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Schmitz J, Kracht J, Evert K, Wenzel JJ, Schemmerer M, Lehmann U, Panning M, Pape L, Pohl M, Bräsen JH. Hepatitis E virus infection of transplanted kidneys. Am J Transplant 2024; 24:491-497. [PMID: 38072120 DOI: 10.1016/j.ajt.2023.11.016] [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: 06/08/2023] [Revised: 11/02/2023] [Accepted: 11/30/2023] [Indexed: 12/29/2023]
Abstract
Immunocompromised patients are at risk of chronic hepatitis E (HEV) infection. Recurrent T cell and borderline rejections in a pediatric patient with high HEV copy numbers led us to study HEV infection within renal transplants. To investigate the frequency of renal HEV infection in transplanted patients, 15 samples from patients with contemporaneous diagnoses of HEV infection were identified at our center. Ten samples had sufficient residual paraffin tissue for immunofluorescence (IF) and RNA-fluorescence-in-situ-hybridization (RNA-FISH). The biopsy of the pediatric index patient was additionally sufficient for tissue polymerase chain reaction and electron microscopy. HEV RNA was detected in paraffin tissue of the index patient by tissue polymerase chain reaction. Subsequently, HEV infection was localized in tubular epithelial cells by IF, RNA-FISH, and electron microscopy. One additional biopsy from an adult was positive for HEV by RNA-FISH and IF. Focal IF positivity for HEV peptide was observed in 7 additional allografts. Ribavirin therapy was not successful in the pediatric index patient; after relapse, ribavirin is still administered. In the second patient, successful elimination of HEV was achieved after short-course ribavirin therapy. HEV infection is an important differential diagnosis for T cell rejection within transplanted kidneys. Immunostaining of HEV peptide does not necessarily prove acute infection. RNA-FISH seems to be a reliable method to localize HEV.
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Affiliation(s)
- Jessica Schmitz
- Nephropathology Unit, Institute of Pathology, Hannover Medical School, Hannover, Germany
| | - Julia Kracht
- Department of General Pediatrics, Adolescent Medicine and Neonatology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany
| | - Katja Evert
- Institute of Pathology, University of Regensburg, Regensburg, Germany
| | - Jürgen J Wenzel
- National Consultant Laboratory for HAV and HEV, Institute of Clinical Microbiology and Hygiene, University Medical Center Regensburg, Regensburg, Germany
| | - Mathias Schemmerer
- National Consultant Laboratory for HAV and HEV, Institute of Clinical Microbiology and Hygiene, University Medical Center Regensburg, Regensburg, Germany
| | - Ulrich Lehmann
- Molecular Pathology, Institute of Pathology, Hannover Medical School, Hannover, Germany
| | - Marcus Panning
- Institute of Virology, University Clinics Freiburg, Freiburg, Germany
| | - Lars Pape
- Department of Pediatrics II, University Hospital of Essen, Essen, Germany
| | - Martin Pohl
- Department of General Pediatrics, Adolescent Medicine and Neonatology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany
| | - Jan Hinrich Bräsen
- Nephropathology Unit, Institute of Pathology, Hannover Medical School, Hannover, Germany.
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Gronewold M, Grote I, Bartels S, Christgen H, Kandt LD, Brito MJ, Cserni G, Daemmrich ME, Fogt F, Helmke BM, ter Hoeve N, Lang‐Schwarz C, Vieth M, Wellmann A, Kuehnle E, Kulik U, Riedel G, Reineke‐Plaass T, Lehmann U, Koorman T, Derksen PWB, Kreipe H, Christgen M. Microenvironment-induced restoration of cohesive growth associated with focal activation of P-cadherin expression in lobular breast carcinoma metastatic to the colon. J Pathol Clin Res 2024; 10:e12361. [PMID: 38618992 PMCID: PMC10796744 DOI: 10.1002/2056-4538.12361] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 11/30/2023] [Accepted: 12/21/2023] [Indexed: 04/16/2024]
Abstract
Invasive lobular carcinoma (ILC) is a special breast cancer type characterized by noncohesive growth and E-cadherin loss. Focal activation of P-cadherin expression in tumor cells that are deficient for E-cadherin occurs in a subset of ILCs. Switching from an E-cadherin deficient to P-cadherin proficient status (EPS) partially restores cell-cell adhesion leading to the formation of cohesive tubular elements. It is unknown what conditions control EPS. Here, we report on EPS in ILC metastases in the large bowel. We reviewed endoscopic colon biopsies and colectomy specimens from a 52-year-old female (index patient) and of 18 additional patients (reference series) diagnosed with metastatic ILC in the colon. EPS was assessed by immunohistochemistry for E-cadherin and P-cadherin. CDH1/E-cadherin mutations were determined by next-generation sequencing. The index patient's colectomy showed transmural metastatic ILC harboring a CDH1/E-cadherin p.Q610* mutation. ILC cells displayed different growth patterns in different anatomic layers of the colon wall. In the tunica muscularis propria and the tela submucosa, ILC cells featured noncohesive growth and were E-cadherin-negative and P-cadherin-negative. However, ILC cells invading the mucosa formed cohesive tubular elements in the intercryptal stroma of the lamina propria mucosae. Inter-cryptal ILC cells switched to a P-cadherin-positive phenotype in this microenvironmental niche. In the reference series, colon mucosa infiltration was evident in 13 of 18 patients, one of which showed intercryptal EPS and conversion to cohesive growth as described in the index patient. The large bowel is a common metastatic site in ILC. In endoscopic colon biopsies, the typical noncohesive growth of ILC may be concealed by microenvironment-induced EPS and conversion to cohesive growth.
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Affiliation(s)
- Malte Gronewold
- Institute of PathologyHannover Medical SchoolHannoverGermany
| | - Isabel Grote
- Institute of PathologyHannover Medical SchoolHannoverGermany
| | - Stephan Bartels
- Institute of PathologyHannover Medical SchoolHannoverGermany
| | | | - Leonie D Kandt
- Institute of PathologyHannover Medical SchoolHannoverGermany
| | | | - Gàbor Cserni
- Department of PathologyUniversity of SzegedSzegedHungary
| | | | - Franz Fogt
- Pennsylvania Hospital – Penn Pathology and Laboratory MedicinePhiladelphiaPAUSA
| | | | - Natalie ter Hoeve
- Department of PathologyUniversity Medical Center UtrechtUtrechtThe Netherlands
| | | | - Michael Vieth
- Klinikum Bayreuth – Institut für PathologieBayreuthGermany
| | | | - Elna Kuehnle
- Clinic for Obstetrics and Gynecology the NeonatologyHannover Medical SchoolHannoverGermany
| | - Ulf Kulik
- Department of General, Visceral, and Transplant SurgeryHannover Medical SchoolHannoverGermany
| | - Gesa Riedel
- Department of Immunology and RheumatologyHannover Medical SchoolHannoverGermany
| | | | - Ulrich Lehmann
- Institute of PathologyHannover Medical SchoolHannoverGermany
| | - Thijs Koorman
- Department of PathologyUniversity Medical Center UtrechtUtrechtThe Netherlands
| | - Patrick WB Derksen
- Department of PathologyUniversity Medical Center UtrechtUtrechtThe Netherlands
| | - Hans Kreipe
- Institute of PathologyHannover Medical SchoolHannoverGermany
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3
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Pfarr N, von Schwarzenberg K, Zocholl D, Merkelbach-Bruse S, Siemanowski J, Mayr EM, Herold S, Kleo K, Heukamp LC, Willing EM, Menzel M, Lehmann U, Bartels S, Chakraborty S, Baretton G, Demes MC, Döring C, Kazdal D, Budczies J, Rad R, Wild P, Christinat Y, McKee T, Schirmacher P, Horst D, Büttner R, Stenzinger A, Sehouli J, Vollbrecht C, Hummel M, Braicu EI, Weichert W. High Concordance of Different Assays in the Determination of Homologous Recombination Deficiency-Associated Genomic Instability in Ovarian Cancer. JCO Precis Oncol 2024; 8:e2300348. [PMID: 38513168 DOI: 10.1200/po.23.00348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 11/10/2023] [Accepted: 01/03/2024] [Indexed: 03/23/2024] Open
Abstract
PURPOSE Poly(ADP-ribose) polymerase inhibitors (PARPi) have shown promising clinical results in the treatment of ovarian cancer. Analysis of biomarker subgroups consistently revealed higher benefits for patients with homologous recombination deficiency (HRD). The test that is most often used for the detection of HRD in clinical studies is the Myriad myChoice assay. However, other assays can also be used to assess biomarkers, which are indicative of HRD, genomic instability (GI), and BRCA1/2 mutation status. Many of these assays have high potential to be broadly applied in clinical routine diagnostics in a time-effective decentralized manner. Here, we compare the performance of a multitude of alternative assays in comparison with Myriad myChoice in high-grade serous ovarian cancer (HGSOC). METHODS DNA from HGSOC samples was extracted from formalin-fixed paraffin-embedded tissue blocks of cases previously run with the Myriad myChoice assay, and GI was measured by multiple molecular assays (CytoSNP, AmoyDx, Illumina TSO500 HRD, OncoScan, NOGGO GISv1, QIAseq HRD Panel and whole genome sequencing), applying different bioinformatics algorithms. RESULTS Application of different assays to assess GI, including Myriad myChoice, revealed high concordance of the generated scores ranging from very substantial to nearly perfect fit, depending on the assay and bioinformatics pipelines applied. Interlaboratory comparison of assays also showed high concordance of GI scores. CONCLUSION Assays for GI assessment not only show a high concordance with each other but also in correlation with Myriad myChoice. Thus, almost all of the assays included here can be used effectively to assess HRD-associated GI in the clinical setting. This is important as PARPi treatment on the basis of these tests is compliant with European Medicines Agency approvals, which are methodologically not test-bound.
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Affiliation(s)
- Nicole Pfarr
- Institute of Pathology, School of Medicine and Health, Technical University Munich, Munich, Germany
| | - Karin von Schwarzenberg
- Institute of Pathology, School of Medicine and Health, Technical University Munich, Munich, Germany
| | - Dario Zocholl
- Institute of Biometry and Clinical Epidemiology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | | | - Janna Siemanowski
- Institute of Pathology, University Hospital Cologne, Cologne, Germany
| | - Eva-Maria Mayr
- Institute of Pathology, School of Medicine and Health, Technical University Munich, Munich, Germany
| | - Sylvia Herold
- Institute of Pathology, University Hospital Dresden, Dresden, Germany
| | - Karsten Kleo
- Institute of Pathology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin & Berlin Institute of Health, Berlin, Germany
| | - Lukas C Heukamp
- Institute of Pathology and Hematopathology, Hamburg, Germany
- North-Eastern German Society of Gynecological Oncology (NOGGO), Berlin, Germany
| | - Eva-Maria Willing
- Institute of Pathology and Hematopathology, Hamburg, Germany
- North-Eastern German Society of Gynecological Oncology (NOGGO), Berlin, Germany
| | - Michael Menzel
- Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany
| | - Ulrich Lehmann
- Institute of Pathology, Medizinische Hochschule Hannover, Hannover, Germany
| | - Stephan Bartels
- Institute of Pathology, Medizinische Hochschule Hannover, Hannover, Germany
| | - Shounak Chakraborty
- Institute of Pathology, School of Medicine and Health, Technical University Munich, Munich, Germany
| | - Gustavo Baretton
- Institute of Pathology, University Hospital Dresden, Dresden, Germany
| | - Melanie C Demes
- Dr Senckenberg Institute of Pathology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Claudia Döring
- Dr Senckenberg Institute of Pathology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Daniel Kazdal
- Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany
| | - Jan Budczies
- Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany
| | - Roland Rad
- Institute of Functional Genomics, Klinikum Rechts der Isar, Technical University Munich, Munich, Germany
| | - Peter Wild
- Dr Senckenberg Institute of Pathology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Yann Christinat
- Department of Pathology, University Hospital of Geneva, Geneva, Switzerland
| | - Thomas McKee
- Department of Pathology, University Hospital of Geneva, Geneva, Switzerland
| | - Peter Schirmacher
- Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany
| | - David Horst
- Institute of Pathology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin & Berlin Institute of Health, Berlin, Germany
| | - Reinhard Büttner
- Institute of Pathology, University Hospital Cologne, Cologne, Germany
| | | | - Jalid Sehouli
- North-Eastern German Society of Gynecological Oncology (NOGGO), Berlin, Germany
- Department of Gynecology, Campus Virchow Klinikum, Charité University Medicine, Berlin, Germany
| | - Claudia Vollbrecht
- Institute of Pathology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin & Berlin Institute of Health, Berlin, Germany
| | - Michael Hummel
- Institute of Pathology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin & Berlin Institute of Health, Berlin, Germany
| | - Elena I Braicu
- North-Eastern German Society of Gynecological Oncology (NOGGO), Berlin, Germany
- Department of Gynecology, Campus Virchow Klinikum, Charité University Medicine, Berlin, Germany
- Tumor Bank Ovarian Cancer Network (TOC) and Biostatistics, Charité Berlin, Berlin, Germany
| | - Wilko Weichert
- Institute of Pathology, School of Medicine and Health, Technical University Munich, Munich, Germany
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Lehmann U, Stenzinger A. [The biomarker POLE in tumor pathology]. Pathologie (Heidelb) 2024; 45:67-68. [PMID: 38051340 DOI: 10.1007/s00292-023-01284-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/06/2023] [Indexed: 12/07/2023]
Affiliation(s)
- Ulrich Lehmann
- Institut für Pathologie, Molekularpathologie, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, OE5110, 30625, Hannover, Deutschland.
| | - Albrecht Stenzinger
- Molekularpathologisches Zentrum, Pathologisches Institut, Universität Heidelberg, Im Neuenheimer Feld 224, 69120, Heidelberg, Deutschland.
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Grote I, Poppe A, Lehmann U, Christgen M, Kreipe H, Bartels S. Frequency of genetic alterations differs in advanced breast cancer between metastatic sites. Genes Chromosomes Cancer 2024; 63:e23199. [PMID: 37672607 DOI: 10.1002/gcc.23199] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 08/15/2023] [Accepted: 08/29/2023] [Indexed: 09/08/2023] Open
Abstract
About 20%-30% of breast cancer (BC) patients will develop distant metastases, preferentially in bones, liver, lung, and brain. BCs with different intrinsic subtypes prefer different sites for metastasis. These subtypes vary in the abundance of genetic alterations which may influence the localization of metastases. Currently, information about the relation between metastatic site and mutational profile of BC is limited. In this study, n = 521 BC metastases of the most frequently affected sites (bone, brain, liver, and lung) were investigated for the frequency of AKT1, ERBB2, ESR1, PIK3CA, and TP53 mutations via NGS and pyrosequencing. Somatic mutations were present in 64% cases. PIK3CA and TP53 were the most frequently mutated genes under study. We provide an analysis of the mutational profile of BCs and the affected metastatic site. Genetic alterations differed significantly depending on the organ site affected by metastases. TP53 mutations were mostly observed in brain metastases (51.0%), metastases outside of the brain revealed a much lower proportion of TP53 mutated samples. PIK3CA mutations are frequent in liver (40.6%), lung (36.8%), and bone metastases (35.7%), whereas less common in brain metastases (18.4%). The highest percentage of ESR1 mutations was observed in liver and lung metastases (about 30% each), whereas metastatic lesions in the brain showed significantly less ESR1 mutations, only in 2.0% of the cases. In summary, we found significant differences of mutational status in mBC depending on the affected organ and intrinsic subtype. Organotropism of metastatic cancer spread may be influenced by the mutational profile of individual BCs.
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Affiliation(s)
- Isabel Grote
- Institute of Pathology, Hannover Medical School, Hannover, Germany
| | - Alexandra Poppe
- Institute of Pathology, Hannover Medical School, Hannover, Germany
| | - Ulrich Lehmann
- Institute of Pathology, Hannover Medical School, Hannover, Germany
| | | | - Hans Kreipe
- Institute of Pathology, Hannover Medical School, Hannover, Germany
| | - Stephan Bartels
- Institute of Pathology, Hannover Medical School, Hannover, Germany
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6
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Stenzinger A, Vogel A, Lehmann U, Lamarca A, Hofman P, Terracciano L, Normanno N. Molecular profiling in cholangiocarcinoma: A practical guide to next-generation sequencing. Cancer Treat Rev 2024; 122:102649. [PMID: 37984132 DOI: 10.1016/j.ctrv.2023.102649] [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: 09/20/2023] [Accepted: 10/29/2023] [Indexed: 11/22/2023]
Abstract
Cholangiocarcinomas (CCA) are a heterogeneous group of tumors that are classified as intrahepatic, perihilar, or distal according to the anatomic location within the biliary tract. Each CCA subtype is associated with distinct genomic alterations, including single nucleotide variants, copy number variants, and chromosomal rearrangements or gene fusions, each of which can influence disease prognosis and/or treatment outcomes. Molecular profiling using next-generation sequencing (NGS) is a powerful technique for identifying unique gene variants carried by an individual tumor, which can facilitate their accurate diagnosis as well as promote the optimal selection of gene variant-matched targeted treatments. NGS is particularly useful in patients with CCA because between one-third and one-half of these patients have genomic alterations that can be targeted by drugs that are either approved or in clinical development. NGS can also provide information about disease evolution and secondary resistance alterations that can develop during targeted therapy, and thus facilitate assessment of prognosis and choice of alternative targeted treatments. Pathologists play a critical role in assessing the viability of biopsy samples for NGS, and advising treating clinicians whether NGS can be performed and which of the available platforms should be used to optimize testing outcomes. This review aims to provide clinical pathologists and other healthcare professionals with practical step-by-step guidance on the use of NGS for molecular profiling of patients with CCA, with respect to tumor biopsy techniques, pre-analytic sample preparation, selecting the appropriate NGS panel, and understanding and interpreting results of the NGS test.
