1
|
Sisdelli L, Cordioli MIV, Vaisman F, Monte O, Longui CA, Cury AN, Freitas MO, Rangel-Pozzo A, Mai S, Cerutti JM. A Multifocal Pediatric Papillary Thyroid Carcinoma (PTC) Harboring the AGK-BRAF and RET/PTC3 Fusion in a Mutually Exclusive Pattern Reveals Distinct Levels of Genomic Instability and Nuclear Organization. Biology (Basel) 2021; 10:biology10020125. [PMID: 33562578 PMCID: PMC7914679 DOI: 10.3390/biology10020125] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 01/11/2021] [Accepted: 02/01/2021] [Indexed: 12/18/2022]
Abstract
Simple Summary Genetic alterations, such as RET/PTC and AGK-BRAF fusions, are frequent events in pediatric papillary thyroid carcinoma (PTC). However, their role as prognostic markers in pediatric PTC is still under investigation. In this study, we present a patient harboring three tumor foci with distinct genetic alterations (AGK-BRAF, RET/PTC3 and an absence of canonical alterations) that were investigated for DNA structure and telomere-related genomic instability. These preliminary results highlight that AGK-BRAF fusion likely affects nuclear architecture, which might explain a more aggressive disease outcome observed in pediatric PTC cases with AGK-BRAF fusion. Abstract The spectrum and incidence of gene fusions in papillary thyroid carcinoma (PTC) can differ significantly depending on the age of onset, histological subtype or radiation exposure history. In sporadic pediatric PTC, RET/PTC1-3 and AGK-BRAF fusions are common genetic alterations. The role of RET/PTC as a prognostic marker in pediatric PTC is still under investigation. We recently showed that AGK-BRAF fusion is prevalent in young patients (mean 10 years) and associated with specific and aggressive pathological features such as multifocality and lung metastasis. In this pilot study, we report a unique patient harboring three different foci: the first was positive for AGK-BRAF fusion, the second was positive for just RET/PTC3 fusion and the third was negative for both rearrangements. To investigate whether AGK-BRAF and RET/PTC3 are associated with genomic instability and chromatin modifications, we performed quantitative fluorescence in situ hybridization (Q-FISH) of telomere repeats followed by 3D imaging analysis and 3D super-resolution Structured Illumination Microscopy (3D-SIM) to analyze the DNA structure from the foci. We demonstrated in this preliminary study that AGK-BRAF is likely associated with higher levels of telomere-related genomic instability and chromatin remodeling in comparison with RET/PTC3 foci. Our results suggest a progressive disruption in chromatin structure in AGK-BRAF-positive cells, which might explain a more aggressive disease outcome in patients harboring this rearrangement.
Collapse
Affiliation(s)
- Luiza Sisdelli
- The Genetic Basis of Thyroid Tumors Lab, Division of Genetics, Department of Morphology and Genetics, Universidade Federal de São Paulo, São Paulo 04039-032, Brazil; (L.S.); (M.I.V.C.)
- Cell Biology, Research Institute of Oncology and Hematology, University of Manitoba, CancerCare Manitoba, Winnipeg, MB R3E 0V9, Canada; (A.R.-P.); (S.M.)
| | - Maria Isabel V. Cordioli
- The Genetic Basis of Thyroid Tumors Lab, Division of Genetics, Department of Morphology and Genetics, Universidade Federal de São Paulo, São Paulo 04039-032, Brazil; (L.S.); (M.I.V.C.)
| | | | - Osmar Monte
- Department of Pediatrics, Irmandade da Santa Casa de Misericórdia de São Paulo, São Paulo 01221-010, Brazil; (O.M.); (C.A.L.)
| | - Carlos A. Longui
- Department of Pediatrics, Irmandade da Santa Casa de Misericórdia de São Paulo, São Paulo 01221-010, Brazil; (O.M.); (C.A.L.)
