| Japanese Journal of Clinical Oncology | Pages |
Introduction
Materials and Methods
Tissue Samples
DNA Extraction
Analysis of AR Gene Mutations
DNA Sequencing
Results
Screening of AR Gene Mutations by PCR-SSCP Analysis
Sequencing
Clinicopathological Correlation
Discussion
Acknowledgments
References
Genetic Alterations of Androgen Receptor Gene in Japanese Human Prostate Cancer
In order to determine the significance of androgen receptor (AR) gene mutations for Japanese prostate cancers, we examined the entire coding region, from exon A to H, in 36 primary lesions. Five in stage A, 12 in stage B, six in stage C and 13 in stage D were subjected to PCR-SSCP analysis for genomic DNA and nucleotide sequencing. Mutations were detected in five samples (14%). Two in stage D and refractory to anti-androgen treatment showed mis-sense mutations. The other three showed changes in the length of the CAG repeat in exon A, with an expansion or a contraction of one repeat unit. However, no association with changes in AR function was indicated because they had not been refractory to hormone therapy. Since these latter three tumors were associated with microsatellite instability, the changes might have been the result of an impairment of mismatch repair. This study indicates that AR gene mutations play a role, in only a subset of prostate cancer patients, in a treatment-refractory state.
Introduction
Prostate cancer is the most common cancer in American men (1) and lately its incidence has been increasing in Japan (2). It has been established that androgen is necessary for both the growth and differentiation of the prostate gland (3). One useful therapeutic approach is therefore anti-androgen treatment and this has proved temporarily effective in bringing about remission of prostate cancer (4). However, in most cases recurrence occurs in association with acquired resistance to anti-androgen drugs. It is therefore very important that the mechanisms involved be clarified (4). Interestingly, although growth of the LNCaP human prostate cancer cell line is usually androgen independent, it can be stimulated by androgen, estrogen or anti-androgen treatment. This cell line has a point mutation at codon 877 of the androgen receptor (AR) gene, which is located within the steroid binding site and changes the steroid specificity (5,6). Such mutations could therefore be involved in the mechanisms underlying prostate cancer becoming refractory after hormonal therapy.
Changes in the CAG repeat number in the AR gene, as reported in neural disease, might also be important. The expansion of CAG repeats in spinal and bulbar muscular atrophy (SBMA) has been well documented (7) and Huntington's disease (HD), dentatorubral and pallidoluysian atrophy (DRPLA) and spinocerebellar ataxia type I result from a trinucleotide repeat expansion (8,9). Contraction of CAG repeats in the AR gene has in fact already been described (10) in human prostate cancers.
To clarify the role of AR mutations in progression and/or the refractory state, we therefore examined 36 Japanese prostate cancers for mutations in the entire coding region by PCR-SSCP analysis and nucleotide sequencing of exons A-H.
Materials and Methods
Tissue Samples
Samples of 36 prostate tumors were collected from 36 patients who visited Mie University Hospital, Chiba University Hospital and the Osaka Center for Adult Disease between 1991 and 1993. The age of the patients ranged from 42 to 83 years old with a median of 69 years. All 36 samples were of primary prostate tumors and were obtained by radical prostectomy (21 cases), radical cystoprostectomy of bladder tumors (two cases) and autopsy (13 cases).
Table| Sample | Age of patient |
State | Histological grade |
Gleason score |
Refratory to hormone therapy |
| 1 | 64 | A | W | 3 | - |
| 2 | 72 | A | W | 3 | - |
| 3 | 76 | A | W | 4 | - |
| 4 | 78 | A | P | 8 | - |
| 5 | 45 | A | P | 9 | - |
| 6 | 63 | B | M | 6 | - |
| 7 | 58 | B | M | 6 | - |
| 8 | 70 | B | M | 5 | - |
| 9 | 64 | B | M | 5 | - |
| 10 | 65 | B | M | 6 | - |
| 11 | 57 | B | M | 7 | - |
| 12 | 73 | B | M | 6 | - |
| 13 | 66 | B | M | 5 | - |
| 14 | 82 | B | M | 7 | - |
| 15 | 57 | B | P | 8 | - |
| 16 | 72 | B | P | 7 | - |
| 17 | 65 | B | P | 9 | - |
| 18 | 63 | C | W | 5 | - |
| 19 | 64 | C | M | 5 | - |
| 20 | 73 | C | M | 6 | - |
| 21 | 73 | C | M | 6 | - |
| 22 | 61 | C | M | 6 | - |
| 23 | 67 | C | P | 8 | - |
| 24 | 67 | D | W | 5 | + |
| 25 | 77 | D | M | 7 | + |
| 26 | 73 | D | M | 7 | + |
| 27 | 65 | D | M | 8 | + |
| 28 | 71 | D | P | 7 | + |