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Affiliation(s)
- Albrecht Stenzinger
- Institute of Pathology Heidelberg (IPH), Center for Molecular Pathology, University Hospital Heidelberg, In Neuenheimer Feld 224, 69120 Heidelberg, Building 6224, Germany.
| | - Arndt Vogel
- Division of Gastroenterology and Hepatology, Toronto General Hospital Medical Oncology, Princess Margaret Cancer Centre, Schwartz Reisman Liver Research Centre, 200 Elizabeth Street, Office: 9 EB 236 Toronto, ON, M5G 2C4, Canada.
| | - Ulrich Lehmann
- Institute for Pathology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany.
| | - Angela Lamarca
- Department of Medical Oncology, Oncohealth Institute, Instituto de Investigación Sanitaria de la Fundación Jiménez Díaz, Fundación Jiménez Díaz University Hospital, Av. de los Reyes Católicos, 2, 28040 Madrid, Spain; Department of Medical Oncology, The Christie NHS Foundation Trust, Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Oxford Road, Manchester, M13 9PL, UK.
| | - Paul Hofman
- Laboratory of Clinical and Experimental Pathology, FHU OncoAge, IHU RespirERA, Siège de l'Université: Grand Château, 28 Avenue de Valrose, 06103 Nice CEDEX 2, France.
| | - Luigi Terracciano
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini, 4, 20072 Pieve Emanuele, Milan, Italy; IRCCS Humanitas Research Hospital, Via Alessandro Manzoni, 56, 20089 Rozzano, Milan, Italy.
| | - Nicola Normanno
- Cell Biology and Biotherapy Unit, Istituto Nazionale Tumori - IRCCS - Fondazione G. Pascale, Napoli, Italy.
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Lehmann U, Stenzinger A. [The IDH1/2 biomarker in tumor pathology]. Pathologie (Heidelb) 2023; 44:318-319. [PMID: 37249659 DOI: 10.1007/s00292-023-01199-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/14/2023] [Indexed: 05/31/2023]
Affiliation(s)
- Ulrich Lehmann
- Institut für Pathologie, Molekularpathologie, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland.
| | - Albrecht Stenzinger
- Institut für Pathologie, Molekularpathologisches Zentrum, Universitätsklinikum Heidelberg, Heidelberg, Deutschland
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8
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Bartels S, Grote I, Wagner M, Boog J, Schipper E, Reineke‐Plaass T, Kreipe H, Lehmann U. Concordance in detection of microsatellite instability by PCR and NGS in routinely processed tumor specimens of several cancer types. Cancer Med 2023; 12:16707-16715. [PMID: 37376830 PMCID: PMC10501280 DOI: 10.1002/cam4.6293] [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: 03/18/2023] [Revised: 06/14/2023] [Accepted: 06/15/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND Microsatellite instability (MSI) occurs in several cancer types and is commonly used for prognosis and as a predictive biomarker for immune checkpoint therapy. METHODS We analyzed n = 263 formalin-fixed paraffin-embedded (FFPE) tumor specimens (127 colorectal cancer (CRC), 55 endometrial cancer (EC), 33 stomach adenocarcinoma (STAD), and 48 solid tumor specimens of other tumor types) with a capillary electrophoresis based multiplex monomorphic marker MSI-PCR panel and an amplicon-based NGS assay for microsatellite instability (MSI+). In total, n = 103 (39.2%) cases with a known defect of the DNA mismatch repair system (dMMR), determined by a loss in protein expression of MSH2/MSH6 (n = 48, 46.6%) or MLH1/PMS2 (n = 55, 53.4%), were selected. Cases with an isolated loss of MSH6 or PMS2 were excluded. RESULTS The overall sensitivity and specificity of the NGS assay in comparison with the MSI-PCR were 92.2% and 98.8%. With CRC cases a nearly optimal concordance was reached (sensitivity 98.1% and specificity 100.0%). Whereas EC cases only show a sensitivity of 88.6% and a specificity of 95.2%, caused by several cases with instability in less than five monomorphic markers, which could be difficult to analyze by NGS (subtle MSI+ phenotype). CONCLUSIONS MSI analysis of FFPE DNA by NGS is feasible and the results show a high concordance in comparison with the monomorphic marker MSI-PCR. However, cases with a subtle MSI+ phenotype, most frequently manifest in EC, have a risk of a false-negative result by NGS and should be preferentially analyzed by capillary electrophoresis.
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Affiliation(s)
- Stephan Bartels
- Institute of Pathology, Hannover Medical SchoolHannoverGermany
| | - Isabel Grote
- Institute of Pathology, Hannover Medical SchoolHannoverGermany
| | | | - Jannik Boog
- Institute of Pathology, Hannover Medical SchoolHannoverGermany
| | - Elisa Schipper
- Institute of Pathology, Hannover Medical SchoolHannoverGermany
| | | | - Hans Kreipe
- Institute of Pathology, Hannover Medical SchoolHannoverGermany
| | - Ulrich Lehmann
- Institute of Pathology, Hannover Medical SchoolHannoverGermany
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9
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Lehmann U, Stenzinger A. [The biomarker PIK3CA in tumor pathology]. Pathologie (Heidelb) 2023:10.1007/s00292-023-01190-9. [PMID: 36932239 DOI: 10.1007/s00292-023-01190-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/15/2023] [Indexed: 03/19/2023]
Affiliation(s)
- Ulrich Lehmann
- Molekularpathologie, Institut für Pathologie, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, OE5110, 30625, Hannover, Deutschland.
| | - Albrecht Stenzinger
- Molekularpathologisches Zentrum, Pathologisches Institut, Universität Heidelberg, Im Neuenheimer Feld 224, 69120, Heidelberg, Deutschland.
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10
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Feist H, Lehmann U, Bajwa S, Brüschke C, Schaumann N. Villitis of unknown etiology, chronic deciduitis, chronic chorioamnionitis and chronic histiocytic intervillositis in monozygotic and dizygotic twin pregnancies. A retrospective analysis of 16 cases. Placenta 2023; 133:32-39. [PMID: 36791493 DOI: 10.1016/j.placenta.2023.02.002] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 01/27/2023] [Accepted: 02/03/2023] [Indexed: 02/08/2023]
Abstract
INTRODUCTION Villitis of unknown etiology (VUE), chronic chorioamnionitis (CC), chronic deciduitis (CD) and chronic histiocytic intervillositis (CHI) are most likely the result of a pathologic immune reaction caused by maternal anti-fetal rejection. We analyzed placentas of twin pregnancies with manifestation of these lesions in monozygotic and dizygotic instances. METHODS Twin pregnancies from our archive with at least one chronic inflammatory lesion were selected for further analysis and assessed concerning zygosity (gender, chorionicity, short tandem repeat (STR)-analysis). RESULTS The cohort comprised sixteen twin placentas, monozygotic in five cases and dizygotic in 11 cases, respectively. VUE (n = 4), CC (n = 1) and CHI (n = 3) manifested concordantly in both placentas of the monozygotic pregnancies and affected discordantly one of the twin placentas in the dizygotic instances. CD (n = 10) manifested concordantly in two and discordantly in one of the monozygotic placentas, and concordantly in three and discordantly in four of the dizygotic instances. Intrauterine fetal demise (n = 3), preterm birth (n = 9) and low birth weight (n = 2) were recognized. Discordant fetal growth in live born children was recognized in two dizygotic cases with discordant manifestation of VUE and CHI. DISCUSSION The concordant manifestation of VUE, CC and CHI in monozygotic and the discordant pattern of inflammation in dizygotic pregnancies points to pathologic immune mechanisms against genetically determined fetal antigens being essential for the development of these entities. The heterogenous manifestation of CD could be a hint for diverse fetal or maternal etiologic factors that may contribute to this lesion.
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Affiliation(s)
- Henning Feist
- Department of Pathology, Diakonissenkrankenhaus Flensburg, Flensburg, Germany.
| | - Ulrich Lehmann
- Department of Pathology, Medical School Hannover, Hannover, Germany
| | - Simin Bajwa
- Department of Obstetrics and Gynecology, Diakonissenkrankenhaus Flensburg, Flensburg, Germany
| | - Corinna Brüschke
- Department of Pathology, Asklepios Klinikum Nord, Hamburg, Germany
| | - Nora Schaumann
- Department of Pathology, Medical School Hannover, Hannover, Germany
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11
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Neumann O, Lehmann U, Bartels S, Pfarr N, Albrecht T, Ilm K, Christmann J, Volckmar A, Goldschmid H, Kirchner M, Allgäuer M, Walker M, Kreipe H, Tannapfel A, Weichert W, Schirmacher P, Kazdal D, Stenzinger A. First proficiency testing for NGS-based and combined NGS- and FISH-based detection of FGFR2 fusions in intrahepatic cholangiocarcinoma. J Pathol Clin Res 2023; 9:100-107. [PMID: 36635225 PMCID: PMC9896158 DOI: 10.1002/cjp2.308] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 12/06/2022] [Accepted: 12/14/2022] [Indexed: 01/14/2023]
Abstract
Intrahepatic cholangiocarcinoma harbours druggable genetic lesions including FGFR2 gene fusions. Reliable and accurate detection of these fusions is becoming a critical component of the molecular work-up, but real-world data on the performance of fluorescence in situ hybridisation (FISH) and targeted RNA-based next-generation sequencing (NGS) are very limited. Bridging this gap, we report results of the first round robin test for FGFR2 fusions in cholangiocarcinoma and contextualise test data with genomic architecture. A cohort of 10 cholangiocarcinoma (4 fusion positive and 6 fusion negative) was tested by the Institute of Pathology, University Hospital Heidelberg, Germany. Data were validated by four academic pathology departments in Germany. Fusion-positive cases comprised FGFR2::BICC1, FGFR2::DBP, FGFR2::TRIM8, and FGFR2::ATE1 fusions. In a second step, a round robin test involving 21 academic and non-academic centres testing with RNA-based NGS approaches was carried out; five participants performed FISH testing in addition. Thirteen of 16 (81%) centres successfully passed the NGS only and 3 of 5 (60%) centres passed the combined NGS + FISH round robin test. Identified obstacles were bioinformatic pipelines not optimised for the detection of FGFR2 fusions and assays not capable of detecting unknown fusion partners. This study shows the benefit of targeted RNA-NGS for the detection of FGFR2 gene fusions. Due to the marked heterogeneity of the genomic architecture of these fusions, fusion partner agnostic (i.e. open) methodological approaches that are capable of identifying yet unknown fusion partners are superior. Furthermore, we highlight pitfalls in subsequent bioinformatic analysis and limitations of FISH-based tests.
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Affiliation(s)
- Olaf Neumann
- Institut für PathologieUniversitätsklinikum HeidelbergHeidelbergGermany
| | - Ulrich Lehmann
- Institut für PathologieMedizinische Hochschule HannoverHannoverGermany
| | - Stephan Bartels
- Institut für PathologieMedizinische Hochschule HannoverHannoverGermany
| | - Nicole Pfarr
- Institut für PathologieTechnische Universität MünchenMunichGermany,German Cancer Consortium (DKTK)HeidelbergGermany
| | - Thomas Albrecht
- Institut für PathologieUniversitätsklinikum HeidelbergHeidelbergGermany
| | - Katharina Ilm
- Qualitätssicherungs‐Initiative Pathologie, QuIP GmbHBerlinGermany
| | | | | | - Hannah Goldschmid
- Institut für PathologieUniversitätsklinikum HeidelbergHeidelbergGermany
| | - Martina Kirchner
- Institut für PathologieUniversitätsklinikum HeidelbergHeidelbergGermany
| | - Michael Allgäuer
- Institut für PathologieUniversitätsklinikum HeidelbergHeidelbergGermany
| | - Maria Walker
- Institut für PathologieTechnische Universität MünchenMunichGermany
| | - Hans Kreipe
- Institut für PathologieMedizinische Hochschule HannoverHannoverGermany
| | | | - Wilko Weichert
- Institut für PathologieTechnische Universität MünchenMunichGermany,German Cancer Consortium (DKTK)HeidelbergGermany
| | - Peter Schirmacher
- Institut für PathologieUniversitätsklinikum HeidelbergHeidelbergGermany
| | - Daniel Kazdal
- Institut für PathologieUniversitätsklinikum HeidelbergHeidelbergGermany
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12
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Mueller S, Grote I, Bartels S, Kandt L, Christgen H, Lehmann U, Gluz O, Graeser M, Kates R, Harbeck N, Kreipe H, Christgen M. p53 Expression in Luminal Breast Cancer Correlates With TP53 Mutation and Primary Endocrine Resistance. Mod Pathol 2023; 36:100100. [PMID: 36788081 DOI: 10.1016/j.modpat.2023.100100] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 10/24/2022] [Revised: 01/02/2023] [Accepted: 01/05/2023] [Indexed: 01/13/2023]
Abstract
TP53 mutation is associated with primary endocrine resistance in luminal breast cancer (BC). Nuclear accumulation of p53, as determined by immunohistochemistry (IHC), is a surrogate marker for TP53 mutation. The immunohistochemical p53 index that defines a p53-positive status is not well established. This study determined the optimal p53 index cutoff to identify luminal BCs harboring TP53 mutations. In total, 364 luminal BCs from the West German Study Group ADAPT trial (NCT01779206) were analyzed for TP53 mutations by next-generation sequencing and for p53 expression by IHC (DO-7 antibody). P53 indices were determined by automated image analysis. All tumors were from patients treated with short-term preoperative endocrine therapy (pET; tamoxifen or aromatase inhibitor) before tumor resection. IHC evaluation included needle biopsies before therapy (baseline) and resections specimens after therapy (post-pET). Optimal p53 index cutoffs were defined with Youden statistics. TP53 mutations were detected in 16.3% of BC cases. The median p53 indices were significantly higher in TP53-mutated BCs compared to BCs harboring wild-type TP53 (baseline: 47.0% vs 6.4%, P < .001; post-pET: 50.1% vs 1.1%, P < .001). Short-term pET decreased p53 indices in BCs harboring wild-type TP53 (P < .001) but not in TP53-mutated BCs (P = .102). For baseline biopsies, the optimal p53 index cutoff was ≥34.6% (specificity 0.92, sensitivity 0.63, Youden index 0.54, accuracy: 0.87). For post-pET specimens, the optimal cutoff was ≥25.3% (specificity 0.95, sensitivity 0.65, Youden index 0.60, accuracy: 0.90). Using these cutoffs to define the p53 status, p53-positive BCs were >2-fold more common in pET nonresponders compared to pET responders (baseline: 37/162, 22.8% vs 18/162, 11.1%, P = .007; post-pET: 36/179, 20.1% vs 16/179, 8.9%, P = .004). In summary, IHC for p53 identifies TP53-mutated luminal BCs with high specificity and accuracy. Optimal cutoffs are ≥35% and ≥25% for treatment-naïve and endocrine-pretreated patients, respectively.
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Affiliation(s)
- Sophie Mueller
- Institute of Pathology, Hannover Medical School, Hannover, Germany
| | - Isabel Grote
- Institute of Pathology, Hannover Medical School, Hannover, Germany
| | - Stephan Bartels
- Institute of Pathology, Hannover Medical School, Hannover, Germany
| | - Leonie Kandt
- Institute of Pathology, Hannover Medical School, Hannover, Germany
| | | | - Ulrich Lehmann
- Institute of Pathology, Hannover Medical School, Hannover, Germany
| | - Oleg Gluz
- West German Study Group, Moenchengladbach, Germany; Ev. Bethesda Hospital, Moenchengladbach, Germany; Women's Clinic and Breast Center, University Clinics Cologne, Cologne, Germany
| | - Monika Graeser
- West German Study Group, Moenchengladbach, Germany; Ev. Bethesda Hospital, Moenchengladbach, Germany; Department of Gynecology, University Medical Center Hamburg, Hamburg, Germany
| | - Ron Kates
- West German Study Group, Moenchengladbach, Germany
| | - Nadia Harbeck
- West German Study Group, Moenchengladbach, Germany; Department of OB&GYN and CCC Munich, Breast Center, LMU University Hospital, Munich, Germany
| | - Hans Kreipe
- Institute of Pathology, Hannover Medical School, Hannover, Germany
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13
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Bücker L, Lehmann U. CDH1 (E-cadherin) Gene Methylation in Human Breast Cancer: Critical Appraisal of a Long and Twisted Story. Cancers (Basel) 2022; 14:cancers14184377. [PMID: 36139537 PMCID: PMC9497067 DOI: 10.3390/cancers14184377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 07/26/2022] [Revised: 09/05/2022] [Accepted: 09/05/2022] [Indexed: 11/27/2022] Open
Abstract
Simple Summary Genes can be inactivated by specific modifications of DNA bases, most often by adding a methyl group to the DNA base cytosine if it is followed by guanosine (CG methylation). This modification prevents gene expression and has been reported for many different genes in nearly all types of cancer. A prominent example is the gene CDH1, which encodes the cell-adhesion molecule E-cadherin. This is an important player in the spreading of tumor cells within the body (metastasis). Particularly in human breast cancer, many different research groups have studied the inactivation of the CDH1 gene via DNA methylation using various methods. Over the last 20 years, different, in part, even contradicting results have been published for the CDH1 gene in breast cancer. This review summarizes the most important publications and explains the bewildering heterogeneity of results through careful analysis of the methods which have been used. Abstract Epigenetic inactivation of a tumor suppressor gene by aberrant DNA methylation is a well-established defect in human tumor cells, complementing genetic inactivation by mutation (germline or somatic). In human breast cancer, aberrant gene methylation has diagnostic, prognostic, and predictive potential. A prominent example is the hypermethylation of the CDH1 gene, encoding the adhesion protein E-Cadherin (“epithelial cadherin”). In numerous publications, it is reported as frequently affected by gene methylation in human breast cancer. However, over more than two decades of research, contradictory results concerning CDH1 gene methylation in human breast cancer accumulated. Therefore, we review the available evidence for and against the role of DNA methylation of the CDH1 gene in human breast cancer and discuss in detail the methodological reasons for conflicting results, which are of general importance for the analysis of aberrant DNA methylation in human cancer specimens. Since the loss of E-cadherin protein expression is a hallmark of invasive lobular breast cancer (ILBC), special attention is paid to CDH1 gene methylation as a potential mechanism for loss of expression in this special subtype of human breast cancer. Proper understanding of the methodological basis is of utmost importance for the correct interpretation of results supposed to demonstrate the presence and clinical relevance of aberrant DNA methylation in cancer specimens.
