Yihua Liu1, Zachary Weber2, F Anthony San Lucas3, Aditya Deshpande4, Yasminka A Jakubek3, Raed Sulaiman5, Mary Fagerness5, Natasha Flier5, Joseph Sulaiman5, Christel M Davis2, Jerry Fowler3, David Starks5, Luis Rojas-Espaillat5, Alexander J Lazar1, Gareth E Davies2, Erik A Ehli6, Paul Scheet7. 1. Graduate School of Biomedical Sciences, University of Texas at Houston Health Science Center, Houston, TX, United States; University of Texas MD Anderson Cancer Center, Houston, TX, United States. 2. Avera Institute for Human Genetics, Sioux Falls, SD, United States. 3. University of Texas MD Anderson Cancer Center, Houston, TX, United States. 4. University of Texas MD Anderson Cancer Center, Houston, TX, United States; Weill Cornell Graduate School of Medical Sciences, New York, NY, United States. 5. Avera Cancer Institute, Sioux Falls, SD, United States. 6. Avera Institute for Human Genetics, Sioux Falls, SD, United States. Electronic address: Erik.Ehli@avera.org. 7. Graduate School of Biomedical Sciences, University of Texas at Houston Health Science Center, Houston, TX, United States; University of Texas MD Anderson Cancer Center, Houston, TX, United States. Electronic address: PAScheet@mdanderson.org.
Abstract
OBJECTIVE: Uterine carcinosarcoma (UCS) is a rare and aggressive form of uterine cancer. It is bi-phasic, exhibiting histological features of both malignant epithelial (carcinoma) and mesenchymal (sarcoma) elements, reflected in ambiguity in accepted treatment guidelines. We sought to study the genomic and transcriptomic profiles of these elements individually to gain further insights into the development of these tumors. METHODS: We macro-dissected carcinomatous, sarcomatous, and normal tissues from formalin fixed paraffin embedded uterine samples of 10 UCS patients. Single nucleotide polymorphism microarrays, targeted DNA sequencing and whole-transcriptome RNA-sequencing were performed. Somatic chromosomal alterations (SCAs), point mutation and gene expression profiles were compared between carcinomatous and sarcomatous components. RESULTS: In addition to TP53, other recurrently mutated genes harboring putative driver or loss-of-function mutations included PTEN, FBXW7, FGFR2, KRAS, PIK3CA and CTNNB1, genes known to be involved in UCS. Intra-patient somatic mutation and SCA profiles were highly similar between paired carcinoma and sarcoma samples. An epithelial-mesenchymal transition (EMT) signature tended to differentiate components, with EMT-like status more common in advanced-stage patients exhibiting higher inter-component SCA heterogeneity. CONCLUSIONS: From DNA analysis, our results indicate a monoclonal disease origin for this cohort. Yet expression-derived EMT statuses of the carcinomatous and sarcomatous components were often discrepant, and advanced cases displayed greater genomic heterogeneity. Therefore, separately-profiled components of UCS tumors may better inform disease progression or potential.
OBJECTIVE: Uterine carcinosarcoma (UCS) is a rare and aggressive form of uterine cancer. It is bi-phasic, exhibiting histological features of both malignant epithelial (carcinoma) and mesenchymal (sarcoma) elements, reflected in ambiguity in accepted treatment guidelines. We sought to study the genomic and transcriptomic profiles of these elements individually to gain further insights into the development of these tumors. METHODS: We macro-dissected carcinomatous, sarcomatous, and normal tissues from formalin fixed paraffin embedded uterine samples of 10 UCS patients. Single nucleotide polymorphism microarrays, targeted DNA sequencing and whole-transcriptome RNA-sequencing were performed. Somatic chromosomal alterations (SCAs), point mutation and gene expression profiles were compared between carcinomatous and sarcomatous components. RESULTS: In addition to TP53, other recurrently mutated genes harboring putative driver or loss-of-function mutations included PTEN, FBXW7, FGFR2, KRAS, PIK3CA and CTNNB1, genes known to be involved in UCS. Intra-patient somatic mutation and SCA profiles were highly similar between paired carcinoma and sarcoma samples. An epithelial-mesenchymal transition (EMT) signature tended to differentiate components, with EMT-like status more common in advanced-stage patients exhibiting higher inter-component SCA heterogeneity. CONCLUSIONS: From DNA analysis, our results indicate a monoclonal disease origin for this cohort. Yet expression-derived EMT statuses of the carcinomatous and sarcomatous components were often discrepant, and advanced cases displayed greater genomic heterogeneity. Therefore, separately-profiled components of UCS tumors may better inform disease progression or potential.
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