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Exome Sequencing of Uterine Leiomyosarcomas Identifies Frequent Mutations in , , and


Uterine leiomyosarcomas are rare, malignant smooth muscle tumors with a poor 5-year survival and high recurrence rate. They account for 1–2% of all uterine malignancies with an estimated incidence of 0.4/100,000 women per year. The symptoms and signs of this tumor type widely overlap with those of common benign uterine leiomyomas, making early diagnosis of uterine leiomyosarcomas difficult. Currently, the diagnosis of these tumors is often incidental and postoperative. Despite previous cytogenetic and molecular studies, their molecular background has remained elusive. Identification of novel molecular genetic characteristics in uterine leiomyosarcomas is clinically relevant to further improve the diagnosis and prognosis of the patients. Here, we performed exome sequencing on 19 tumors, revealing frequent mutations in TP53, ATRX, and MED12. The discovery of frequent inactivating ATRX mutations provides a potential novel therapeutic target for uterine leiomyosarcomas.


Vyšlo v časopise: Exome Sequencing of Uterine Leiomyosarcomas Identifies Frequent Mutations in , , and. PLoS Genet 12(2): e32767. doi:10.1371/journal.pgen.1005850
Kategorie: Research Article
prolekare.web.journal.doi_sk: https://doi.org/10.1371/journal.pgen.1005850

Souhrn

Uterine leiomyosarcomas are rare, malignant smooth muscle tumors with a poor 5-year survival and high recurrence rate. They account for 1–2% of all uterine malignancies with an estimated incidence of 0.4/100,000 women per year. The symptoms and signs of this tumor type widely overlap with those of common benign uterine leiomyomas, making early diagnosis of uterine leiomyosarcomas difficult. Currently, the diagnosis of these tumors is often incidental and postoperative. Despite previous cytogenetic and molecular studies, their molecular background has remained elusive. Identification of novel molecular genetic characteristics in uterine leiomyosarcomas is clinically relevant to further improve the diagnosis and prognosis of the patients. Here, we performed exome sequencing on 19 tumors, revealing frequent mutations in TP53, ATRX, and MED12. The discovery of frequent inactivating ATRX mutations provides a potential novel therapeutic target for uterine leiomyosarcomas.


Zdroje

1. Toro JR, Travis LB, Wu HJ, Zhu K, Fletcher CD, Devesa SS. Incidence patterns of soft tissue sarcomas, regardless of primary site, in the surveillance, epidemiology and end results program, 1978–2001: An analysis of 26,758 cases. Int J Cancer 2006;119(12): 2922–2930. 17013893

2. Koivisto-Korander R, Martinsen JI, Weiderpass E, Leminen A, Pukkala E. Incidence of uterine leiomyosarcoma and endometrial stromal sarcoma in Nordic countries: results from NORDCAN and NOCCA databases. Maturitas 2012;72(1): 56–60. doi: 10.1016/j.maturitas.2012.01.021 22377186

3. Reed NS, Mangioni C, Malmstrom H, Scarfone G, Poveda A, Pecorelli S, et al. Phase III randomised study to evaluate the role of adjuvant pelvic radiotherapy in the treatment of uterine sarcomas stages I and II: an European Organisation for Research and Treatment of Cancer Gynaecological Cancer Group Study (protocol 55874). Eur J Cancer 2008;44(6): 808–818. doi: 10.1016/j.ejca.2008.01.019 18378136

4. Hensley ML. Role of chemotherapy and biomolecular therapy in the treatment of uterine sarcomas. Best Pract Res Clin Obstet Gynaecol. 2011;25(6): 773–782. doi: 10.1016/j.bpobgyn.2011.06.003 21752717

5. Mayerhofer K, Obermair A, Windbichler G, Petru E, Kaider A, Hefler L, et al. Leiomyosarcoma of the uterus: a clinicopathologic multicenter study of 71 cases. Gynecol Oncol 1999;74(2): 196–201. 10419731

6. Abeler VM, Royne O, Thoresen S, Danielsen HE, Nesland JM, Kristensen GB. Uterine sarcomas in Norway. A histopathological and prognostic survey of a total population from 1970 to 2000 including 419 patients. Histopathology 2009;54(3): 355–364. doi: 10.1111/j.1365-2559.2009.03231.x 19236512

7. Pelmus M, Penault-Llorca F, Guillou L, Collin F, Bertrand G, Trassard M, et al. Prognostic factors in early-stage leiomyosarcoma of the uterus. Int J Gynecol Cancer 2009;19(3): 385–390. doi: 10.1111/IGC.0b013e3181a1bfbc 19407564

8. Kapp DS, Shin JY, Chan JK. Prognostic factors and survival in 1396 patients with uterine leiomyosarcomas: emphasis on impact of lymphadenectomy and oophorectomy. Cancer 2008;112(4): 820–830. doi: 10.1002/cncr.23245 18189292

9. Sandberg AA. Updates on the cytogenetics and molecular genetics of bone and soft tissue tumors: leiomyosarcoma. Cancer Genet Cytogenet. 2005;161(1): 1–19. 16114134

10. Yang J, Du X, Chen K, Ylipaa A, Lazar AJ, Trent J, et al. Genetic aberrations in soft tissue leiomyosarcoma. Cancer Lett. 2009;275(1): 1–8. doi: 10.1016/j.canlet.2008.06.013 18649996

11. Kobayashi H, Uekuri C, Akasaka J, Ito F, Shigemitsu A, Koike N, et al. The biology of uterine sarcomas: A review and update. Mol Clin Oncol. 2013;1(4): 599–609. 24649216