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Affiliation(s)
| | - Ulrich Lehmann
- Correspondence: ; Tel.: +49-(0)511-532-4501; Fax: +49-(0)511-532-5799
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14
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Neumann O, Ball M, Lehmann U, Schirmacher P, Stenzinger A, Kazdal D. [Erratum to: Genes and pathways: FGFR2 translocations and gene fusion analysis]. Pathologie (Heidelb) 2022; 43:387. [PMID: 35925318 DOI: 10.1007/s00292-022-01091-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Affiliation(s)
- Olaf Neumann
- Institut für Pathologie, Universitätsklinikum Heidelberg, 69120, Heidelberg, Deutschland
- Zentrum für Personalisierte Medizin Heidelberg (ZPM), Heidelberg, Deutschland
- Deutsches Konsortium für Translationale Krebsforschung (DKTK), Heidelberg, Deutschland
| | - Markus Ball
- Institut für Pathologie, Universitätsklinikum Heidelberg, 69120, Heidelberg, Deutschland
- Translational Lung Research Center (TLRC) Heidelberg, Deutsches Zentrum für Lungenforschung (DZL), Heidelberg, Deutschland
| | - Ulrich Lehmann
- Institut für Pathologie, Medizinische Hochschule Hannover, Hannover, Deutschland
| | - Peter Schirmacher
- Institut für Pathologie, Universitätsklinikum Heidelberg, 69120, Heidelberg, Deutschland
- Zentrum für Personalisierte Medizin Heidelberg (ZPM), Heidelberg, Deutschland
- Deutsches Konsortium für Translationale Krebsforschung (DKTK), Heidelberg, Deutschland
- Liver Cancer Center Heidelberg, Heidelberg, Deutschland
| | - Albrecht Stenzinger
- Institut für Pathologie, Universitätsklinikum Heidelberg, 69120, Heidelberg, Deutschland.
- Zentrum für Personalisierte Medizin Heidelberg (ZPM), Heidelberg, Deutschland.
- Deutsches Konsortium für Translationale Krebsforschung (DKTK), Heidelberg, Deutschland.
- Translational Lung Research Center (TLRC) Heidelberg, Deutsches Zentrum für Lungenforschung (DZL), Heidelberg, Deutschland.
| | - Daniel Kazdal
- Institut für Pathologie, Universitätsklinikum Heidelberg, 69120, Heidelberg, Deutschland.
- Zentrum für Personalisierte Medizin Heidelberg (ZPM), Heidelberg, Deutschland.
- Deutsches Konsortium für Translationale Krebsforschung (DKTK), Heidelberg, Deutschland.
- Translational Lung Research Center (TLRC) Heidelberg, Deutsches Zentrum für Lungenforschung (DZL), Heidelberg, Deutschland.
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15
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Lehmann U, Stenzinger A. [The molecular pathology breviary: What do "WGS, WES, transcriptome, RNAseq" mean?]. Pathologie (Heidelb) 2022; 43:317-318. [PMID: 35258653 DOI: 10.1007/s00292-022-01058-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/02/2022] [Indexed: 12/14/2022]
Affiliation(s)
- Ulrich Lehmann
- Molekularpathologie, Institut für Pathologie, Medizinische Hochschule Hannover, OE5110, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland.
| | - Albrecht Stenzinger
- Molekularpathologisches Zentrum, Pathologisches Institut, Universität Heidelberg, Im Neuenheimer Feld 224, 69120, Heidelberg, Deutschland.
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16
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Lehmann U, Stenzinger A. [The molecular pathology breviary: what do hybrid capture, anchored multiplex PCR and amplicon-based mean?]. Pathologe 2022; 43:229-230. [PMID: 34982211 DOI: 10.1007/s00292-021-01036-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/24/2021] [Indexed: 06/14/2023]
Affiliation(s)
- Ulrich Lehmann
- Molekularpathologie, Institut für Pathologie, Medizinische Hochschule Hannover, OE5110, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland.
| | - Albrecht Stenzinger
- Molekularpathologisches Zentrum, Pathologisches Institut, Universität Heidelberg, Im Neuenheimer Feld 224, 69120, Heidelberg, Deutschland.
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17
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Christgen M, Kandt LD, Antonopoulos W, Bartels S, Van Bockstal MR, Bredt M, Brito MJ, Christgen H, Colpaert C, Cserni B, Cserni G, Daemmrich ME, Danebrock R, Dedeurwaerdere F, van Deurzen CH, Erber R, Fathke C, Feist H, Fiche M, Gonzalez CA, Ter Hoeve ND, Kooreman L, Krech T, Kristiansen G, Kulka J, Laenger F, Lafos M, Lehmann U, Martin-Martinez MD, Mueller S, Pelz E, Raap M, Ravarino A, Reineke-Plaass T, Schaumann N, Schelfhout AM, De Schepper M, Schlue J, Van de Vijver K, Waelput W, Wellmann A, Graeser M, Gluz O, Kuemmel S, Nitz U, Harbeck N, Desmedt C, Floris G, Derksen PW, van Diest PJ, Vincent-Salomon A, Kreipe H. Inter-observer agreement for the histological diagnosis of invasive lobular breast carcinoma. J Pathol Clin Res 2022; 8:191-205. [PMID: 34889530 PMCID: PMC8822373 DOI: 10.1002/cjp2.253] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 11/17/2021] [Accepted: 11/24/2021] [Indexed: 12/20/2022]
Abstract
Invasive lobular breast carcinoma (ILC) is the second most common breast carcinoma (BC) subtype and is mainly driven by loss of E‐cadherin expression. Correct classification of BC as ILC is important for patient treatment. This study assessed the degree of agreement among pathologists for the diagnosis of ILC. Two sets of hormone receptor (HR)‐positive/HER2‐negative BCs were independently reviewed by participating pathologists. In set A (61 cases), participants were provided with hematoxylin/eosin (HE)‐stained sections. In set B (62 cases), participants were provided with HE‐stained sections and E‐cadherin immunohistochemistry (IHC). Tumor characteristics were balanced. Participants classified specimens as non‐lobular BC versus mixed BC versus ILC. Pairwise inter‐observer agreement and agreement with a pre‐defined reference diagnosis were determined with Cohen's kappa statistics. Subtype calls were correlated with molecular features, including CDH1/E‐cadherin mutation status. Thirty‐five pathologists completed both sets, providing 4,305 subtype calls. Pairwise inter‐observer agreement was moderate in set A (median κ = 0.58, interquartile range [IQR]: 0.48–0.66) and substantial in set B (median κ = 0.75, IQR: 0.56–0.86, p < 0.001). Agreement with the reference diagnosis was substantial in set A (median κ = 0.67, IQR: 0.57–0.75) and almost perfect in set B (median κ = 0.86, IQR: 0.73–0.93, p < 0.001). The median frequency of CDH1/E‐cadherin mutations in specimens classified as ILC was 65% in set A (IQR: 56–72%) and 73% in set B (IQR: 65–75%, p < 0.001). Cases with variable subtype calls included E‐cadherin‐positive ILCs harboring CDH1 missense mutations, and E‐cadherin‐negative ILCs with tubular elements and focal P‐cadherin expression. ILCs with trabecular growth pattern were often misclassified as non‐lobular BC in set A but not in set B. In conclusion, subtyping of BC as ILC achieves almost perfect agreement with a pre‐defined reference standard, if assessment is supported by E‐cadherin IHC. CDH1 missense mutations associated with preserved E‐cadherin protein expression, E‐ to P‐cadherin switching in ILC with tubular elements, and trabecular ILC were identified as potential sources of discordant classification.
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Affiliation(s)
| | | | | | - Stephan Bartels
- Institute of Pathology, Hannover Medical School, Hannover, Germany
| | | | - Martin Bredt
- Institute of Pathology, Hannover Medical School, Hannover, Germany
| | - Maria Jose Brito
- Pathology and Breast Unit, Champalimaud Foundation, Lisbon, Portugal
| | | | - Cecile Colpaert
- Department of Pathology, Universitair Ziekenhuis Leuven, Leuven, Belgium
| | | | - Gábor Cserni
- Department of Pathology, University of Szeged, Szeged, Hungary
| | | | | | | | | | - Ramona Erber
- Institute of Pathology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), and Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, Germany
| | - Christine Fathke
- Institute of Pathology, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| | - Henning Feist
- Institute of Pathology, Diakonissenkrankenhaus Flensburg, Flensburg, Germany
| | - Maryse Fiche
- Institute of Pathology Aurigen, Aurigen SA, Lausanne, Switzerland
| | - Claudia Aura Gonzalez
- Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Dublin, Ireland
| | - Natalie D Ter Hoeve
- Department of Pathology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Loes Kooreman
- Institute of Pathology and GROW - School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Till Krech
- Institute of Pathology, University Clinics Hamburg-Eppendorf, Hamburg, Germany.,Germany and Pathocom Network for Pathology, Osnabrück, Germany
| | | | - Janina Kulka
- 2nd Department of Pathology, Semmelweis University Budapest, Budapest, Hungary
| | - Florian Laenger
- Institute of Pathology, Hannover Medical School, Hannover, Germany
| | - Marcel Lafos
- Institute of Pathology, Hannover Medical School, Hannover, Germany
| | - Ulrich Lehmann
- Institute of Pathology, Hannover Medical School, Hannover, Germany
| | | | - Sophie Mueller
- Institute of Pathology, Hannover Medical School, Hannover, Germany
| | - Enrico Pelz
- Institute of Pathology Viersen, Viersen, Germany
| | - Mieke Raap
- Institute of Pathology, Hannover Medical School, Hannover, Germany
| | | | | | - Nora Schaumann
- Institute of Pathology, Hannover Medical School, Hannover, Germany
| | | | - Maxim De Schepper
- Department of Pathology, University Hospitals Leuven, Campus Gasthuisberg, Leuven, Belgium.,Laboratory for Translational Breast Cancer Research, Department of Oncology, KU Leuven, Leuven, Belgium
| | - Jerome Schlue
- Institute of Pathology, Hannover Medical School, Hannover, Germany
| | - Koen Van de Vijver
- Cancer Research Institute Ghent, Ghent University Hospital, Ghent, Belgium
| | - Wim Waelput
- Department of Pathology, UZ Brussel, Vrije Universiteit Brussel, Brussels, Belgium
| | | | - Monika Graeser
- West German Study Group, Moenchengladbach, Germany.,Ev. Hospital Bethesda, Breast Center Niederrhein, Moenchengladbach, Germany.,Gynecologic University Clinic Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Oleg Gluz
- West German Study Group, Moenchengladbach, Germany.,Ev. Hospital Bethesda, Breast Center Niederrhein, Moenchengladbach, Germany
| | - Sherko Kuemmel
- West German Study Group, Moenchengladbach, Germany.,Breast Unit, Kliniken Essen-Mitte, Essen, Germany, and Charité - Universitätsmedizin Berlin, Department of Gynecology with Breast Center, Berlin, Germany
| | - Ulrike Nitz
- West German Study Group, Moenchengladbach, Germany.,Ev. Hospital Bethesda, Breast Center Niederrhein, Moenchengladbach, Germany
| | - Nadia Harbeck
- West German Study Group, Moenchengladbach, Germany.,Department of Gynecology and Obstetrics, Breast Center, University of Munich (LMU) and CCCLMU, Munich, Germany
| | - Christine Desmedt
- Laboratory for Translational Breast Cancer Research, Department of Oncology, KU Leuven, Leuven, Belgium
| | - Giuseppe Floris
- Department of Pathology, University Hospitals Leuven, Campus Gasthuisberg, Leuven, Belgium.,Department of Imaging and Radiology, Laboratory for Cell and Tissue Translational Research, KU-Leuven/UZ Leuven, Leuven, Belgium
| | - Patrick Wb Derksen
- Department of Pathology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Paul J van Diest
- Department of Pathology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Anne Vincent-Salomon
- Pathology-Genetics-Immunology Department, Institut Curie, PSL Research University, Paris, France
| | - Hans Kreipe
- Institute of Pathology, Hannover Medical School, Hannover, Germany
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18
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Lehmann U, Stenzinger A. [The molecular pathological breviary: allele frequencies in NGS analysis]. Pathologe 2022; 43:154-156. [PMID: 34643753 DOI: 10.1007/s00292-021-01003-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/14/2021] [Indexed: 06/13/2023]
Affiliation(s)
- Ulrich Lehmann
- Molekularpathologie, Institut für Pathologie, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, OE 5110, 30625, Hannover, Deutschland.
| | - Albrecht Stenzinger
- Molekularpathologisches Zentrum, Pathologisches Institut, Universität Heidelberg, Im Neuenheimer Feld 224, 69120, Heidelberg, Deutschland
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19
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Grote I, Bartels S, Christgen H, Radner M, Gronewold M, Kandt L, Raap M, Lehmann U, Gluz O, Graeser M, Kuemmel S, Nitz U, Harbeck N, Kreipe H, Christgen M. ERBB2 mutation is associated with sustained tumor cell proliferation after short-term preoperative endocrine therapy in early lobular breast cancer. Mod Pathol 2022; 35:1804-1811. [PMID: 35842479 PMCID: PMC9708567 DOI: 10.1038/s41379-022-01130-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 06/15/2022] [Accepted: 06/15/2022] [Indexed: 12/24/2022]
Abstract
Invasive lobular breast cancer (ILC) is a special breast cancer (BC) subtype and is mostly hormone receptor (HR)-positive and ERBB2 non-amplified. Endocrine therapy restrains tumor proliferation and is the mainstay of lobular BC treatment. Mutation of ERBB2 has been associated with recurrent ILC. However, it is unknown whether ERBB2 mutation impacts on the otherwise exquisite responsiveness of early ILC to endocrine therapy. We have recently profiled n = 622 HR-positive early BCs from the ADAPT trial for mutations in candidate genes involved in endocrine resistance, including ERBB2. All patients were treated with short-term preoperative endocrine therapy (pET, tamoxifen or aromatase inhibitors) before tumor resection. Tumor proliferation after endocrine therapy (post-pET Ki67 index) was determined prospectively by standardized central pathology assessment supported by computer-assisted image analysis. Sustained or suppressed proliferation were defined as post-pET Ki67 ≥10% or <10%. Here, we report a subgroup analysis pertaining to ILCs in this cohort. ILCs accounted for 179/622 (28.8%) cases. ILCs were enriched in mutations in CDH1 (124/179, 69.3%, P < 0.0001) and ERBB2 (14/179, 7.8%, P < 0.0001), but showed fewer mutations in TP53 (7/179, 3.9%, P = 0.0048) and GATA3 (11/179, 6.1%, P < 0.0001). Considering all BCs irrespective of subtypes, ERBB2 mutation was not associated with proliferation. In ILCs, however, ERBB2 mutations were 3.5-fold more common in cases with sustained post-pET proliferation compared to cases with suppressed post-pET proliferation (10/75, 13.3% versus 4/104, 3.8%, P = 0.0248). Moreover, ERBB2 mutation was associated with high Oncotype DX recurrence scores (P = 0.0087). In summary, our findings support that ERBB2 mutation influences endocrine responsiveness in early lobular BC.