| 29 | 75 | D | P | 9 | + |
| 30 | 75 | D | P | 9 | + |
| 31 | 42 | D | P | 9 | + |
| 32 | 66 | D | P | 9 | + |
| 33 | 80 | D | P | 9 | + |
| 34 | 83 | D | P | 9 | + |
| 35 | 83 | D | P | 9 | + |
| 36 | 78 | D | P | 10 | + |
| Average | 66.5 | 6.9 |
The samples were immediately frozen after resection and kept at -80°C until use. Sections of the frozen samples were subjected to light microscopic review after hematoxylin-eosin staining by a pathologist experienced in the diagnosis of prostate cancer and normal tissues were removed to obtain material containing more than 75% tumor cells for DNA extraction.
All samples were staged and graded according to the General Rules for Clinical and Pathological Studies on Prostatic Cancer using the Gleason system of classification (10,11). Table Genomic DNA was extracted from frozen tissues by standard procedures using proteinase K digestion, serial phenol and chloroform extractions and ethanol precipitation (12). Eleven sets of primers were prepared to amplify DNA fragments covering exons A-H of the AR gene, mostly based on reported sequences (Table
DNA was extracted from shifted bands obtained by PCR-SSCP analysis. Fragments were directly subcloned into the pCR vector using a TA cloning system kit (Invitrogen, San Diego, CA, USA) and sequenced by the Sanger dideoxynucleotide method with a Sequenase Ver. 2.0 kit (United States Biochemical, Cleveland, OH, USA).DNA Extraction
Analysis of AR Gene Mutations
Exon
Sense primer
Antisense primer
A1
5[prime]-GAGAAGGGGAGGCGGGGTAA-3[prime]
5[prime]-CTGCAGCAGCAGCAAACTGG-3[prime]
A3
5[prime]-CAGCAGGGTGAGGATGGTTC-3[prime]
5[prime]-CTTTAAGGTCAGCGGAGCAG-3[prime]
A4
5[prime]-GACTCAGCTGCCCCATCCAC-3[prime]
5[prime]-TGCTCCAACHCCTCCACACC-3[prime]
A5
5[prime]-GGCACTTCGACCATTTCTGA-3[prime]
5[prime]-AGACAGGGTAGACGGCAGTT-3[prime]
A6
5[prime]-AGGGAGCTCCGGGACACTTG-3[prime]
5[prime]-TTCGGCTGTGAAGAGAGTGT-3[prime]
A7
5[prime]-CACCCTCAGCCGCCGCTTCC-3[prime]
5[prime]-CCTGGGCCGAAAGGCGACAT-3[prime]
B1
5[prime]-CTGCAGGTTAATGCTGAAGA-3[prime]
5[prime]-CCATAGTGACACCCAGAAGC-3[prime]
B2
5[prime]-ACCTGCCTGATCTGTGGAGA-3[prime]
5[prime]-GCCAATGACTCTATTTCTGA-3[prime]
C1
5[prime]-GTTTGGTGCCATACTCTGTC-3[prime]
5[prime]-TCCTTCGGAATTTATCAATA-3[prime]
C2
5[prime]-CTCCCAGGGAAACAGAAGTA-3[prime]
5[prime]-GTTGCCTATGAAAGGGTCAG-3[prime]
D1
5[prime]-TGTTTTTGACCACTGATGAT-3[prime]
5[prime]-CAGAAAGATGGGCTGACATT-3[prime]
Sample No.
Stage
Histology
Mutation
Exon
Codon
Type
A.A. change
4
A
P
A
(CAG)21 to (CAG)22*
+ Gly
18
C
W
A
(CAG)23 to (CAG)22
- Gly
29
D
P
A
(CAG)21 to (CAG)22
+ Gly
30
D
P
D
Codon 701
CTC to CAC
Leu to His
34
D
P
H
Codon 910
AAA to AGA
Lys to Arg
DNA Sequencing
Results
Screening of AR Gene Mutations by PCR-SSCP Analysis
The labeled PCR products from pairs of tumor and non-tumor DNA samples were analyzed by electrophoresis. Five of the 36 prostate cancers showed mobility shifts. Samples 4, 18 and 29 showed a band shift in exon A (Fig.
Figure
Sequencing
The PCR products of all five samples showing band shifts in the SSCP analysis were subcloned and sequenced (Fig.
Figure
Clinicopathological Correlation
The data for AR gene mutations are summarized in Table
Discussion
Androgen acts on its target cells by binding to AR, causing transformation into a DNA-binding form that can interact with hormone responsive genes (16). The AR gene is located on the X chromosome and is composed of 8(A-H) coding exons. Exon A encodes a peptide encompassing 58% of the AR protein, the 917-amino acid protein having a DNA binding domain at the N-terminus and a steroid binding domain at the C-terminus (17). Mutations in the AR gene are known to cause androgen insensitivity syndrome (AIS) in males (18). So far, 65 different amino acid substitutions between amino acids 664 and 913 have been described (19).
The concept of androgen dependence of prostate cancer is based on the fact that a dramatic reduction in tumor mass is acheived after surgical castration or estrogen therapy. The development and progression of cancer in the prostate therefore appear to be androgen dependent. However, after androgen deprivation treatment, this androgen dependence is lost in most cases and progression to a more malignant status occurs. Qualitative and/or quantitative abnormalities in the AR gene may be involved in this phenomenon, hence information relating to AR expression levels and genetic alterations in prostate cancer is important.
