From the *Department of Pathology, Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, NY; †Department of Pathology, The Sol Goldman Pancreatic Cancer Research Center, The Johns Hopkins Medical Institutions, Baltimore, MD; ‡Department of Otolaryngology/Head and Neck Surgery, Columbia University Medical Center; and §Department of Otolaryngology/Head and Neck Surgery, Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, NY.
Pancreas. 2014 Mar;43(2):245-9. doi: 10.1097/MPA.0000000000000034.
Mucinous cystic neoplasms (MCNs) are rare, potentially curable, mucin-producing neoplasms of the pancreas. We have previously reported PIK3CA (phosphoinositide-3-kinase catalytic subunit, p110α) mutations in intraductal papillary mucinous neoplasms, another mucin-producing neoplasm of the pancreas. In this study, we analyzed the presence of PIK3CA and AKT1/PKB (V-akt murine thymoma viral oncogene homolog 1) hot-spot mutations in MCN specimens.
Using the genomic DNA sequencing of tumor tissues isolated by laser capture microdissection, we evaluated 15 well-characterized MCNs for the E542K, E545K (exon 9), and H1047R (exon 20) hot-spot mutations in the PIK3CA gene and the E17K mutation in the AKT1 gene.
A hot-spot mutation (E545K) of the PIK3CA gene was detected in 1 of the 15 MCNs and further confirmed by a mutant-enriched method. Interestingly, this mutation was found to be present only in the high-grade but not in low-grade dysplastic epithelium obtained from this neoplasm and coexisted with a KRAS mutation. No mutations were identified in the AKT1 gene.
Our data, when combined with previous reports on intraductal papillary mucinous neoplasms, indicate that oncogenic activation of the PI3K pathway involving PIK3CA gene mutations can contribute to the progression of mucin-producing neoplasms but not pancreatic intraepithelial neoplasia. PIK3CA status could be useful for understanding their progression to malignancy.
黏液性囊性肿瘤(MCN)是一种罕见的、潜在可治愈的胰腺黏液性肿瘤。我们之前曾报道过,在另一种胰腺黏液性肿瘤——导管内乳头状黏液性肿瘤中存在 PIK3CA(磷酸肌醇 3-激酶催化亚单位,p110α)突变。在本研究中,我们分析了 MCN 标本中 PIK3CA 和 AKT1/PKB(V-akt 鼠胸腺瘤病毒癌基因同源物 1)热点突变的存在情况。
通过激光捕获显微切割分离的肿瘤组织的基因组 DNA 测序,我们评估了 15 个特征明确的 MCN 中 PIK3CA 基因的 E542K、E545K(外显子 9)和 H1047R(外显子 20)热点突变和 AKT1 基因的 E17K 突变。
在 15 个 MCN 中检测到 PIK3CA 基因的热点突变(E545K),并通过富集突变的方法进一步证实。有趣的是,该突变仅存在于该肿瘤的高级别而非低级别异型增生上皮中,并且与 KRAS 突变共存。在 AKT1 基因中未发现突变。
我们的数据与之前关于导管内乳头状黏液性肿瘤的报告相结合,表明涉及 PIK3CA 基因突变的 PI3K 通路的致癌激活可能有助于黏液性肿瘤的进展,但不会导致胰腺上皮内瘤变。PIK3CA 状态可能有助于了解其向恶性肿瘤的进展。