Molecular Profiles of Mixed Endometrial Carcinoma.

Autor: Matrai C; Departments of Pathology and Laboratory Medicine., Motanagh S; Departments of Pathology and Laboratory Medicine.; Caryl and Israel Englander Institute for Precision Medicine, Weill Cornell Medicine and New York-Presbyterian, New York, NY., Mirabelli S; Departments of Pathology and Laboratory Medicine., Ma L; Departments of Pathology and Laboratory Medicine., He B; Departments of Pathology and Laboratory Medicine., Chapman-Davis E; Obstetrics and Gynecology, Division of Gynecologic Oncology., Kurtis B; Cancer Genetics Incorporated, Rutherford, NJ., Elemento O; Physiology and Biophysics.; Institute for Computational Biomedicine, Weill Cornell Medicine.; Caryl and Israel Englander Institute for Precision Medicine, Weill Cornell Medicine and New York-Presbyterian, New York, NY., Mosquera JM; Departments of Pathology and Laboratory Medicine.; Caryl and Israel Englander Institute for Precision Medicine, Weill Cornell Medicine and New York-Presbyterian, New York, NY., Ellenson LH; Departments of Pathology and Laboratory Medicine.
Jazyk: angličtina
Zdroj: The American journal of surgical pathology [Am J Surg Pathol] 2020 Aug; Vol. 44 (8), pp. 1104-1111.
DOI: 10.1097/PAS.0000000000001519
Abstrakt: Mixed endometrial carcinomas are defined as a combination of 2 or more distinct histologic subtypes, one of which must be a type II tumor comprising at least 5% of the tumor volume. The oncogenesis of these tumors remains unclear, particularly in light of the increasingly appreciated morphologic overlap among subtypes, as well as evolving molecular data. We evaluated 8 cases of mixed endometrial carcinoma, including 4 endometrioid (EC)/serous (SC), 1 SC/clear cell (CC), and 3 EC/CC cases, to study the underlying molecular features and oncogenic mechanisms at play. Each component was analyzed by a targeted next-generation sequencing assay. All tumors shared mutations in both components. In 6 cases, one component showed additional mutations. Two EC/SC cases showed shared mutations and mutations unique to each component. When present, unique mutations were typically seen in the SC component, including variants in POLE and TP53, as well as potentially targetable genes DDR2, MAP2K1, and CCNE1. In EC/SC tumors, ERBB2 abnormalities were seen in 2 cases. EC/CC cases showed FGFR2 activating mutations in the EC component only. No fusion drivers were identified. Our data suggest that the majority of these tumors begin as a single clone and diverge along 2 pathways: (1) tumor progression, with one component showing additional mutations, and (2) tumor divergence, in which tumor components have both shared mutations and mutations unique to each component. In addition, the findings suggest a component of morphologic mimicry in these tumors. Our findings are clinically relevant since targetable mutations may be present in only one component of mixed tumors.
Databáze: MEDLINE