| | - Adriano N. Cury
- Department of Medicine, Irmandade da Santa Casa de Misericórdia de São Paulo, São Paulo 01221-010, Brazil;
| | - Monique O. Freitas
- Medical Genetics Service of the Martagão Gesteira Childcare and Pediatrics Institute (IPPMG), Medical School, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-912, Brazil;
| | - Aline Rangel-Pozzo
- Cell Biology, Research Institute of Oncology and Hematology, University of Manitoba, CancerCare Manitoba, Winnipeg, MB R3E 0V9, Canada; (A.R.-P.); (S.M.)
| | - Sabine Mai
- Cell Biology, Research Institute of Oncology and Hematology, University of Manitoba, CancerCare Manitoba, Winnipeg, MB R3E 0V9, Canada; (A.R.-P.); (S.M.)
| | - Janete M. Cerutti
- The Genetic Basis of Thyroid Tumors Lab, Division of Genetics, Department of Morphology and Genetics, Universidade Federal de São Paulo, São Paulo 04039-032, Brazil; (L.S.); (M.I.V.C.)
- Correspondence: ; Tel.: +55-11-5576-4979
| |
Collapse
|
2
|
Rangel-Pozzo A, Sisdelli L, Cordioli MIV, Vaisman F, Caria P, Mai S, Cerutti JM. Genetic Landscape of Papillary Thyroid Carcinoma and Nuclear Architecture: An Overview Comparing Pediatric and Adult Populations. Cancers (Basel) 2020; 12:E3146. [PMID: 33120984 PMCID: PMC7693829 DOI: 10.3390/cancers12113146] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 10/15/2020] [Accepted: 10/26/2020] [Indexed: 12/16/2022] Open
Abstract
Thyroid cancer is a rare malignancy in the pediatric population that is highly associated with disease aggressiveness and advanced disease stages when compared to adult population. The biological and molecular features underlying pediatric and adult thyroid cancer pathogenesis could be responsible for differences in the clinical presentation and prognosis. Despite this, the clinical assessment and treatments used in pediatric thyroid cancer are the same as those implemented for adults and specific personalized target treatments are not used in clinical practice. In this review, we focus on papillary thyroid carcinoma (PTC), which represents 80-90% of all differentiated thyroid carcinomas. PTC has a high rate of gene fusions and mutations, which can influence the histologic subtypes in both children and adults. This review also highlights telomere-related genomic instability and changes in nuclear organization as novel biomarkers for thyroid cancers.
Collapse
Affiliation(s)
- Aline Rangel-Pozzo
- Cell Biology, Research Institute of Oncology and Hematology, University of Manitoba, CancerCare Manitoba, Winnipeg, MB R3E 0V9, Canada;
| | - Luiza Sisdelli
- Genetic Bases of Thyroid Tumors Laboratory, Division of Genetics, Department of Morphology and Genetics, Universidade Federal de São Paulo/EPM, São Paulo, SP 04039-032, Brazil; (L.S.); (M.I.V.C.); (J.M.C.)
| | - Maria Isabel V. Cordioli
- Genetic Bases of Thyroid Tumors Laboratory, Division of Genetics, Department of Morphology and Genetics, Universidade Federal de São Paulo/EPM, São Paulo, SP 04039-032, Brazil; (L.S.); (M.I.V.C.); (J.M.C.)
| | - Fernanda Vaisman
- Instituto Nacional do Câncer, Rio de Janeiro, RJ 22451-000, Brazil;
| | - Paola Caria
- Department of Biomedical Sciences, University of Cagliari, 09042 Cagliari, Italy
| | - Sabine Mai
- Cell Biology, Research Institute of Oncology and Hematology, University of Manitoba, CancerCare Manitoba, Winnipeg, MB R3E 0V9, Canada;
| | - Janete M. Cerutti
- Genetic Bases of Thyroid Tumors Laboratory, Division of Genetics, Department of Morphology and Genetics, Universidade Federal de São Paulo/EPM, São Paulo, SP 04039-032, Brazil; (L.S.); (M.I.V.C.); (J.M.C.)
