Loss of heterozygosity and microsatellite instability on chromosome arm 10q in neuroblastoma

Loss of heterozygosity and microsatellite instability on chromosome arm 10q in neuroblastoma

Cancer Genetics and Cytogenetics 174 (2007) 1e8 Loss of heterozygosity and microsatellite instability on chromosome arm 10q in neuroblastoma ´ ngel P...

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Cancer Genetics and Cytogenetics 174 (2007) 1e8

Loss of heterozygosity and microsatellite instability on chromosome arm 10q in neuroblastoma ´ ngel Pestan˜ad, Ignacio J. Encı´oa, Paula La´zcoza, Jorge Mun˜ozb, Manuel Nistalc, A Javier S. Castresanab,* a Department of Health Sciences, Public University of Navarra, 31006 Pamplona, Spain Molecular Neuro-Oncology Laboratory, University of Navarra, Irunlarrea 1, 31008 Pamplona, Spain c Department of Pathology, La Paz Hospital, Paseo de la Castellana 261, 28046 Madrid, Spain d Institute for Biomedical Research, CSIC-UAM, C/Arturo Duperier 4, 28029 Madrid, Spain

b

Received 21 June 2006; received in revised form 31 July 2006; accepted 7 August 2006

Abstract

Tumor suppressor genes can be inactivated by various mechanisms, including promoter hypermethylation and loss of heterozygosity. We screened the 10q locus for loss of heterozygosity and the promoter methylation status of PTEN, MGMT, MXI1, and FGFR2 in neuroblastic tumors and neuroblastoma cell lines. Expression of these genes in cell lines was analyzed with reverse transcriptaseepolymerase chain reaction. Loss of heterozygosity at 10q was detected in 18% of tumors and microsatellite instability in 14%. Promoter hypermethylation of MGMT appeared in 8% of tumors and 25% of cell lines. Correlation between methylation status and lack of expression was evident for PTEN, FGFR2, and MXI1 and was less clear for MGMT. No associations between these alterations and MYCN amplification, 1p deletion, or aggressive tumor histology could be demonstrated, singly or in combination. These data suggest that 10q alterations might be implicated in the development of a small number of neuroblastomas. Ó 2007 Elsevier Inc. All rights reserved.

1. Introduction Neuroblastic tumors are the most frequently occurring solid extracranial tumors during childhood. Apart from spontaneous regression in patients less than 12 months old, the full clinical spectrum of these tumors includes a very aggressive behavior and unresponsiveness to treatment. Most pediatric cancer deaths under 5 year of age are due to neuroblastoma. Depending on their schwannian stroma component, these tumors are classified as neuroblastoma, nodular or intermixed ganglioneuroblastoma, or ganglioneuroma. The genetic alterations most frequently found in neuroblastoma are gain of 17q, loss of heterozygosity (LOH) at 11q, MYCN amplification, and 1p36 allelic loss. Other alterations described include gains of 4q, 6p, 7q, 11q, and 18q; amplification of MDM2 and MYCL genes; allelic losses at 14q, and 10q [1e3]. A high frequency of LOH at 10q has been described in tumors such as glioblastoma [4], melanoma [5], prostate [6], and endometrium cancer [7]. Loss of heterozygosity

* Corresponding author. Tel.: þ34-948-425600; fax: þ34-948-425652. E-mail address: [email protected] (J.S. Castresana). 0165-4608/07/$ e see front matter Ó 2007 Elsevier Inc. All rights reserved. doi:10.1016/j.cancergencyto.2006.08.014

at 10q is the most frequent genetic alteration in glioblastomas, occurring in approximately 80% of cases [8]. LOH at 10q25~qter has even been described in familial neuroblastomas [9]. These data suggest that alterations of tumor suppressor genes located within this region may be important in neuroblastoma tumorigenesis and progression. Cancerrelated genes located at 10q include PTEN, DMBT1, MGMT, FGFR2, and MXI1. The phosphatase and tensin homolog (mutated in multiple advanced cancers 1) gene (PTEN ) on chromosome 10 was described in 1997 by three independent groups [9e11]. Located at 10q23.3, PTEN codes for a phospholipid phosphatase with high homology to the cytoskeletal proteins tensin and auxilin in their N-termini [11]. This protein suppresses growth and cell proliferation through the Akt/ PKB pathway [12,13] and promotes cell cycle stop and apoptosis [14]. Moreover, PTEN has been related to metastasis (overexpression of PTEN inhibited cell migration, whereas antisense PTEN enhanced migration) [15], inhibition of angiogenesis [16], and to good responsiveness to chemotherapeutic treatments [17]. PTEN mutations after LOH at 10q have been reported in various tumors, including glioblastoma [18], prostate [19] and endometrial cancer [20].

