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Dugo E, Piva F, Giulietti M, Giannella L, Ciavattini A. Copy number variations in endometrial cancer: from biological significance to clinical utility. Int J Gynecol Cancer 2024; 34:1089-1097. [PMID: 38677776 DOI: 10.1136/ijgc-2024-005295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2024] Open
Abstract
The molecular basis of endometrial cancer, which is the most common malignancy of the female reproductive organs, relies not only on onset of mutations but also on copy number variations, the latter consisting of gene gains or losses. In this review, we introduce copy number variations and discuss their involvement in endometrial cancer to determine the perspectives of clinical applicability. We performed a literature analysis on PubMed of publications over the past 30 years and annotated clinical information, including histological and molecular subtypes, adopted molecular techniques for identification of copy number variations, their locations, and the genes involved. We highlight correlations between the presence of some specific copy number variations and myometrial invasion, lymph node metastasis, advanced International Federation of Gynecology and Obstetrics (FIGO) stage, high grade, drug response, and cancer progression. In particular, type I endometrial cancer cells have few copy number variations and are mainly located in 8q and 1q, while type II, high grade, and advanced FIGO stage endometrial cancer cells are aneuploid and have a greater number of copy number variations. As expected, the higher the number of copy number variations the worse the prognosis, especially if they amplify CCNE1, ERBB2, KRAS, MYC, and PIK3CA oncogenes. Great variability in copy number and location among patients with the same endometrial cancer histological or molecular subtype emerged, making them interesting candidates to be explored for the improvement of patient stratification. Copy number variations have a role in endometrial cancer progression, and therefore their detection may be useful for more accurate prediction of prognosis. Unfortunately, only a few studies have been carried out on the role of copy number variations according to the molecular classification of endometrial cancer, and even fewer have explored the correlation with drugs. For these reasons, further studies, also using single cell RNA sequencing, are needed before reaching a clinical application.
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Affiliation(s)
- Erica Dugo
- Department of Specialistic Clinical and Odontostomatological Sciences, Polytechnic University of Marche, Ancona, Italy
| | - Francesco Piva
- Department of Specialistic Clinical and Odontostomatological Sciences, Polytechnic University of Marche, Ancona, Italy
| | - Matteo Giulietti
- Department of Specialistic Clinical and Odontostomatological Sciences, Polytechnic University of Marche, Ancona, Italy
| | - Luca Giannella
- Woman's Health Sciences Department, Polytechnic University of Marche, Ancona, Italy
| | - Andrea Ciavattini
- Woman's Health Sciences Department, Polytechnic University of Marche, Ancona, Italy
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Quantitative next-generation sequencing-based analysis indicates progressive accumulation of microsatellite instability between atypical hyperplasia/endometrial intraepithelial neoplasia and paired endometrioid endometrial carcinoma. Mod Pathol 2019; 32:1508-1520. [PMID: 31186530 DOI: 10.1038/s41379-019-0298-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 05/03/2019] [Accepted: 05/04/2019] [Indexed: 12/30/2022]
Abstract
Atypical hyperplasia/endometrial intraepithelial neoplasia is an accepted precursor to endometrioid-type endometrial carcinoma. Mismatch repair-deficient endometrial carcinomas are also known to be a biologically and clinically distinct subset of tumors. However, the development of microsatellite instability in endometrial carcinogenesis has not yet been evaluated by novel next-generation sequencing-based methods. We examined 17 mismatch repair-deficient endometrioid endometrial carcinomas and their paired atypical hyperplasia/endometrial intraepithelial neoplasia precursors using a next-generation sequencing panel with quantitative microsatellite instability detection at 336 loci. Findings were compared to histological features, polymerase chain reaction-based microsatellite instability testing, immunohistochemical expression of mismatch repair proteins, and tumor mutational burden calculations. All 17 endometrial carcinomas and 8/17 atypical hyperplasia/endometrial intraepithelial neoplasia showed microsatellite instability by next-generation sequencing-based testing. Endometrial carcinoma specimens showed significantly more unstable microsatellite loci than paired atypical hyperplasia/endometrial intraepithelial neoplasia (mean: 40.0% vs 19.9 unstable loci, respectively). Out of nine microsatellite-stable atypical hyperplasia/endometrial intraepithelial neoplasia specimens, four showed mismatch repair loss by immunohistochemistry. All atypical hyperplasia/endometrial intraepithelial neoplasia and endometrial carcinoma specimens with microsatellite instability were also mismatch repair-deficient by immunohistochemistry. Tumor mutational burden was significantly greater in endometrial carcinoma than in paired atypical hyperplasia/endometrial intraepithelial neoplasia specimens, and tumor mutational burden was significantly correlated with percent unstable microsatellite loci. Paired atypical hyperplasia/endometrial intraepithelial neoplasia and endometrial carcinoma specimens show progressive accumulation of unstable microsatellite loci following loss of mismatch repair protein expression. Comprehensive next-generation sequencing-based testing of endometrial carcinomas offers new insights into endometrial carcinogenesis and opportunities for improved tumor surveillance, diagnosis, and management.