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Affiliation(s)
- Isabel Grote
- grid.10423.340000 0000 9529 9877Institute of Pathology, Hannover Medical School, Hannover, Germany
| | - Stephan Bartels
- grid.10423.340000 0000 9529 9877Institute of Pathology, Hannover Medical School, Hannover, Germany
| | - Henriette Christgen
- grid.10423.340000 0000 9529 9877Institute of Pathology, Hannover Medical School, Hannover, Germany
| | - Martin Radner
- grid.10423.340000 0000 9529 9877Institute of Pathology, Hannover Medical School, Hannover, Germany
| | - Malte Gronewold
- grid.10423.340000 0000 9529 9877Institute of Pathology, Hannover Medical School, Hannover, Germany
| | - Leonie Kandt
- grid.10423.340000 0000 9529 9877Institute of Pathology, Hannover Medical School, Hannover, Germany
| | - Mieke Raap
- grid.10423.340000 0000 9529 9877Institute of Pathology, Hannover Medical School, Hannover, Germany
| | - Ulrich Lehmann
- grid.10423.340000 0000 9529 9877Institute of Pathology, Hannover Medical School, Hannover, Germany
| | - Oleg Gluz
- grid.476830.eWest German Study Group, Moenchengladbach, Germany ,Ev. Bethesda Hospital, Moenchengladbach, Germany ,University Clinics Cologne, Women’s Clinic and Breast Center, Cologne, Germany
| | - Monika Graeser
- grid.476830.eWest German Study Group, Moenchengladbach, Germany ,Ev. Bethesda Hospital, Moenchengladbach, Germany ,grid.13648.380000 0001 2180 3484University Medical Center Hamburg, Department of Gynecology, Hamburg, Germany
| | - Sherko Kuemmel
- grid.476830.eWest German Study Group, Moenchengladbach, Germany ,Clinics Essen-Mitte, Breast Unit, Essen, Germany ,grid.6363.00000 0001 2218 4662Charité, Women’s Clinic, Berlin, Germany
| | - Ulrike Nitz
- grid.476830.eWest German Study Group, Moenchengladbach, Germany ,Ev. Bethesda Hospital, Moenchengladbach, Germany
| | - Nadia Harbeck
- grid.476830.eWest German Study Group, Moenchengladbach, Germany ,grid.5252.00000 0004 1936 973XLMU University Hospital, Breast Center, Department OB&GYN and CCC Munich, Munich, Germany
| | - Hans Kreipe
- grid.10423.340000 0000 9529 9877Institute of Pathology, Hannover Medical School, Hannover, Germany
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20
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Grote I, Bartels S, Kandt L, Bollmann L, Christgen H, Gronewold M, Raap M, Lehmann U, Gluz O, Nitz U, Kuemmel S, Zu Eulenburg C, Braun M, Aktas B, Grischke EM, Schumacher C, Luedtke-Heckenkamp K, Kates R, Wuerstlein R, Graeser M, Harbeck N, Christgen M, Kreipe H. TP53 mutations are associated with primary endocrine resistance in luminal early breast cancer. Cancer Med 2021; 10:8581-8594. [PMID: 34779146 PMCID: PMC8633262 DOI: 10.1002/cam4.4376] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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: 05/26/2021] [Revised: 09/10/2021] [Accepted: 09/13/2021] [Indexed: 12/19/2022] Open
Abstract
Background Whereas the genomic landscape of endocrine‐resistant breast cancer has been intensely characterized in previously treated cases with local or distant recurrence, comparably little is known about genomic alterations conveying primary non‐responsiveness to endocrine treatment in luminal early breast cancer. Methods In this study, 622 estrogen receptor‐expressing breast cancer cases treated with short‐term preoperative endocrine therapy (pET) from the WSG‐ADAPT trial (NCT01779206) were analyzed for genetic alterations associated with impaired endocrine proliferative response (EPR) to 3‐week pET with tamoxifen or aromatase inhibitors. EPR was categorized as optimal (post‐pET Ki67 <10%) versus slightly, moderately, and severely impaired (post‐pET Ki67 10%–19%, 20%–34%, and ≥35%, respectively). Recently described gene mutations frequently found in previously treated advanced breast cancer were analyzed (ARID1A, BRAF, ERBB2, ESR1, GATA3, HRAS, KRAS, NRAS, PIK3CA, and TP53) by next‐generation sequencing. Amplifications of CCND1, FGFR1, ERBB2, and PAK1 were determined by digital PCR or fluorescence in situ hybridization. Results ERBB2 amplification (p = 0.0015) and mutations of TP53 (p < 0.0001) were significantly associated with impaired EPR. Impaired EPR in TP53‐mutated breast cancer cases was independent from the Oncotype DX Recurrence Score group and was seen both with tamoxifen‐ and aromatase inhibitor‐based pET (p = 0.0005 each). Conclusion We conclude that impaired EPR to pET is suitable to identify cases with primary endocrine resistance in early luminal breast cancer and that TP53‐mutated luminal cancers might not be sufficiently treated by endocrine therapy alone.
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Affiliation(s)
- Isabel Grote
- Hannover Medical School, Institute of Pathology, Hannover, Germany
| | - Stephan Bartels
- Hannover Medical School, Institute of Pathology, Hannover, Germany
| | - Leonie Kandt
- Hannover Medical School, Institute of Pathology, Hannover, Germany
| | - Laura Bollmann
- Hannover Medical School, Institute of Pathology, Hannover, Germany
| | | | - Malte Gronewold
- Hannover Medical School, Institute of Pathology, Hannover, Germany
| | - Mieke Raap
- Hannover Medical School, Institute of Pathology, Hannover, Germany
| | - Ulrich Lehmann
- Hannover Medical School, Institute of Pathology, Hannover, Germany
| | - Oleg Gluz
- West German Study Group, Moenchengladbach, Germany.,Ev. Bethesda Hospital, Moenchengladbach, Germany.,University Clinics Cologne, Women's Clinic and Breast Center, Cologne, Germany
| | - Ulrike Nitz
- West German Study Group, Moenchengladbach, Germany.,Ev. Bethesda Hospital, Moenchengladbach, Germany
| | - Sherko Kuemmel
- West German Study Group, Moenchengladbach, Germany.,Clinics Essen-Mitte, Breast Unit, Essen, Germany.,Charité, Women's Clinic, Berlin, Germany
| | | | | | - Bahriye Aktas
- University Clinics Essen, Women's Clinic, Essen, Germany.,University Clinics Leipzig, Women's Clinic, Leipzig, Germany
| | | | | | | | - Ronald Kates
- West German Study Group, Moenchengladbach, Germany
| | - Rachel Wuerstlein
- Department OB&GYN and CCC Munich, LMU University Hospital, Breast Center, Munich, Germany
| | - Monika Graeser
- West German Study Group, Moenchengladbach, Germany.,Ev. Bethesda Hospital, Moenchengladbach, Germany.,Department of Gynecology, University Medical Center Hamburg, Hamburg, Germany
| | - Nadia Harbeck
- West German Study Group, Moenchengladbach, Germany.,Department OB&GYN and CCC Munich, LMU University Hospital, Breast Center, Munich, Germany
| | | | - Hans Kreipe
- Hannover Medical School, Institute of Pathology, Hannover, Germany
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21
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Lehmann U, Stenzinger A. [The molecular pathology breviary: read depth and coverage in NGS analysis]. Pathologe 2021; 43:65-66. [PMID: 34643752 DOI: 10.1007/s00292-021-01009-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/02/2021] [Indexed: 11/24/2022]
Affiliation(s)
- Ulrich Lehmann
- Molekularpathologie, Institut für Pathologie, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, OE5110, 30625, Hannover, Deutschland.
| | - Albrecht Stenzinger
- Molekularpathologisches Zentrum, Pathologisches Institut, Universität Heidelberg, Im Neuenheimer Feld 224, 69120, Heidelberg, Deutschland
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22
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Weichert W, Bartels S, Baretton G, Braicu E, Demes M, Endris V, Herold S, Heukamp L, Hummel M, Lehmann U, Merkelbach-Bruse S, Pfarr N, Rad R, Sehouli J, Siemanowski J, Stenzinger A, von Schwarzenberg K, Vollbrecht C, Wild P, Zocholl D. 758P Concordance between multiple HRD assays is substantial in high-grade ovarian cancer. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1200] [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: 10/20/2022] Open
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23
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Banan R, Akbarian A, Samii M, Samii A, Bertalanffy H, Lehmann U, Hartmann C, Brüning R. Diffuse midline gliomas, H3 K27M-mutant are associated with less peritumoral edema and contrast enhancement in comparison to glioblastomas, H3 K27M-wildtype of midline structures. PLoS One 2021; 16:e0249647. [PMID: 34347774 PMCID: PMC8336828 DOI: 10.1371/journal.pone.0249647] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 03/23/2021] [Indexed: 12/19/2022] Open
Abstract
Purpose The entity ‘diffuse midline glioma, H3 K27M-mutant (DMG)’ was introduced in the revised 4th edition of the 2016 WHO classification of brain tumors. However, there are only a few reports on magnetic resonance imaging (MRI) of these tumors. Thus, we conducted a retrospective survey focused on MRI features of DMG compared to midline glioblastomas H3 K27M-wildtype (mGBM-H3wt). Methods We identified 24 DMG cases and 19 mGBM-H3wt patients as controls. After being retrospectively evaluated for microscopic evidence of microvascular proliferations (MVP) and tumor necrosis by two experienced neuropathologists to identify the defining histological criteria of mGBM-H3wt, the samples were further analyzed by two experienced readers regarding imaging features such as shape, peritumoral edema and contrast enhancement. Results The DMG were found in the thalamus in 37.5% of cases (controls 63%), in the brainstem in 50% (vs. 32%) and spinal cord in 12.5% (vs. 5%). In MRI and considering MVP, DMG were found to be by far less likely to develop peritumoral edema (OR: 0.13; 95%-CL: 0.02–0.62) (p = 0.010). They, similarly, were associated with a significantly lower probability of developing strong contrast enhancement compared to mGBM-H3wt (OR: 0.10; 95%-CL: 0.02–0.47) (P = 0.003). Conclusion Despite having highly variable imaging features, DMG exhibited markedly less edema and lower contrast enhancement in MRI compared to mGBM-H3wt. Of these features, the enhancement level was associated with evidence of MVP.
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Affiliation(s)
- Rouzbeh Banan
- Department of Neuropathology, University of Heidelberg, Heidelberg, Germany
- Department of Neuropathology, Institute of Pathology, Hannover Medical School, Hannover, Germany
| | - Arash Akbarian
- Department of Neuroradiology, INI-Hannover, Hannover, Germany
| | - Majid Samii
- Department of Neurosurgery, INI-Hannover, Hannover, Germany
| | - Amir Samii
- Department of Neurosurgery, INI-Hannover, Hannover, Germany
| | | | - Ulrich Lehmann
- Institute of Pathology, Hannover Medical School, Hannover, Germany
| | - Christian Hartmann
- Department of Neuropathology, Institute of Pathology, Hannover Medical School, Hannover, Germany
| | - Roland Brüning
- Radiology and Neuroradiology, Asklepios Klinik Barmbek, Hamburg, Germany
- * E-mail:
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24
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Busche S, John K, Wandrer F, Vondran FWR, Lehmann U, Wedemeyer H, Essmann F, Schulze-Osthoff K, Bantel H. BH3-only protein expression determines hepatocellular carcinoma response to sorafenib-based treatment. Cell Death Dis 2021; 12:736. [PMID: 34312366 PMCID: PMC8313681 DOI: 10.1038/s41419-021-04020-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [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: 06/08/2021] [Revised: 07/05/2021] [Accepted: 07/06/2021] [Indexed: 02/07/2023]
Abstract
Hepatocellular carcinoma (HCC) represents a global health challenge with limited therapeutic options. Anti-angiogenic immune checkpoint inhibitor-based combination therapy has been introduced for progressed HCC, but improves survival only in a subset of HCC patients. Tyrosine-kinase inhibitors (TKI) such as sorafenib represent an alternative treatment option but have only modest efficacy. Using different HCC cell lines and HCC tissues from various patients reflecting HCC heterogeneity, we investigated whether the sorafenib response could be enhanced by combination with pro-apoptotic agents, such as TNF-related apoptosis-inducing ligand (TRAIL) or the BH3-mimetic ABT-737, which target the death receptor and mitochondrial pathway of apoptosis, respectively. We found that both agents could enhance sorafenib-induced cell death which was, however, dependent on specific BH3-only proteins. TRAIL augmented sorafenib-induced cell death only in NOXA-expressing HCC cells, whereas ABT-737 enhanced the sorafenib response also in NOXA-deficient cells. ABT-737, however, failed to augment sorafenib cytotoxicity in the absence of BIM, even when NOXA was strongly expressed. In the presence of NOXA, BIM-deficient HCC cells could be in turn strongly sensitized for cell death induction by the combination of sorafenib with TRAIL. Accordingly, HCC tissues sensitive to apoptosis induction by sorafenib and TRAIL revealed enhanced NOXA expression compared to HCC tissues resistant to this treatment combination. Thus, our results suggest that BH3-only protein expression determines the treatment response of HCC to different sorafenib-based drug combinations. Individual profiling of BH3-only protein expression might therefore assist patient stratification to certain TKI-based HCC therapies.
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Affiliation(s)
- Stephanie Busche
- grid.10423.340000 0000 9529 9877Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany
| | - Katharina John
- grid.10423.340000 0000 9529 9877Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany
| | - Franziska Wandrer
- grid.10423.340000 0000 9529 9877Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany
| | - Florian W. R. Vondran
- grid.10423.340000 0000 9529 9877Department of Visceral and Transplantation Surgery, Hannover Medical School, Hannover, Germany ,grid.452463.2German Centre for Infection Research (DZIF), partner site Hannover-Braunschweig, Hannover, Germany
| | - Ulrich Lehmann
- grid.10423.340000 0000 9529 9877Department of Pathology, Hannover Medical School, Hannover, Germany
| | - Heiner Wedemeyer
- grid.10423.340000 0000 9529 9877Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany
| | - Frank Essmann
- grid.502798.10000 0004 0561 903XDr. Margarete-Fischer-Bosch Institute of Clinical Pharmacology, Stuttgart, Germany
| | - Klaus Schulze-Osthoff
- grid.10392.390000 0001 2190 1447Interfaculty Institute of Biochemistry, University of Tübingen, Tübingen, Germany ,grid.7497.d0000 0004 0492 0584German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Heidelberg, Germany ,grid.10392.390000 0001 2190 1447Cluster of Excellence iFIT (EXC 2180) “Image-Guided and Functionally Instructed Tumor Therapies”, University of Tübingen, Tübingen, Germany
| | - Heike Bantel
- grid.10423.340000 0000 9529 9877Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany
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25
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Lehmann U, Jung A. [Next generation sequencing in histopathology : Applications and methodological challenges]. Pathologe 2021; 42:363-368. [PMID: 34170385 DOI: 10.1007/s00292-021-00953-6] [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] [Subscribe] [Scholar Register] [Accepted: 05/04/2021] [Indexed: 10/21/2022]
Abstract
The enormous increase in sequencing capacity due to the development of next generation sequencing technologies opens up new opportunities in the fields of histopathology, research, and diagnostics, but also poses huge challenges.The identification of genomic aberrations (point mutations, small insertions and deletions, fusion transcripts, and tumor mutation burden (TMB)) have already become a reliable part of routine molecular diagnostics. This will be supplemented by additional applications, namely gene amplifications, microsatellite instability, genomic signatures like homologous recombination deficiency (HRD), mRNA expression patterns, B‑ and T‑cell clonality, and DNA methylation. Challenges in preanalytics and the evaluation of assay sensitivity and specificity as well as proper curation of identified aberrations, which requires a new type of specialist, are presented and discussed.
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Affiliation(s)
- Ulrich Lehmann
- Institut für Pathologie, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland.
| | - Andreas Jung
- Pathologisches Institut, Medizinische Fakultät, LMU München, Thalkirchner Str. 36, 80337, München, Deutschland
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26
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Radner M, van Luttikhuizen JL, Bartels S, Bublitz J, Grote I, Rieger L, Christgen H, Stark H, Werlein C, Lafos M, Steinemann D, Lehmann U, Christgen M, Kreipe H. Chromosome 2q gain and epigenetic silencing of GATA3 in microglandular adenosis of the breast. J Pathol Clin Res 2021; 7:220-232. [PMID: 33382535 PMCID: PMC8073017 DOI: 10.1002/cjp2.195] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 11/06/2020] [Accepted: 11/20/2020] [Indexed: 01/30/2023]
Abstract
Microglandular adenosis (MGA) represents a rare neoplasm of the mammary gland, which in a subset of cases may be associated with triple-negative breast cancer (BC). The biology of MGA is poorly understood. In this study, eight MGA cases (n = 4 with and n = 4 without associated BC) were subjected to a comprehensive characterization using immunohistochemistry, genome-wide DNA copy number (CN) profiling, fluorescence in situ hybridization (FISH), next-generation sequencing (NGS), and DNA methylation profiling using 850 K arrays and bisulfite pyrosequencing. Median patient age was 61 years (range 57-76 years). MGA lesions were estrogen receptor (ER)-negative, progesterone receptor-negative, HER2-negative, and S100-positive. DNA CN alterations (CNAs) were complex or limited to few gains and losses. CN gain on chromosome 2q was the most common CNA and was validated by FISH in five of eight cases. NGS demonstrated an average of two mutations per case (range 0-5) affecting 10 different genes (ARID1A, ATM, CTNNB1, FBXW7, FGFR2, MET, PIK3CA, PMS2, PTEN, and TP53). CNAs and mutations were similar in MGA and adjacent BC, indicating clonal relatedness. DNA methylation profiling identified aberrant hypermethylation of CpG sites within GATA3, a key transcription factor required for luminal differentiation. Immunohistochemistry showed regular GATA3 protein expression in the normal mammary epithelium and in ER-positive BC. Conversely, GATA3 was reduced or lost in all MGA cases tested (8/8). In conclusion, MGA is characterized by common CN gain on chromosome 2q and loss of GATA3. Epigenetic inactivation of GATA3 may provide a new clue to the peculiar biology of this rare neoplasia.
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Affiliation(s)
- Martin Radner
- Institute of PathologyHannover Medical SchoolHannoverGermany
| | | | - Stephan Bartels
- Institute of PathologyHannover Medical SchoolHannoverGermany
| | - Janin Bublitz
- Department of Human GeneticsHannover Medical SchoolHannoverGermany
| | - Isabel Grote
- Institute of PathologyHannover Medical SchoolHannoverGermany
| | - Luisa Rieger
- Institute of PathologyHannover Medical SchoolHannoverGermany
| | | | - Helge Stark
- Institute of PathologyHannover Medical SchoolHannoverGermany
| | | | - Marcel Lafos
- Institute of PathologyHannover Medical SchoolHannoverGermany
| | - Doris Steinemann
- Department of Human GeneticsHannover Medical SchoolHannoverGermany
| | - Ulrich Lehmann
- Institute of PathologyHannover Medical SchoolHannoverGermany
| | | | - Hans Kreipe
- Institute of PathologyHannover Medical SchoolHannoverGermany
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27
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Lehmann U, Stark H, Bartels S, Schlue J, Büsche G, Kreipe H. Genome-wide DNA methylation profiling is able to identify prefibrotic PMF cases at risk for progression to myelofibrosis. Clin Epigenetics 2021; 13:28. [PMID: 33541399 PMCID: PMC7860011 DOI: 10.1186/s13148-021-01010-y] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 01/11/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Patients suffering from the BCR-ABL1-negative myeloproliferative disease prefibrotic primary myelofibrosis (pre-PMF) have a certain risk for progression to myelofibrosis. Accurate risk estimation for this fibrotic progression is of prognostic importance and clinically relevant. Commonly applied risk scores are based on clinical, cytogenetic, and genetic data but do not include epigenetic modifications. Therefore, we evaluated the assessment of genome-wide DNA methylation patterns for their ability to predict fibrotic progression in PMF patients. RESULTS For this purpose, the DNA methylation profile was analyzed genome-wide in a training set of 22 bone marrow trephines from patients with either fibrotic progression (n = 12) or stable disease over several years (n = 10) using the 850 k EPIC array from Illumina. The DNA methylation classifier constructed from this data set was validated in an independently measured test set of additional 11 bone marrow trephines (7 with stable disease, 4 with fibrotic progress). Hierarchical clustering of methylation β-values and linear discriminant classification yielded very good discrimination between both patient groups. By gene ontology analysis, the most differentially methylated CpG sites are primarily associated with genes involved in cell-cell and cell-matrix interactions. CONCLUSIONS In conclusion, we could show that genome-wide DNA methylation profiling of bone marrow trephines is feasible under routine diagnostic conditions and, more importantly, is able to predict fibrotic progression in pre-fibrotic primary myelofibrosis with high accuracy.
