Lee Seungju, Kim Hyun Yul, Jung Youn Joo, Jung Chang Shin, Im Dongwon, Kim Jee Yeon, Lee Sun Min, Oh Seung Hwan
Department of Surgery, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea.
Department of Pathology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea.
Curr Probl Cancer. 2022 Apr;46(2):100843. doi: 10.1016/j.currproblcancer.2022.100843. Epub 2022 Feb 9.
Triple-negative breast cancer (TNBC) has higher loco-regional recurrence and visceral metastasis compared to other breast cancer subtypes; however, little is known about the molecular pathogenesis of TNBC. Therefore, we compared the mutation profiles of early TNBC with those of hormone receptor-positive (HR+) and/or human epidermal growth factor receptor 2-negative (HER2-) breast cancer using a customized next-generation sequencing capture panel. DNA was obtained from the primary tumor tissues of 34 patients diagnosed with pT2N0-1M0 HR+/HER2- breast cancer or TNBC. Using SureSelectXT kit (Agilent), next-generation sequencing for 48 breast cancer-associated genes was performed on HiSeq platform (Illumina) with germline confirmation. Also, plasma was collected from 24 patients before surgery, cell-free nucleic acids were extracted, and performed therascreen PIK3CA RGQ PCR assay. Significant mutations were found in TP53, PIK3CA, AR, BRCA1, PTEN, BRCA2, BRIP2, KIT, MET, AKT1, ALK, BARD1, BRAF, CD274, ERBB2, FGFR1, IDH2, NOTCH1, RET, and STK11 (in descending order of occurrence). TP53 mutations were identified in the TNBC group more frequently than in the HR+/HER2- group (P = 0.003). The presence of TP53 mutations was associated with a higher tumor grade (P = 0.008), p53 positivity (P < 0.0001), and a higher Ki-67 index (P = 0.004). PIK3CA was the most frequently mutated gene in HR+/HER2- breast cancer (8/22, 36.4%), but not in TNBC (1/12, 8.3%). The TP53 mutation is associated with higher tumor grade and Ki-67 expression in both groups, and with larger tumor size in TNBC, but not in HR+/HER2- breast cancer. In the foundation of TP53 mutation, concomitant mutation numbers are proportional to tumor size, reflecting clonal progression.
与其他乳腺癌亚型相比,三阴性乳腺癌(TNBC)具有更高的局部区域复发率和内脏转移率;然而,人们对TNBC的分子发病机制知之甚少。因此,我们使用定制的二代测序捕获芯片,比较了早期TNBC与激素受体阳性(HR+)和/或人表皮生长因子受体2阴性(HER2-)乳腺癌的突变谱。从34例诊断为pT2N0-1M0 HR+/HER2-乳腺癌或TNBC的患者的原发性肿瘤组织中获取DNA。使用SureSelectXT试剂盒(安捷伦公司),在HiSeq平台(Illumina公司)上对48个乳腺癌相关基因进行二代测序,并进行种系确认。此外,在术前从24例患者中采集血浆,提取游离核酸,并进行therascreen PIK3CA RGQ PCR检测。在TP53、PIK3CA、AR、BRCA1、PTEN、BRCA2、BRIP2、KIT、MET、AKT1、ALK、BARD1、BRAF、CD274、ERBB2、FGFR1、IDH2、NOTCH1、RET和STK11中发现了显著突变(按出现频率降序排列)。TNBC组中TP53突变的发生率高于HR+/HER2-组(P = 0.003)。TP53突变的存在与更高的肿瘤分级(P = 0.008)、p53阳性(P < 0.0001)和更高的Ki-67指数(P = 0.004)相关。PIK3CA是HR+/HER2-乳腺癌中最常发生突变的基因(8/22,36.4%),但在TNBC中并非如此(1/12,8.3%)。TP53突变在两组中均与更高的肿瘤分级和Ki-67表达相关,在TNBC中还与更大的肿瘤大小相关,但在HR+/HER2-乳腺癌中并非如此。在TP53突变的基础上,伴随突变的数量与肿瘤大小成正比,反映了克隆进展。