Shim Kwang Eon, Lee Chung, Kim Jin Up, Choi Gwang Ho, Kwak Kyoung Min, Kim Seok Hyung, Kim Hyunho, Yoon Jong Woo, Shin Tae Young, Jeong Chang Wook, Kim Hyunsuk
Internal Medicine, Hallym University Medical Center, Chuncheon Sacred Heart Hospital, Chuncheon-si, Gangwon-do, Republic of Korea.
Samsung Genome Institute, Samsung Medical Center, Seoul.
Medicine (Baltimore). 2020 May;99(19):e20071. doi: 10.1097/MD.0000000000020071.
Renal cell carcinoma (RCC) is known to be more prevalent in autosomal dominant polycystic kidney disease (ADPKD) patients than in the general population. However, little is known about genetic alterations or changes in signaling pathways in RCC in patients with ADPKD.In the current report, whole-exome and transcriptome sequencing was performed for paired samples of tumor tissue, cyst tissue, and peripheral blood (triple set) from a patient diagnosed with ADPKD and RCC.A 68-year-old man with ADPKD underwent left partial nephrectomy and was diagnosed with RCC. DNA and RNA were extracted from the triple set of the patient. A nonsense mutation in PKD2 (p.Arg742X), which is well known as a pathogenic variant in ADPKD, was identified in the paired triple set. In the tumor sample, a somatic missense mutation of VHL (p.S65L) was found, which is known as a pathogenic mutation in Von Hippel-Lindau syndrome and RCC. Furthermore, loss of chromosome 3p, where VHL is located, was detected. Upregulated VEGFA was found in the analysis of RCC mRNA, which might be caused by the loss of VHL and accelerate angiogenesis in RCC.Proliferation was also expected to be activated by the MAPK signaling pathway, including NRAS and MAPK1 expression.
已知肾细胞癌(RCC)在常染色体显性多囊肾病(ADPKD)患者中比在普通人群中更为普遍。然而,对于ADPKD患者中RCC的基因改变或信号通路变化知之甚少。在本报告中,对一名被诊断为ADPKD和RCC的患者的肿瘤组织、囊肿组织和外周血(三联样本)配对样本进行了全外显子组和转录组测序。一名患有ADPKD的68岁男性接受了左肾部分切除术,并被诊断为RCC。从该患者的三联样本中提取了DNA和RNA。在配对的三联样本中鉴定出PKD2中的一个无义突变(p.Arg742X),该突变在ADPKD中是众所周知的致病变异。在肿瘤样本中,发现了VHL的一个体细胞错义突变(p.S65L),该突变在冯·希佩尔-林道综合征和RCC中是已知的致病突变。此外,检测到VHL所在的3号染色体短臂缺失。在RCC mRNA分析中发现VEGFA上调,这可能是由于VHL缺失所致,并加速了RCC中的血管生成。增殖也预计会被包括NRAS和MAPK1表达在内的MAPK信号通路激活。