Xiaoling Xu, Shogo Kobayashi, Wenhui Qiao, Cuiling Li, Cuiying Xiao, Svetlana Radaeva, Bangyan Stiles, Rui-Hong Wang, Nobuya Ohara, Tadashi Yoshino, Derek LeRoith, Michael S. Torbenson, Gregory J. Gores, Hong Wu, Bin Gao, Chu-Xia Deng
J Clin Invest.
2006;
116(7):1843–1852
doi:10.1172/JCI27282
This article Copyright © 2006, The American Society for Clinical Investigation
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holangiocellular carcinoma (CC), the second most common primary liver cancer, is associated with a poor prognosis. It has been shown that CCs harbor alterations of a number of tumor-suppressor genes and oncogenes, yet key regulators for tumorigenesis remain unknown. Here we have generated a mouse model that develops CC with high penetrance using liver-specific targeted disruption of tumor suppressors SMAD4 and PTEN. In the absence of SMAD4 and PTEN, hyperplastic foci emerge exclusively from bile ducts of mutant mice at 2 months of age and continue to grow, leading to tumor formation in all animals at 4–7 months of age. We show that CC formation follows a multistep progression of histopathological changes that are associated with significant alterations, including increased levels of phosphorylated AKT, FOXO1, GSK-3β, mTOR, and ERK and increased nuclear levels of cyclin D1. We further demonstrate that SMAD4 and PTEN regulate each other through a novel feedback mechanism to maintain an expression balance and synergistically repress CC formation. Finally, our analysis of human CC detected PTEN inactivation in a majority of p-AKT–positive CCs, while about half also lost SMAD4 expression. These findings elucidate the relationship between SMAD4 and PTEN and extend our understanding of CC formation.