan="1" align="left" valign="top">antisense</td>
<td colspan="1" rowspan="1" align="left" valign="top">5′-CCAGAGACCCCAGTTGCAAACC-3′</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top"></td>
</tr>
<tr>
<td colspan="1" rowspan="1" align="left" valign="top">7</td>
<td colspan="1" rowspan="1" align="left" valign="top">sense</td>
<td colspan="1" rowspan="1" align="left" valign="top">5′-TGCTTGCCACAGGTCT-3′</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">210</td>
</tr>
<tr>
<td colspan="1" rowspan="1" align="left" valign="top"></td>
<td colspan="1" rowspan="1" align="left" valign="top">antisense</td>
<td colspan="1" rowspan="1" align="left" valign="top">5′-ACAGCAGGCCAGTGT-3′</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top"></td>
</tr>
<tr>
<td colspan="1" rowspan="1" align="left" valign="top">8</td>
<td colspan="1" rowspan="1" align="left" valign="top">sense</td>
<td colspan="1" rowspan="1" align="left" valign="top">5′-AGGACCTGATTTCCTTAC-3′</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">245</td>
</tr>
<tr>
<td colspan="1" rowspan="1" align="left" valign="top"></td>
<td colspan="1" rowspan="1" align="left" valign="top">antisense</td>
<td colspan="1" rowspan="1" align="left" valign="top">5′-TCTGAGGCATAACTGC-3′</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top"></td>
</tr>
<tr>
<td colspan="1" rowspan="1" align="left" valign="top">9</td>
<td colspan="1" rowspan="1" align="left" valign="top">sense</td>
<td colspan="1" rowspan="1" align="left" valign="top">5′-TATGCCTCAGATTCACT-3′</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">174</td>
</tr>
<tr>
<td colspan="1" rowspan="1" align="left" valign="top"></td>
<td colspan="1" rowspan="1" align="left" valign="top">antisense</td>
<td colspan="1" rowspan="1" align="left" valign="top">5′-TTGAGTGTTAGACTGGAAAC-3′</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top"></td>
</tr>
</tbody>
</table>
</table-wrap>
<fig position="float" id="f1">
<label>Figure 1.</label>
<caption>
<p>Morphological pattern of angiosarcomas.
<bold>A</bold>
: Angiosarcoma (case 18). H&E Magnification, ×265.
<bold>B</bold>
: Angiosarcoma (case 8). H&E Magnification, ×265.
<bold>C</bold>
: Angiosarcoma (case 12). H&E Magnification, ×265.
<bold>D</bold>
: Angiosarcoma (case 10). H&E Magnification, ×165</p>
</caption>
<graphic xlink:href="jh1181485001"></graphic>
</fig>
<fig position="float" id="f2">
<label>Figure 2.</label>
<caption>
<p>Immunohistochemical expression pattern of p53, MDM-2 protein and VEGF.
<bold>A</bold>
: Angiosarcoma (case 1), immunolocalization of p53. Magnification, ×180.
<bold>B</bold>
: Angiosarcoma (case 17), immunolocalization of p53. Magnification, ×310.
<bold>C</bold>
: Angiosarcoma (case 10), nuclear immunolocalization of MDM-2. Magnification, ×180.
<bold>D</bold>
: Angiosarcoma (case 16), nuclear and cytoplasmic staining of MDM-2. Magnification, ×180.
<bold>E</bold>
: Angiosarcoma (case 16), immunolocalization of VEGF. Magnification, ×325.
<bold>F</bold>
: Angiosarcoma (case 1). Immunolocalization of VEGF, Magnification, ×260.
<bold>G</bold>
: Control (case C1), negative immunostaining for p53. Magnification, ×180.
<bold>H</bold>
: Control (case C7), negative immunostaining for MDM-2. Magnification, ×180.</p>
</caption>
<graphic xlink:href="jh1181485002"></graphic>
</fig>
<fig position="float" id="f3">
<label>Figure 3.</label>
<caption>
<p>The hypothetical role of the p53/MDM-2 pathway in normal endothelium and angiosarcoma development. Expression of wt-p53 is linked to the control of angiogenesis. wt-p53 positively regulates genes involved in intercellular signaling such as thrombospondin-1, a negative regulator of angiogenesis, and it exerts negative influence on VEGF gene expression. Abrogation of wt-p53 in endothelial cells either by functional inactivation through overexpression of mdm-2 protein or by p53 mutation obviously reflects the loss of an important cellular growth control and angiosuppressive pathway in angiosarcomas. Discontinuation of wt-p53 function leads to a decrease in Thrombospondin-1 production and a decline in the negative transcriptional control of VEGF. This shifts the net balance of positive and negative angiogenic factors to neovascularisation.</p>
</caption>
<graphic xlink:href="jh1181485003"></graphic>
</fig>
</floats-wrap>
</pmc>
<affiliations>
<list></list>
<tree>
<noCountry>
<name sortKey="Haas, Christian" sort="Haas, Christian" uniqKey="Haas C" first="Christian" last="Haas">Christian Haas</name>
<name sortKey="Hirschmann, Astrid" sort="Hirschmann, Astrid" uniqKey="Hirschmann A" first="Astrid" last="Hirschmann">Astrid Hirschmann</name>
<name sortKey="Lohrs, Udo" sort="Lohrs, Udo" uniqKey="Lohrs U" first="Udo" last="Löhrs">Udo Löhrs</name>
<name sortKey="Rossle, Matthias" sort="Rossle, Matthias" uniqKey="Rossle M" first="Matthias" last="Rössle">Matthias Rössle</name>
<name sortKey="Sendelhofert, Andrea" sort="Sendelhofert, Andrea" uniqKey="Sendelhofert A" first="Andrea" last="Sendelhofert">Andrea Sendelhofert</name>
<name sortKey="Sturzl, Michael" sort="Sturzl, Michael" uniqKey="Sturzl M" first="Michael" last="Stürzl">Michael Stürzl</name>
<name sortKey="Zietz, Christian" sort="Zietz, Christian" uniqKey="Zietz C" first="Christian" last="Zietz">Christian Zietz</name>
</noCountry>
</tree>
</affiliations>
</record>

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