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Ronchi S, Facchi S, Di Lauro E, Libera L, Carnevali IW, Zefiro F, Alexandrova E, Rizzo F, Sessa F, Tibiletti MG. Immunohistochemical and molecular pattern of p53 in epithelial ovarian cancers negative for germline BRCA1/2 variants. Pathol Res Pract 2024; 255:155183. [PMID: 38364651 DOI: 10.1016/j.prp.2024.155183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 01/26/2024] [Accepted: 01/28/2024] [Indexed: 02/18/2024]
Abstract
Epithelial ovarian cancers (EOC) associated with germline or somatic BRCA pathogenetic variants have a significantly higher rate of TP53aberrations. The majority of TP53 mutations are detectable by immunohistochemistry and several studies demonstrated that an abnormal p53 pattern characterized high-grade EOCs. An abnormal p53 immunohistochemical staining in fallopian tube (serous tubal intraepithelial carcinoma (STIC) and "p53 signature" is considered as a precancerous lesion of high-grade EOCs and it is often found in fallopian tube tissues of BRCA germline mutated patients suggesting that STIC is an early lesion and the TP53 mutation is an early driver event of BRCA mutated high-grade EOCs. No relevant data are present in literature about the involvement of p53 abnormal pattern in EOC carcinogenesis of patients negative for germline BRCA variants. We describe TP53 mutation results in relationship to the immunohistochemical pattern of p53 expression in a series of EOCs negative for BRCA1 and BRCA2 germline mutations. In addition, we also investigated STIC presence and "p53 signature" in fallopian tube sampling of these EOCs. Our results demonstrate that TP53 alterations are frequent and early events in sporadic EOCs including also low-grade carcinomas. Also in this series, STIC is associated with an abnormal p53 pattern in fallopian tubes of high-grade EOCs. In summary, TP53 aberrations are the most frequent and early molecular events in EOC carcinogenesis independently from BRCA mutation status.
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Affiliation(s)
- Susanna Ronchi
- Unit of Pathology, Ospedale di Circolo, ASST SetteLaghi, Research Center for Familial and Hereditary Tumors, Department of Medicine and Surgery, University of Insubria, 21100 Varese, Italy.
| | - Sofia Facchi
- Unit of Pathology, Ospedale di Circolo, ASST SetteLaghi, Research Center for Familial and Hereditary Tumors, Department of Medicine and Surgery, University of Insubria, 21100 Varese, Italy.
| | - Eleonora Di Lauro
- Unit of Pathology, Ospedale di Circolo, ASST SetteLaghi, Research Center for Familial and Hereditary Tumors, Department of Medicine and Surgery, University of Insubria, 21100 Varese, Italy.
| | - Laura Libera
- Unit of Pathology, Ospedale di Circolo, ASST SetteLaghi, Research Center for Familial and Hereditary Tumors, Department of Medicine and Surgery, University of Insubria, 21100 Varese, Italy.
| | - Ileana Wanda Carnevali
- Unit of Pathology, Ospedale di Circolo, ASST SetteLaghi, Research Center for Familial and Hereditary Tumors, Department of Medicine and Surgery, University of Insubria, 21100 Varese, Italy.
| | - Francesca Zefiro
- Department of Obstetric and Gynecology, ASST Settelaghi, University of Insubria, 21100 Varese, Italy.
| | - Elena Alexandrova
- Laboratory of Molecular Medicine and Genomics, Department of Medicine, Surgery and Dentistry 'ScuolaMedicaSalernitana', University of Salerno, 84081 Baronissi, Italy.
| | - Francesca Rizzo
- Laboratory of Molecular Medicine and Genomics, Department of Medicine, Surgery and Dentistry 'ScuolaMedicaSalernitana', University of Salerno, 84081 Baronissi, Italy; Genome Research Center for Health - CRGS, Campus of Medicine of the University of Salerno, 84081 Baronissi, SA, Italy.
| | - Fausto Sessa
- Unit of Pathology, Ospedale di Circolo, ASST SetteLaghi, Research Center for Familial and Hereditary Tumors, Department of Medicine and Surgery, University of Insubria, 21100 Varese, Italy.
| | - Maria Grazia Tibiletti
- Unit of Pathology, Ospedale di Circolo, ASST SetteLaghi, Research Center for Familial and Hereditary Tumors, Department of Medicine and Surgery, University of Insubria, 21100 Varese, Italy.
