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Mendoza RP, Chen‐Yost HI, Wanjari P, Wang P, Symes E, Johnson DN, Reeves W, Mueller J, Antic T, Biernacka A. Lung adenocarcinomas with isolated TP53 mutation: A comprehensive clinical, cytopathologic and molecular characterization. Cancer Med 2024; 13:e6873. [PMID: 38164123 PMCID: PMC10824142 DOI: 10.1002/cam4.6873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 11/14/2023] [Accepted: 12/13/2023] [Indexed: 01/03/2024] Open
Abstract
BACKGROUND TP53 mutation is present in about 50.8% of lung adenocarcinomas, frequently in combination with other genetic alterations. However, a rare subset harbors the TP53 mutation alone. METHODS Next-generation sequencing was performed in 840 lung adenocarcinomas diagnosed by fine needle aspiration. Fourteen cases (1.7%) showed isolated TP53 alteration and were subjected to a comprehensive analysis. RESULTS The average age at diagnosis was 65 years (range 48-79); 9 males and 5 females. All were smokers with an average pack-year of 41 (range 10-70). Nine had metastases, mostly in the brain (n = 2) and pleura (n = 2). After a follow-up period of up to 102 months, 9 died, 4 were alive with disease, and 1 was lost to follow-up. The median survival was 13 months. Most tumors exhibited poor differentiation, composed of solid sheets with moderate to severe atypia, increased mitotic activity, and necrotic background. Half were positive for TTF-1 and showed p53 overexpression. PD-L1 was positive in 6 cases. Most alterations were missense mutations in exons 5-8, and this mutation type was associated with p53 overexpression. Tumors with combined missense mutation and truncated protein had higher PD-L1 expression and significantly shorter overall survival, along with a trend towards an increase in tumor mutational burden (TMB). CEBPA deletion of undetermined significance was the most common copy number alteration. CONCLUSION Isolated TP53 mutation was seen in association with smoking, high-grade cytomorphologic features, adverse prognosis, and recurrent CEBPA deletions. These tumors tend to have strong PD-L1 expression and high TMB, suggesting potential benefit from immune checkpoint inhibitors. Hence, the recognition of this molecular group has prognostic and therapeutic implications.
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Affiliation(s)
- Rachelle P. Mendoza
- Department of PathologyUniversity of Rochester Medical CenterRochesterNew YorkUSA
| | | | - Pankhuri Wanjari
- Department of PathologyThe University of Chicago HospitalsChicagoIllinoisUSA
| | - Peng Wang
- Department of PathologyThe University of Chicago HospitalsChicagoIllinoisUSA
| | - Emily Symes
- Department of PathologyThe University of Chicago HospitalsChicagoIllinoisUSA
| | - Daniel N. Johnson
- Department of PathologyOSF Little Company of Mary Medical CenterEvergreen ParkIllinoisUSA
| | - Ward Reeves
- Department of PathologyThe University of Chicago HospitalsChicagoIllinoisUSA
| | - Jeffrey Mueller
- Department of PathologyThe University of Chicago HospitalsChicagoIllinoisUSA
| | - Tatjana Antic
- Department of PathologyThe University of Chicago HospitalsChicagoIllinoisUSA
| | - Anna Biernacka
- Department of PathologyThe University of Chicago HospitalsChicagoIllinoisUSA
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Libura M, Pawełczyk M, Florek I, Matiakowska K, Jaźwiec B, Borg K, Solarska I, Zawada M, Czekalska S, Libura J, Salamanczuk Z, Jakóbczyk M, Mucha B, Duszeńko E, Soszyńska K, Karabin K, Piątkowska-Jakubas B, Całbecka M, Gajkowska-Kulig J, Gadomska G, Kiełbiński M, Ejduk A, Kata D, Grosicki S, Kyrcz-Krzemień S, Warzocha K, Kuliczkowski K, Skotnicki A, Jęrzejczak WW, Haus O. CEBPA copy number variations in normal karyotype acute myeloid leukemia: Possible role of breakpoint-associated microhomology and chromatin status in CEBPA mutagenesis. Blood Cells Mol Dis 2015; 55:284-92. [PMID: 26460249 DOI: 10.1016/j.bcmd.2015.07.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2015] [Revised: 07/03/2015] [Accepted: 07/04/2015] [Indexed: 10/23/2022]
Abstract
Copy number variations (CNV) in CEBPA locus represent heterogeneous group of mutations accompanying acute myeloid leukemia (AML). The aim of this study was to characterize different CEBPA mutation categories in regard to biological data like age, cytology, CD7, and molecular markers, and identify possible factors affecting their etiology. We report here the incidence of 12.6% of CEBPA mutants in the population of 262 normal karyotype AML (NK-AML) patients. We confirmed that double mutant AMLs presented uniform biological features when compared to single CEBPA mutations and accompanied mostly younger patients. We hypothesized that pathogenesis of distinct CEBPA mutation categories might be influenced by different factors. The detailed sequence analysis revealed frequent breakpoint-associated microhomologies of 2 to 12bp. The analysis of distribution of microhomology motifs along CEBPA gene showed that longer stretches of microhomology at the mutational junctions were relatively rare by chance which suggests their functional role in the CEBPA mutagenesis. Additionally, accurate quantification of CEBPA transcript levels showed that double CEBPA mutations correlated with high-level CEBPA expression, whereas single N-terminal CEBPA mutations were associated with low-level CEBPA expression. This might suggest that high-level CEBPA expression and/or accessibility of CEBPA locus contribute to B-ZIP in-frame duplications.