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The deleted in malignant brain tumors 1 gene (DMBT1), located at 10q25.3~26.1, is a member of the scavenger receptor cysteine-rich (SRCR) protein family [21] described in 1997 by Mollenhauer et al. [22]. DMBT1 homozygous deletions have been detected in medulloblastoma [22], oligodendroglioma [23], and lung and gastrointestinal cancers [24,25]. Allelic losses of microsatellite markers flanking this gene locus have been described in various tumors, including prostate cancer [6] and glioblastoma [26,27]. The O6-methylguanine-DNA methyltransferase gene (MGMT ), located at 10q26.1, codes for a protein implicated in DNA repair, one that specifically removes promutagenic alkyl groups from the O6 position of guanine. MGMT inactivation produces mutationsdin particular, G:C/A:T transitions. Promoter methylation of this gene in glioblastomas has been associated with increased frequency of G:C/A:T TP53 mutations [28]. The fibroblast growth factor receptor 2 gene (FGFR2) belongs to a gene family that codes for tyrosine kinase receptors. These proteins are implicated in cell proliferation, differentiation, and migration, and also apoptosis inhibition. FGFR2, located at 10q26, has 22 exons and is the biggest gene of the FGFR gene family [29e32]. Amplification and overexpression of FGFR2 in breast tumors [33], and FGFR2 downregulation in prostate cancer [34] have been described. The tumor suppressor gene MAX interactor 1 (MXI1) spans a region of ~60 kb at 10q24~q25 and comprises 6 exons [35]. This gene is a member of the v-myc myelocytomatosis viral oncogene homolog (MYC ) family of transcription factors and codes for a B-HLH-LZ protein [36]. MXI1 allelic losses have been described in glioblastomas [37] and prostate cancer [38]. Our objective was to analyze the possible importance of promoter hypermethylation of PTEN, MGMT, FGFR2, and MXI1 genes and of allelic losses on chromosome arm 10q in neuroblastic tumors.

German Collection of Microorganisms and Cell Cultures (DSMZ, Braunschweig, Germany). All cell lines were grown with Dulbecco’s modified Eagle’s medium supplemented with 10% fetal bovine serum, 2% L-glutamine, and nonessential amino acids (5%), following manufacturer instructions.

2. Materials and methods

2.4. Sodium bisulfite modification

2.1. Samples and cell lines

DNA from the 41 tumors and the 12 cell lines was modified with sodium bisulfite using the CpGenome DNA modification kit (Chemicon, Temecula, CA) according to the manufacturer’s protocol.

Frozen neuroblastic tumors were obtained from Hospital La Paz, Madrid, Spain (n 5 41; 26 neuroblastomas, 12 ganglioneuroblastomas, and 3 ganglioneuromas). DNA isolated from blood samples of 21 patients was used as negative control for LOH analysis. Clinicopathological data included patient age and sex, tumor location, diagnosis, Shimada’s index, and cell proliferation index (Ki67). Twelve neuroblastoma cell lines were also used in methylation and expression analysis. Cell lines SK-N-DZ, SKN-SH, SK-N-Be(2), SK-N-FI, Be(2)C, and MC-IXC were provided by the American Type Culture Collection (ATCC, Manassas, VA) and cell lines IMR-32, Kelly, SIMA, SHSY5Y, SK-N-MC, and MHH-NB-11 were provided by the

