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化生性乳腺癌中的端粒酶逆转录酶(TERT)启动子热点突变与基因扩增

TERT promoter hotspot mutations and gene amplification in metaplastic breast cancer.

作者信息

da Silva Edaise M, Selenica Pier, Vahdatinia Mahsa, Pareja Fresia, Da Cruz Paula Arnaud, Ferrando Lorenzo, Gazzo Andrea M, Dopeso Higinio, Ross Dara S, Bakhteri Ariya, Riaz Nadeem, Chandarlapaty Sarat, Razavi Pedram, Norton Larry, Wen Hannah Y, Brogi Edi, Weigelt Britta, Zhang Hong, Reis-Filho Jorge S

机构信息

Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.

Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA.

出版信息

NPJ Breast Cancer. 2021 Apr 16;7(1):43. doi: 10.1038/s41523-021-00250-8.

Abstract

Metaplastic breast cancers (MBCs) are characterized by complex genomes, which seem to vary according to their histologic subtype. TERT promoter hotspot mutations and gene amplification are rare in common forms of breast cancer, but present in a subset of phyllodes tumors. Here, we sought to determine the frequency of genetic alterations affecting TERT in a cohort of 60 MBCs with distinct predominant metaplastic components (squamous, 23%; spindle, 27%; osseous, 8%; chondroid, 42%), and to compare the repertoire of genetic alterations of MBCs according to the presence of TERT promoter hotspot mutations or gene amplification. Forty-four MBCs were subjected to: whole-exome sequencing (WES; n = 27) or targeted sequencing of 341-468 cancer-related genes (n = 17); 16 MBCs were subjected to Sanger sequencing of the TERT promoter, TP53 and selected exons of PIK3CA, HRAS, and BRAF. TERT promoter hotspot mutations (n = 9) and TERT gene amplification (n = 1) were found in 10 of the 60 MBCs analyzed, respectively. These TERT alterations were less frequently found in MBCs with predominant chondroid differentiation than in other MBC subtypes (p = 0.01, Fisher's exact test) and were mutually exclusive with TP53 mutations (p < 0.001, CoMEt). In addition, a comparative analysis of the MBCs subjected to WES or targeted cancer gene sequencing (n = 44) revealed that MBCs harboring TERT promoter hotspot mutations or gene amplification (n = 6) more frequently harbored PIK3CA than TERT wild-type MBCs (n = 38; p = 0.001; Fisher's exact test). In conclusion, TERT somatic genetic alterations are found in a subset of TP53 wild-type MBCs with squamous/spindle differentiation, highlighting the genetic diversity of these cancers.

摘要

化生性乳腺癌(MBC)具有复杂的基因组,其基因组似乎因组织学亚型而异。TERT启动子热点突变和基因扩增在常见类型的乳腺癌中很少见,但在一部分叶状肿瘤中存在。在此,我们试图确定在60例具有不同主要化生成分(鳞状,23%;梭形,27%;骨样,8%;软骨样,42%)的MBC队列中影响TERT的基因改变频率,并根据TERT启动子热点突变或基因扩增的存在情况比较MBC的基因改变谱。44例MBC进行了:全外显子组测序(WES;n = 27)或341 - 468个癌症相关基因的靶向测序(n = 17);16例MBC进行了TERT启动子、TP53以及PIK3CA、HRAS和BRAF选定外显子的Sanger测序。在分析的60例MBC中,分别有10例发现了TERT启动子热点突变(n = 9)和TERT基因扩增(n = 1)。与其他MBC亚型相比,这些TERT改变在以软骨样分化为主的MBC中较少见(p = 0.01,Fisher精确检验),并且与TP53突变相互排斥(p < 0.001,CoMEt)。此外,对进行WES或靶向癌症基因测序的MBC(n = 44)的比较分析显示,携带TERT启动子热点突变或基因扩增的MBC(n = 6)比TERT野生型MBC(n = 38)更频繁地携带PIK3CA(p = 0.001;Fisher精确检验)。总之,在一部分具有鳞状/梭形分化的TP53野生型MBC中发现了TERT体细胞基因改变,突出了这些癌症的基因多样性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/caf3/8052452/973b408e4ef5/41523_2021_250_Fig1_HTML.jpg

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