Several studies on mutations in the AR gene in human prostate cancer have already been reported. Gaddipati et al. (14) found that 25% of advanced lesions had a mutation at codon 877, which lies within the hormone-binding domain. This was the same as that detected in LNCaP. Further, Tilley et al. (20), in Australia, detected a high rate of AR gene mutation in primary stage C and stage D prostate cancer prior to initiation of hormone therapy, 50% of these mutations being in exon A. On the other hand, a low incidence of AR gene mutation was reported in the UK (21), although the entire coding region of the AR gene was examined. With regard to mutations in the AR gene in Japanese prostate cancer, there have been two reports; one concerned with clinical and the other with latent cancer. Only one out of eight (12.5%) Japanese prostate cancer anti-androgen therapy-resistant cases was found to be positive, the primary tumor having a mutation at codon 701 in exon D, with an additional mutation at codon 877 in exon H in a lymphnode metastasis (22). Furthermore, while 23% of latent prostate cancers were found to exhibit mutations, the figure was zero for clinical lesions (23). Using PCR-SSCP analysis, exons B-H of the AR gene were analyzed in these two groups.
In this study, we analyzed mutations along the entire coding region of the AR gene for 36 prostate tumors in stages A-D and found two significant mutations (5%) in stage D refractory cases. Since 13 cases were refractory, only 15% of refractory cancers were demonstrated to be associated with AR gene mutations. Hence the available data suggest that the frequency of AR gene mutation is low in Japanese prostate cancer cases. The one mutation at codon 910 which was found in this study has not been reported previously, although the one at codon 701 was already known from studies of AIS patients and also prostate cancer, as noted above. Although the androgen-binding ability of the two mutants identified remains to be clarified, the prostate cancers harboring these mutations were found to become androgen independent after anti-androgen therapy.
As for the number of CAG repeats in the AR gene, Schoenberg et al. (10) reported a contraction of CAG repeats in a prostate cancer case which showed a paradoxical agonistic response to hormone therapy with an anti-androgen flutamide. It has been reported that an expansion of CAG repeats causes a linear decrease in the transactivation function of the AR protein, even though they are not included in the DNA-binding domain (24). In the present study, three cases demonstrated changes in the number of CAG repeats in the AR gene, two with an increase of one and one with a contraction of one. Since the length of the CAG repeat region varies within a range of about 17-29 in normal individuals, the significance of these `mutations' is unclear. Since all three cases were associated with microsatellite instability (M.Watanabe et al., unpublished results), the changes in the number of CAG repeats may have been the result of an impairment of mismatch repair.
Immunohistochemical studies have demonstrated that prostate cancers may contain both AR-positive and AR-negative malignant cells, even before androgen withdrawal therapy (25,26). It is therefore unclear whether alterations in the expression levels of the AR gene contribute to the progression of human prostate cancers to AR independence. In addition, Visakorpi et al. (27) recently reported high-level AR amplification in 30% of recurrent prostate cancers after hormone therapy, suggesting that this might enable prostate cancer cells to grow in an environment having a low concentration of androgen (27). Hence it is plausible that AR gene amplification could in fact be a major cause of the refractory state in Japanese prostate cancer. This possibility clearly warrants further attention.
Acknowledgments
This work was supported by a Grant-in-Aid from the Ministry of Health and Welfare for a Comprehensive 10-Year Strategy for Cancer Control, Japan, and a Grant-in-Aid for Cancer Research from the Ministry of Education, Science and Culture.
References
This article has been cited by other articles:
This page is run by Oxford University Press, Great Clarendon Street, Oxford OX2 6DP, as part of the OUP Journals
Comments and feedback: www-admin{at}oup.co.uk
Last modification: 19 May 1998
Copyright© Japanese Journal of Clinical Oncology, 1997.
This page is run by Oxford University Press, Great Clarendon Street, Oxford OX2 6DP, as part of the OUP Journals
Comments and feedback: www-admin{at}oup.co.uk
Last modification: 19 May 1998
Copyright© Japanese Journal of Clinical Oncology, 1997.
![]()
CiteULike
Connotea
Del.icio.us What's this?
![]()
![]()