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Affiliation(s)
- Ulrich Lehmann
- Institute of Pathology, Medical School Hannover, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
| | - Helge Stark
- Institute of Pathology, Medical School Hannover, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Stephan Bartels
- Institute of Pathology, Medical School Hannover, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Jerome Schlue
- Institute of Pathology, Medical School Hannover, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Guntram Büsche
- Institute of Pathology, Medical School Hannover, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Hans Kreipe
- Institute of Pathology, Medical School Hannover, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
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28
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Uecker M, Lehmann U, Braubach P, Schukfeh N, Madadi-Sanjani O, Ure BM, Petersen C, Kuebler JF. Choledochal Cysts Resected during Childhood Show No Mutations of KRAS and BRAF as Early Markers of Malignancy in Cholangiocytes. Eur J Pediatr Surg 2021; 31:20-24. [PMID: 32820496 DOI: 10.1055/s-0040-1715610] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
INTRODUCTION In patients with choledochal cysts (CDC), a hyperplasia-dysplasia-carcinoma sequence can lead to biliary tract malignancy. The limited data available suggest that the risk decreases considerably after excision in childhood. We analyzed samples of resected CDC from pediatric patients histologically and performed mutational analysis of the proto-oncogenes KRAS and BRAF as early markers of malignant alteration in cholangiocytes. MATERIALS AND METHODS After institutional review board approval, patients undergoing resection for CDC in our center from 2011 to 2019 were retrospectively identified. Histopathological reports were searched for inflammation and endothelial alteration. Cases with sufficient tissue specimen were tested for KRAS codon 12/13 and BRAF codon 600 mutations by pyrosequencing. RESULTS In total, 42 patients underwent resection for choledochal cyst in the study period. Median age at surgery was 2.4 years (range = 18 days-18 years). Histopathological analysis showed no malignancy, but various degrees of inflammation or fibrosis in approximately 50% of the patients and in all age groups. Sufficient tissue for mutation analysis was available for 22 cases, all of which tested negative for KRAS or BRAF mutation. CONCLUSION In our series, chronic inflammatory changes were frequently present in CDC of infants and children. However, the lack of KRAS and BRAF mutations suggests that no malignant changes have been initiated in this group of European patients undergoing early resection.
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Affiliation(s)
- Marie Uecker
- Department of Pediatric Surgery, Hannover Medical School, Hannover, Germany
| | - Ulrich Lehmann
- Department of Pathology, Hannover Medical School, Hannover, Germany
| | - Peter Braubach
- Department of Pathology, Hannover Medical School, Hannover, Germany
| | - Nagoud Schukfeh
- Department of Pediatric Surgery, Hannover Medical School, Hannover, Germany
| | | | - Benno M Ure
- Department of Pediatric Surgery, Hannover Medical School, Hannover, Germany
| | - Claus Petersen
- Department of Pediatric Surgery, Hannover Medical School, Hannover, Germany
| | - Joachim F Kuebler
- Department of Pediatric Surgery, Hannover Medical School, Hannover, Germany
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29
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Bartels S, Vogtmann J, Schipper E, Büsche G, Schlue J, Lehmann U, Kreipe H. Combination of myeloproliferative neoplasm driver gene activation with mutations of splice factor or epigenetic modifier genes increases risk of rapid blastic progression. Eur J Haematol 2021; 106:520-528. [PMID: 33460496 DOI: 10.1111/ejh.13579] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [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: 11/06/2020] [Accepted: 01/09/2021] [Indexed: 01/04/2023]
Abstract
OBJECTIVES Myeloproliferative neoplasms (MPN) comprising polycythemia vera (PV), essential thrombocythemia (ET) and primary myelofibrosis (PMF) follow a bi-phasic course of disease with fibrotic and/or blastic progression. At presentation in the chronic phase, currently there are only insufficient tools to predict the risk of progression in individual cases. METHODS In this study, chronic phase MPN (16 PMF, 11 PV, and 11 MPN unclassified) with blastic transformation during course of disease (n = 38, median follow-up 5.3 years) were analyzed by high-throughput sequencing. MPN cases with a comparable follow-up period and without evidence of blast increase served as control (n = 63, median follow-up 5.8 years). RESULTS Frequent ARCH/CHIP-associated mutations (TET2, ASXL1, DNMT3A) found at presentation were not significantly associated with blastic transformation. By contrast, mutations of SRSF2, U2AF1, and IDH1/2 at first presentation were frequently observed in the progression cohort (13/38, 34.2%) and were completely missing in the control group without blast transformation during follow-up (P = .0007 for SRSF2; P = .0063 for U2AF1 and IDH1/2). CONCLUSION Unlike frequent ARCH/CHIP alterations (TET2, ASXL1, DNMT3A), mutations in SRSF2, IDH1/2, and U2AF1 when manifest already at first presentation provide an independent risk factor for rapid blast transformation of MPN.
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Affiliation(s)
- Stephan Bartels
- Institut für Pathologie, Medizinische Hochschule Hannover, Hannover, Germany
| | - Julia Vogtmann
- Institut für Pathologie, Medizinische Hochschule Hannover, Hannover, Germany
| | - Elisa Schipper
- Institut für Pathologie, Medizinische Hochschule Hannover, Hannover, Germany
| | - Guntram Büsche
- Institut für Pathologie, Medizinische Hochschule Hannover, Hannover, Germany
| | - Jerome Schlue
- Institut für Pathologie, Medizinische Hochschule Hannover, Hannover, Germany
| | - Ulrich Lehmann
- Institut für Pathologie, Medizinische Hochschule Hannover, Hannover, Germany
| | - Hans Kreipe
- Institut für Pathologie, Medizinische Hochschule Hannover, Hannover, Germany
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30
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Bartels S, Faisal M, Büsche G, Schlue J, Hasemeier B, Schipper E, Vogtmann J, Westphal L, Lehmann U, Kreipe H. [Bone marrow fibrosis in primary myelofibrosis in relation to myelodysplasia- and age-related mutations of hematopoietic cells]. Pathologe 2020; 41:124-128. [PMID: 33113046 DOI: 10.1007/s00292-020-00828-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Besides histopathological findings, there are no indicators of increased risk for fibrotic progression in myeloproliferative neoplasms (MPNs). Age-related clonal hematopoiesis (ARCH) or clonal hematopoiesis of indetermined potential (CHIP) are frequent findings in the elderly and combinations with MPN driver mutations (JAK2, MPL, and CALR) have been described. To determine the impact of ARCH/CHIP-related mutations for the development of fibrosis in primary myelofibrosis (PMF), the mutational status of cases with fibrotic progression from grade 0 to grade 2/3 (n = 77) as evidenced by follow-up bone marrow biopsies (median 6.2 years) was compared to prefibrotic PMF samples without the development of fibrosis (n = 27; median follow-up 7.3 years). Frequent ARCH/CHIP-associated mutations (TET2, ASXL1, DNMT3A) demonstrable at presentation were not connected with fibrotic progression. However, mutations that are rarely found in ARCH/CHIP (SRSF2, U2AF1, SF3B1, IDH1/2, and EZH2) were present in 24.7% of cases with later development of fibrosis and not detectable in cases staying free from fibrosis (P = 0.0028). Determination of tumor mutational burden (TMB) in a subgroup of cases (n = 32) did not show significant differences (7.68 mutations/MB vs. 6.85 mutations/MB). We conclude that mutations rarely found in ARCH/CHIP provide an independent risk factor for rapid fibrotic progression (median 2.0 years) when already manifest at first presentation.
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Affiliation(s)
- S Bartels
- Institut für Pathologie, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland
| | - M Faisal
- Institut für Pathologie, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland
| | - G Büsche
- Institut für Pathologie, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland
| | - J Schlue
- Institut für Pathologie, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland
| | - B Hasemeier
- Institut für Pathologie, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland
| | - E Schipper
- Institut für Pathologie, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland
| | - J Vogtmann
- Institut für Pathologie, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland
| | - L Westphal
- Institut für Pathologie, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland
| | - U Lehmann
- Institut für Pathologie, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland
| | - H Kreipe
- Institut für Pathologie, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland.
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Banan R, Stichel D, Bleck A, Hong B, Lehmann U, Suwala A, Reinhardt A, Schrimpf D, Buslei R, Stadelmann C, Ehlert K, Prinz M, Acker T, Schittenhelm J, Kaul D, Schweizer L, Capper D, Harter PN, Etminan N, Jones DTW, Pfister SM, Herold-Mende C, Wick W, Sahm F, von Deimling A, Hartmann C, Reuss DE. Infratentorial IDH-mutant astrocytoma is a distinct subtype. Acta Neuropathol 2020; 140:569-581. [PMID: 32776277 DOI: 10.1007/s00401-020-02194-y] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [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: 06/26/2020] [Revised: 07/10/2020] [Accepted: 07/10/2020] [Indexed: 12/11/2022]
Abstract
Diffuse IDH-mutant astrocytic tumors are rarely diagnosed in the cerebellum or brainstem. In this multi-institutional study, we characterized a series of primary infratentorial IDH-mutant astrocytic tumors with respect to clinical and molecular parameters. We report that about 80% of IDH mutations in these tumors are of non-IDH1-R132H variants which are rare in supratentorial astrocytomas. Most frequently, IDH1-R132C/G and IDH2-R172S/G mutations were present. Moreover, the frequencies of ATRX-loss and MGMT promoter methylation, which are typically associated with IDH mutations in supratentorial astrocytic tumors, were significantly lower in the infratentorial compartment. Gene panel sequencing revealed two samples with IDH1-R132C/H3F3A-K27M co-mutations. Genome-wide DNA methylation as well as chromosomal copy number profiling provided further evidence for a molecular distinctiveness of infratentorial IDH-mutant astrocytomas. Clinical outcome of patients with infratentorial IDH-mutant astrocytomas is significantly better than that of patients with diffuse midline gliomas, H3K27M-mutant (p < 0.005) and significantly worse than that of patients with supratentorial IDH-mutant astrocytomas (p = 0.028). The presented data highlight the very existence and distinctiveness of infratentorial IDH-mutant astrocytomas that have important implications for diagnostics and prognostication. They imply that molecular testing is critical for detection of these tumors, since many of these tumors cannot be identified by immunohistochemistry applied for the mutated IDH1-R132H protein or loss of ATRX.
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Affiliation(s)
- Rouzbeh Banan
- Department of Neuropathology, Institute of Pathology, Hannover Medical School (MHH), Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Damian Stichel
- Clinical Cooperation Unit Neuropathology, German Cancer Research Center (DKFZ), German Consortium for Translational Cancer Research (DKTK), Heidelberg, Germany
| | - Anja Bleck
- Department of Neuropathology, Institute of Pathology, Hannover Medical School (MHH), Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Bujung Hong
- Department of Neurosurgery, Hannover Medical School, Hannover, Germany
| | - Ulrich Lehmann
- Institute of Pathology, Hannover Medical School, Hannover, Germany
| | - Abigail Suwala
- Clinical Cooperation Unit Neuropathology, German Cancer Research Center (DKFZ), German Consortium for Translational Cancer Research (DKTK), Heidelberg, Germany
- Department of Neuropathology, Institute of Pathology, Heidelberg University Hospital, Heidelberg, Germany
| | - Annekathrin Reinhardt
- Clinical Cooperation Unit Neuropathology, German Cancer Research Center (DKFZ), German Consortium for Translational Cancer Research (DKTK), Heidelberg, Germany
- Department of Neuropathology, Institute of Pathology, Heidelberg University Hospital, Heidelberg, Germany
| | - Daniel Schrimpf
- Clinical Cooperation Unit Neuropathology, German Cancer Research Center (DKFZ), German Consortium for Translational Cancer Research (DKTK), Heidelberg, Germany
- Department of Neuropathology, Institute of Pathology, Heidelberg University Hospital, Heidelberg, Germany
| | - Rolf Buslei
- Institute of Pathology, Klinikum Bamberg, Klinikum, Germany
| | - Christine Stadelmann
- Institute of Neuropathology, University Medical Center Göttingen, Göttingen, Germany
| | - Karoline Ehlert
- Department of Pediatric Oncology and Hematology, University of Greifswald, Greifswald, Germany
| | - Marco Prinz
- Institute of Neuropathology, University of Freiburg, Freiburg, Germany
| | - Till Acker
- Institute of Neuropathology, University of Gießen, Gießen, Germany
| | - Jens Schittenhelm
- Department of Neuropathology, University of Tübingen, Tübingen, Germany
| | - David Kaul
- Department of Radiation Oncology and Radiotherapy, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Leonille Schweizer
- Department of Neuropathology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Berlin, Germany
- German Cancer Research Center (DKFZ), German Cancer Consortium (DKTK), Partner Site Berlin, Heidelberg, Germany
| | - David Capper
- Department of Neuropathology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Berlin, Germany
- German Cancer Research Center (DKFZ), German Cancer Consortium (DKTK), Partner Site Berlin, Heidelberg, Germany
| | - Patrick N Harter
- Institute of Neurology (Edinger Institute), Goethe University, Frankfurt, Germany
- German Cancer Consortium (DKTK), Partner Site Frankfurt/Mainz, Frankfurt am Main, Frankfurt, Germany
- German Cancer Research Center (DKFZ), Heidelberg, Germany
- Frankfurt Cancer Institute (FCI), Frankfurt am Main, Frankfurt, Germany
| | - Nima Etminan
- Department of Neurosurgery, University Hospital Mannheim, University of Heidelberg, Heidelberg, Germany
| | - David T W Jones
- German Cancer Consortium (DKTK), Heidelberg, Germany
- Hopp Childrens Cancer Center Heidelberg (KiTZ), Heidelberg, Germany
- Pediatric Glioma Research Group, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Stefan M Pfister
- German Cancer Consortium (DKTK), Heidelberg, Germany
- Hopp Childrens Cancer Center Heidelberg (KiTZ), Heidelberg, Germany
- Division of Pediatric Neurooncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of Pediatric Oncology and Hematology, University Hospital Heidelberg, Heidelberg, Germany
| | - Christel Herold-Mende
- Department of Neurosurgery, Division of Experimental Neurosurgery, University Hospital, Heidelberg, Germany
| | - Wolfgang Wick
- German Cancer Consortium (DKTK), Heidelberg, Germany
- Neurology Clinic, University of Heidelberg Medical Center, Heidelberg, Germany
| | - Felix Sahm
- Clinical Cooperation Unit Neuropathology, German Cancer Research Center (DKFZ), German Consortium for Translational Cancer Research (DKTK), Heidelberg, Germany
- Department of Neuropathology, Institute of Pathology, Heidelberg University Hospital, Heidelberg, Germany
| | - Andreas von Deimling
- Clinical Cooperation Unit Neuropathology, German Cancer Research Center (DKFZ), German Consortium for Translational Cancer Research (DKTK), Heidelberg, Germany
- Department of Neuropathology, Institute of Pathology, Heidelberg University Hospital, Heidelberg, Germany
- German Cancer Consortium (DKTK), Heidelberg, Germany
| | - Christian Hartmann
- Department of Neuropathology, Institute of Pathology, Hannover Medical School (MHH), Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
| | - David E Reuss
- Clinical Cooperation Unit Neuropathology, German Cancer Research Center (DKFZ), German Consortium for Translational Cancer Research (DKTK), Heidelberg, Germany.
- Department of Neuropathology, Institute of Pathology, Heidelberg University Hospital, Heidelberg, Germany.
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32
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Saborowski A, Lehmann U, Vogel A. FGFR inhibitors in cholangiocarcinoma: what's now and what's next? Ther Adv Med Oncol 2020; 12:1758835920953293. [PMID: 32983265 PMCID: PMC7498964 DOI: 10.1177/1758835920953293] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [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: 04/11/2020] [Accepted: 08/06/2020] [Indexed: 12/15/2022] Open
Abstract
Patients with intrahepatic cholangiocarcinoma (iCCA) face a highly dismal prognosis, due to late stage diagnosis, the relative chemoresistance of the disease, and an overall limited portfolio of established therapeutic concepts. In recent years, a number of next generation sequencing studies have provided detailed information on the molecular landscape of biliary malignancies, and have laid the groundwork for the evaluation of novel, targeted therapeutic opportunities. Although nearly 40% of patients harbor genetic alterations for which targeted options exist, rapid translation into clinical trials is hampered by the overall low patient numbers. One of the most frequent genetic events in patients with iCCAs are fusions that involve the fibroblast growth factor receptor 2 (FGFR2). Impressive results from pivotal phase II studies in pre-treated patients have confirmed that FGFR-inhibitors are a promising therapeutic option for this genetic subgroup, and the rapid pace with which these inhibitors are being clinically developed is clearly justified by the imminent benefit for the patients. However, the success of these agents should not blind us to key challenges that need to be addressed to optimize FGFR-directed therapies in the future. A better understanding of mechanisms that convey primary and secondary resistance will be crucial to improve up-front patient stratification, to prolong the duration of response, and to implement reasonable co-treatment approaches. In this review, we provide background information on the pathobiology of oncogenic FGFR fusions and selected genetic testing strategies, summarize the latest clinical data, and discuss future directions of FGFR-directed therapies in patients with iCCA.