2.2. Nucleic acids extraction DNA from frozen tumor specimens was obtained by means of phenolechloroform purification [39]. DNA from cell lines was extracted using the Wizard genomic DNA purification kit (Promega, Madison, WI), according to the manufacturer’s protocol. RNA from cell lines was obtained with the QuickPrep total RNA extraction kit (Amersham Biosciences, Buckinghamshire, UK), according to the manufacturer’s instructions. 2.3. LOH and MSI analysis Blood and tumor DNA from 21 patients were screened for LOH on chromosome arm 10q with the following polymorphic markers: PTENCA (near PTEN ), D10S597, D10S221 (near MXI1), D10S209, D10S587 (near DMBT1), and D10S214 (near MGMT ). Approximately 50 ng of DNA template was amplified in a total volume of 25 mL containing 10 pmol of each primer, 1 unit of Taq DNA polymerase (BioTaq; Bioline, London, UK), 2 mmol/L MgCl2, 10 reaction buffer, and 0.2 mmol/ L of each dNTP. Reactions were heated at 95 C for 5 minutes, followed by 35 cycles at 94 C for 30 seconds, 60 C (for D10S209 and D10S587) or 61 C (for D10S214, D10S597, and D10S221) or 59 C (for PTENCA) for 30 seconds, and 72 C for 1 minute. A final extension step at 72 C for 10 minutes was applied. After amplification, 17 mL of the polymerase chain reaction (PCR) product was subjected to electrophoresis through a 15% polyacrylamide gel. The DNA bands were visualized after ethidium bromide staining.

2.5. Methylation-specific polymerase chain reaction Methylation-specific polymerase chain reaction (MSP) was used to examine methylation at promoter regions of the PTEN, MGMT, MXI1, and FGFR2 genes. The PCRs were performed in a final volume of 25 mL containing 2e2.5 mmol/L MgCl2, 5e10 pmol each primer, 0.8 mmol/L dNTPs, 5% dimethyl sulfoxide (DMSO), 1 unit of Taq polymerase (AmpliTaq Gold; Applied Biosystems, Foster City, CA), and 60 ng of sodium bisulfite-modified

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Table 1 Primers and conditions for methylation-specific polymerase chain reaction Gene PTEN U M MGMT U M FGFR2 U M MXI1 U M

Primer forward (50 e30 )

Primer reverse (50 e30 )

Size, bp

T,  C

Cycles

GTGTTGGTGGAGGTAGTTGTTT TTCGTTCGTCGTCGTCGTATTT

ACCACTTAACTCTAAACCACAACCA GCCGCTTAACTCTAAACCGCAACCG

162 206

62 62

38 38

GAGAGATTTGTGTTTTGGGTTTAGTG ATTCGCGTTTCGGGTTTAGC

CCTTCAACCAATACAAACCAAACAA CGACCGATACAAACCGAACG

236 227

62 62

38 38

TGTTTTGAGTTTTTGTAATTTGTGA GCGTTTTGAGTTTTCGTAATTCGC

TAATCCTTAAATCTTCACCAACACC AATAATCCTTAAATCTTCGCCGACG

181 184

54 62

38 35

GGTTGGAGATTTTTTAGTGTTTTGT GTCGGAGATTTTTTAGCGTTTCGT

CAACCTCTAAAACCCAATTACACCAC CTCTAAAACCCGATTACGCCG

238 233

62 62

30e35 30e35

Abbreviations: M, methylated; T, temperature; U, unmethylated.

or unmodified DNA. Annealing temperatures were from 54 C to 62 C. Next, 10 mL of each PCR product was loaded onto a 2.5% agarose gel stained with ethidium bromide (0.1 mL/mL). Primer sequences are described in Table 1. 2.6. RT-PCR One microgram of RNA from each cell line was mixed with 1 mL dNTPs 10 mmol/L, and 1 mL 250 mmol/L random primers in a final volume of 12 mL. The mixture was heated at 65 C for 5 minutes. Then, 4 mL 5 reaction buffer and 2 mL 0.1 mmol/L dithiothreitol were added. The mixture was heated at 42 C for 2 minutes, and incubated with 1 mL of Superscript II RNA reverse transcriptase (Invitrogen Life Technologies, Carlsbad, CA). Samples were heated at 25 C for 10 minutes and at 42 C for 50 minutes. A final step at 70 C for 15 minutes was used. cDNAs were stored at 20 C until their use. Approximately 75 ng of cDNA was amplified in a total volume of 25 mL containing 0.2 mmol/L of each dNTP, 1.5e2.5 mmol/L MgCl2, 10 reaction buffer, 5e10 pmol of each primer, 5% DMSO, and 1 unit of Taq DNA polymerase (AmpliTaq Gold). Primers for MGMT, FGFR2, MXI1, and TFR amplification were designed with Oligo 4.0 software (Molecular Biology Insights [MBI], Hamel, MN). Primers and conditions used for PTEN RT-PCR were as previously described [40] (Table 2). A fragment of the

transferrin receptor gene (TFRC) was amplified as an internal control. 2.7. Statistical analysis Fisher’s exact test was used to screen for any statistical association among LOH and MSI at 10q, promoter hypermethylation of PTEN, MGMT, FGFR2, and MXI1 genes, and clinicopathological data of tumors.

