Vranic Semir, Marchiò Caterina, Castellano Isabella, Botta Cristina, Scalzo Maria Stella, Bender Ryan P, Payan-Gomez Cesar, di Cantogno Ludovica Verdun, Gugliotta Patrizia, Tondat Fabrizio, di Celle Paola Francia, Mariani Sara, Gatalica Zoran, Sapino Anna
Department of Medical Sciences, University of Turin, Turin 10126, Italy; Department of Pathology, Clinical Center, University of Sarajevo, Sarajevo 71000, Bosnia and Herzegovina.
Department of Medical Sciences, University of Turin, Turin 10126, Italy.
Hum Pathol. 2015 Sep;46(9):1350-9. doi: 10.1016/j.humpath.2015.05.017. Epub 2015 Jun 5.
Despite the marked improvement in the understanding of molecular mechanisms and classification of apocrine carcinoma, little is known about its specific molecular genetic alterations and potentially targetable biomarkers. In this study, we explored immunohistochemical and molecular genetic characteristics of 37 invasive apocrine carcinomas using immunohistochemistry (IHC), fluorescent in situ hybridization (FISH), multiplex ligation-dependent probe amplification (MLPA), and next-generation sequencing (NGS) assays. IHC revealed frequent E-cadherin expression (89%), moderate (16%) proliferation activity [Ki-67, phosphohistone H3], infrequent (~10%) expression of basal cell markers [CK5/6, CK14, p63, caveolin-1], loss of PTEN (83%), and overexpression of HER2 (32%), EGFR (41%), cyclin D1 (50%), and MUC-1 (88%). MLPA assay revealed gene copy gains of MYC, CCND1, ZNF703, CDH1, and TRAF4 in 50% or greater of the apocrine carcinomas, whereas gene copy losses frequently affected BRCA2 (75%), ADAM9 (54%), and BRCA1 (46%). HER2 gain, detected by MLPA in 38% of the cases, was in excellent concordance with HER2 results obtained by IHC/FISH (κ = 0.915, P < .001). TOP2A gain was observed in one case, while five cases (21%) exhibited TOP2A loss. Unsupervised hierarchical cluster analysis revealed two distinct clusters: HER2-positive and HER2-negative (P = .03 and .04, respectively). NGS assay revealed mutations of the TP53 (2 of 7, 29%), BRAF/KRAS (2 of 7, 29%), and PI3KCA/PTEN genes (7 of 7, 100%). We conclude that morphologically defined apocrine carcinomas exhibit complex molecular genetic alterations that are consistent with the "luminal-complex" phenotype. Some of the identified molecular targets are promising biomarkers; however, functional studies are needed to prove these observations.
尽管在大汗腺癌的分子机制理解和分类方面有显著改善,但对其特定的分子遗传改变和潜在的可靶向生物标志物知之甚少。在本研究中,我们使用免疫组织化学(IHC)、荧光原位杂交(FISH)、多重连接依赖探针扩增(MLPA)和下一代测序(NGS)检测方法,探索了37例浸润性大汗腺癌的免疫组织化学和分子遗传特征。免疫组织化学显示E-钙黏蛋白表达频繁(89%),增殖活性中等(16%)[Ki-67、磷酸化组蛋白H3],基底细胞标志物[CK5/6、CK14、p63、小窝蛋白-1]表达不频繁(约10%),PTEN缺失(83%),HER2、表皮生长因子受体(EGFR)(41%)、细胞周期蛋白D1(50%)和黏蛋白-1(MUC-1)(88%)过表达。MLPA检测显示,在50%或更多的大汗腺癌中,MYC、CCND1、ZNF703、CDH1和TRAF4基因拷贝数增加,而基因拷贝数缺失常影响BRCA2(75%)、ADAM9(54%)和BRCA1(46%)。MLPA在38%的病例中检测到HER2基因拷贝数增加,与免疫组织化学/荧光原位杂交获得的HER2结果高度一致(κ = 0.915,P < 0.001)。在1例中观察到TOP2A基因拷贝数增加,而5例(21%)表现为TOP2A缺失。无监督层次聚类分析揭示了两个不同的聚类:HER2阳性和HER2阴性(P分别为0.03和0.04)。NGS检测显示TP53(7例中的2例,29%)、BRAF/KRAS(7例中的2例,29%)和PI3KCA/PTEN基因(7例中的7例,100%)发生突变。我们得出结论,形态学定义的大汗腺癌表现出与“管腔-复杂”表型一致的复杂分子遗传改变。一些已确定的分子靶点是有前景的生物标志物;然而,需要进行功能研究来证实这些观察结果。