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Affiliation(s)
- Anna Saborowski
- Department of Gastroenterology, Hepatology & Endokrinologie, Medizinische Hochschule Hannover, Hannover, Germany
| | - Ulrich Lehmann
- Institute of Pathology, Medizinische Hochschule Hannover, Hannover, Germany
| | - Arndt Vogel
- Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Carl-Neuberg Str. 1, Hannover, 30625, Germany
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33
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Kirchner M, Glade J, Lehmann U, Merkelbach-Bruse S, Hummel M, Lehmann A, Trautmann M, Kumbrink J, Jung A, Dietmaier W, Endris V, Kazdal D, Ploeger C, Evert M, Horst D, Kreipe H, Kirchner T, Wardelmann E, Büttner R, Weichert W, Dietel M, Schirmacher P, Stenzinger A, Pfarr N. NTRK testing: First results of the QuiP-EQA scheme and a comprehensive map of NTRK fusion variants and their diagnostic coverage by targeted RNA-based NGS assays. Genes Chromosomes Cancer 2020; 59:445-453. [PMID: 32319699 DOI: 10.1002/gcc.22853] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [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: 03/17/2020] [Revised: 04/16/2020] [Accepted: 04/17/2020] [Indexed: 12/21/2022] Open
Abstract
Gene fusions involving the three neurotrophic tyrosine receptor kinase genes NTRK1, NTRK2, or NTRK3 were identified as oncogenic drivers in many cancer types. Two small molecule inhibitors have been tested in clinical trials recently and require the detection of a NTRK fusion gene prior to therapeutic application. Fluorescence in situ hybridization (FISH) and targeted next-generation sequencing (tNGS) assays are commonly used for diagnostic profiling of gene fusions. In the presented study we applied an external quality assessment (EQA) scheme in order to investigate the suitability of FISH and RNA-/DNA-based tNGS for detection of NTRK fusions in a multinational and multicentric ring trial. In total 27 participants registered for this study. Nine institutions took part in the FISH-based and 18 in the NGS-based round robin test, the latter additionally subdivided into low-input and high-input NGS methods (regarding nucleic acid input). Regardless of the testing method applied, all participants received tumor sections of 10 formalin-fixed and paraffin-embedded (FFPE) tissue blocks for in situ hybridization or RNA/DNA extraction, and the results were submitted via an online questionnaire. For FISH testing, eight of nine (88.8%) participants, and for NGS-based testing 15 of 18 (83.3%) participants accomplished the round robin test successfully. The overall high success rate demonstrates that FISH- and tNGS-based NTRK testing can be well established in a routine diagnostic setting. Complementing this dataset, we provide an updated in silico analysis on the coverage of more than 150 NTRK fusion variants by several commercially available RNA-based tNGS panels.
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Affiliation(s)
- Martina Kirchner
- Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany
| | - Julia Glade
- Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany
| | - Ulrich Lehmann
- Institute of Pathology, University Hospital Hannover, Hannover, Germany
| | | | - Michael Hummel
- Institute of Pathology, Charité University Hospital, Berlin, Germany
| | - Annika Lehmann
- Institute of Pathology, Charité University Hospital, Berlin, Germany
| | - Marcel Trautmann
- Institute of Pathology, University Hospital Münster, Münster, Germany
| | - Jörg Kumbrink
- Institute of Pathology, Ludwig Maximilian University (LMU), Munich, Germany
| | - Andreas Jung
- Institute of Pathology, Ludwig Maximilian University (LMU), Munich, Germany
| | - Wolfgang Dietmaier
- Institute of Pathology, University Hospital Regensburg, Regensburg, Germany
| | - Volker Endris
- Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany
| | - Daniel Kazdal
- Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany
| | - Carolin Ploeger
- Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany
| | - Matthias Evert
- Institute of Pathology, University Hospital Regensburg, Regensburg, Germany
| | - David Horst
- Institute of Pathology, Charité University Hospital, Berlin, Germany
| | - Hans Kreipe
- Institute of Pathology, University Hospital Hannover, Hannover, Germany
| | - Thomas Kirchner
- Institute of Pathology, Ludwig Maximilian University (LMU), Munich, Germany
| | - Eva Wardelmann
- Institute of Pathology, University Hospital Münster, Münster, Germany
| | - Reinhard Büttner
- Institute of Pathology, University Hospital Cologne, Cologne, Germany
| | - Wilko Weichert
- Institute of Pathology, Technical University Munich (TUM), Munich, Germany
| | - Manfred Dietel
- Institute of Pathology, Charité University Hospital, Berlin, Germany.,Quality Assurance Initiative in Pathology (QuiP), Berlin, Germany
| | - Peter Schirmacher
- Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany
| | | | - Nicole Pfarr
- Institute of Pathology, Technical University Munich (TUM), Munich, Germany
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Behling F, Barrantes-Freer A, Behnes CL, Stockhammer F, Rohde V, Adel-Horowski A, Rodríguez-Villagra OA, Barboza MA, Brück W, Lehmann U, Stadelmann C, Hartmann C. Expression of Olig2, Nestin, NogoA and AQP4 have no impact on overall survival in IDH-wildtype glioblastoma. PLoS One 2020; 15:e0229274. [PMID: 32160197 PMCID: PMC7065747 DOI: 10.1371/journal.pone.0229274] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Accepted: 02/03/2020] [Indexed: 11/29/2022] Open
Abstract
Despite many years of research efforts and clinical trials the prognosis of patients diagnosed with glioblastoma remains very poor. The oligodendrocyte transcription factor 2 (Olig2) was identified as a marker for glioma stem cells, which are believed to be responsible for glioma recurrence and therapy resistance. In this retrospective analysis we assessed the prognostic value of oligodendroglial and glioma stem cell markers in 113 IDH-wildtype glioblastomas. Immunohistochemical staining for Olig2, NogoA, AQP4 and Nestin was performed in combination with sequencing of IDH1 and IDH2 as well as promotor methylation analysis of the MGMT gene. Even though differences in overall survival according to Olig2 expression were observed, univariate and multivariate survival analysis did not reveal a firm significant prognostic impact of Olig2, NogoA, AQP4 or Nestin expression. Additionally, no differences in the expression of these markers depending on clinical status, age or gender were found. The established independent prognostic factors age<65, Karnofsky Performance Status> = 70 and methylated MGMT gene promoter were significant in the multivariate analysis. In conclusion expression of oligodendroglial and glioma stem cell markers do not have an independent prognostic effect in IDH-wildtype glioblastoma.
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Affiliation(s)
- Felix Behling
- Institute of Neuropathology, University Medical Center Goettingen, Goettingen, Germany
- Department of Neurosurgery, University Hospital Tuebingen, Tuebingen, Germany
- Center for CNS Tumors, Comprehensive Cancer Center Tuebingen-Stuttgart, University Hospital Tuebingen, Tuebingen, Germany
| | - Alonso Barrantes-Freer
- Institute of Neuropathology, University Medical Center Goettingen, Goettingen, Germany
- Department of Neuropathology, Leipzig University Medicine, Leipzig, Germany
| | - Carl Ludwig Behnes
- Institute of Pathology, University Medical Center Goettingen, Goettingen, Germany
| | - Florian Stockhammer
- Department of Neurosurgery, University Medical Center Goettingen, Goettingen, Germany
| | - Veit Rohde
- Department of Neurosurgery, University Medical Center Goettingen, Goettingen, Germany
| | - Antonia Adel-Horowski
- Department of Neurosurgery, University Medical Center Goettingen, Goettingen, Germany
| | - Odir Antonio Rodríguez-Villagra
- Neuroscience Research Center, University of Costa Rica, San José, Costa Rica
- Institute for Psychological Research, University of Costa Rica, San José, Costa Rica
| | - Miguel Angel Barboza
- Neurosciences Department, Hospital Dr. Rafael A. Calderón Guardia, CCSS, University of Costa Rica, San José, Costa Rica
| | - Wolfgang Brück
- Institute of Neuropathology, University Medical Center Goettingen, Goettingen, Germany
| | - Ulrich Lehmann
- Institute of Pathology, Hannover Medical School, Hannover, Germany
| | - Christine Stadelmann
- Institute of Neuropathology, University Medical Center Goettingen, Goettingen, Germany
| | - Christian Hartmann
- Department of Neuropathology, Institute of Pathology, Hannover Medical School, Hannover, Germany
- * E-mail:
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Bartels S, Hasemeier B, Vogtmann J, Schipper E, Büsche G, Schlue J, Kreipe H, Lehmann U. Feasibility of Combined Detection of Gene Mutations and Fusion Transcripts in Bone Marrow Trephines from Leukemic Neoplasms. J Mol Diagn 2020; 22:591-598. [PMID: 32036087 DOI: 10.1016/j.jmoldx.2020.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 12/13/2019] [Accepted: 01/14/2020] [Indexed: 10/25/2022] Open
Abstract
Chromosomal translocations resulting in fusion genes represent important oncogenic drivers and potential therapeutic targets in rare leukemia subtypes. Formalin-fixed, paraffin-embedded trephines are frequently used in hematologic diagnostic tests and provide relevant access to leukemic cells for further studies, for example, phenotyping in bone marrow fibrosis. However, high-throughput molecular analysis of nucleic acids obtained from this material is challenging, especially the reliable detection of RNA transcripts. Sixty-three formalin-fixed, paraffin-embedded bone marrow trephines of patients with chronic eosinophilic leukemia, chronic myeloid leukemia, acute myeloid leukemia, and myeloproliferative neoplasms were analyzed for gene mutations and the presence of fusion transcripts with a commercial amplicon-based next-generation sequencing approach. Fusion transcripts relevant for diagnosis and therapy could be detected and validated (by RT-PCR) in 25 patients (39.7%). Retrospectively selected material, up to 10 years old, was used for this purpose, and only one sample failed in the RNA analysis (1.6%). This study concludes that amplicon-based fusion transcript detection in bone marrow trephines is feasible and that bone marrow trephines taken for histologic assessment can also be applied for high-throughput molecular analysis.
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Affiliation(s)
- Stephan Bartels
- Institute of Pathology, Medizinische Hochschule Hannover, Hannover, Germany.
| | - Britta Hasemeier
- Institute of Pathology, Medizinische Hochschule Hannover, Hannover, Germany
| | - Julia Vogtmann
- Institute of Pathology, Medizinische Hochschule Hannover, Hannover, Germany
| | - Elisa Schipper
- Institute of Pathology, Medizinische Hochschule Hannover, Hannover, Germany
| | - Guntram Büsche
- Institute of Pathology, Medizinische Hochschule Hannover, Hannover, Germany
| | - Jerome Schlue
- Institute of Pathology, Medizinische Hochschule Hannover, Hannover, Germany
| | - Hans Kreipe
- Institute of Pathology, Medizinische Hochschule Hannover, Hannover, Germany
| | - Ulrich Lehmann
- Institute of Pathology, Medizinische Hochschule Hannover, Hannover, Germany
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Christgen M, Bartels S, van Luttikhuizen JL, Bublitz J, Rieger LU, Christgen H, Stark H, Sander B, Lehmann U, Steinemann D, Derksen PWB, Kreipe H. E-cadherin to P-cadherin switching in lobular breast cancer with tubular elements. Mod Pathol 2020; 33:2483-2498. [PMID: 32572153 PMCID: PMC7685979 DOI: 10.1038/s41379-020-0591-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [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: 03/06/2020] [Revised: 05/13/2020] [Accepted: 05/14/2020] [Indexed: 12/12/2022]
Abstract
Loss of E-cadherin expression due to mutation of the CDH1 gene is a characteristic feature of invasive lobular breast cancer (ILBC). Beta-catenin, which binds to the cytoplasmic domain of E-cadherin, is simultaneously downregulated, reflecting disassembly of adherens junctions (AJs) and loss of cell adhesion. E-cadherin to P-cadherin expression switching can rescue AJs and cell adhesion. However, P-cadherin has not been implicated in ILBC, so far. We aimed to characterize 13 ILBCs with exceptional histomorphology, which we termed ILBCs with tubular elements. The CDH1 mutational status was determined by next generation sequencing and whole-genome copy number (CN) profiling. Expression of cadherins was assessed by immunohistochemistry. ILBCs with tubular elements were ER-positive (13/13) and HER2-negative (13/13) and harbored deleterious CDH1 mutations (11/13) accompanied by loss of heterozygosity due to deletion of chromosome 16q22.1 (9/11). E-cadherin expression was lost or reduced in noncohesive tumor cells and in admixed tubular elements (13/13). Beta-catenin expression was lost in noncohesive tumor cells, but was retained in tubular elements (11/13), indicating focal rescue of AJ formation. N-cadherin and R-cadherin were always negative (0/13). Strikingly, P-cadherin was commonly positive (12/13) and immunoreactivity was accentuated in tubular elements. Adjacent lobular carcinoma in situ (LCIS) was always P-cadherin-negative (0/7). In a reference cohort of LCIS specimens, P-cadherin was constantly not expressed (0/25). In a reference cohort of invasive mammary carcinomas, P-cadherin-positive cases (36/268, 13%) were associated with triple-negative nonlobular breast cancer (P < 0.001). Compared with ILBCs from the reference cohort, P-cadherin expression was more common in ILBCs with tubular elements (12/13 versus 7/84, P < 0.001). In summary, E-cadherin to P-cadherin switching occurs in a subset of ILBCs. P-cadherin is the molecular determinant of a mixed-appearing histomorphology in ILBCs with tubular elements.
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Affiliation(s)
| | - Stephan Bartels
- grid.10423.340000 0000 9529 9877Institute of Pathology, Hannover Medical School, Hannover, Germany
| | - Jana L. van Luttikhuizen
- grid.10423.340000 0000 9529 9877Department of Human Genetics, Hannover Medical School, Hannover, Germany
| | - Janin Bublitz
- grid.10423.340000 0000 9529 9877Department of Human Genetics, Hannover Medical School, Hannover, Germany
| | - Luisa U. Rieger
- grid.10423.340000 0000 9529 9877Institute of Pathology, Hannover Medical School, Hannover, Germany
| | - Henriette Christgen
- grid.10423.340000 0000 9529 9877Institute of Pathology, Hannover Medical School, Hannover, Germany
| | - Helge Stark
- grid.10423.340000 0000 9529 9877Institute of Pathology, Hannover Medical School, Hannover, Germany
| | - Bjoern Sander
- grid.10423.340000 0000 9529 9877Institute of Pathology, Hannover Medical School, Hannover, Germany
| | - Ulrich Lehmann
- grid.10423.340000 0000 9529 9877Institute of Pathology, Hannover Medical School, Hannover, Germany
| | - Doris Steinemann
- grid.10423.340000 0000 9529 9877Department of Human Genetics, Hannover Medical School, Hannover, Germany
| | - Patrick W. B. Derksen
- grid.7692.a0000000090126352Department of Pathology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Hans Kreipe
- grid.10423.340000 0000 9529 9877Institute of Pathology, Hannover Medical School, Hannover, Germany
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37
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Granit RZ, Masury H, Condiotti R, Fixler Y, Gabai Y, Glikman T, Dalin S, Winter E, Nevo Y, Carmon E, Sella T, Sonnenblick A, Peretz T, Lehmann U, Paz K, Piccioni F, Regev A, Root DE, Ben-Porath I. Regulation of Cellular Heterogeneity and Rates of Symmetric and Asymmetric Divisions in Triple-Negative Breast Cancer. Cell Rep 2019; 24:3237-3250. [PMID: 30232005 DOI: 10.1016/j.celrep.2018.08.053] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [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: 03/28/2018] [Revised: 07/06/2018] [Accepted: 08/17/2018] [Indexed: 01/06/2023] Open
Abstract
Differentiation events contribute to phenotypic cellular heterogeneity within tumors and influence disease progression and response to therapy. Here, we dissect mechanisms controlling intratumoral heterogeneity within triple-negative basal-like breast cancers. Tumor cells expressing the cytokeratin K14 possess a differentiation state that is associated with that of normal luminal progenitors, and K14-negative cells are in a state closer to that of mature luminal cells. We show that cells can transition between these states through asymmetric divisions, which produce one K14+ and one K14- daughter cell, and that these asymmetric divisions contribute to the generation of cellular heterogeneity. We identified several regulators that control the proportion of K14+ cells in the population. EZH2 and Notch increase the numbers of K14+ cells and their rates of symmetric divisions, and FOXA1 has an opposing effect. Our findings demonstrate that asymmetric divisions generate differentiation transitions and heterogeneity, and identify pathways that control breast cancer cellular composition.