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Wang Y, Hu L, Ji P, Teng F, Tian W, Liu Y, Cogdell D, Liu J, Sood AK, Broaddus R, Xue F, Zhang W. MIIP remodels Rac1-mediated cytoskeleton structure in suppression of endometrial cancer metastasis. J Hematol Oncol 2016; 9:112. [PMID: 27760566 PMCID: PMC5069779 DOI: 10.1186/s13045-016-0342-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Accepted: 10/08/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Endometrial carcinoma (EC) is one of the most common malignancies of the female reproductive system. Migration and invasion inhibitory protein (MIIP) gene was recently discovered candidate tumor suppress gene which located at chromosome 1p36.22. 1p36 deletion was found in many types of tumor including EC. In the present study, we will determine the role and mechanism of MIIP in EC metastasis. METHODS Immunohistochemistry was used to measure MIIP expression in normal and EC tissue. Both gain-of-function (infection) and loss-of-function (siRNA) assays were used to alter MIIP expression levels. The effect of MIIP on cell migration and invasion was measured by transwell assay. F-actin immunofluorescence staining was used to observe the cell morphology. The activation of GTP-loaded Rac1 was evaluated by Rac activity assay kit. Immunoprecipitation/WB was used to measure the interaction between MIIP and PAK1. RESULTS We demonstrate that MIIP expression was significantly decreased in EC patients comparing to the normal ones, and decreased MIIP expression in EC tissues is associated with deep myometrial invasion, advanced stage, and the presence of lymph node metastasis. Using both gain-of-function (infection) and loss-of-function (siRNA) assays, we show that MIIP markedly blocked EC cell migration, whereas loss of MIIP led to increase in EC cell migration. We demonstrate that elevated expression of MIIP resulted in cytoskeleton reorganization with decreased formation of lamellipodia. We also provide evidence that MIIP is a key molecule in directing Rac1 signaling cascades in EC. Ectopically expressed MIIP consistently competed with Rac1-GTP for binding with the PAK1 p21-binding domain. Our data show that MIIP and PAK1 bind each other and that a C-terminal polyproline domain of MIIP is required for PAK1 binding. Deletion of the PAK1-binding domain of MIIP reduced cell migration-inhibiting activity. CONCLUSIONS MIIP may function as a tumor suppressor gene for endometrial carcinoma. MIIP attenuates Rac1 signaling through a protein interaction network, and loss of this regulator may contribute to EC metastasis.
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Affiliation(s)
- Yingmei Wang
- Department of Gynecology and Obstetrics, Tianjin Medical University General Hospital, Tianjin, China. .,Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
| | - Limei Hu
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.,Department of Systems Biology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Ping Ji
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.,Present Address: Department of Biochemistry and Molecular Biology, The University of Texas Medical Branch, Galveston, TX, USA
| | - Fei Teng
- Department of Gynecology and Obstetrics, Tianjin Medical University General Hospital, Tianjin, China
| | - Wenyan Tian
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Yuexin Liu
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.,Department of Bioinformatics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - David Cogdell
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Jinsong Liu
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Anil K Sood
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.,Center for RNAi and Non-Coding RNA, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Russell Broaddus
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Fengxia Xue
- Department of Gynecology and Obstetrics, Tianjin Medical University General Hospital, Tianjin, China.
| | - Wei Zhang
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. .,Department of Cancer Biology, Comprehensive Cancer Center of Wake Forest Baptist Medical Center, Winston-Salem, NC, 27157, USA.
