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Lebok P, Kopperschmidt V, Kluth M, Hube-Magg C, Özden C, B T, Hussein K, Mittenzwei A, Lebeau A, Witzel I, Wölber L, Mahner S, Jänicke F, Geist S, Paluchowski P, Wilke C, Heilenkötter U, Simon R, Sauter G, Terracciano L, Krech R, von d Assen A, Müller V, Burandt E. Partial PTEN deletion is linked to poor prognosis in breast cancer. BMC Cancer 2015; 15:963. [PMID: 26672755 PMCID: PMC4682275 DOI: 10.1186/s12885-015-1770-3] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2015] [Accepted: 10/10/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Deletions of chromosome 10q23, including the PTEN (phosphatase and tensin homolog) locus, are known to occur in breast cancer, but systematic analyses of its clinical relevance are lacking. METHODS We thus analyzed a tissue microarray (TMA) with 2,197 breast cancers by fluorescence in-situ hybridization (FISH) using a PTEN-specific probe. RESULTS PTEN deletions were detected in 19% of no special type, 9% of lobular, 4% of tubular cancers and 46% in carcinomas with medullary features. 98.7% of deletions were heterozygous and only 1.3% were homozygous. PTEN deletion was significantly linked to advanced tumor stage (p=0.0054), high-grade (p<0.0001), high tumor cell proliferation (Ki67 Labeling Index; p<0.0001), and shortened overall survival (p=0.0090). PTEN deletions were inversely associated with features of luminal type breast cancers (ER/PR positivity; p<0.0001 each, and CCND1 amplification; p=0.0020). PTEN deletions were also strongly linked to amplification of genes involved in the PTEN/AKT pathway such as MYC (p=0.0430) and HER2 (p=0.0065). Remarkably the combined analysis of MYC, HER2, CCND1 and PTEN aberrations suggested that aberrations of multiple PTEN/AKT pathway genes have a strong additive effect on breast cancer prognosis. While cancers with one of these aberrations behaved only marginally different from cancers with none, disease outcome was markedly worse in cancers with two or more aberrations as compared to those with only one aberration (p=0.0002). In addition, the particularly poor prognosis of patients with HER2 amplification and PTEN deletions challenges the concept of PTEN deletions interfering with trastuzumab therapy. CONCLUSION PTEN deletion occurs in a relevant fraction of breast cancers, and is linked to aggressive tumor behavior. Reduced PTEN function cooperates with MYC and HER2 activation in conferring aggressive phenotype to cancer cells.
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Affiliation(s)
- P Lebok
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - V Kopperschmidt
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - M Kluth
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - C Hube-Magg
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - C Özden
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Taskin B
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - K Hussein
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - A Mittenzwei
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - A Lebeau
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - I Witzel
- Department of Gynecology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - L Wölber
- Department of Gynecology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - S Mahner
- Department of Gynecology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - F Jänicke
- Department of Gynecology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - S Geist
- Department of Gynecology, Regio Clinic Pinneberg, Pinneberg, Germany.
| | - P Paluchowski
- Department of Gynecology, Regio Clinic Pinneberg, Pinneberg, Germany.
| | - C Wilke
- Department of Gynecology, Regio Clinic Elmshorn, Elmshorn, Germany.
| | - U Heilenkötter
- Department of Gynecology, Clinical Centre Itzehoe, Itzehoe, Germany.
| | - Ronald Simon
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Guido Sauter
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - L Terracciano
- Department of Pathology, Basel University Clinics, Basel, Switzerland.
| | - R Krech
- Institute of Pathology, Clinical Centre Osnabrück, Osnabrück, Germany.
| | | | - V Müller
- Department of Gynecology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - E Burandt
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
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Lebok P, Mittenzwei A, Kluth M, Özden C, Taskin B, Hussein K, Möller K, Hartmann A, Lebeau A, Witzel I, Mahner S, Wölber L, Jänicke F, Geist S, Paluchowski P, Wilke C, Heilenkötter U, Simon R, Sauter G, Terracciano L, Krech R, von der Assen A, Müller V, Burandt E. 8p deletion is strongly linked to poor prognosis in breast cancer. Cancer Biol Ther 2015; 16:1080-7. [PMID: 25961141 DOI: 10.1080/15384047.2015.1046025] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
Deletions of chromosome 8p occur frequently in breast cancers, but analyses of its clinical relevance have been limited to small patient cohorts and provided controversial results. A tissue microarray with 2,197 breast cancers was thus analyzed by fluorescence in-situ hybridization using an 8p21 probe in combination with a centromere 8 reference probe. 8p deletions were found in 50% of carcinomas with no special type, 67% of papillary, 28% of tubular, 37% of lobular cancers and 56% of cancers with medullary features. Deletions were always heterozygous. 8p deletion was significantly linked to advanced tumor stage (P < 0.0001), high-grade (P < 0.0001), high tumor cell proliferation (Ki67 Labeling Index; P < 0.0001), and shortened overall survival (P < 0.0001). For example, 8p deletion was seen in 32% of 290 grade 1, 43% of 438 grade 2, and 65% of 427 grade 3 cancers. In addition, 8p deletions were strongly linked to amplification of MYC (P < 0.0001), HER2 (P < 0.0001), and CCND1 (p = 0.001), but inversely associated with ER receptor expression (p = 0.0001). Remarkably, 46.5% of 8p-deleted cancers harbored amplification of at least one of the analyzed genes as compared to 27.5% amplifications in 8p-non-deleted cancers (P < 0.0001). In conclusion, 8p deletion characterizes a subset of particularly aggressive breast cancers. As 8p deletions are easy to analyze, this feature appears to be highly suited for future DNA based prognostic breast cancer panels. The strong link of 8p deletion with various gene amplifications raises the possibility of a role for regulating genomic stability.
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Key Words
- 8p
- ER, estrogen receptor
- FISH
- FISH, fluorescence in situ hybridization
- HER2, human epidermal growth factor receptor 2
- Ki67LI, Ki67 Labeling index
- LOH, loss of heterozygosity
- NGS, next generation sequencing
- NST, no special type
- PR, progesterone receptor
- TMA, tissue microarray
- breast cancer
- deletion
- pN, nodal stage
- pT, pathological tumor stage
- prognosis
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Affiliation(s)
- P Lebok
- a Institute of Pathology; University Medical Center Hamburg-Eppendorf ; Hamburg , Germany
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Hoerster F, Hattersley A, Ashcroft F, Geist S, Rating D, Wolf N, Ebinger F, Grulich-Henn J. Erfolgreiche Therapie mit Glibenclamid bei einem Patienten mit permanentem neonatalem Diabetes, Entwicklungsretardierung und Epilepsie auf Grund einer Mutation der Kir 6.2 Untereinheit des ATP-sensitiven Kaliumkanals. DIABETOL STOFFWECHS 2007. [DOI: 10.1055/s-2007-982331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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