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Affiliation(s)
- Roy Z Granit
- Department of Developmental Biology and Cancer Research, Institute for Medical Research-Israel-Canada, The Hebrew University-Hadassah Medical School, Jerusalem 91120, Israel
| | - Hadas Masury
- Department of Developmental Biology and Cancer Research, Institute for Medical Research-Israel-Canada, The Hebrew University-Hadassah Medical School, Jerusalem 91120, Israel
| | - Reba Condiotti
- Department of Developmental Biology and Cancer Research, Institute for Medical Research-Israel-Canada, The Hebrew University-Hadassah Medical School, Jerusalem 91120, Israel
| | - Yaakov Fixler
- Department of Developmental Biology and Cancer Research, Institute for Medical Research-Israel-Canada, The Hebrew University-Hadassah Medical School, Jerusalem 91120, Israel
| | - Yael Gabai
- Department of Developmental Biology and Cancer Research, Institute for Medical Research-Israel-Canada, The Hebrew University-Hadassah Medical School, Jerusalem 91120, Israel
| | - Tzofia Glikman
- Department of Developmental Biology and Cancer Research, Institute for Medical Research-Israel-Canada, The Hebrew University-Hadassah Medical School, Jerusalem 91120, Israel
| | - Simona Dalin
- Department of Developmental Biology and Cancer Research, Institute for Medical Research-Israel-Canada, The Hebrew University-Hadassah Medical School, Jerusalem 91120, Israel
| | - Eitan Winter
- Info-CORE, Bioinformatics Unit of the I-CORE Computation Center at The Hebrew University and Hadassah, Jerusalem 91120, Israel
| | - Yuval Nevo
- Info-CORE, Bioinformatics Unit of the I-CORE Computation Center at The Hebrew University and Hadassah, Jerusalem 91120, Israel
| | - Einat Carmon
- Department of Surgery, Hadassah-Hebrew University Medical Center, Jerusalem 91120, Israel
| | - Tamar Sella
- Department of Radiology, Hadassah-Hebrew University Medical Center, Jerusalem 91120, Israel
| | - Amir Sonnenblick
- Sharett Institute of Oncology, Hadassah-Hebrew University Medical Center, Jerusalem 91120, Israel
| | - Tamar Peretz
- Sharett Institute of Oncology, Hadassah-Hebrew University Medical Center, Jerusalem 91120, Israel
| | - Ulrich Lehmann
- Institute of Pathology, Medizinische Hochschule Hannover, 30625 Hannover, Germany
| | - Keren Paz
- Champions Oncology, Inc., Baltimore, MD 21205, USA
| | | | - Aviv Regev
- Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA; Howard Hughes Medical Institute and David H. Koch Institute of Integrative Cancer Biology, Department of Biology, Massachusetts Institute of Technology, Cambridge, MA 02142, USA
| | - David E Root
- Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
| | - Ittai Ben-Porath
- Department of Developmental Biology and Cancer Research, Institute for Medical Research-Israel-Canada, The Hebrew University-Hadassah Medical School, Jerusalem 91120, Israel.
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38
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Pfarr N, Kirchner M, Lehmann U, Leichsenring J, Merkelbach‐Bruse S, Glade J, Hummel M, Stögbauer F, Lehmann A, Trautmann M, Kumbrink J, Jung A, Dietmaier W, Endris V, Kazdal D, Evert M, Horst D, Kreipe H, Kirchner T, Wardelmann E, Lassen U, Büttner R, Weichert W, Dietel M, Schirmacher P, Stenzinger A. Testing
NTRK
testing: Wet‐lab and in silico comparison of RNA‐based targeted sequencing assays. Genes Chromosomes Cancer 2019; 59:178-188. [DOI: 10.1002/gcc.22819] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Revised: 10/19/2019] [Accepted: 10/22/2019] [Indexed: 01/03/2023] Open
Affiliation(s)
- Nicole Pfarr
- Institute of PathologyTechnical University Munich (TUM) Munich Germany
| | - Martina Kirchner
- Institute of PathologyUniversity Hospital Heidelberg Heidelberg Germany
| | - Ulrich Lehmann
- Institute of PathologyUniversity Hospital Hannover Hannover Germany
| | | | | | - Julia Glade
- Institute of PathologyUniversity Hospital Heidelberg Heidelberg Germany
| | - Michael Hummel
- Institute of PathologyCharité University Hospital Berlin Germany
| | - Fabian Stögbauer
- Institute of PathologyTechnical University Munich (TUM) Munich Germany
| | - Annika Lehmann
- Institute of PathologyCharité University Hospital Berlin Germany
| | - Marcel Trautmann
- Gerhard‐Domagk‐Institute of Pathology, and Division of Translational Pathology, Gerhard‐Domagk‐Institute of PathologyUniversity Hospital Münster Münster Germany
| | - Jörg Kumbrink
- Institute of PathologyLudwig Maximilian University (LMU) Munich Germany
| | - Andreas Jung
- Institute of PathologyLudwig Maximilian University (LMU) Munich Germany
| | | | - Volker Endris
- Institute of PathologyUniversity Hospital Heidelberg Heidelberg Germany
| | - Daniel Kazdal
- Institute of PathologyUniversity Hospital Heidelberg Heidelberg Germany
| | - Matthias Evert
- Institute of PathologyUniversity Hospital Regensburg Regensburg Germany
| | - David Horst
- Institute of PathologyCharité University Hospital Berlin Germany
| | - Hans Kreipe
- Institute of PathologyUniversity Hospital Hannover Hannover Germany
| | - Thomas Kirchner
- Institute of PathologyLudwig Maximilian University (LMU) Munich Germany
| | - Eva Wardelmann
- Gerhard‐Domagk‐Institute of Pathology, and Division of Translational Pathology, Gerhard‐Domagk‐Institute of PathologyUniversity Hospital Münster Münster Germany
| | - Ulrik Lassen
- Department of Oncology, RigshospitaletUniversity of Copenhagen Copenhagen Denmark
| | - Reinhard Büttner
- Institute of PathologyUniversity Hospital Cologne Cologne Germany
| | - Wilko Weichert
- Institute of PathologyTechnical University Munich (TUM) Munich Germany
| | | | - Peter Schirmacher
- Institute of PathologyUniversity Hospital Heidelberg Heidelberg Germany
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39
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Feist H, Brüschke C, Lehmann U, Blöcker T, Gbur K, Peters J, Müller AM. Discordancy for a Villous Maturation Defect in a Dizygotic Twin Placenta. Fetal Pediatr Pathol 2019; 38:432-436. [PMID: 31025579 DOI: 10.1080/15513815.2019.1604924] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Background: Dizygotic twin pregnancies with discordant manifestation of abnormalities with unclear etiology are of interest because they arise in the same environment. Case report: We present a dizygotic third trimester twin placenta with discordant villous maturation, one placenta lacking developed syncytiocapillary membranes. The twins were eutrophic with no perinatal or postnatal complications. Conclusions: Discordant manifestation of villous maturation in dizygotic twin placentas could be a hint for a genetic rather than an environmental etiology. Villous maturation defect may be underrecognized and has been associated with perinatal morbidity and stillbirth in the late third trimester. Proper recognition is important because of the increased recurrence risk of villous dysmaturity.
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Affiliation(s)
- Henning Feist
- Department of Pathology, Diakonissenkrankenhaus Flensburg , Flensburg , Germany
| | - Corinna Brüschke
- Department of Pathology, Asklepios Klinikum Hamburg Nord , Hamburg , Germany
| | - Ulrich Lehmann
- Department of Pathology, Medizinische Hochschule Hannover , Hannover , Germany
| | - Thordis Blöcker
- Department of Obstetrics and Gynecology, Diakonissenkrankenhaus Flensburg , Flensburg , Germany
| | - Kornelia Gbur
- Department of Obstetrics and Gynecology, Asklepios Klinikum Hamburg Nord , Hamburg , Germany
| | - Jochen Peters
- Department of Pathology, Diakonissenkrankenhaus Flensburg , Flensburg , Germany
| | - Annette M Müller
- Department of Pathology/Pediatric Pathology, University of Cologne , Cologne , Germany
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40
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Lehmann U, Bartels S. [Liquid biopsy in tumor diagnostics : Applications, perspectives, and limitations of the "cancer liquidome"]. Pathologe 2019; 40:250-255. [PMID: 31049676 DOI: 10.1007/s00292-019-0604-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The detection of tumor-specific genetic alterations in body fluids as an addition to or even replacement for established tissue-based tumor diagnostics is currently a hot topic in academic research and industry. Progress in methods for nucleic acid analyses together with promising results from clinical studies have raised great expectations for cancer screening, diagnosis, prognosis, and therapy monitoring by means of a minimally invasive blood draw. Individual focused assays have already been introduced into routine diagnostics and represent a valuable option in cases where no tissue samples are available. However, before the use of liquid biopsy outside of clinical studies is enforced and more complex markers (like tumor mutational burden) are analyzed, several practical challenges and principal problems have to be addressed. This review focusses on the detection of free-circulating nucleic acids in blood plasma and critically discusses established and future applications as well as challenges and limitations of this new method.
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Affiliation(s)
- U Lehmann
- Institut für Pathologie, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland.
| | - S Bartels
- Institut für Pathologie, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland
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41
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Leichsenring J, Horak P, Kreutzfeldt S, Heining C, Christopoulos P, Volckmar A, Neumann O, Kirchner M, Ploeger C, Budczies J, Heilig CE, Hutter B, Fröhlich M, Uhrig S, Kazdal D, Allgäuer M, Harms A, Rempel E, Lehmann U, Thomas M, Pfarr N, Azoitei N, Bonzheim I, Marienfeld R, Möller P, Werner M, Fend F, Boerries M, Bubnoff N, Lassmann S, Longerich T, Bitzer M, Seufferlein T, Malek N, Weichert W, Schirmacher P, Penzel R, Endris V, Brors B, Klauschen F, Glimm H, Fröhling S, Stenzinger A. Variant classification in precision oncology. Int J Cancer 2019; 145:2996-3010. [DOI: 10.1002/ijc.32358] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Accepted: 04/08/2019] [Indexed: 02/06/2023]
Affiliation(s)
- Jonas Leichsenring
- Institute of Pathology, University Hospital Heidelberg Heidelberg Germany
| | - Peter Horak
- National Center for Tumor Diseases (NCT) Heidelberg Heidelberg Germany
- German Cancer Consortium (DKTK) Heidelberg Germany
| | - Simon Kreutzfeldt
- National Center for Tumor Diseases (NCT) Heidelberg Heidelberg Germany
- German Cancer Consortium (DKTK) Heidelberg Germany
| | - Christoph Heining
- National Center for Tumor Diseases (NCT) Dresden Germany
- University Hospital Carl Gustav Carus Dresden Germany
| | - Petros Christopoulos
- Thoraxklinik Heidelberg Germany
- Translational Lung Cancer Research Heidelberg (TLCR‐H)German Center for Lung Research (DZL) Giessen Germany
| | - Anna‐Lena Volckmar
- Institute of Pathology, University Hospital Heidelberg Heidelberg Germany
| | - Olaf Neumann
- Institute of Pathology, University Hospital Heidelberg Heidelberg Germany
| | - Martina Kirchner
- Institute of Pathology, University Hospital Heidelberg Heidelberg Germany
| | - Carolin Ploeger
- Institute of Pathology, University Hospital Heidelberg Heidelberg Germany
| | - Jan Budczies
- Institute of Pathology, University Hospital Heidelberg Heidelberg Germany
| | | | | | | | - Sebastian Uhrig
- German Cancer Research Center (DKFZ) Heidelberg Germany
- Faculty of BiosciencesHeidelberg University Heidelberg Germany
| | - Daniel Kazdal
- Institute of Pathology, University Hospital Heidelberg Heidelberg Germany
| | - Michael Allgäuer
- Institute of Pathology, University Hospital Heidelberg Heidelberg Germany
| | - Alexander Harms
- Institute of Pathology, University Hospital Heidelberg Heidelberg Germany
| | - Eugen Rempel
- Institute of Pathology, University Hospital Heidelberg Heidelberg Germany
| | - Ulrich Lehmann
- Institute of Pathology, Hannover Medical School Hanover Germany
| | - Michael Thomas
- Thoraxklinik Heidelberg Germany
- Translational Lung Cancer Research Heidelberg (TLCR‐H)German Center for Lung Research (DZL) Giessen Germany
| | - Nicole Pfarr
- Institute of Pathology, Technische Universität München Munich Germany
| | - Ninel Azoitei
- Clinic of Internal Medicine IUniversity Hospital Ulm Ulm Germany
| | - Irina Bonzheim
- Institute of Pathology, University Hospital Tübingen Tübingen Germany
| | | | - Peter Möller
- Institute of Pathology, University Hospital Ulm Ulm Germany
| | - Martin Werner
- Institute of Pathology, Medical Center, University of Freiburg Breisgau Germany
| | - Falko Fend
- Institute of Pathology, University Hospital Tübingen Tübingen Germany
| | - Melanie Boerries
- German Cancer Consortium (DKTK) Heidelberg Germany
- German Cancer Research Center (DKFZ) Heidelberg Germany
- Institute of Molecular Medicine and Cell ResearchUniversity of Freiburg Freiburg Germany
- MIRACUM Consortium of the Medical Informatics Initiative Freiburg Germany
| | - Nikolas Bubnoff
- German Cancer Consortium (DKTK) Heidelberg Germany
- German Cancer Research Center (DKFZ) Heidelberg Germany
- Department of Hematology, Oncology and Stem Cell Transplantation, Medical Center, Faculty of MedicineUniversity of Freiburg Freiburg Germany
- Department of Hematology and OncologyMedical Center, University of Schleswig‐Holstein Lübeck Germany
| | - Silke Lassmann
- Institute of Pathology, Medical Center, University of Freiburg Breisgau Germany
| | - Thomas Longerich
- Institute of Pathology, University Hospital Heidelberg Heidelberg Germany
- Heidelberg‐Göttingen‐Hannover Medizininformatik (HiGHmed) Konsortium Heidelberg Germany
| | - Michael Bitzer
- Department of Internal Medicine IUniversity Hospital Tübingen Tübingen Germany
| | | | - Nisar Malek
- Department of Internal Medicine IUniversity Hospital Tübingen Tübingen Germany
| | - Wilko Weichert
- Institute of Pathology, Technische Universität München Munich Germany
| | - Peter Schirmacher
- Institute of Pathology, University Hospital Heidelberg Heidelberg Germany
- German Cancer Consortium (DKTK) Heidelberg Germany
| | - Roland Penzel
- Institute of Pathology, University Hospital Heidelberg Heidelberg Germany
| | - Volker Endris
- Institute of Pathology, University Hospital Heidelberg Heidelberg Germany
| | - Benedikt Brors
- National Center for Tumor Diseases (NCT) Heidelberg Heidelberg Germany
- German Cancer Consortium (DKTK) Heidelberg Germany
- German Cancer Research Center (DKFZ) Heidelberg Germany
| | | | - Hanno Glimm
- National Center for Tumor Diseases (NCT) Dresden Germany
| | - Stefan Fröhling
- National Center for Tumor Diseases (NCT) Heidelberg Heidelberg Germany
- German Cancer Consortium (DKTK) Heidelberg Germany
- DKFZ‐Heidelberg Center for Personalized Oncology (HIPO) Heidelberg Germany
| | - Albrecht Stenzinger
- Institute of Pathology, University Hospital Heidelberg Heidelberg Germany
- DKFZ‐Heidelberg Center for Personalized Oncology (HIPO) Heidelberg Germany
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42
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Korth J, Anastasiou OE, Bräsen JH, Brinkhoff A, Lehmann U, Kribben A, Dittmer U, Verheyen J, Wilde B, Ciesek S, Witzke O, Widera M. The detection of BKPyV genotypes II and IV after renal transplantation as a simple tool for risk assessment for PyVAN and transplant outcome already at early stages of BKPyV reactivation. J Clin Virol 2019; 113:14-19. [PMID: 30771597 DOI: 10.1016/j.jcv.2019.02.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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: 08/27/2018] [Revised: 01/07/2019] [Accepted: 02/08/2019] [Indexed: 12/25/2022]
Abstract
BACKGROUND After reactivation the BK-polyomavirus (BKPyV) associated nephropathy (PyVAN) is observed in 1-10% of renal transplant recipients, of which up to 80% undergo graft failure. BKPyV reactivation after renal transplantation was associated with donor-derived serotypes against which the recipient has no immunological protection. However, PyVAN risk assessment seroactivity testing is a time-consuming and cost intensive process. OBJECTIVES Since BKPyV serotypes can be attributed to distinct genotypes I to IV, in the present study we retrospectively analyzed whether a simple PCR-based BKPyV genotyping assay might be a fast and inexpensive method to assess the risk for PyVAN and transplant outcome already at early stages of BKPyV reactivation. STUDY DESIGN 56 patients who were renal transplanted and tested positive for BKPyV viremia were included into the study. The BKPyV-VP1-coding sequences were PCR-amplified, sequenced, and subjected to genotyping. For group specific analysis patients were grouped in genotype I (n = 46) and a second group including genotype II and IV (n = 10) and associated with their clinical outcomes. RESULTS The most abundant genotype I was detected in 46 of 56 (82%) patients, however, in the genotype II and IV group PyVAN was twice as frequent as compared to the genotype I group 24 months after transplantation (8 of 10 (80%) vs. 17 of 46 (37%); p = 0.001). Accordingly, graft failure was significantly more frequent in the genotype II and IV group (3 of 10 (30%) vs. 2 of 46 (4%); p = 0.007). CONCLUSION PCR-based BKPyV genotyping might represent a fast and inexpensive method to assess the risk for PyVAN and transplant outcome already at early stages of BKPyV reactivation even if matched samples of the donor are not available.
