In-depth molecular analysis of combined and co-primary pulmonary large cell neuroendocrine carcinoma and adenocarcinoma

Autor: Robert-Jan van Suylen, T. Dorine den Toom, PALGA-group, Wim Timens, B. Hermans, Ernst-Jan M. Speel, Lisa M. Hillen, Jan H. von der Thüsen, Peggy N. Atmodimedjo, Esther C. van den Broek, Irene van der Baan, Jules L. Derks, Winand N.M. Dinjens, Cecile Coumans-Stallinga, Anne-Marie C. Dingemans, Hendrikus J. Dubbink
Přispěvatelé: Pulmonologie, RS: GROW - R3 - Innovative Cancer Diagnostics & Therapy, MUMC+: MA Med Staf Artsass Longziekten (9), RS: GROW - R2 - Basic and Translational Cancer Biology, Pathologie, MUMC+: DA Pat Pathologie (9), MUMC+: MA Med Staf Spec Longziekten (9), Pathology, Pulmonary Medicine, Guided Treatment in Optimal Selected Cancer Patients (GUTS), Groningen Research Institute for Asthma and COPD (GRIAC)
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: International Journal of Cancer, 150(5), 802-815. Wiley
International Journal of Cancer, 150(5), 802-815. Wiley-Liss Inc.
ISSN: 0020-7136
Popis: Up to 14% of large cell neuroendocrine carcinomas (LCNEC) are diagnosed in continuity with non-small cell lung carcinoma. In addition to these combined lesions, 1-7% of lung tumors present as co-primary tumors with multiple synchronous lesions. We evaluated molecular and clinicopathological characteristics of combined and co-primary LCNEC-adenocarcinoma (ADC) tumors. Ten patients with LCNEC-ADC (combined) and 5 patients with multiple synchronous ipsilateral LCNEC and ADC tumors (co-primary) were included. DNA was isolated from distinct tumor parts and 65 cancer genes were analyzed by next generation sequencing. Immunohistochemistry was performed including neuroendocrine markers, pRb, Ascl1 and Rest. Pure ADC (N=37) and LCNEC (N=17) cases were used for reference. At least 1 shared mutation, indicating tumor clonality, was found in LCNEC- and ADC-parts of 10/10 combined tumors but only in 1/5 co-primary tumors. A range of identical mutations was observed in both parts of combined tumors: 8/10 contained ADC-related (EGFR/KRAS/STK11 and/or KEAP1), 4/10 RB1 and 9/10 TP53 mutations. Loss of pRb IHC was observed in 6/10 LCNEC- and 4/10 ADC-parts. The number and intensity of expression of Ascl1 and neuroendocrine markers increased from pure ADC (low) to combined ADC (intermediate) and combined and pure LCNEC (high). The opposite was true for Rest expression. In conclusion, all combined LCNEC-ADC tumors were clonally related indicating a common origin. A relatively high frequency of pRb inactivation was observed in both LCNEC- and ADC-parts, suggesting an underlying role in LCNEC-ADC development. Furthermore, neuroendocrine differentiation might be modulated by Ascl1(+) and Rest(-) expression. This article is protected by copyright. All rights reserved.
Databáze: OpenAIRE
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