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Sever E, Doğer E, Çakıroğlu Y, Sünnetçi D, Çine N, Savlı H, Yücesoy İ. The effect of first chromosome long arm duplication on survival of endometrial carcinoma. Turk J Obstet Gynecol 2014; 11:207-210. [PMID: 28913021 PMCID: PMC5558362 DOI: 10.4274/tjod.05617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2014] [Accepted: 07/26/2014] [Indexed: 12/01/2022] Open
Abstract
Objective: The aim of this study is to investigate the effect of first chromosome long arm duplication (dup(1q)) in cases with endometrial carcinoma detected with array based comperative genomic hybridization (aCGH) on survival from the cancer. Materials and Methods: A total of 53 patients with the diagnosis of endometrial carcinom due to endometrial biopsy and who have been operated for this reason have been allocated in the study. Frozen section biopsy and staging surgery have been performed for all the cases. Samples obtained from the tumoral mass have been investigated for chromosomal aberrations with aCGH method. Kaplan-Meier and Cox-regression analysis have been performed for survival analysis. Results: Among 53 cases with endometrial carcinomas, dup(1q) was diagnosed in 14 (26.4%) of the cases. For the patient group that has been followed-up for 24 months (3-33 months), dup(1q) (p=.01), optimal cytoreduction (p<.001), lymph node positivity (p=.006), tumor stage >1 (p=.006) and presence of high risk tumor were the factors that were associated with survival. Cox-regression analysis has revealed that optimal cytoreduction was the most important prognostic factor (p=.02). Conclusion: Presence of 1q duplication can be used as a prognostic factor in the preoperative period.
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Affiliation(s)
- Erman Sever
- Kocaeli University Faculty of Medicine, Department of Obstetrics and Gynecology, Kocaeli, Turkey
| | - Emek Doğer
- Kocaeli University Faculty of Medicine, Department of Obstetrics and Gynecology, Kocaeli, Turkey
| | - Yiğit Çakıroğlu
- Kocaeli University Faculty of Medicine, Department of Obstetrics and Gynecology, Kocaeli, Turkey
| | - Deniz Sünnetçi
- Kocaeli University Faculty of Medicine, Department of Medical Genetics, Kocaeli, Turkey
| | - Naci Çine
- Kocaeli University Faculty of Medicine, Department of Medical Genetics, Kocaeli, Turkey
| | - Hakan Savlı
- Kocaeli University Faculty of Medicine, Department of Medical Genetics, Kocaeli, Turkey
| | - İzzet Yücesoy
- Kocaeli University Faculty of Medicine, Department of Obstetrics and Gynecology, Kocaeli, Turkey
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Gemoll T, Habermann JK, Lahmann J, Szymczak S, Lundgren C, Bündgen NK, Jungbluth T, Nordström B, Becker S, Lomnytska MI, Bruch HP, Ziegler A, Hellman U, Auer G, Roblick UJ, Jörnvall H. Protein profiling of genomic instability in endometrial cancer. Cell Mol Life Sci 2012; 69:325-33. [PMID: 21739232 PMCID: PMC11115173 DOI: 10.1007/s00018-011-0752-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2011] [Revised: 06/07/2011] [Accepted: 06/14/2011] [Indexed: 11/28/2022]
Abstract
DNA aneuploidy has been identified as a prognostic factor in the majority of epithelial malignancies. We aimed at identifying ploidy-associated protein expression in endometrial cancer of different prognostic subgroups. Comparison of gel electrophoresis-based protein expression patterns between normal endometrium (n = 5), diploid (n = 7), and aneuploid (n = 7) endometrial carcinoma detected 121 ploidy-associated protein forms, 42 differentially expressed between normal endometrium and diploid endometrioid carcinomas, 37 between diploid and aneuploid endometrioid carcinomas, and 41 between diploid endometrioid and aneuploid uterine papillary serous cancer. Proteins were identified by mass spectrometry and evaluated by Ingenuity Pathway Analysis. Targets were confirmed by liquid chromatography/mass spectrometry. Mass spectrometry identified 41 distinct polypeptides and pathway analysis resulted in high-ranked networks with vimentin and Nf-κB as central nodes. These results identify ploidy-associated protein expression differences that overrule histopathology-associated expression differences and emphasize particular protein networks in genomic stability of endometrial cancer.
