Ovarian and endometrial endometrioid carcinomas have distinct CTNNB1 and PTEN mutation profiles.
发生在卵巢和子宫内膜的子宫内膜样癌具有不同的CTNNB1和PTEN基因突变特点
McConechy MK,Ding J,Senz J,Yang W,Melnyk N,Tone AA,Prentice LM,Wiegand KC,McAlpine JN,Shah SP,Lee CH,Goodfellow PJ,Gilks CB,Huntsman DG
Abstract
Ovarian endometrioid carcinomas and endometrial endometrioid carcinomas share many histological and molecular alterations. These similarities are likely due to a common endometrial epithelial precursor cell of origin, with most ovarian endometrioid carcinomas arising from endometriosis. To directly compare the mutation profiles of two morphologically similar tumor types, endometrial endometrioid carcinomas (n=307) and ovarian endometrioid carcinomas (n=33), we performed select exon capture sequencing on a panel of genes: ARID1A, PTEN, PIK3CA, KRAS, CTNNB1, PPP2R1A, TP53. We found that PTEN mutations are more frequent in low-grade endometrial endometrioid carcinomas (67%) compared with low-grade ovarian endometrioid carcinomas (17%) (P<0.0001). By contrast, CTNNB1 mutations are significantly different in low-grade ovarian endometrioid carcinomas (53%) compared with low-grade endometrial endometrioid carcinomas (28%) (P<0.0057). This difference in CTNNB1 mutation frequency may be reflective of the distinct microenvironments; the epithelial cells lining an endometriotic cyst within the ovary are exposed to a highly oxidative environment that promotes tumorigenesis. Understanding the distinct mutation patterns found in the PI3K and Wnt pathways of ovarian and endometrial endometrioid carcinomas may provide future opportunities for stratifying patients for targeted therapeutics.
摘要
发生在卵巢和子宫内膜的子宫内膜样癌在组织学和分子改变方面具有很多相似之处,这可能与其共同起源于宫内膜上皮的前体细胞(大多数卵巢的宫内膜样癌起源于子宫内膜异位症)有关。为了解这两种形态学相似的肿瘤在基因突变方面的差异,本研究选择307例宫内膜发生的子宫内膜样癌与33例卵巢发生的子宫内膜样癌进行研究,对ARID1A、PTEN、 PIK3CA、KRAS、CTNNB1、PPP2R1A和TP53等基因进行选择性外显子捕获测序。结果发现:PTEN基因突变在宫内膜发生的低级别子宫内膜样癌中发生率高达67%,而在卵巢发生的低级别子宫内膜样癌中发生率仅为17%(P<0.0001);而ctnnb1基因在宫内膜发生的低级别子宫内膜样癌中发生率仅为28%,而在卵巢发生的低级别子宫内膜样癌中发生率高达53%(p<0.0057)。ctnnb1基因突变频率不同可能反映了两个部位肿瘤的微环境差异;发生在卵巢的宫内膜样囊肿的上皮细胞位于高度氧化性环境中,促进了肿瘤的发生。对卵巢和宫内膜发生的子宫内膜样癌在pi3k和wnt通路上的基因突变差异机制的探讨将有助于为将来进行患者分层靶向治疗提供更多的可能。
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