![]()
![]()
![]()
M. P. Zeegers, L. A.L.M. Kiemeney, A. M. Nieder, and H. Ostrer
How Strong Is the Association Between CAG and GGN Repeat Length Polymorphisms in the Androgen Receptor Gene and Prostate Cancer Risk?
Cancer Epidemiol. Biomarkers Prev.,
November 1, 2004;
13(11):
1765 - 1771.
[Abstract]
[Full Text]
[PDF]
![]()
![]()
![]()

![]()
![]()
![]()
G. Buchanan, M. Yang, A. Cheong, J. M. Harris, R. A. Irvine, P. F. Lambert, N. L. Moore, M. Raynor, P. J. Neufing, G. A. Coetzee, et al.
Structural and functional consequences of glutamine tract variation in the androgen receptor
Hum. Mol. Genet.,
August 15, 2004;
13(16):
1677 - 1692.
[Abstract]
[Full Text]
[PDF]
![]()
![]()
![]()

![]()
![]()
![]()
D. J. Lamb, E. Puxeddu, N. Malik, D. L. Stenoien, R. Nigam, G. Y. Saleh, M. Mancini, N. L. Weigel, and M. Marcelli
Molecular Analysis of the Androgen Receptor in Ten Prostate Cancer Specimens Obtained Before and After Androgen Ablation
J Androl,
March 1, 2003;
24(2):
215 - 225.
[Abstract]
[Full Text]
[PDF]
![]()
![]()
![]()

![]()
![]()
![]()
A. V. Krishnan, X.-Y. Zhao, S. Swami, L. Brive, D. M. Peehl, K. R. Ely, and D. Feldman
A Glucocorticoid-Responsive Mutant Androgen Receptor Exhibits Unique Ligand Specificity: Therapeutic Implications for Androgen-Independent Prostate Cancer
Endocrinology,
May 1, 2002;
143(5):
1889 - 1900.
[Abstract]
[Full Text]
[PDF]
![]()
![]()
![]()

![]()
![]()
![]()
G. Buchanan, N. M. Greenberg, H. I. Scher, J. M. Harris, V. R. Marshall, and W. D. Tilley
Collocation of Androgen Receptor Gene Mutations in Prostate Cancer
Clin. Cancer Res.,
May 1, 2001;
7(5):
1273 - 1281.
[Abstract]
[Full Text]
![]()
![]()
![]()

![]()
![]()
![]()
M. Marcelli, M. Ittmann, S. Mariani, R. Sutherland, R. Nigam, L. Murthy, Y. Zhao, D. DiConcini, E. Puxeddu, A. Esen, et al.
Androgen Receptor Mutations in Prostate Cancer
Cancer Res.,
February 1, 2000;
60(4):
944 - 949.
[Abstract]
[Full Text]
![]()
![]()
![]()

![]()
![]()
![]()
L. V. Nazareth, D. L. Stenoien, W. E. Bingman III, A. J. James, C. Wu, Y. Zhang, D. P. Edwards, M. Mancini, M. Marcelli, D. J. Lamb, et al.
A C619Y Mutation in the Human Androgen Receptor Causes Inactivation and Mislocalization of the Receptor with Concomitant Sequestration of SRC-1 (Steroid Receptor Coactivator 1)
Mol. Endocrinol.,
December 1, 1999;
13(12):
2065 - 2075.
[Abstract]
[Full Text]
![]()
This Article ![]()
![]()
Abstract
![]()
FREE Full Text (PDF)
![]()
Alert me when this article is cited
![]()
Alert me if a correction is posted
![]()
Services ![]()
![]()
Email this article to a friend
![]()
Similar articles in this journal
![]()
Similar articles in ISI Web of Science
![]()
Similar articles in PubMed
![]()
Alert me to new issues of the journal
![]()
Add to My Personal Archive
![]()
Download to citation manager
![]()
Search for citing articles in:
ISI Web of Science (25)
![]()
Request Permissions
![]()
Google Scholar ![]()
![]()
Articles by Watanabe, M.
![]()
Articles by Nagao, M.
![]()
Search for Related Content
![]()
PubMed ![]()
![]()
PubMed Citation
![]()
Articles by Watanabe, M.
![]()
Articles by Nagao, M.
![]()
Social Bookmarking ![]()
![]()
What's this?