Schumacher J A, Elenitoba-Johnson K S J, Lim M S
Associated and Regional University Pathologists (ARUP) Institute for Clinical and Experimental Pathology, University of Utah Health Sciences Center, Salt Lake City, Utah, USA.
J Clin Pathol. 2008 Jan;61(1):109-14. doi: 10.1136/jcp.2007.047928. Epub 2007 May 25.
The c-kit D816V activating mutation is found in >80% of cases of systemic mastocytosis (SM) and represents a potential drug target. Furthermore, because D816V is one of the diagnostic criteria for SM, it is clinically relevant to determine whether the mutation is present. Traditional techniques such as DNA sequencing are often not sensitive enough to detect mutations in low-abundance tumour cells, including SM. Here, an allele-specific assay to detect the D816V mutation in DNA from archived formalin-fixed paraffin-embedded tissues is described.
A two-tube PCR format was employed to amplify c-kit exon 17 as a control and an allele-specific reaction to selectively amplify the D816V mutant allele using standard oligonucleotides. A D816V-mutant plasmid control was generated by site-directed mutagenesis of wild-type cells. 14 cases of SM, one D816V-positive seminoma sample, and 35 cases without SM were analysed using the assay.
The assay successfully amplified D816V in the mutant plasmid control, 13/14 cases of SM, and confirmed D816V in a seminoma sample. In addition, D816V was not amplified in 35/35 cases without SM. Serial dilution experiments demonstrated sensitivity down to <1%.
A sensitive, specific and cost-effective assay to detect the D816V mutation in archived formalin-fixed paraffin-embedded tissues from cases of SM has been developed.
在超过80%的系统性肥大细胞增多症(SM)病例中发现了c-kit D816V激活突变,其代表一个潜在的药物靶点。此外,由于D816V是SM的诊断标准之一,确定该突变是否存在具有临床相关性。传统技术如DNA测序往往不够灵敏,无法检测包括SM在内的低丰度肿瘤细胞中的突变。本文描述了一种用于检测存档福尔马林固定石蜡包埋组织DNA中D816V突变的等位基因特异性检测方法。
采用双管PCR形式扩增c-kit第17外显子作为对照,并进行等位基因特异性反应,使用标准寡核苷酸选择性扩增D816V突变等位基因。通过对野生型细胞进行定点诱变产生D816V突变体质粒对照。使用该检测方法分析了14例SM病例、1例D816V阳性精原细胞瘤样本和35例无SM的病例。
该检测方法在突变体质粒对照、14例SM病例中的13例中成功扩增出D816V,并在一个精原细胞瘤样本中证实了D816V。此外,在35例无SM的病例中均未扩增出D816V。系列稀释实验显示灵敏度低至<1%。
已开发出一种灵敏、特异且经济高效的检测方法,用于检测存档福尔马林固定石蜡包埋的SM病例组织中的D816V突变。