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结节性筋膜炎中通过启动子交换基因融合激活 USP6。

USP6 activation in nodular fasciitis by promoter-swapping gene fusions.

机构信息

Department of Pathology, Texas Children's Hospital, Houston, TX, USA.

Department of Pathology & Immunology, Baylor College of Medicine, Houston, TX, USA.

出版信息

Mod Pathol. 2017 Nov;30(11):1577-1588. doi: 10.1038/modpathol.2017.78. Epub 2017 Jul 28.


DOI:10.1038/modpathol.2017.78
PMID:28752842
Abstract

Nodular fasciitis is a self-limited myofibroblastic lesion that can be misdiagnosed as a sarcoma as a result of its rapid growth, cellularity, and sometimes prominent mitotic activity. A recurrent translocation t(17;22) has been identified in nodular fasciitis, fusing the coding region of USP6 to the promoter region of MYH9, and resulting in increased USP6 expression. A subset of cases show USP6 rearrangement without the typical fusion variants by RT-PCR, or any MYH9 rearrangement by FISH. We sought to further characterize such tumors using molecular diagnostic assays. A novel RT-PCR assay was designed to detect the two known MYH9-USP6 fusion types in formalin-fixed paraffin-embedded and frozen tissue, and a break-apart FISH assay was designed to detect USP6 rearrangement. Twenty-six cases of nodular fasciitis diagnosed between 2002 and 2013 were retrieved from the pathology files of our institutions and were confirmed to be positive by FISH and/or RT-PCR. Seven samples showed USP6 rearrangement by FISH but were negative for MYH9-USP6 fusion by RT-PCR; these cases were subjected to a next-generation sequencing assay utilizing anchored multiplex PCR technology. This assay targets a single partner gene associated with fusions in bone and soft tissue tumors for agnostic detection of gene fusion partners. Novel fusion partners were identified in all seven cases and confirmed by RT-PCR. Structurally, all fusions consisted of the juxtaposition of the entire coding region of USP6 with the promoter of the partner gene, driving increased USP6 expression. This study confirms the neoplastic nature of nodular fasciitis, defines additional pathogenic fusion partners, and adds to the growing body of literature on USP6-associated neoplasia. Given the diagnostic challenges of these tumors, molecular assays can be useful ancillary tools; however, the prevalence of promoter swapping must be recognized when interpreting results.

摘要

结节性筋膜炎是一种自限性的肌纤维母细胞病变,由于其快速生长、细胞丰富,有时有明显的有丝分裂活性,可能被误诊为肉瘤。结节性筋膜炎中已鉴定出一种复发性易位 t(17;22),该易位将 USP6 的编码区融合到 MYH9 的启动子区域,导致 USP6 表达增加。一小部分病例通过 RT-PCR 显示 USP6 重排,而没有典型的融合变体,通过 FISH 显示任何 MYH9 重排。我们试图使用分子诊断检测进一步表征此类肿瘤。设计了一种新的 RT-PCR 检测方法,用于检测福尔马林固定石蜡包埋和冷冻组织中的两种已知的 MYH9-USP6 融合类型,设计了一种断裂分离 FISH 检测方法,用于检测 USP6 重排。从我们机构的病理学档案中检索到 26 例 2002 年至 2013 年期间诊断的结节性筋膜炎病例,并通过 FISH 和/或 RT-PCR 证实为阳性。7 例 FISH 显示 USP6 重排,但 RT-PCR 检测 MYH9-USP6 融合为阴性;对这些病例进行了下一代测序检测,利用锚定多重 PCR 技术。该检测针对与骨和软组织肿瘤融合相关的单个伙伴基因,用于基因融合伙伴的盲目检测。在所有 7 例中均鉴定到新的融合伙伴,并通过 RT-PCR 证实。结构上,所有融合均由 USP6 的整个编码区与伙伴基因的启动子并置组成,导致 USP6 表达增加。这项研究证实了结节性筋膜炎的肿瘤性质,定义了额外的致病融合伙伴,并为 USP6 相关肿瘤的不断增加的文献增添了新内容。鉴于这些肿瘤的诊断挑战,分子检测可以作为有用的辅助工具;但是,在解释结果时必须认识到启动子交换的普遍性。

相似文献

[1]
USP6 activation in nodular fasciitis by promoter-swapping gene fusions.

