Correlation of MTDH/AEG-1 and HOTAIR Expression with Metastasis and Response to Treatment in Sarcoma Patients.

BACKGROUND Chemoresistance and metastasis are the main reasons for the failure of current treatments with sarcoma patients. Novel biomarkers are required to predict metastasis and response to treatment. The oncogene MTDH/AEG1 and the long noncoding RNA (lincRNA) HOTAIR are two novel factors involved in drug resistance and metastasis in various types of solid tumors. However, the correlation between MTDH/AEG-1 and HOTAIR expression with metastasis and drug resistance in sarcoma is unknown. METHODS Expression of MTDH protein or HOTAIR was detected by Western blotting or qRT-PCR, respectively, in primary and metastatic sarcoma patient tissue samples. RESULTS High individual or co-expression of MTDH/AEG1 and HOTAIR was observed in three of four primary and six of eight metastatic sarcoma patient tumor samples. High level expression of both of MTDH/AEG1 and HOTAIR in the primary tumor correlated with a likelihood to metastasize. MTDH expression was lower in samples pre-treated with irradiation and/or chemotherapy as compared to those that had not been treated. HOTAIR expression seemed to correlate with the percent necrosis seen in different sarcoma samples. CONCLUSIONS High levels of both MTDH/AEG-1 and HOTAIR in primary sarcoma are correlated with a high probability of metastasis. By contrast, reduced expression of both MTDH/AEG-1 and HOTAIR is correlated with a good response to treatment in terms of necrosis, suggesting that levels of MTDH and HOTAIR are potential biomarkers for treatment efficacy. Whether we can predict disease progression in sarcoma remains to be seen. Additional study is needed to better define the best clinical application of MTDH/AEG-1 and HOTAIR expression with metastasis and outcome.