Bosse T,ter Haar NT,Seeber LM,v Diest PJ,Hes FJ,Vasen HF,Nout RA,Creutzberg CL,Morreau H,Smit VT
Abstract
The switch/sucrose non-fermentable (SWI/SNF) subunit ARID1A (AT-rich interactive domain 1A gene) has been recently postulated as a novel tumor suppressor of gynecologic cancer and one of the driver genes in endometrial carcinogenesis. However, specific relationships with established molecular alterations in endometrioid endometrial cancer (EEC) are currently unknown. We analyzed the expression of ARID1A in 146 endometrial cancers (130 EECs and 16 non-EECs) in relation to alterations in the PI3K-Akt pathway (PTEN expression/KRAS/PIK3CA mutations), TP53 status (TP53 immunohistochemistry) and microsatellite instability. To discriminate between microsatellite instability due to somatic MLH1 promoter hypermethylation or germline mutations in one of the mismatch repair genes (Lynch syndrome), we included a 'Lynch syndrome set'. This set included 21 cases with confirmed germline mutations and 15 cases that were suspected to have a germline mutation. Loss of ARID1A expression was exclusively found in EECs in 31% (40/130) of the EEC cases. No loss of expression of the other subunits of the SWI/SNF complex, SMARCD3 and SMARCB1, was detected. Alterations in the PI3K-Akt pathway were more frequent when ARID1A expression was lost. Loss of ARID1A and mutant-like TP53 expression was nearly mutually exclusive (P=0.0004). In contrast to Lynch-associated tumors, a strong association between ARID1A loss and sporadic microsatellite instability was found. Only five cases (14%) of the 'Lynch syndrome set' as compared with 24 cases (75%, P<0.0001) of the sporadic microsatellite-unstable tumors showed loss of ARID1A. These observations suggest that ARID1A is a causative gene, instead of a target gene, of microsatellite instability by having a role in epigenetic silencing of the MLH1 gene in endometrial cancer.
摘要
交换型转换/蔗糖不发酵亚基ARID1A(富含AT相互作用结构域1A基因)最近被视为一个新的妇科恶性肿瘤抑癌基因,同时也是子宫内膜肿瘤发生的驱动基因之一。然而,子宫内膜样子宫内膜癌(EEC)中几个公认分子变化之间的特定关系目前仍未知。我们分析了146例子宫内膜癌(130例EECs和16例非EECs)中ARID1A的表达及其与PI3K-Akt通路的变化(PTEN表达/KRAS/PIK3CA基因突变),TP53状态(TP53免疫组化)和微卫星不稳定的关系。为了区分因由体细胞MLH1基因启动子甲基化或由于错配修复基因之一的胚系突变(林奇综合征)所致的微卫星不稳定性,我们计入了“林奇综合征组”。这组包括21例已确诊为胚系突变和15例疑似胚系突变者。发现ARID1A缺失表达只存在于EECs个体中且占31%的比例(40/130)。未检测到交换型转换/蔗糖不发酵亚基复合物的其他亚基的缺失表达,比如SMARCD3和SMARCB1。当ARID1A表达缺失时,PI3K-Akt通路改变显得更频繁。ARID1A表达缺失和突变样TP53表达几乎是互相排斥(P=0.0004)。与林奇相关肿瘤相比较,发现ARID1A缺失与散发的微卫星不稳定性之间存在强相关。“林奇综合征组”中只有5例(14%)表现出ARID1A缺失,然而在微卫星不稳定性肿瘤散发病例中有24例(75%,P<0.0001)显示出ARID1A缺失。这些观查结果表明,ARID1A基因是微卫星不稳定性的诱发基因,而不是目标基因。它在子宫内膜癌MLH1基因的表观遗传沉默中扮演一个重要的角色。
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