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Pandya D, Tomita S, Rhenals MP, Swierczek S, Reid K, Camacho-Vanegas O, Camacho C, Engelman K, Polukort S, RoseFigura J, Chuang L, Andikyan V, Cohen S, Fiedler P, Sieber S, Shih IM, Billaud JN, Sebra R, Reva B, Dottino P, Martignetti JA. Mutations in cancer-relevant genes are ubiquitous in histologically normal endometrial tissue. Gynecol Oncol 2024; 185:194-201. [PMID: 38452634 DOI: 10.1016/j.ygyno.2024.02.027] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 02/17/2024] [Accepted: 02/20/2024] [Indexed: 03/09/2024]
Abstract
OBJECTIVE Endometrial cancer (EndoCA) is the most common gynecologic cancer and incidence and mortality rate continue to increase. Despite well-characterized knowledge of EndoCA-defining mutations, no effective diagnostic or screening tests exist. To lay the foundation for testing development, our study focused on defining the prevalence of somatic mutations present in non-cancerous uterine tissue. METHODS We obtained ≥8 uterine samplings, including separate endometrial and myometrial layers, from each of 22 women undergoing hysterectomy for non-cancer conditions. We ultra-deep sequenced (>2000× coverage) samples using a 125 cancer-relevant gene panel. RESULTS All women harbored complex mutation patterns. In total, 308 somatic mutations were identified with mutant allele frequencies ranging up to 96.0%. These encompassed 56 unique mutations from 24 genes. The majority of samples possessed predicted functional cancer mutations but curiously no growth advantage over non-functional mutations was detected. Functional mutations were enriched with increasing patient age (p = 0.045) and BMI (p = 0.0007) and in endometrial versus myometrial layers (68% vs 39%, p = 0.0002). Finally, while the somatic mutation landscape shared similar mutation prevalence in key TCGA-defined EndoCA genes, notably PIK3CA, significant differences were identified, including NOTCH1 (77% vs 10%), PTEN (9% vs 61%), TP53 (0% vs 37%) and CTNNB1 (0% vs 26%). CONCLUSIONS An important caveat for future liquid biopsy/DNA-based cancer diagnostics is the repertoire of shared and distinct mutation profiles between histologically unremarkable and EndoCA tissues. The lack of selection pressure between functional and non-functional mutations in histologically unremarkable uterine tissue may offer a glimpse into an unrecognized EndoCA protective mechanism.
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Affiliation(s)
- Deep Pandya
- The Rudy L. Ruggles Biomedical Research Institute, Nuvance Health, Danbury, CT 06902, United States of America
| | - Shannon Tomita
- Departments of Obstetrics/Gynecology & Reproductive Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States of America
| | - Maria Padron Rhenals
- Genetics and Genomic Science, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States of America
| | - Sabina Swierczek
- The Rudy L. Ruggles Biomedical Research Institute, Nuvance Health, Danbury, CT 06902, United States of America; Department of Obstetrics, Gynecology and Reproductive Sciences, Larner College of Medicine, University of Vermont, Burlington, VT, United States of America
| | - Katherine Reid
- Genetics and Genomic Science, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States of America
| | - Olga Camacho-Vanegas
- Genetics and Genomic Science, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States of America
| | - Catalina Camacho
- Genetics and Genomic Science, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States of America
| | - Kelsey Engelman
- Genetics and Genomic Science, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States of America
| | - Stephanie Polukort
- The Rudy L. Ruggles Biomedical Research Institute, Nuvance Health, Danbury, CT 06902, United States of America
| | | | - Linus Chuang
- The Rudy L. Ruggles Biomedical Research Institute, Nuvance Health, Danbury, CT 06902, United States of America
| | - Vaagn Andikyan
- The Rudy L. Ruggles Biomedical Research Institute, Nuvance Health, Danbury, CT 06902, United States of America
| | - Samantha Cohen
- Genetics and Genomic Science, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States of America
| | - Paul Fiedler
- The Rudy L. Ruggles Biomedical Research Institute, Nuvance Health, Danbury, CT 06902, United States of America
| | - Steven Sieber
- The Rudy L. Ruggles Biomedical Research Institute, Nuvance Health, Danbury, CT 06902, United States of America
| | - Ie-Ming Shih
- Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD 21205, United States of America
| | - Jean-Noël Billaud
- QIAGEN Bioinformatics, 1001 Marshall Street, Redwood City, CA 94063, United States of America
| | - Robert Sebra
- Genetics and Genomic Science, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States of America
| | - Boris Reva
- Genetics and Genomic Science, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States of America
| | - Peter Dottino
- Departments of Obstetrics/Gynecology & Reproductive Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States of America; MDDx Inc., Tarrytown, NY 10591., United States of America
| | - John A Martignetti
- The Rudy L. Ruggles Biomedical Research Institute, Nuvance Health, Danbury, CT 06902, United States of America; Departments of Obstetrics/Gynecology & Reproductive Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States of America; Genetics and Genomic Science, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States of America; MDDx Inc., Tarrytown, NY 10591., United States of America.
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