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Affiliation(s)
- Johannes Korth
- Department of Nephrology, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Germany; Institute for Virology, University Hospital Essen, University of Duisburg-Essen Virchowstr. 179, 45147, Essen, Germany.
| | - Olympia Evdoxia Anastasiou
- Department of Gastroenterology, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Germany
| | - Jan Hinrich Bräsen
- Institute for Pathology, Hanover Medical School, Carl-Neuberg-Str. 1, 30625, Hanover, Germany
| | - Alexandra Brinkhoff
- Department of Nephrology, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Germany
| | - Ulrich Lehmann
- Institute for Pathology, Hanover Medical School, Carl-Neuberg-Str. 1, 30625, Hanover, Germany
| | - Andreas Kribben
- Department of Nephrology, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Germany
| | - Ulf Dittmer
- Institute for Virology, University Hospital Essen, University of Duisburg-Essen Virchowstr. 179, 45147, Essen, Germany
| | - Jens Verheyen
- Institute for Virology, University Hospital Essen, University of Duisburg-Essen Virchowstr. 179, 45147, Essen, Germany
| | - Benjamin Wilde
- Department of Nephrology, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Germany
| | - Sandra Ciesek
- Institute for Virology, University Hospital Essen, University of Duisburg-Essen Virchowstr. 179, 45147, Essen, Germany
| | - Oliver Witzke
- Department of Infectious Diseases, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Germany
| | - Marek Widera
- Institute for Virology, University Hospital Essen, University of Duisburg-Essen Virchowstr. 179, 45147, Essen, Germany
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43
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Faisal M, Stark H, Büsche G, Schlue J, Teiken K, Kreipe HH, Lehmann U, Bartels S. Comprehensive mutation profiling and mRNA expression analysis in atypical chronic myeloid leukemia in comparison with chronic myelomonocytic leukemia. Cancer Med 2019; 8:742-750. [PMID: 30635983 PMCID: PMC6382710 DOI: 10.1002/cam4.1946] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [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: 10/02/2018] [Revised: 11/30/2018] [Accepted: 12/06/2018] [Indexed: 02/06/2023] Open
Abstract
Atypical chronic myeloid leukemia (aCML) and chronic myelomonocytic leukemia (CMML) represent two histologically and clinically overlapping myelodysplastic/myeloproliferative neoplasms. Also the mutational landscapes of both entities show congruencies. We analyzed and compared an aCML cohort (n = 26) and a CMML cohort (n = 59) by next‐generation sequencing of 25 genes and by an nCounter approach for differential expression in 107 genes. Significant differences were found with regard to the mutation frequency of TET2, SETBP1, and CSF3R. Blast content of the bone marrow revealed an inverse correlation with the mutation status of SETBP1 in aCML and TET2 in CMML, respectively. By linear discriminant analysis, a mutation‐based machine learning algorithm was generated which placed 19/26 aCML cases (73%) and 54/59 (92%) CMML cases into the correct category. After multiple correction, differential mRNA expression could be detected between both cohorts in a subset of genes (FLT3, CSF3R, and SETBP1 showed the strongest correlation). However, due to high variances in the mRNA expression, the potential utility for the clinic is limited. We conclude that a medium‐sized NGS panel provides a valuable assistance for the correct classification of aCML and CMML.
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Affiliation(s)
- Muhammad Faisal
- Institute of Pathology, Hannover Medical School, Hannover, Germany
| | - Helge Stark
- Institute of Pathology, Hannover Medical School, Hannover, Germany
| | - Guntram Büsche
- Institute of Pathology, Hannover Medical School, Hannover, Germany
| | - Jerome Schlue
- Institute of Pathology, Hannover Medical School, Hannover, Germany
| | - Kristin Teiken
- Institute of Pathology, Hannover Medical School, Hannover, Germany
| | - Hans H Kreipe
- Institute of Pathology, Hannover Medical School, Hannover, Germany
| | - Ulrich Lehmann
- Institute of Pathology, Hannover Medical School, Hannover, Germany
| | - Stephan Bartels
- Institute of Pathology, Hannover Medical School, Hannover, Germany
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44
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Christgen M, Bartels S, Radner M, Raap M, Rieger L, Christgen H, Gluz O, Nitz U, Harbeck N, Lehmann U, Kreipe H. ERBB2 mutation frequency in lobular breast cancer with pleomorphic histology or high-risk characteristics by molecular expression profiling. Genes Chromosomes Cancer 2019; 58:175-185. [PMID: 30520184 DOI: 10.1002/gcc.22716] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [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: 06/28/2018] [Revised: 11/26/2018] [Accepted: 11/26/2018] [Indexed: 12/15/2022] Open
Abstract
HER2-positive breast cancer is defined by amplification or overexpression of the HER2/ERBB2 oncogene and accounts for about 15% of breast cancer cases. Somatic mutation of ERBB2 is an alternative mechanism, by which activation of HER2 signaling can occur. ERBB2 mutation has been associated with invasive lobular breast cancer (ILBC). This study investigates the frequency and phenotype of ILBC harboring mutated ERBB2. The ERBB2 mutation status was determined by next generation sequencing and/or pyrosequencing in n = 106 ILBCs, including n = 86 primary or locally recurrent tumors and n = 20 metastases from visceral organs, soft tissue, or skin. Immunohistochemical characteristics were determined using tissue microarrays. This series was enriched for ILBCs with pleomorphic histology and/or high-risk expression profiles (Oncotype DX, recurrence score RS > 25). Nearly all specimens were E-cadherin-negative (99%), estrogen receptor (ER)-positive (92%), and lacked ERBB2 overexpression (96%). ERBB2 mutations (p.V777L, p.L755S, p.S310F) were identified in 5/106 (5%) cases. ERBB2-mutated cases included 2/86 (2%) primary tumors and 3/20 (15%) metastases (P = 0.045). ERBB2-mutated cases were associated with loss of ER (2/7, 29%, P = 0.035) and histological grade 3 (4/34, 12%, P = 0.023), but not with solid growth (3/31, 10%, P = 0.148) or pleomorphic histology (2/27, 7%, P = 0.599). No ERBB2 mutation was detected in ILBCs with RS > 25 (0/22, 0%). In 10 patients with multiple matched specimens (n = 25), the ERBB2 mutational status was always concordant. In summary, a small subset of ILBCs harbors potentially actionable ERBB2 mutations. In ERBB2-mutated ILBCs, no association with pleomorphic histology was found.
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Affiliation(s)
| | - Stephan Bartels
- Institute of Pathology, Hannover Medical School, Hannover, Germany
| | - Martin Radner
- Institute of Pathology, Hannover Medical School, Hannover, Germany
| | - Mieke Raap
- Institute of Pathology, Hannover Medical School, Hannover, Germany
| | - Luisa Rieger
- Institute of Pathology, Hannover Medical School, Hannover, Germany
| | | | - Oleg Gluz
- West German Study Group, Moenchengladbach, Germany.,Breast Center Niederrhein, Evangelic Bethesda Hospital, Moenchengladbach, Germany.,University Clinics Cologne, Cologne, Germany
| | - Ulrike Nitz
- West German Study Group, Moenchengladbach, Germany.,Breast Center Niederrhein, Evangelic Bethesda Hospital, Moenchengladbach, Germany
| | - Nadia Harbeck
- West German Study Group, Moenchengladbach, Germany.,Breast Center, Department of Obstetrics and Gynecology, University of Munich (LMU), Munich, Germany
| | - Ulrich Lehmann
- Institute of Pathology, Hannover Medical School, Hannover, Germany
| | - Hans Kreipe
- Institute of Pathology, Hannover Medical School, Hannover, Germany
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45
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Hong B, Banan R, Christians A, Nakamura M, Lalk M, Lehmann U, Hartmann C, Krauss JK. Cerebellar glioblastoma: a clinical series with contemporary molecular analysis. Acta Neurochir (Wien) 2018; 160:2237-2248. [PMID: 30203362 DOI: 10.1007/s00701-018-3673-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Accepted: 09/04/2018] [Indexed: 12/31/2022]
Abstract
BACKGROUND Glioblastomas (GBM) are localized in only less than 1% of patients in the cerebellum. Therefore, tumor characteristics, survival, and the efficacy of therapies are not yet well defined. The present study aims to characterize the molecular features of cerebellar GBM (GBMc) in 8 patients treated with contemporary modality in our institution. METHODS Patients' treatment history, progression-free survival (PFS), and overall survival (OS) were analyzed. All histopathological specimens were re-investigated. EGFR amplification was determined by FISH, H3F3A, and HIST1H3B mutation status and MGMT promoter methylation after bisulfite treatment by pyrosequencing and BRAF V600E by pyrosequencing and immunohistochemistry. TERT promoter mutations were analyzed by Sanger sequencing, CDKN2A/B deletions by digital PCR. The expression of IDH1 R132H, ATRX, and p53 was determined through immunohistochemistry. RESULTS Six adults and two children (mean age 36 years) underwent tumor resection via medial or lateral suboccipital craniotomy. The median overall survival (mOS) of the adult patients was 7 months. GBMc from two children demonstrated a H3F3A K27M mutation. One of these also harbored a BRAF V600E mutation and has already had a PFS of 74 months. Mutated IDH1 R132H protein was expressed in 2 GBM from adult patients with previous supratentorial anaplastic astrocytoma. One patient carried a TERT promoter mutation. Another patient initially presented with a thalamic pilocytic astrocytoma. The cerebellar tumor revealed neither a BRAF V600E nor a H3F3A mutation but a homozygous CDKN2A/B deletion. CONCLUSIONS GBM located in the cerebellum can be found in all age groups. We provide novel molecular genetic data on these rare tumors. Mutated IDH1 R132H protein and H3F3A K27M mutations indicate that a substantial number of GBMc are "metastatic" or "diaschismatic" lesions. Mutation of BRAF V600E may have a stronger biological significance than H3F3A K27M alterations. In a subset of patients, GBM may arise primarily as a distinct entity in the cerebellum.
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Anwar S, Vogel A, Lehmann U. LINE-1 hypomethylation is a specific aberration in human hepatocellular carcinomas and correlates with shorter overall survival and CIMP-phenotypes. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy317.005] [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: 11/14/2022] Open
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Schacht V, Lehmann U, Reineke-Plaass T, Länger F, Auber B, Morlot S, Kreipe HH. [Possibilities and limitations of molecular pathology in dermatohistology]. Hautarzt 2018; 69:563-569. [PMID: 29876610 DOI: 10.1007/s00105-018-4206-6] [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] [Indexed: 11/29/2022]
Abstract
Malignant tumours, infections caused by microorganisms or genodermatoses are diagnosed with additional help of molecular pathology methods. Polymerase chain reaction (PCR), sequencing and in situ hybridisations play an important role. It remains to be seen if methods such as "liquid biopsies" or "single cell genomics" can be developed as routine diagnostics. High technical efforts, high costs and no possibility for resistency testing is accompanied by fast verification, high sensitivity and high specificity. Overall, molecular pathology results have to be combined with the clinical picture, histology or immunohistochemistry and culturing results to achieve a correct diagnosis for the patient.
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Affiliation(s)
- V Schacht
- Klinik für Dermatologie, Allergologie und Venerologie, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland.
| | - U Lehmann
- Institut für Pathologie, Medizinische Hochschule Hannover, Hannover, Deutschland
| | - T Reineke-Plaass
- Institut für Pathologie, Medizinische Hochschule Hannover, Hannover, Deutschland
| | - F Länger
- Institut für Pathologie, Medizinische Hochschule Hannover, Hannover, Deutschland
| | - B Auber
- Institut für Humangenetik, Medizinische Hochschule Hannover, Hannover, Deutschland
| | - S Morlot
- Institut für Humangenetik, Medizinische Hochschule Hannover, Hannover, Deutschland
| | - H-H Kreipe
- Institut für Pathologie, Medizinische Hochschule Hannover, Hannover, Deutschland
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Bartels S, van Luttikhuizen JL, Christgen M, Mägel L, Luft A, Hänzelmann S, Lehmann U, Schlegelberger B, Leo F, Steinemann D, Kreipe H. CDKN2A
loss and PIK3CA
mutation in myoepithelial-like metaplastic breast cancer. J Pathol 2018; 245:373-383. [DOI: 10.1002/path.5091] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Revised: 04/09/2018] [Accepted: 04/25/2018] [Indexed: 12/19/2022]
Affiliation(s)
- Stephan Bartels
- Institute of Pathology, Hannover Medical School; Hannover Germany
| | | | | | - Lavinia Mägel
- Institute of Pathology, Hannover Medical School; Hannover Germany
| | - Angelina Luft
- Institute of Pathology, Hannover Medical School; Hannover Germany
| | - Sonja Hänzelmann
- Institute of Human Genetics, Hannover Medical School; Hannover Germany
| | - Ulrich Lehmann
- Institute of Pathology, Hannover Medical School; Hannover Germany
| | | | - Fabian Leo
- Institute of Pathology, Hannover Medical School; Hannover Germany
| | - Doris Steinemann
- Institute of Human Genetics, Hannover Medical School; Hannover Germany
| | - Hans Kreipe
- Institute of Pathology, Hannover Medical School; Hannover Germany
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Bartels S, Adisa A, Aladelusi T, Lemound J, Stucki-Koch A, Hussein S, Kreipe H, Hartmann C, Lehmann U, Hussein K. Molecular defects in BRAF wild-type ameloblastomas and craniopharyngiomas-differences in mutation profiles in epithelial-derived oropharyngeal neoplasms. Virchows Arch 2018; 472:1055-1059. [PMID: 29546640 DOI: 10.1007/s00428-018-2323-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [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: 10/26/2017] [Revised: 01/26/2018] [Accepted: 02/13/2018] [Indexed: 12/18/2022]
Abstract
The aim of this study was to evaluate the mutation profile of BRAF wild-type craniopharyngiomas and ameloblastomas. Pre-screening by immunohistochemistry and pyrosequencing for identifying BRAF wild-type tumors was performed on archived specimens of ameloblastic tumors (n = 20) and craniopharyngiomas (n = 62). Subsequently, 19 BRAF wild-type tumors (nine ameloblastic tumors and ten craniopharyngiomas) were analyzed further using next-generation sequencing (NGS) targeting hot spot mutations of 22 cancer-related genes. Thereby, we found craniopharyngiomas mainly CTNNB1 mutated (8/10), including two FGFR3/CTNNB1-double mutated tumors. Ameloblastic tumors were often FGFR2 mutated (4/9; including one FGFR2/TP53/PTEN-triple mutated case) and rarely CTNNB1/TP53-double mutated (1/9) and KRAS-mutated (1/9). In the remaining samples, no mutation could be detected in the 22 genes under investigation. In conclusion, mutation profiles of BRAF wild-type craniopharyngiomas and ameloblastomas share mutations of FGFR genes and have additional mutations with potential for targeted therapy.
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Affiliation(s)
- Stephan Bartels
- Institute of Pathology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Akinyele Adisa
- Oral Pathology Department University College Hospital Ibadan, University of Ibadan, Ibadan, Nigeria
| | - Timothy Aladelusi
- Oral and Maxillofacial Surgery Department University College Hospital Ibadan, University of Ibadan, Ibadan, Nigeria
| | - Juliana Lemound
- Department of Cranio-Maxillofacial Surgery, Hannover Medical School, Hannover, Germany
| | - Angelika Stucki-Koch
- Institute of Pathology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Sami Hussein
- Department of Neurosurgery, Al-Makassed-Hospital, Al-Quds School of Medicine, Jerusalem, Israel
| | - Hans Kreipe
- Institute of Pathology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Christian Hartmann
- Institute of Pathology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.,Department of Neuropathology, Hannover Medical School, Hannover, Germany
| | - Ulrich Lehmann
- Institute of Pathology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Kais Hussein
- Institute of Pathology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
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50
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Scholz C, Golas MM, Weber RG, Hartmann C, Lehmann U, Sahm F, Schmidt G, Auber B, Sturm M, Schlegelberger B, Illig T, Steinemann D, Hofmann W. Rare compound heterozygous variants in PNKP identified by whole exome sequencing in a German patient with ataxia-oculomotor apraxia 4 and pilocytic astrocytoma. Clin Genet 2018; 94:185-186. [PMID: 29498415 DOI: 10.1111/cge.13216] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Revised: 01/16/2018] [Accepted: 01/16/2018] [Indexed: 02/02/2023]
Abstract
Ataxia-oculomotor apraxia type 4 (AOA4) is a rare autosomal recessive neurologic disorder. The phenotype is characterized by ataxia, oculomotor apraxia, peripheral neuropathy and dystonia. AOA4 is caused by biallelic pathogenic variants in the PNKP gene encoding a polynucleotide kinase 3'-phosphatase with an important function in DNA-damage repair. By whole exome sequencing, we identified 2 variants within the PNKP gene in a 27-year-old German woman with a clinical AOA phenotype combined with a cerebellar pilocytic astrocytoma diagnosed at 23 years of age. One variant, a duplication in exon 14 resulting in the frameshift c.1253_1269dup p.(Thr424fs*49), has previously been described as pathogenic, for example, in cases of AOA4. The second variant, representing a nonsense mutation in exon 17, c.1545C>G p.(Tyr515*), has not yet been described and is predicted to cause a loss of the 7 C-terminal amino acids. This is the first description of AOA4 in a patient with central European descent. Furthermore, the occurrence of a pilocytic astrocytoma has not been described before in an AOA4 patient. Our data demonstrate compound heterozygous PNKP germline variants in a German patient with AOA4 and provide evidence for a possible link with tumor predisposition. Localization of the 2 variants in human PNKP NP_009185.2. NM_007254.3:c.1253_1269dup p.(Thr424fs*49) is predicted to cause a frameshift within the kinase domain, NM_007254.3:c.1545C>G p.(Tyr515*) is predicted to cause loss of 2 C-terminal amino acids of the kinase domain and 5 additional C-terminal amino acids.
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Affiliation(s)
- C Scholz
- Department of Human Genetics, Hannover Medical School, Hanover, Germany
| | - M M Golas
- Department of Human Genetics, Hannover Medical School, Hanover, Germany
| | - R G Weber
- Department of Human Genetics, Hannover Medical School, Hanover, Germany
| | - C Hartmann
- Department of Neuropathology, Hannover Medical School, Hanover, Germany.,Institute of Pathology, Hannover Medical School, Hanover, Germany
| | - U Lehmann
- Institute of Pathology, Hannover Medical School, Hanover, Germany
| | - F Sahm
- Department of Neuropathology, Institute of Pathology, University of Heidelberg, Heidelberg, Germany.,CCU Neuropathology, German Consortium for Translational Cancer Research, German Cancer Research Center, Heidelberg, Germany
| | - G Schmidt
- Department of Human Genetics, Hannover Medical School, Hanover, Germany
| | - B Auber
- Department of Human Genetics, Hannover Medical School, Hanover, Germany
| | - M Sturm
- Institute of Medical Genetics and Applied Genomics, University of Tübingen, Tübingen, Germany
| | - B Schlegelberger
- Department of Human Genetics, Hannover Medical School, Hanover, Germany
| | - T Illig
- Department of Human Genetics, Hannover Medical School, Hanover, Germany
| | - D Steinemann
- Department of Human Genetics, Hannover Medical School, Hanover, Germany
| | - W Hofmann
- Department of Human Genetics, Hannover Medical School, Hanover, Germany
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