| |
Collapse
|
3
|
Sisdelli L, Cordioli MICV, Vaisman F, Moraes L, Colozza-Gama GA, Alves PAG, Araújo ML, Alves MTS, Monte O, Longui CA, Cury AN, Carvalheira G, Cerutti JM. AGK-BRAF is associated with distant metastasis and younger age in pediatric papillary thyroid carcinoma. Pediatr Blood Cancer 2019; 66:e27707. [PMID: 30924609 DOI: 10.1002/pbc.27707] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 01/24/2019] [Accepted: 02/23/2019] [Indexed: 01/08/2023]
Abstract
BACKGROUND The incidence of thyroid carcinoma has increased in most populations, including pediatric patients. The increase is almost exclusively due to an increase in the incidence of papillary thyroid carcinoma (PTC). Genetic alterations leading to mitogen-activated protein kinase (MAPK) pathway activation are highly prevalent in PTC, with BRAF V600E mutation being the most common event in adult PTC. Although a lower prevalence of BRAF V600E had been reported among pediatric patients, a higher prevalence of BRAF fusion has been identified in both radiation-exposed and sporadic pediatric PTC. However, little is known about the prognostic implications of BRAF fusions in pediatric PTC. PROCEDURE In this study, we investigated the prevalence of BRAF alterations (AGK-BRAF fusion and BRAF V600E mutation) in a large set of predominantly sporadic pediatric PTC cases and correlate with clinicopathological features. Somatic AGK-BRAF fusion was investigated by RT-PCR and confirmed by FISH break-apart. The BRAF V600E mutation was screened using Sanger sequencing. RESULTS AGK-BRAF fusion, found in 19% of pediatric PTC patients, was associated with distant metastasis and younger age. Conversely, the BRAF V600E, found in 15% of pediatric PTC patients, was correlated with older age and larger tumor size. CONCLUSION Collectively, our results advance knowledge concerning genetic bases of pediatric thyroid carcinoma, with potential implications for diagnosis, prognosis, and therapeutic approaches.
Collapse
Affiliation(s)
- Luiza Sisdelli
- Genetic Bases of Thyroid Tumors Laboratory, Division of Genetics, Department of Morphology and Genetics, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Maria Isabel Cunha Vieira Cordioli
- Genetic Bases of Thyroid Tumors Laboratory, Division of Genetics, Department of Morphology and Genetics, Universidade Federal de São Paulo, São Paulo, Brazil
| | | | - Lais Moraes
- Genetic Bases of Thyroid Tumors Laboratory, Division of Genetics, Department of Morphology and Genetics, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Gabriel Avelar Colozza-Gama
- Genetic Bases of Thyroid Tumors Laboratory, Division of Genetics, Department of Morphology and Genetics, Universidade Federal de São Paulo, São Paulo, Brazil
| | | | | | | | - Osmar Monte
- Department of Pediatrics, Irmandade da Santa Casa de Misericórdia de São Paulo, São Paulo, Brazil
| | - Carlos Alberto Longui
- Department of Pediatrics, Irmandade da Santa Casa de Misericórdia de São Paulo, São Paulo, Brazil
| | - Adriano Namo Cury
- Departmentof Medicine, Irmandade da Santa Casa de Misericórdia de São Paulo, São Paulo, Brazil
| | - Gianna Carvalheira
- Genetic Bases of Thyroid Tumors Laboratory, Division of Genetics, Department of Morphology and Genetics, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Janete Maria Cerutti
- Genetic Bases of Thyroid Tumors Laboratory, Division of Genetics, Department of Morphology and Genetics, Universidade Federal de São Paulo, São Paulo, Brazil
| |
Collapse
|
4
|
Cordioli MICV, Moraes L, Bastos AU, Besson P, Alves MTDS, Delcelo R, Monte O, Longui C, Cury AN, Cerutti JM. Fusion Oncogenes Are the Main Genetic Events Found in Sporadic Papillary Thyroid Carcinomas from Children. Thyroid 2017; 27:182-188. [PMID: 27849443 DOI: 10.1089/thy.2016.0387] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [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] [Indexed: 11/12/2022]
