Piscuoglio Salvatore, Murray Melissa, Fusco Nicola, Marchiò Caterina, Loo Florence L, Martelotto Luciano G, Schultheis Anne M, Akram Muzaffar, Weigelt Britta, Brogi Edi, Reis-Filho Jorge S
Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
School of Pathology, University of Milan, Milan, Italy.
Histopathology. 2015 Nov;67(5):719-29. doi: 10.1111/his.12712. Epub 2015 May 24.
Somatic mutations in exon 2 of the mediator complex subunit 12 (MED12) gene have been identified in 60% of breast fibroadenomas (FAs). The aim of this study was to define whether phyllodes tumours (PTs) would harbour MED12 somatic mutations in a way akin to FAs.
A collection of 73 fibroepithelial tumours (including 26 FAs, 25 benign PTs, nine borderline PTs and 13 malignant PTs) from 64 patients was retrieved from the authors' institution. Sections from formalin-fixed paraffin-embedded (FFPE) blocks were microdissected to ensure an enrichment in neoplastic stromal elements of >70%. DNA samples extracted from tumour and matched normal tissues were subjected to Sanger sequencing of exon 2 of the MED12 gene. MED12 exon 2 somatic mutations, including 28 somatic single nucleotide variants and 19 insertions and deletions, were found in 65%, 88%, 78% and 8% of FAs, benign PTs, borderline PTs and malignant PTs, respectively. Malignant PTs harboured MED12 exon 2 somatic mutations significantly less frequently than FAs, benign and borderline PTs.
Although MED12 exon 2 somatic mutations probably constitute the driver genetic event of most FAs, benign and borderline PTs, our results suggest that the majority of malignant PTs may be driven by other genetic/epigenetic alterations.
在60%的乳腺纤维腺瘤(FA)中已鉴定出中介体复合物亚基12(MED12)基因第2外显子的体细胞突变。本研究的目的是确定叶状肿瘤(PT)是否会以类似于FA的方式存在MED12体细胞突变。
从作者所在机构收集了64例患者的73个纤维上皮性肿瘤(包括26个FA、25个良性PT、9个交界性PT和13个恶性PT)。对福尔马林固定石蜡包埋(FFPE)块的切片进行显微切割,以确保肿瘤性间质成分的富集率>70%。对从肿瘤组织和配对的正常组织中提取的DNA样本进行MED12基因第2外显子的桑格测序。在FA、良性PT、交界性PT和恶性PT中,MED12第2外显子体细胞突变的发生率分别为65%、88%、78%和8%,其中包括28个体细胞单核苷酸变异以及19个插入和缺失。恶性PT中MED12第2外显子体细胞突变的发生率明显低于FA、良性和交界性PT。
虽然MED12第2外显子体细胞突变可能是大多数FA、良性和交界性PT的驱动性遗传事件,但我们的结果表明,大多数恶性PT可能由其他遗传/表观遗传改变驱动。