title: Proteins of the mitotic checkpoint and spindle are related to chromosomal instability and unfavourable prognosis in patients with myelodysplastic syndrome.
abstract: OBJECTIVE
  To study the immunoexpression of proteins related to the mitotic checkpoint (cell division cycle 20 (CDC20), mitotic arrest deficient 2 (MAD2)) and the mitotic spindle (Aurora-B) in patients with myelodysplastic syndrome (MDS).
  
  
  METHODS
  Protein expression was analysed in bone marrow tissue samples from 40 patients with MDS using immunohistochemistry. Prognostic markers (transfusion dependency, depth of cytopenias, chromosomal abnormalities and survival) were also studied.
  
  
  RESULTS
  Higher MAD2 expression was observed among patients with platelets <50×10(9)/L than among patients with platelets ≥50×10(9)/L (42.6±22.8% vs 22.7±19.1%, respectively). Higher CDC20 expression was identified among patients with three dysplasias compared with patients who presented with one or two dysplasias (33.9±24.1% vs 10.5±5.7% vs 12.8±7.8%, respectively), among patients who exhibited a complex versus non-complex karyotype (50.0±30.2% vs 18.4±14%, respectively) and among patients with platelets <50×10(9)/L vs platelets ≥50×10(9)/L (38.2±26.2% vs 16.1±12.4%, respectively). Higher Aurora-B expression was found in patients with an abnormal versus normal karyotype (21.2±13.2% vs 7.5±5.0%, respectively). High expression of MAD2 and CDC20 (≥50%) was associated with severe thrombocytopenia. We also found statistically significant differences in the overall survival rate when comparing different degrees of CDC20, MAD2 and Aurora-B protein expression.
  
  
  CONCLUSIONS
  To the best of our knowledge, this is the first report to demonstrate that these proteins are associated with chromosomal abnormalities and poor prognosis in patients with MDS.
authors: Department of Pathology, Post-Graduate Program in Pathology, Federal University of Ceará, Fortaleza, Ceará, Brazil.
authors: Kelly Roveran
authors: KR
authors: Genga
authors: Department of Pathology, Federal University of Ceará, Fortaleza, Ceará, Brazil.
authors: Francisco Dário Rocha
authors: FD
authors: Filho
authors: Department of Pathology, Federal University of Ceará, Fortaleza, Ceará, Brazil.
authors: Francisco Valdeci de Almeida
authors: FV
authors: Ferreira
authors: Laboratory Cytogenomic of Cancer, Federal University of Ceará, Fortaleza, Ceará, Brazil.
authors: Juliana Cordeiro
authors: JC
authors: de Sousa
authors: University of Fortaleza, Fortaleza, Ceará, Brazil.
authors: Fernando Sergio
authors: FS
authors: Studart
authors: Laboratory Cytogenomic of Cancer, Federal University of Ceará, Fortaleza, Ceará, Brazil Department of Clinical Medicine, Post-Graduate Program in Medical Sciences, Federal University of Ceará, Fortaleza, Ceará, Brazil.
authors: Silvia Maria Meira
authors: SM
authors: Magalhães
authors: Department of Pathology, Post-Graduate Program in Pathology, Federal University of Ceará, Fortaleza, Ceará, Brazil.
authors: Fabíola Fernandes
authors: FF
authors: Heredia
authors: Department of Pathology, Post-Graduate Program in Pathology, Federal University of Ceará, Fortaleza, Ceará, Brazil Laboratory Cytogenomic of Cancer, Federal University of Ceará, Fortaleza, Ceará, Brazil Department of Clinical Medicine, Post-Graduate Program in Medical Sciences, Federal University of Ceará, Fortaleza, Ceará, Brazil.
authors: Ronald Feitosa
authors: RF
authors: Pinheiro
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D064107:Aurora Kinase B / Q000032:analysis*; D001853:Bone Marrow / Q000737:chemistry* / Q000473:pathology; D064199:Cdc20 Proteins / Q000032:analysis*; D043171:Chromosomal Instability; D002871:Chromosome Banding; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D059785:Karyotype; D059566:M Phase Cell Cycle Checkpoints; D064246:Mad2 Proteins / Q000032:analysis*; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000097:blood / Q000235:genetics / Q000378:metabolism* / Q000401:mortality / Q000473:pathology; D010976:Platelet Count; D011379:Prognosis; D012189:Retrospective Studies; D008941:Spindle Apparatus / Q000737:chemistry*; D013921:Thrombocytopenia / Q000097:blood / Q000235:genetics / Q000378:metabolism; D055815:Young Adult
chemical_list: D064199:Cdc20 Proteins; C577697:MAD2L1 protein, human; D064246:Mad2 Proteins; C577488:CDC20 protein, human; C576921:AURKB protein, human; D064107:Aurora Kinase B
keywords: HEMATOPATHOLOGY; IMMUNOHISTOCHEMISTRY; MYELODYSPLASIA