Illei Peter B, Rusch Valerie W, Zakowski Maureen F, Ladanyi Marc
Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York, 10021, USA.
Clin Cancer Res. 2003 Jun;9(6):2108-13.
Homozygous deletions at chromosome region 9p21 targeting the CDKN2A gene have been reported as a common cytogenetic abnormality in mesothelioma. MTAP, a gene approximately 100-kb telomeric to CDKN2A, encodes methylthioadenosine phosphorylase, an enzyme essential in the salvage of cellular adenine and methionine, and its codeletion with CDKN2A has been reported in other tumors. The aim of this study was to define the prevalence of homozygous deletion of CDKN2A alone or in combination with MTAP in a large series of pleural mesothelioma.
We used a fluorescent in situ hybridization assay for CDKN2A and MTAP on interphase nuclei in imprints of frozen tissue from 95 cases of pleural mesothelioma. Histologically, the cases were classified as epithelial (71), biphasic (19) and sarcomatous (5). In each experiment, a 9p21 locus specific probe and a chromosome 9 centromeric probe were used and fluorescent in situ hybridization signals for both probes were simultaneously recorded in at least 100 nuclei. Cases were considered homozygously deleted if both 9p21 signals were lost in at least 20% of nuclei.
Overall, 70 cases (74%) had homozygous deletion of CDKN2A. MTAP was codeleted in 64 of these cases (91%). No case with MTAP deletion without CDKN2A deletion was identified. Homozygous loss of CDKN2A was seen in 49 of 71 epithelial (70%), 16 of 19 biphasic (89%), and 5 of 5 sarcomatous (100%) mesotheliomas.
Homozygous deletion of CDKN2A is seen in the majority of pleural mesotheliomas, and MTAP is codeleted in most of these cases. Previous cell line studies have shown that loss of MTAP renders cells dependent on de novo synthesis of purine derivatives. Thus, the particularly high prevalence of MTAP codeletion in mesothelioma makes it an ideal candidate for trials of targeted therapy using inhibitors of de novo AMP synthesis (e.g., L-alanosine).
据报道,靶向CDKN2A基因的9号染色体区域9p21纯合缺失是间皮瘤常见的细胞遗传学异常。MTAP基因位于CDKN2A基因端粒大约100 kb处,编码甲硫腺苷磷酸化酶,这是细胞腺嘌呤和甲硫氨酸补救途径中必需的一种酶,并且在其他肿瘤中已报道其与CDKN2A基因共同缺失。本研究的目的是确定在一大系列胸膜间皮瘤中单独或与MTAP联合存在的CDKN2A纯合缺失的发生率。
我们对95例胸膜间皮瘤冰冻组织印片的间期核进行了针对CDKN2A和MTAP的荧光原位杂交检测。从组织学上看,这些病例分为上皮型(71例)、双相型(19例)和肉瘤型(5例)。在每个实验中,使用一个9p21位点特异性探针和一个9号染色体着丝粒探针,并在至少100个核中同时记录两种探针的荧光原位杂交信号。如果至少20%的核中两个9p21信号均缺失,则认为该病例为纯合缺失。
总体而言,70例(74%)存在CDKN2A纯合缺失。其中64例(91%)MTAP与CDKN2A共同缺失。未发现MTAP缺失而CDKN2A未缺失的病例。在71例上皮型间皮瘤中有49例(70%)、19例双相型间皮瘤中有16例(89%)、5例肉瘤型间皮瘤中有5例(100%)出现CDKN2A纯合缺失。
大多数胸膜间皮瘤存在CDKN2A纯合缺失,且大多数病例中MTAP与CDKN2A共同缺失。先前的细胞系研究表明,MTAP缺失使细胞依赖嘌呤衍生物的从头合成。因此,间皮瘤中MTAP共同缺失的特别高发生率使其成为使用从头合成AMP抑制剂(如L-丙氨酸)进行靶向治疗试验的理想候选对象。