Abstract
BACKGROUND Previous studies reported significant differences in the clinical presentation and outcomes of papillary thyroid carcinoma (PTC) in pediatric patients compared with adults. Previous studies have suggested that the clinicopathological differences observed between pediatric and adult PTCs may be due the existence of distinct genetic alterations. However, the knowledge of genetic events in pediatric PTCs is based primarily on studies in radiation-exposed PTCs or in the few studies that enrolled predominantly adolescent patients. The aim of this study was to characterize the known oncogenic alterations of the MAPK pathway found in adult and radiation-exposed PTCs in a cohort of predominantly sporadic pediatric PTC patients. METHODS Thirty-five pediatric PTCs were screened for the most prevalent fusions (RET/PTC1, RET/PTC2, RET/PTC3, ETV6-NTRK3, and AGK-BRAF) and point mutations (BRAFV600E and NRASQ61) described in sporadic pediatric PTCs. The mutational status was correlated with clinicopathological data. RESULTS Mutations were found in 20 out of 35 (57%) PTC cases. Fusion oncogenes were the main genetic alterations found. RET/PTC1-3 rearrangements were found in 13 (37%), ETV6-NTRK3 in 3 (9%), AGK-BRAF in 4 (11%), and BRAFV600E in 3 (9%). No mutation was found in NRASQ61. BRAFV600E was associated with older age and larger tumor size (p < 0.05), and RET/PTC3 was associated with a larger tumor size and multifocality (p < 0.05). CONCLUSIONS The genetic signature in this cohort was remarkably different than that observed in adults. Although observed at a lower prevalence, the spectrum of mutations was quite similar to that described in radiation-exposed pediatric PTCs. As mutations were unidentifiable in over 40% of the PTC cases, more comprehensive studies conducted in these patients will help to decipher the genetic landscape of sporadic pediatric PTCs.
Collapse
Affiliation(s)
- Maria Isabel C Vieira Cordioli
- 1 Genetic Bases of Thyroid Tumors Laboratory, Division of Genetics, Department of Morphology and Genetics and Division of Endocrinology, Department of Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo , São Paulo, SP, Brazil
| | - Lais Moraes
- 1 Genetic Bases of Thyroid Tumors Laboratory, Division of Genetics, Department of Morphology and Genetics and Division of Endocrinology, Department of Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo , São Paulo, SP, Brazil
| | - André U Bastos
- 1 Genetic Bases of Thyroid Tumors Laboratory, Division of Genetics, Department of Morphology and Genetics and Division of Endocrinology, Department of Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo , São Paulo, SP, Brazil
| | - Paloma Besson
- 1 Genetic Bases of Thyroid Tumors Laboratory, Division of Genetics, Department of Morphology and Genetics and Division of Endocrinology, Department of Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo , São Paulo, SP, Brazil
| | - Maria Teresa de Seixas Alves
- 2 Department of Pathology, Escola Paulista de Medicina, Universidade Federal de São Paulo , São Paulo, SP, Brazil
| | - Rosana Delcelo
- 2 Department of Pathology, Escola Paulista de Medicina, Universidade Federal de São Paulo , São Paulo, SP, Brazil
| | - Osmar Monte
- 3 Pediatric Division, Faculdade de Ciências Médicas, Irmandade da Santa Casa de Misericórdia de São Paulo , São Paulo, SP, Brazil
| | - Carlos Longui
- 3 Pediatric Division, Faculdade de Ciências Médicas, Irmandade da Santa Casa de Misericórdia de São Paulo , São Paulo, SP, Brazil
| | - Adriano Namo Cury
- 4 Division of Endocrinology, Department of Medicine, Faculdade de Ciências Médicas, Irmandade da Santa Casa de Misericórdia de São Paulo , São Paulo, SP, Brazil
| | - Janete M Cerutti