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Affiliation(s)
- Timo Gemoll
- Department of Medical Biochemistry and Biophysics, Karolinska Institutet, Scheeles väg 2, 17177 Stockholm, Sweden
- Department of Surgery, University of Lübeck, 23538 Lübeck, Germany
- Karolinska Biomic Center, Karolinska Institutet, 17176 Stockholm, Sweden
| | - Jens K. Habermann
- Department of Medical Biochemistry and Biophysics, Karolinska Institutet, Scheeles väg 2, 17177 Stockholm, Sweden
- Department of Surgery, University of Lübeck, 23538 Lübeck, Germany
| | - Johanna Lahmann
- Department of Surgery, University of Lübeck, 23538 Lübeck, Germany
| | - Silke Szymczak
- Institute of Medical Biometry and Statistics, University of Lübeck, 23562 Lübeck, Germany
| | - Caroline Lundgren
- Department of Oncology, Radiumhemmet, Karolinska University Hospital, 17176 Stockholm, Sweden
| | - Nana K. Bündgen
- Department of Surgery, University of Lübeck, 23538 Lübeck, Germany
| | - Thomas Jungbluth
- Department of Surgery, University of Lübeck, 23538 Lübeck, Germany
| | - Britta Nordström
- Department of Oncology, Radiumhemmet, Karolinska University Hospital, 17176 Stockholm, Sweden
| | - Susanne Becker
- Karolinska Biomic Center, Karolinska Institutet, 17176 Stockholm, Sweden
| | - Marta I. Lomnytska
- Karolinska Biomic Center, Karolinska Institutet, 17176 Stockholm, Sweden
- Department of Oncology, Radiumhemmet, Karolinska University Hospital, 17176 Stockholm, Sweden
| | - Hans-Peter Bruch
- Department of Surgery, University of Lübeck, 23538 Lübeck, Germany
| | - Andreas Ziegler
- Institute of Medical Biometry and Statistics, University of Lübeck, 23562 Lübeck, Germany
| | - Ulf Hellman
- Ludwig Institute for Cancer Research, Ltd., 75124 Uppsala, Sweden
| | - Gert Auer
- Karolinska Biomic Center, Karolinska Institutet, 17176 Stockholm, Sweden
| | - Uwe J. Roblick
- Department of Medical Biochemistry and Biophysics, Karolinska Institutet, Scheeles väg 2, 17177 Stockholm, Sweden
- Department of Surgery, University of Lübeck, 23538 Lübeck, Germany
| | - Hans Jörnvall
- Department of Medical Biochemistry and Biophysics, Karolinska Institutet, Scheeles väg 2, 17177 Stockholm, Sweden
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Habermann JK, Bündgen NK, Gemoll T, Hautaniemi S, Lundgren C, Wangsa D, Doering J, Bruch HP, Nordstroem B, Roblick UJ, Jörnvall H, Auer G, Ried T. Genomic instability influences the transcriptome and proteome in endometrial cancer subtypes. Mol Cancer 2011; 10:132. [PMID: 22040021 PMCID: PMC3261822 DOI: 10.1186/1476-4598-10-132] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2011] [Accepted: 10/31/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In addition to clinical characteristics, DNA aneuploidy has been identified as a prognostic factor in epithelial malignancies in general and in endometrial cancers in particular. We mapped ploidy-associated chromosomal aberrations and identified corresponding gene and protein expression changes in endometrial cancers of different prognostic subgroups. METHODS DNA image cytometry classified 25 endometrioid cancers to be either diploid (n = 16) or aneuploid (n = 9), and all uterine papillary serous cancers (UPSC) to be aneuploid (n = 8). All samples were subjected to comparative genomic hybridization and gene expression profiling. Identified genes were subjected to Ingenuity pathway analysis (IPA) and were correlated to protein expression changes. RESULTS Comparative genomic hybridization revealed ploidy-associated specific, recurrent genomic imbalances. Gene expression analysis identified 54 genes between diploid and aneuploid endometrioid carcinomas, 39 genes between aneuploid endometrioid cancer and UPSC, and 76 genes between diploid endometrioid and aneuploid UPSC to be differentially expressed. Protein profiling identified AKR7A2 and ANXA2 to show translational alterations consistent with the transcriptional changes. The majority of differentially expressed genes and proteins belonged to identical molecular functions, foremost Cancer, Cell Death, and Cellular Assembly and Organization. CONCLUSIONS We conclude that the grade of genomic instability rather than the histopathological subtype correlates with specific gene and protein expression changes. The identified genes and proteins might be useful as molecular targets for improved diagnostic and therapeutic intervention and merit prospective validation.