3. Results 3.1. LOH and MSI analysis LOH and MSI were determined with six polymorphic markers (D10S209, D10S214, D10S221, D10S587, D10S597, and PTENCA) located on chromosome arm 10q. We found LOH, MSI, or both at five of the six markers: D10S209, D10S221, D10S587, D10S597, and PTENCA (Table 3; Fig. 1). 3.2. Promoter methylation We studied the promoter methylation status of PTEN, MGMT, FGFR2, and MXI1 in 41 neuroblastic tumors and 12 neuroblastoma cell lines by MSP. We found hypermethylation only at the MGMT promoter, in 8% of tumors

Table 2 Primers and conditions for reverse transcriptaseepolymerase chain reaction Gene PTEN primer 1 primer 2 primer 3 MGMT FGFR2 MXI1 TFR

Primer forward (50 -30 )

Primer reverse (50 -30 )

Size, bp

T,  C

Cycles

282 139 136 298

50 62 60 60

40 35 35 30

CTCCAATTCAGGACCCACACGAC AAGTACAGCTTCACCTTAAA CGGGAAGACAAGTTCATGTAC GGGGAAGCTGGAGCTGTCTG TTTAAGCAGGAGCATCGCATTG GGCACACAACACTTGGTTTGC GTCAATGTCCCAAACGTCACCAGA

TCTCCGAATTTCACAACCTTCA ACGTGTGATTGATGGACCCGT AGCTGTTCCAGTCGCCACTTT ATTTCGGGAATGCTGAGAAAACAGACAGA

Abbreviation: T, temperature. PTEN RT-PCR was performed in two steps: first, with primers 1 and 2, and second with primers 3 and 2 (nested PCR).

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Table 3 Loss of heterozygosity and microsatellite instability and promoter methylation in neuroblastic tumors LOH/MSI

Methylation

Tumor

Diagnostic

D10S209

D10S214

D10S221

D10S587

D10S597

PTENCA

PTEN

MGMT

FGFR2

MXI1

1 17 94 3 5 7 8 9 10 61 82 83 86 92 107 12 13 14 15 16 18 33 37 34 45 48 51 52 63 64 73 77 85 87 90 91 95 96 97 99 102

GN GN GN GNB GNB GNB GNB GNB GNB GNB GNB GNB GNB GNB GNB NB NB NB NB NB NB NB NB NB NB NB NB NB NB NB NB NB NB NB NB NB NB NB NB NB NB

 n.d. n.d. n.d.  n.d. n.d. n.d. n.d. n.d.  n.d. n.d.  n.d. n.d. n.d. n.d. n.d. n.d. n.d. n.d. n.d.   n.a. n.a. n.d.  MSI n.a.  n.d. n.d.    n.d.  n.d. 

 n.d. n.d. n.d.  n.d.  n.d. n.d. n.d.  n.d. n.d.  n.d. n.d. n.d. n.d. n.d. n.d. n.d. n.d. n.d.   n.a. n.a. n.d.   n.a.  n.d. n.d.    n.d.  n.d. 

 n.d. n.d. n.d.  n.d. n.d. n.d. n.d. n.d. MSI n.d. n.d.  n.d. n.d. n.d. n.d. n.d. n.d. n.d. n.d. n.d.   n.a. n.a. n.d.  LOH n.a.  n.d. n.d. MSI   n.d.  n.d. 

 n.d. n.d. n.d.  n.d. n.d. n.d. n.d. n.d.  n.d. n.d.  n.d. n.d. n.d. n.d. n.d. n.d. n.d. n.d. n.d.    n.a. n.d.  MSI n.a.  n.d. n.d.    n.d.  n.d. 

 n.d. n.d. n.d.  n.d. n.d. n.d. n.d. n.d.  n.d. n.d.  n.d. n.d. n.d. n.d. n.d. n.d. n.d. n.d. n.d.   n.a. n.a. n.d.  MSI n.a.  n.d. n.d. n.a.   n.d.  n.d. 

 n.d. n.d. n.d.  n.d. n.d. n.d. n.d. n.d.  n.d. n.d. LOH n.d. n.d. n.d. n.d. n.d. n.d. n.d. n.d. n.d.  n.a. n.a. n.a. n.d.  MSI n.a.  n.d. n.d. n.a.   n.d.  n.d. LOH

     n.a.            n.a. n.a. n.a.   n.a. n.a.                 