12. Garraway LA, Lander ES. Lessons from the cancer genome. Cell 2013;153(1): 17–37. doi: 10.1016/j.cell.2013.03.002 23540688

13. Heaphy CM, de Wilde RF, Jiao Y, Klein AP, Edil BH, Shi C, et al. Altered telomeres in tumors with ATRX and DAXX mutations. Science 2011;333(6041): 425. doi: 10.1126/science.1207313 21719641

14. Jiao Y, Shi C, Edil BH, de Wilde RF, Klimstra DS, Maitra A, et al. DAXX/ATRX, MEN1, and mTOR pathway genes are frequently altered in pancreatic neuroendocrine tumors. Science 2011;331(6021): 1199–1203. doi: 10.1126/science.1200609 21252315

15. Mäkinen N, Mehine M, Tolvanen J, Kaasinen E, Li Y, Lehtonen HJ, et al. MED12, the mediator complex subunit 12 gene, is mutated at high frequency in uterine leiomyomas. Science 2011;334(6053): 252–255. doi: 10.1126/science.1208930 21868628

16. de Vos S, Wilczynski SP, Fleischhacker M, Koeffler P. P53 Alterations in Uterine Leiomyosarcomas Versus Leiomyomas. Gynecol Oncol 1994;54(2): 205–208. 8063247

17. Jeffers MD, Farquharson MA, Richmond JA, McNicol AM. P53 Immunoreactivity and Mutation of the P53 Gene in Smooth Muscle Tumours of the Uterine Corpus. J Pathol 1995;177(1): 65–70. 7472782

18. Zhai YL, Kobayashi Y, Mori A, Orii A, Nikaido T, Konishi I, et al. Expression of steroid receptors, Ki-67, and p53 in uterine leiomyosarcomas. Int J Gynecol Pathol 1999;18(1): 20–28. 9891238

19. Muller PA, Vousden KH. P53 Mutations in Cancer. Nat Cell Biol 2013;15(1): 2–8. doi: 10.1038/ncb2641 23263379

20. Lee JC, Jeng YM, Liau JY, Tsai JH, Hsu HH, Yang CY. Alternative lengthening of telomeres and loss of ATRX are frequent events in pleomorphic and dedifferentiated liposarcomas. Mod Pathol. 2015;28(8): 1064–1073. doi: 10.1038/modpathol.2015.67 26022452

21. Liau JY, Tsai JH, Jeng YM, Lee JC, Hsu HH, Yang CY. Leiomyosarcoma with alternative lengthening of telomeres is associated with aggressive histologic features, loss of ATRX expression, and poor clinical outcome. Am J Surg Pathol. 2015;39(2): 236–244. doi: 10.1097/PAS.0000000000000324 25229770

22. Slatter TL, Hsia H, Samaranayaka A, Sykes P, Clow W, Devenish CJ, et al. Loss of ATRX and DAXX expression identifies poor prognosis for smooth muscle tumours of uncertain malignant potential and early stage uterine leiomyosarcoma. J Path: Clin Res. 2015;1(2): 95–105.

23. Huho A, Sheehan CE, Otto GA, Wang K, Palmer G, Yelensky R, et al. Evaluation of Uterine Leiomyosarcoma by Next Generation Sequencing Reveals Actionable Genomic Abnormalities and New Routes to Targeted Therapies. USCAP 2014, #1184, Mod. Pathol. 2014;27(S2): 287A.

24. Lovejoy CA, Li W, Reisenweber S, Thongthip S, Bruno J, de Lange T, et al. Loss of ATRX, genome instability, and an altered DNA damage response are hallmarks of the alternative lengthening of telomeres pathway. PLoS Genet. 2012;8(7): e1002772. 22829774

25. Flynn RL, Cox KE, Jeitany M, Wakimoto H, Bryll AR, Ganem NJ, et al. Alternative lengthening of telomeres renders cancer cells hypersensitive to ATR inhibitors. Science 2015;347(6219): 273–277. doi: 10.1126/science.1257216 25593184

26. Mehine M, Mäkinen N, Heinonen HR, Aaltonen LA, Vahteristo P. Genomics of uterine leiomyomas: insights from high-throughput sequencing. Fertil Steril. 2014;102(3): 621–629. doi: 10.1016/j.fertnstert.2014.06.050 25106763

27. Conaway RC, Conaway JW. Function and regulation of the Mediator complex. Curr Opin Genet Dev. 2011;21(2): 225–230. doi: 10.1016/j.gde.2011.01.013 21330129

28. Hendrickson MR, Tavassoli FA, Kempson RL, McCluggage WG, Haller U, Kubik-Huch RA. Mesenchymal tumours and related lesions. In: Tavassoli FA, Devilee P, editors. Tumours of the Breast and Female Genital Organs. Lyon: IARC; 2003. pp. 233.

29. Mäkinen N, Vahteristo P, Bützow R, Sjöberg J, Aaltonen LA. Exomic landscape of MED12 mutation negative and positive uterine leiomyomas. Int J Cancer 2014;134(4): 1008–1012. doi: 10.1002/ijc.28410 23913526

30. Hiltemann S, Jenster G, Trapman J, van der Spek P, Stubbs A. Discriminating somatic and germline mutations in tumor DNA samples without matching normals. Genome Res 2015;25(9): 1382–1390. doi: 10.1101/gr.183053.114 26209359

31. Koivisto-Korander R, Bützow R, Koivisto AM, Leminen A. Immunohistochemical studies on uterine carcinosarcoma, leiomyosarcoma, and endometrial stromal sarcoma: expression and prognostic importance of ten different markers. Tumour Biol. 2011;32(3): 451–459. doi: 10.1007/s13277-010-0138-1 21161468

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