Department of Vascular and Thyroid Surgery, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou City, Guangdong Province, China.
J Vasc Surg. 2011 Dec;54(6):1760-8. doi: 10.1016/j.jvs.2011.06.098. Epub 2011 Oct 1.
As a common disease, the molecular etiology of noninherited vascular anomalies is still poorly understood. Recently, somatic mutations in exon 17 of the endothelial cell tyrosine kinase receptor Tie-2 (encoded by TEK) were identified in 49.1% of patients with common sporadic venous malformation, a subtype of vascular anomalies. We assessed whether such a mutational region also had a role in the Chinese population or in other subtypes of noninherited vascular anomalies (vascular tumors and vascular malformations).
Direct sequencing of polymerase chain reaction (PCR)-amplified DNA, extracted from 139 lesions in 129 individuals with noninherited vascular anomalies (vascular tumors or vascular malformations) and 60 control samples, was used for detecting the mutations in exon 17 of the TEK gene. Mutations were confirmed by allele-specific PCR. Clone sequences were then used for the mutations identified for the first time. We also explored the associations between these mutations and clinical characteristics (gender, onset age, number of lesions, severity, category, and recurrence of the disease) in both vascular tumors and vascular malformations.
Two somatic TEK mutations (Y897C, R915C) were identified in vascular tumors, and seven somatic TEK mutations (Y897H, Y897C, L914F, R915C, S917I, R918C, R918H) were identified in vascular malformations. Among these mutations, R918C (2,752 C > T) and R918H (2,753 G > A) were first identified in noninherited vascular anomalies. Somatic TEK mutations were detected in lesions from 4 of 23 (17.4%) vascular tumors and 35 of 106 (33.0%) vascular malformations, where most mutations were single substitutions in vascular tumors (100%) and vascular malformations (88.6%), while the remainders were double substitutions. In addition to the reported venous malformation, such mutations were identified in some other subtypes of vascular anomalies, including vascular tumors (infantile hemangioma, pyogenic granuloma, and epithelioid hemangioma) and vascular malformations (capillary malformation, arteriovenous malformation, capillary lymphatic malformation, and capillary arteriovenous malformation). By contrast, these mutations were absent from the control tissues or blood. However, mutations showed no association (P > .05) with clinical characteristics in vascular anomalies or either of its two types (vascular tumors or vascular malformations).
Our study revealed that somatic mutations in exon 17 of the TEK gene were more common in noninherited vascular anomalies than previously reported. Furthermore, such substitutions may shed new light on the molecular etiology, diagnosis, and potential therapeutic targets of vascular anomalies.
作为一种常见疾病,非遗传性血管异常的分子病因仍知之甚少。最近,在 49.1%的常见散发性静脉畸形患者(血管异常的一种亚型)中发现内皮细胞酪氨酸激酶受体 Tie-2(由 TEK 编码)外显子 17 中的体细胞突变。我们评估了这种突变区域是否也在中国人群或其他非遗传性血管异常(血管肿瘤和血管畸形)中发挥作用。
直接测序聚合酶链反应(PCR)扩增的 DNA,从 129 名非遗传性血管异常(血管肿瘤或血管畸形)患者的 139 个病变和 60 个对照样本中提取,用于检测 TEK 基因外显子 17 中的突变。突变通过等位基因特异性 PCR 确认。然后使用克隆序列对首次发现的突变进行确认。我们还探讨了这些突变与血管肿瘤和血管畸形中这些突变与临床特征(性别、发病年龄、病变数量、严重程度、类别和疾病复发)之间的关联。
在血管肿瘤中发现了两个体细胞 TEK 突变(Y897C,R915C),在血管畸形中发现了七个体细胞 TEK 突变(Y897H,Y897C,L914F,R915C,S917I,R918C,R918H)。在这些突变中,R918C(2,752C > T)和 R918H(2,753G > A)是首次在非遗传性血管异常中发现的。在 23 个血管肿瘤中的 4 个(17.4%)和 106 个血管畸形中的 35 个(33.0%)病变中检测到体细胞 TEK 突变,其中大多数突变是血管肿瘤中的单个取代(100%)和血管畸形(88.6%),而其余的则是双取代。除了报告的静脉畸形外,这些突变还存在于其他一些血管异常亚型中,包括血管肿瘤(婴儿血管瘤、化脓性肉芽肿和上皮样血管内皮瘤)和血管畸形(毛细血管畸形、动静脉畸形、毛细血管淋巴管畸形和毛细血管动静脉畸形)。相比之下,这些突变在对照组织或血液中不存在。然而,突变与血管异常或其两种类型(血管肿瘤或血管畸形)的临床特征均无关联(P >.05)。
本研究表明,TEK 基因外显子 17 的体细胞突变在非遗传性血管异常中比以前报道的更为常见。此外,这种取代可能为血管异常的分子病因、诊断和潜在治疗靶点提供新的线索。