 B    n.a.            n.a. n.a. n.a.   n.a. n.a.  B    B           

                 n.a. n.a. n.a.   n.a. n.a.       n.a.          

                 n.a. n.a. n.a. n.a.  n.a. n.a.                 

Abbreviations: GN, ganglioneuroma; GNB, ganglioneuroblastoma; LOH, loss of heterozygosity; MSI, microsatellite instability; n.a., not amplified; NB, neuroblastoma; n.d., not determined; B, hemimethylated; , unmethylated, no loss of heterozygosity or microsatellite instability.

and in 3 cell lines: SK-N-SH, SK-N-MC, and IMR-32 (Tables 3 and 4; Fig. 2). 3.3. RT-PCR We analyzed the expression of PTEN, MGMT, FGFR2, and MXI1 genes in 12 neuroblastoma cell lines by semiquantitative RT-PCR. All cell lines expressed those genes (Table 4). 3.4. Statistical analysis Fisher’s exact test did not reveal any significant association between the genetic alterations found in tumor samples and clinicopathological data.

4. Discussion Several tumors present structural alterations on chromosome 10 as their most common genetic event. Moreover, in glioblastomas, oligodendrogliomas, and meningiomas, LOH at 10q is associated with tumor progression and poor prognosis [23,41e44]. Other nonenervous system tumors, such as melanomas and prostate tumors, also show LOH, and some of them MSI, at 10q [6,45]. Allelic losses are frequent in neuroblastic tumors. Loss of chromosome 1p is the most frequent genetic alteration found in these tumors and it, together with MYCN amplification, predicts poor outcome [46]. LOH at 11q has been described in 50% of stage 4 high-risk neuroblastomas without MYCN amplification [47]. Losses on other

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Fig. 1. (A) Loss of heterozygosity at D10S221 polymorphic marker and (B) microsatellite instability at D10S209 polymorphic marker in neuroblastic tumors. Polymerase chain reaction (PCR) products were run in a 15% polyacrylamide gel and visualized after ethidium bromide staining (0.5 mg/mL) Lanes N and T, DNA from peripheral blood and from tumor tissue of the same patient (indicated by sample number). Lane M1: 10-bp DNA ladder; lane M2: 1 kb Plus DNA ladder. Sample number 64 showed both loss of heterozygosity and microsatellite instability.

chromosomal regions (e.g., 14q, 9p, 2q, and 10q) are less frequent, and not all of them are associated with prognosis [47,48]. In the present study, we analyzed LOH and MSI on chromosome arm 10q by using six polymorphic markers in 21 neuroblastic tumors. We found LOH in 18% and MSI in 14% of tumors. Aberrant promoter methylation as a tumor suppressor mechanism of inactivation has been described in several tumors. Methylation of several genes, including MGMT, SLIT2, CD44, CFLAR (alias FLIP), and RASSF1A, has been described in neuroblastomas [49e54]. Moreover, CpG methylation profiles characterize different clinical subgroups and strongly correlate with outcome [55,56]. In the present study, we examined the promoter hypermethylation of PTEN, MGMT, FGFR2, and MXI1 genes in 41

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neuroblastic tumors and 12 neuroblastoma cell lines. To our knowledge, this report is the first to analyze methylation status of PTEN, FGFR2, and MXI1 in neuroblastic tumors. PTEN inactivation by promoter hypermethylation has been described in various tumors, including lung, endometrial, and gastric carcinomas [57e59]. Whang et al. [60] restored PTEN expression in prostate cancer cell lines by in vitro treatment with the demethylating agent 5-azadeoxycytidine, indicating that PTEN promoter hypermethylation reduces or avoids its expression, at least in this type of tumor. Baeza et al. [61] reported PTEN methylation in 35% of glioblastomas, and in 36% of glioblastoma cell lines. Moritake et al. [62] showed that the PTEN gene is very infrequently mutated in neuroblastomas (only one cell line of the 16 neuroblastoma cell lines and 11 tumors analyzed displayed a mutation, a 1-bp frameshift deletion in exon 7, and an allelic loss in the opposite allele was revealed by a microsatellite analysis). In the present study, we did not find PTEN methylation in any neuroblastic tumor or neuroblastoma cell lines. All neuroblastoma cell lines showed normal levels of PTEN expression. Several tumors, such as leukemias and lymphomas [63], showed lack of expression of the MGMT gene associated with promoter hypermethylation. In nervous system tumors, MGMT hypermethylation has been described in ependymomas, oligodendrogliomas, neurofibromas, neurofibrosarcomas, diffuse astrocytomas, and glioblastomas [64e68]. In neuroblastomas, Bello et al. [69] and Gonza´lez-Go´mez et al. [50] reported MGMT methylation in 29 and 27% of tumors analyzed, respectively. We found promoter hypermethylation of this gene in 8% of tumors and 25% of cell lines, but no cell line showed lack of expression; we did not see a good correlation between promoter methylation and lack of expression. Mutations in the FGFR2 gene are present in several syndromes with craniosynostosis, such as the Pfeiffer, Apert, and Crouzon syndromes [70]. The gene is amplified and