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Affiliation(s)
- Jens K Habermann
- Laboratory for Surgical Research, Department of Surgery, University of Lübeck, Germany.
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Tan DSP, Lambros MBK, Marchiò C, Reis-Filho JS. ESR1 amplification in endometrial carcinomas: hope or hyperbole? J Pathol 2008; 216:271-4. [PMID: 18788074 DOI: 10.1002/path.2432] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The ESR1 gene maps 6q25 and encodes for oestrogen receptor alpha, which has been shown to play a pivotal role in the development of breast and endometrial cancer. It has recently been reported that oestrogen receptor alpha expression may be driven in some cases by ESR1 gene amplification and that this phenomenon may be an early event in breast and endometrial carcinogenesis. Although copy number gains of 6q have been reported by several groups, their prevalence, association with oestrogen receptor alpha expression, and clinical implications have been a matter of controversy. Here we discuss the key issues regarding the methods employed in the identification of ESR1 amplification, and briefly review the current literature and recent controversies on the subject of ESR1 amplification in endometrial and breast cancers.
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Affiliation(s)
- D S P Tan
- Molecular Pathology Laboratory, The Breakthrough Breast Cancer Research Centre, Institute of Cancer Research, London, SW3 6JB, UK
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Espindola D, Kennedy KA, Fischer EG. Management of abnormal uterine bleeding and the pathology of endometrial hyperplasia. Obstet Gynecol Clin North Am 2008; 34:717-37, ix. [PMID: 18061866 DOI: 10.1016/j.ogc.2007.09.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
There are no screening tests for endometrial carcinoma, and patients typically present with abnormal uterine bleeding. This article discusses the pathophysiology and clinical work-up of abnormal uterine bleeding, and risk factors for endometrial carcinoma. Atypical complex hyperplasia and the more recently defined endometrial intraepithelial neoplasia are well recognized as precancers. Evolving knowledge of their genetic alterations provides the opportunity to develop molecular markers, so that endometrial diseases may be diagnosed at the precancerous or early invasive stage. Emerging molecular markers also provide the opportunity to develop clinically useful screening tests for the most common malignancy of the female genital tract.
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Affiliation(s)
- Dana Espindola
- Basic Medical Sciences Building, Room 249, 1 University of New Mexico, Albuquerque, NM 87131, USA
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Setiawan VW, Ursin G, Horn-Ross PL, Van Den Berg D, Le Marchand L, Henderson BE, Bernstein L, Haiman CA. Germ line variation at 8q24 and endometrial cancer risk. Cancer Epidemiol Biomarkers Prev 2008; 16:2166-8. [PMID: 17932368 DOI: 10.1158/1055-9965.epi-07-0510] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Veronica Wendy Setiawan
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Harlyne Norris Research Tower, 1450 Biggy Street, Room 1504A, Los Angeles, CA 90033, USA
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