- 1 Genetic Bases of Thyroid Tumors Laboratory, Division of Genetics, Department of Morphology and Genetics and Division of Endocrinology, Department of Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo , São Paulo, SP, Brazil
| |
Collapse
|
5
|
Cordioli MICV, Moraes L, Carvalheira G, Sisdelli L, Alves MTS, Delcelo R, Monte O, Longui CA, Cury AN, Cerutti JM. AGK-BRAF gene fusion is a recurrent event in sporadic pediatric thyroid carcinoma. Cancer Med 2016; 5:1535-41. [PMID: 27037835 PMCID: PMC4944880 DOI: 10.1002/cam4.698] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Revised: 01/22/2016] [Accepted: 02/16/2016] [Indexed: 01/24/2023] Open
Abstract
Thyroid cancer is the fastest increasing cancer worldwide in all age groups. Papillary thyroid carcinoma (PTC) is the most common type of thyroid cancer in both adults and children. PTC genomic landscape has been extensively studied in adults, but information regarding sporadic pediatric patients is lacking. Although BRAF V600E mutation is highly prevalent in adults, this mutation is uncommon in pediatric cases. As adult and pediatric PTC is a mitogen‐activated protein kinase‐driven cancer, this altered pathway might be activated by different genetic events. The aim of this study was to investigate the occurrence of AGK‐BRAF fusion gene, recently described in radiation‐exposed pediatric PTC, in a cohort of exclusively sporadic pediatric PTC. The series consisted of 30 pediatric PTC younger than 18 years of age at the time of diagnosis and 15 matched lymph node metastases (LNM). Primary tumors and matched LNM were screened for the presence of the AGK‐BRAF fusion transcript by RT‐PCR. To confirm the identity of the amplified products, randomly selected samples positive for the presence of the fusion transcripts were sequenced. Moreover, BRAF dual‐color, break‐apart probes confirmed BRAF rearrangement. Overall, the AGK‐BRAF fusion gene was detected in 10% (3/30) of primary tumors. For one of these cases, paired LNM was also available, which also shows the presence of AGK‐BRAF fusion gene. This study described, for the first time, the presence of AGK‐BRAF in sporadic pediatric PTC. Understanding the molecular events underlying pediatric PTC may improve preoperative diagnosis, allow molecular prognostication and define a therapeutic approach toward sporadic PTC patients.
Collapse
Affiliation(s)
- Maria Isabel C V Cordioli
- Genetic Bases of Thyroid Tumors Laboratory, Division of Genetics, Department of Morphology and Genetics, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Lais Moraes
- Genetic Bases of Thyroid Tumors Laboratory, Division of Genetics, Department of Morphology and Genetics, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Gianna Carvalheira
- Genetic Bases of Thyroid Tumors Laboratory, Division of Genetics, Department of Morphology and Genetics, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Luiza Sisdelli
- Genetic Bases of Thyroid Tumors Laboratory, Division of Genetics, Department of Morphology and Genetics, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Maria Teresa S Alves
- Department of Pathology, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Rosana Delcelo
- Department of Pathology, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Osmar Monte
- Department of Pediatrics, Irmandade da Santa Casa de Misericórdia de São Paulo, São Paulo, SP, Brazil
| | - Carlos A Longui
- Department of Pediatrics, Irmandade da Santa Casa de Misericórdia de São Paulo, São Paulo, SP, Brazil
| | - Adriano N Cury
- Department of Medicine, Irmandade da Santa Casa de Misericórdia de São Paulo, São Paulo, SP, Brazil
| | - Janete M Cerutti
- Genetic Bases of Thyroid Tumors Laboratory, Division of Genetics, Department of Morphology and Genetics, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| |
Collapse
|