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Genomewide copy number analysis of Müllerian adenosarcoma identified chromosomal instability in the aggressive subgroup.

全基因组拷贝数分析证明苗勒氏腺肉瘤侵袭性亚型具有染色体不稳定性

Lee JC,Lu TP,Changou CA,Liang CW,Huang HN,Lauria A,Huang HY,Lin CY,Chiang YC,Davidson B,Lin MC,Kuo KT
阅读:1215 Modern PathologyAug 2016; 29 (9): 1004 - 1113:1070-82 

Abstract

Müllerian adenosarcomas are malignant gynecologic neoplasms. Advanced staging and sarcomatous overgrowth predict poor prognosis. Because the genomic landscape remains poorly understood, we conducted this study to characterize the genomewide copy number variations in adenosarcomas. Sixteen tumors, including eight with and eight without sarcomatous overgrowth, were subjected to a molecular inversion probe array analysis. Copy number variations, particularly losses, were significantly higher in cases with sarcomatous overgrowth. Frequent gains of chromosomal 12q were noted, often involving cancer-associated genes CDK4 (six cases), MDM2, CPM, YEATS4, DDIT3, GLI1 (five each), HMGA2 and STAT6 (four), without association with sarcomatous overgrowth status. The most frequent losses involved chromosomes 13q (five cases), 9p, 16q and 17q (four cases each) and were almost limited to cases with sarcomatous overgrowth. MDM2 and CDK4 amplification, as well as losses of RB1 (observed in two cases) and CDKN2A/B (one case), was verified by FISH. By immunohistochemistry, all MDM2/CDK4-coamplified cases were confirmed to overexpress both encoded proteins, whereas all four cases with (plus an additional four without) gain of HMGA2 overexpressed the HMGA2 protein. Both cases with RB1 loss were negative for the immunostaining of the encoded protein. Chromothripsis-like copy number profiles involving chromosome 12 or 14 were observed in three fatal cases, all of which harbored sarcomatous overgrowth. With whole chromosome painting and deconvolution fluorescent microscopy, dividing tumor cells in all three cases were shown to have scattered extrachromosomal materials derived from chromosomes involved by chromothripsis, suggesting that this phenomenon may serve as visual evidence for chromothripsis in paraffin tissue. In conclusion, we identified frequent chromosome 12q amplifications, including loci containing potential pharmacological targets. Global chromosomal instability and chromothripsis were more frequent in cases with sarcomatous overgrowth. To our knowledge, this is the first time that evidence of chromothripsis has been demonstrated in paraffin-embedded clinical tissues and in adenosarcomas.

摘要

苗勒氏腺肉瘤是恶性妇科肿瘤。分期高和肉瘤成分过度生长是预后不良的指征。由于对该肿瘤全基因组了解仍很少,我们进行了本研究以阐述腺肉瘤全基因组拷贝数变异的特征。

16个病例,8个伴有肉瘤成分过度生长,另8个则没有,均做了分子反转探针阵列分析。拷贝数变异、尤其是缺失,在肉瘤成分过度生长的病例中有显著增加。我们注意到12号染色体长臂拷贝数多有增加,通常涉及到癌症相关基因CDK4(6例)、MDM2、CPM、YEATS4、DDIT3和GLI1(各5例)、HMGA2和STAT6(4例),但与肉瘤成分的过度生长无关。最常见的染色体丢失涉及13q(5例)、9 p、16q和17 q(各4例),几乎都限于肉瘤成分过度生长的病例。FISH法检测到MDM2/CDK4的扩增以及RB1(观察到2例)和CDKN2A / B(1例)的缺失。MDM2/CDK4共扩增病例免疫组化过度表达该两种基因的编码蛋白,而4例伴有(另外4例未伴有)HMGA2扩增的病例呈现HMGA2蛋白的过表达。所有RB1缺失的病例其编码蛋白免疫组化阴性。在三个终末期病例观察到12或14号染色体拷贝数呈碎裂样特点,所有这几例都伴有肉瘤成分的过度生长。利用全染色体涂染技术和反卷积荧光显微镜,从这三个病例中分离的肿瘤细胞都显示出与染色体碎裂有关的、分散的染色体外物质,表明这一现象可以作为石蜡组织染色体碎裂的光学证据。

总之,我们发现12号染色体拷贝数多有增加,包含潜在的药理靶标位点。全染色体不稳定和染色体碎裂更多见于肉瘤成分过度生长的病例。据我们所知,这是第一次在石蜡包埋组织中阐述腺肉瘤染色体碎裂的证据。

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