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Affiliation(s)
- Marta Libura
- Department of Haematology, Oncology and Internal Diseases, Medical University and University Hospital, 1A Banacha Str., 02-097 Warsaw, Poland.
| | - Marta Pawełczyk
- Department of Haematology, Oncology and Internal Diseases, Medical University and University Hospital, 1A Banacha Str., 02-097 Warsaw, Poland.
| | - Izabella Florek
- Department of Haematology, Faculty of Medicine Jagiellonian University, 19 Kopernika Str., 31-501 Cracow, Poland.
| | - Karolina Matiakowska
- Department of Clinical Genetics, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, 9 Skłodowska-Curie Str., 85-094 Bydgoszcz, Poland.
| | - Bożena Jaźwiec
- Department of Haematology, Blood Neoplasms, and Bone Marrow Transplantation, Medical University, 4 Pasteura Str., 50-367 Wrocław, Poland.
| | - Katarzyna Borg
- Institute of Haematology and Transfusion Medicine, 14 Gandhi Str., 02-776 Warsaw, Poland.
| | - Iwona Solarska
- Institute of Haematology and Transfusion Medicine, 14 Gandhi Str., 02-776 Warsaw, Poland.
| | - Magdalena Zawada
- Department of Haematology, Faculty of Medicine Jagiellonian University, 19 Kopernika Str., 31-501 Cracow, Poland.
| | - Sylwia Czekalska
- Department of Haematology, Faculty of Medicine Jagiellonian University, 19 Kopernika Str., 31-501 Cracow, Poland.
| | - Jolanta Libura
- Department of Haematology, Oncology and Internal Diseases, Medical University and University Hospital, 1A Banacha Str., 02-097 Warsaw, Poland.
| | - Zoriana Salamanczuk
- Department of Haematology, Faculty of Medicine Jagiellonian University, 19 Kopernika Str., 31-501 Cracow, Poland.
| | - Małgorzata Jakóbczyk
- Department of Haematology, Faculty of Medicine Jagiellonian University, 19 Kopernika Str., 31-501 Cracow, Poland.
| | - Barbara Mucha
- Department of Clinical Genetics, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, 9 Skłodowska-Curie Str., 85-094 Bydgoszcz, Poland.
| | - Ewa Duszeńko
- Department of Haematology, Blood Neoplasms, and Bone Marrow Transplantation, Medical University, 4 Pasteura Str., 50-367 Wrocław, Poland.
| | - Krystyna Soszyńska
- Department of Haematology, Blood Neoplasms, and Bone Marrow Transplantation, Medical University, 4 Pasteura Str., 50-367 Wrocław, Poland.
| | - Karolina Karabin
- Department of Haematology, Oncology and Internal Diseases, Medical University and University Hospital, 1A Banacha Str., 02-097 Warsaw, Poland.
| | - Beata Piątkowska-Jakubas
- Department of Haematology, Faculty of Medicine Jagiellonian University, 19 Kopernika Str., 31-501 Cracow, Poland.
| | - Małgorzata Całbecka
- Department of Haematology, Copernicus Hospital, 17/19 Batory Str., 87-100 Toruń, Poland.
| | | | - Grażyna Gadomska
- Department of Haematology, Dr Biziel University Hospital, 75 Ujejskiego Str., 85-168 Bydgoszcz, Poland.
| | - Marek Kiełbiński
- Department of Haematology, Blood Neoplasms, and Bone Marrow Transplantation, Medical University, 4 Pasteura Str., 50-367 Wrocław, Poland.
| | - Anna Ejduk
- Institute of Haematology and Transfusion Medicine, 14 Gandhi Str., 02-776 Warsaw, Poland.
| | - Dariusz Kata
- Department of Hematology and Bone Marrow Transplantation, Medical University of Silesia, 20/24 Francuska str., 40-027 Katowice, Poland.
| | - Sebastian Grosicki
- Department of Hematology, SPZOZ ZSM Chorzów, 11 Strzelców Bytomskich Str., 41-500 Chorzów, Poland.
| | - Sławomira Kyrcz-Krzemień
- Department of Hematology and Bone Marrow Transplantation, Medical University of Silesia, 20/24 Francuska str., 40-027 Katowice, Poland.
| | - Krzysztof Warzocha
- Institute of Haematology and Transfusion Medicine, 14 Gandhi Str., 02-776 Warsaw, Poland.
| | - Kazimierz Kuliczkowski
- Department of Haematology, Blood Neoplasms, and Bone Marrow Transplantation, Medical University, 4 Pasteura Str., 50-367 Wrocław, Poland.
| | - Aleksander Skotnicki
- Department of Haematology, Faculty of Medicine Jagiellonian University, 19 Kopernika Str., 31-501 Cracow, Poland.
| | - Wiesław Wiktor Jęrzejczak
- Department of Haematology, Oncology and Internal Diseases, Medical University and University Hospital, 1A Banacha Str., 02-097 Warsaw, Poland.
| | - Olga Haus
- Department of Clinical Genetics, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, 9 Skłodowska-Curie Str., 85-094 Bydgoszcz, Poland; Department of Haematology, Blood Neoplasms, and Bone Marrow Transplantation, Medical University, 4 Pasteura Str., 50-367 Wrocław, Poland.
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