Mod Pathol. 2017-7-28

[2]
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[3]
[Chromosomal translocation involving USP6 gene in nodular fasciitis].

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[4]
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[5]
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[6]
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Virchows Arch. 2021-6

[7]
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Mod Pathol. 2020-5

[8]
Cutaneous nodular fasciitis with genetic analysis: a case series.

J Cutan Pathol. 2016-12

[9]
USP6 gene rearrangement in nodular fasciitis and histological mimics.

Histopathology. 2016-11

[10]
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[2]
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BMC Musculoskelet Disord. 2025-7-1

[3]
An approach to reconstructing a segmental defect of the mandible involving the condyle secondary to nodular fasciitis in a pediatric patient: a case report.

J Med Case Rep. 2025-5-13

[4]
Physiological roles and therapeutic implications of USP6.

Cell Death Discov. 2025-5-10

[5]
Periorbital nodular fasciitis: a case report.

BMC Ophthalmol. 2025-2-10

[6]
Nodular fasciitis: a case series unveiling novel and rare gene fusions, including two cases with aggressive clinical behavior.

Virchows Arch. 2025-2-6

[7]
Papillary Thyroid Carcinoma with Fibromatosis/Fasciitis-Like/Desmoid-Type Stroma: Case Report of a Rare Subtype with Cytological and Molecular Study.

Head Neck Pathol. 2024-10-22

[8]
Nodular Fasciitis of the Buccal Mucosa with a Novel USP6 Gene Rearrangement: A Case Report and Review of the Literature.

Head Neck Pathol. 2024-8-21

[9]
Soft tissue aneurysmal bone cyst presenting as an enlarging neck mass: Case report and review of the head and neck literature.

Neuroradiol J. 2025-6

[10]
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本文引用的文献

[1]
Unusual Signal Patterns of Break-apart FISH Probes Used in the Diagnosis of Soft Tissue Sarcomas.

Pathol Oncol Res. 2017-10

[2]
Anchored multiplex PCR for targeted next-generation sequencing reveals recurrent and novel USP6 fusions and upregulation of USP6 expression in aneurysmal bone cyst.

Genes Chromosomes Cancer. 2017-4

[3]
ALK oncoproteins in atypical inflammatory myofibroblastic tumours: novel RRBP1-ALK fusions in epithelioid inflammatory myofibroblastic sarcoma.

J Pathol. 2017-2

[4]
Myogenic Progenitor Cells Control Extracellular Matrix Production by Fibroblasts during Skeletal Muscle Hypertrophy.

Cell Stem Cell. 2017-1-5

[5]
The SPARC protein: an overview of its role in lung cancer and pulmonary fibrosis and its potential role in chronic airways disease.

Br J Pharmacol. 2017-1

[6]
Cutaneous nodular fasciitis with genetic analysis: a case series.

J Cutan Pathol. 2016-12

[7]
Jak1-STAT3 Signals Are Essential Effectors of the USP6/TRE17 Oncogene in Tumorigenesis.

Cancer Res. 2016-9-15

[8]
Identification of key long non-coding RNAs as competing endogenous RNAs for miRNA-mRNA in lung adenocarcinoma.

Eur Rev Med Pharmacol Sci. 2016-6

[9]
USP6 gene rearrangement in nodular fasciitis and histological mimics.

Histopathology. 2016-11

[10]
USP6 oncogene promotes Wnt signaling by deubiquitylating Frizzleds.

Proc Natl Acad Sci U S A. 2016-5-24

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