Table 4 Promoter hypermethylation and expression in neuroblastoma cell lines Methylation

Expression

Cell line

PTEN

MGMT

FGFR2

MXI1

PTEN

MGMT

FGFR2

MXI1

Kelly SIMA MCIXC SKNFI SHSY5Y SKNSH SKNMC IMR32 MHHNB11 SKNBe(2) SKNDZ BE(2)C

           

     B B B    

           

           

þ n.e. þ þ þ þ þ þ þ þ þ þ

þ /þ þ þ þ /þ þ þ þ þ /þ þ

þ þ þ þ þ þ þ þ þ þ þ þ

þ þ þ þ þ þ þ þ þ þ þ þ

Abbreviations: n.e., nonevaluable; B, Hemimethylated; , unmethylated/lack of expression; þ, expression; /þ, low expression.

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Pediatrı´a, Madrid, for the V Premio Nutribe´n de Investigacio´n Pedia´trica, and the Fundacio´ Agrupacio´ Mu´tua, Barce´ mbito de la Infancia. lona, for the VI Premio A

References Fig. 2. MGMT promoter hypermethylation in neuroblastic tumors determined by methylation-specific polymerase chain reaction. After bisulfite treatment of tumor genomic DNA, PCR products were run in 2.5% agarose gels stained with 0.1 mg/mL ethidium bromide. Lane M: 1 kb Plus DNA Ladder. Lane 1: DNA obtained from blood of a normal donor (negative control of methylation). Lanes 2e12: DNA from neuroblastic tumors to be tested for MGMT promoter methylation. Lane 13: CpGenome universal methylated DNA (positive control for methylation). Lane 14: water. U, unmethylated; M, methylated.

overexpressed in breast cancer, but downregulated in prostate tumors [33,34]. We analyzed FGFR2 methylation status in 41 neuroblastic tumors and 12 neuroblastoma cell lines, and did not find promoter hypermethylation. All cell lines showed expression of this gene. MXI1 allelic losses have been described in glioblastomas, melanomas, and prostate cancer [37,38,71]. However, mutations of this gene are less frequent in glioblastomas [4]. In a recent study, Kim and Carroll [72] reported the importance of several genes, including MXI1, in MYCN autoregulation in neuroblastomas. They found that the autoregulatory circuit was operative both in single copy MYCN and in amplified cell lines, and that MXI1 was not implicated in this regulation. In the present study, we did not find MXI1 promoter hypermethylation in neuroblastoma tumors and cell lines. Moreover, we did not see reduction of expression in the cell lines. Our results suggest that LOH and MSI on chromosome arm 10q may be responsible for tumorigenesis in only a small percentage of neuroblastic tumors. For that small number of these tumors, however, methylation analysis of PTEN, MGMT, FGFR2, and MXI1 genes revealed that MGMT promoter hypermethylation could be an important genetic alteration. In conclusion, genetic alterations on chromosome arm 10q are not frequent in neuroblastic tumors, although alterations in this region are frequent in other nervous system tumors.

Acknowledgments This research was supported in part by grants from the Departamentos de Salud y de Educacio´n del Gobierno de Navarra, Pamplona; Fondo de Investigacio´n Sanitaria (PI031356), and Ministerio de Ciencia y Tecnologı´a y Fondo Europeo de Desarrollo Regional (BFI2003-08775), Madrid. P.L. received a predoctoral fellowship from the Universidad Pu´blica de Navarra, Pamplona. J.M. was a fellow from the Ministerio de Educacio´n, Cultura y Deporte, Madrid. J.S.C. thanks the Asociacio´n Espan˜ola de

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