Mitus Jerzy, Adamczyk Agnieszka, Majchrzyk Kaja, Kowalik Artur, Ryś Janusz, Niemiec Joanna
Department of Surgical Oncology, National Research Institute of Oncology, Kracow Branch, Krakow, Poland.
Department of of Anatomy, Jagiellonian University Medical College, Krakow, Poland.
Pol J Pathol. 2020;71(1):7-12. doi: 10.5114/pjp.2020.94899.
Phyllodes tumor of the breast (PTB) is a rare neoplasm and accounts for 0.2-2.0% of breast cancer in women. Histopathological diagnosis of the tumor is difficult, and histological features do not always predict the course of the disease and the risk of progression. Pathogenesis and molecular biological characteristics as well as PTB prognostic factors are unknown. In search for genetic factors affecting PTB progression, 10 patients were analyzed for whom material from the primary tumor and local recurrence was available. DNA isolated from paraffin blocks was sequenced using the next-generation sequencing method (NGS). In 4 pairs, consisting of primary tumor and local recurrence, probably pathogenic/pathogenic variants were detected, and in three pairs they were observed in the CDKN2A gene, while other variants were found in PTEN and TP53 genes. NGS results indicate that the above-mentioned variants are hereditary, which suggests that the CDKN2A gene might be involved in cancerogenesis of PTB. Additionally, the selected pathogenic variant of EGFR gene was exclusively detected in one recuurent tumor, which might suggest the involvement of this gene in the mechanism of progression. In order to determine if this variant is associated with progression, the frequency of this mutation should be examined in larger group of malignant and borderline tumors.
乳腺叶状肿瘤(PTB)是一种罕见的肿瘤,占女性乳腺癌的0.2 - 2.0%。该肿瘤的组织病理学诊断困难,组织学特征并不总能预测疾病进程和进展风险。其发病机制、分子生物学特征以及PTB的预后因素尚不清楚。为了寻找影响PTB进展的遗传因素,对10例有原发性肿瘤和局部复发组织样本的患者进行了分析。从石蜡块中提取的DNA采用二代测序方法(NGS)进行测序。在4对原发性肿瘤和局部复发组织样本中,检测到可能的致病/致病性变异,其中3对在CDKN2A基因中观察到变异,而其他变异则在PTEN和TP53基因中发现。NGS结果表明上述变异是遗传性的,这提示CDKN2A基因可能参与PTB的癌变过程。此外,EGFR基因的特定致病性变异仅在1例复发性肿瘤中检测到,这可能提示该基因参与了进展机制。为了确定该变异是否与进展相关,应在更大规模的恶性和交界性肿瘤组中检测该突变的频率。