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Carnevali IW, Cini G, Libera L, Sahnane N, Facchi S, Viel A, Sessa F, Tibiletti MG. MLH1 Promoter Methylation Could Be the Second Hit in Lynch Syndrome Carcinogenesis. Genes (Basel) 2023; 14:2060. [PMID: 38003003 PMCID: PMC10670941 DOI: 10.3390/genes14112060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 11/03/2023] [Accepted: 11/07/2023] [Indexed: 11/26/2023] Open
Abstract
(1) Background: MLH1 hypermethylation is an epigenetic alteration in the tumorigenesis of colorectal cancer (CRC) and endometrial cancer (EC), causing gene silencing, and, as a consequence, microsatellite instability. Commonly, MLH1 hypermethylation is considered a somatic and sporadic event in cancer, and its detection is recognized as a useful tool to distinguish sporadic from inherited conditions (such as, Lynch syndrome (LS)). However, MLH1 hypermethylation has been described in rare cases of CRC and EC in LS patients. (2) Methods: A total of 61 cancers (31 CRCs, 27 ECs, 2 ovarian cancers, and 1 stomach cancer) from 56 patients referred to cancer genetic counselling were selected for loss of MLH1 protein expression and microsatellite instability. All cases were investigated for MLH1 promoter methylation and MLH1/PMS2 germline variants. (3) Results: Somatic MLH1 promoter hypermethylation was identified in 16.7% of CRC and in 40% of EC carriers of MLH1 germline pathogenic variants. In two families, primary and secondary MLH1 epimutations were demonstrated. (4) Conclusions: MLH1 hypermethylation should not be exclusively considered as a sporadic cancer mechanism, as a non-negligible number of LS-related cancers are MLH1 hypermethylated. Current flow charts for universal LS screening, which include MLH1 methylation, should be applied, paying attention to a patient's family and personal history.
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Affiliation(s)
- Ileana Wanda Carnevali
- UO Anatomia Patologica Ospedale di Circolo ASST-Settelaghi, 21100 Varese, Italy; (N.S.); (F.S.)
- Centro di Ricerca per lo Studio dei Tumori Eredo-Famigliari, Università dell’Insubria, 21100 Varese, Italy; (L.L.); (S.F.); (M.G.T.)
| | - Giulia Cini
- Unit of Functional Oncogenomics and Genetics, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, 33081 Aviano, Italy; (G.C.); (A.V.)
| | - Laura Libera
- Centro di Ricerca per lo Studio dei Tumori Eredo-Famigliari, Università dell’Insubria, 21100 Varese, Italy; (L.L.); (S.F.); (M.G.T.)
- Department of Medicine and Thecnological Innovation, Università dell’Insubria, 21100 Varese, Italy
| | - Nora Sahnane
- UO Anatomia Patologica Ospedale di Circolo ASST-Settelaghi, 21100 Varese, Italy; (N.S.); (F.S.)
- Centro di Ricerca per lo Studio dei Tumori Eredo-Famigliari, Università dell’Insubria, 21100 Varese, Italy; (L.L.); (S.F.); (M.G.T.)
| | - Sofia Facchi
- Centro di Ricerca per lo Studio dei Tumori Eredo-Famigliari, Università dell’Insubria, 21100 Varese, Italy; (L.L.); (S.F.); (M.G.T.)
- Department of Medicine and Thecnological Innovation, Università dell’Insubria, 21100 Varese, Italy
| | - Alessandra Viel
- Unit of Functional Oncogenomics and Genetics, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, 33081 Aviano, Italy; (G.C.); (A.V.)
| | - Fausto Sessa
- UO Anatomia Patologica Ospedale di Circolo ASST-Settelaghi, 21100 Varese, Italy; (N.S.); (F.S.)
- Centro di Ricerca per lo Studio dei Tumori Eredo-Famigliari, Università dell’Insubria, 21100 Varese, Italy; (L.L.); (S.F.); (M.G.T.)
- Department of Medicine and Thecnological Innovation, Università dell’Insubria, 21100 Varese, Italy
| | - Maria Grazia Tibiletti
- Centro di Ricerca per lo Studio dei Tumori Eredo-Famigliari, Università dell’Insubria, 21100 Varese, Italy; (L.L.); (S.F.); (M.G.T.)
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Libera L, Sahnane N, Carnevali IW, Cimetti L, Cerutti R, Chiaravalli AM, Riva C, Tibiletti MG, Sessa F, Furlan D. Microsatellite analysis of sporadic and hereditary gynaecological cancer in routine diagnostics. J Clin Pathol 2017; 70:792-797. [DOI: 10.1136/jclinpath-2017-204348] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Revised: 03/14/2017] [Accepted: 03/15/2017] [Indexed: 11/04/2022]
Abstract
Microsatellite instability (MSI) testing is tricky in gynaecological cancers (GC). Thus, we aimed to describe the instability patterns to improve MSI test interpretation in sporadic and hereditary GCs. Ninety-five cases, including uterine and ovarian cancers, with known genetic and immunohistochemical (IHC) features, were analysed for MSI by a mononucleotide repeats pentaplex (MRP). We identified 13 ambiguous cases that did not fully meet MSI criteria (‘borderline’ cases, B-MSI), which were mainly represented by MSH2/MSH6-deficient and Lynch syndrome cases. Also, we evaluated nine additional loci of candidate MSI markers that did not improve the detection of MSI cases, but might be useful for discordant or borderline samples. In conclusion, although MSI and IHC test are highly concordant, a subset of ambiguous MSI cases deserves a careful interpretation in particular when MSH2/MSH6 are involved.RPL22andSRPRtesting may be useful to integrate MRP panel for the analysis of critical cases.
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