Abstract
This study aimed to clarify the genetic features of endometrioid-type endometrial cancer arising in adenomyosis (EC-AIA) using targeted sequencing and immunohistochemistry (IHC) for both carcinoma and adjacent adenomyosis tissues. We identified three endometrioid-type EC-AIAs in 689 patients with endometrial cancer; two exhibited grade 3 endometrioid carcinoma. IHC revealed retained expression of PMS2, MSH6, ARID1A, and PAX2. Two of them showed diffuse strong p53 expression only in the carcinoma. PTEN expression was lost in carcinoma of only one of these cases. Carcinoma had many gene mutations than adjacent adenomyosis in all cases. KRAS and TP53 mutations were found in two of them. The other patient had mutations in KRAS, PIK3CA, and PPP2R1A. They were classified as two “p53-mutated” and one “non-specific molecular profile.” These molecular alterations in endometrioid-type EC-AIA imply similar carcinogenesis to a subset of endometrial endometrioid carcinoma and might be used as targets of liquid biopsy after further validation.
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The data that support the findings of this study are available from the corresponding author upon reasonable request.
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References
Esther Oliva DCW, Neil J. Sebire, Robert A. Soslow (2019) Atlas of tumor pathology, 4th Series, Fascicle 30, Tumors of the Uterine Corpus and Trophoblastic Diseases.
Naftalin J, Hoo W, Pateman K, Mavrelos D, Holland T, Jurkovic D (2012) How common is adenomyosis? A prospective study of prevalence using transvaginal ultrasound in a gynaecology clinic. Hum Reprod 27(12):3432–3439. https://doi.org/10.1093/humrep/des332
Yeniel O, Cirpan T, Ulukus M, Ozbal A, Gundem G, Ozsener S, Zekioglu O, Yilmaz H (2007) Adenomyosis: prevalence, risk factors, symptoms and clinical findings. Clin Exp Obstet Gynecol 34(3):163–167
Bergholt T, Eriksen L, Berendt N, Jacobsen M, Hertz JB (2001) Prevalence and risk factors of adenomyosis at hysterectomy. Hum Reprod 16(11):2418–2421. https://doi.org/10.1093/humrep/16.11.2418
F R (1897) Über einen Fall von Adenomyoma Uteri, Übergang in Karzinom und Metastasenbildung. Virchows Archiv 150:555
Koike N, Tsunemi T, Uekuri C, Akasaka J, Ito F, Shigemitsu A, Kobayashi H (2013) Pathogenesis and malignant transformation of adenomyosis (review). Oncol Rep 29(3):861–867. https://doi.org/10.3892/or.2012.2184
Chao X, Wu M, Ma S, Tan X, Zhong S, Bi Y, Wu H, Lang J, Li L (2020) The clinicopathological characteristics and survival outcomes of endometrial carcinoma coexisting with or arising in adenomyosis: a pilot study. Sci Rep 10(1):5984. https://doi.org/10.1038/s41598-020-63065-w
Machida H, Maeda M, Cahoon SS, Scannell CA, Garcia-Sayre J, Roman LD, Matsuo K (2017) Endometrial cancer arising in adenomyosis versus endometrial cancer coexisting with adenomyosis: are these two different entities? Arch Gynecol Obstet 295(6):1459–1468. https://doi.org/10.1007/s00404-017-4375-z
Lu B, Chen Q, Zhang X, Cheng L (2016) Serous carcinoma arising from uterine adenomyosis/adenomyotic cyst of the cervical stump: a report of 3 cases. Diagn Pathol 11(1):46. https://doi.org/10.1186/s13000-016-0496-0
WHO Classification of Tumours Editorial Board. Female Genital Tumours. WHO Classification of Tumours, 5th Edition, Volume 4 (2020).
Kandoth C, McLellan MD, Vandin F, Ye K, Niu B, Lu C, Xie M, Zhang Q, McMichael JF, Wyczalkowski MA, Leiserson MDM, Miller CA, Welch JS, Walter MJ, Wendl MC, Ley TJ, Wilson RK, Raphael BJ, Ding L (2013) Mutational landscape and significance across 12 major cancer types. Nature 502(7471):333–339. https://doi.org/10.1038/nature12634
Cancer Genome Atlas Research N, Kandoth C, Schultz N, Cherniack AD, Akbani R, Liu Y, Shen H, Robertson AG, Pashtan I, Shen R, Benz CC, Yau C, Laird PW, Ding L, Zhang W, Mills GB, Kucherlapati R, Mardis ER, Levine DA (2013) Integrated genomic characterization of endometrial carcinoma. Nature 497(7447):67–73. https://doi.org/10.1038/nature12113
Anglesio MS, Papadopoulos N, Ayhan A, Nazeran TM, Noe M, Horlings HM, Lum A, Jones S, Senz J, Seckin T, Ho J, Wu RC, Lac V, Ogawa H, Tessier-Cloutier B, Alhassan R, Wang A, Wang Y, Cohen JD, Wong F, Hasanovic A, Orr N, Zhang M, Popoli M, McMahon W, Wood LD, Mattox A, Allaire C, Segars J, Williams C, Tomasetti C, Boyd N, Kinzler KW, Gilks CB, Diaz L, Wang TL, Vogelstein B, Yong PJ, Huntsman DG, Shih IM (2017) Cancer-associated mutations in endometriosis without cancer. N Engl J Med 376(19):1835–1848. https://doi.org/10.1056/NEJMoa1614814
Zou Y, Zhou JY, Guo JB, Wang LQ, Luo Y, Zhang ZY, Liu FY, Tan J, Wang F, Huang OP (2018) The presence of KRAS, PPP2R1A and ARID1A mutations in 101 Chinese samples with ovarian endometriosis. Mutat Res 809:1–5. https://doi.org/10.1016/j.mrfmmm.2018.03.001
Acknowledgements
The authors are grateful to Hitoshi Ichikawa, Sachiyo Mitani, Maiko Masuda, Yoko Shimada, and to other physicians and staff at the National Cancer Center and other hospitals for their help and support. We also thank Editage for English language editing of this manuscript.
Funding
KAKENHI-19K16572, National Cancer Center Research and Development Fund (29-A-2, NCC Biobank, and NCC Core Facility).
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Hiroshi Yoshida: conceptualization, methodology, formal analysis, investigation, resources, data curation, writing–original draft, writing–review and editing. Yuka Asami: formal analysis, resources, data curation, writing–review, and editing. Mayumi Kobayashi-Kato: resources, data curation, writing–review, and editing. Yasuhito Tanase: resources, data curation, writing–review, and editing. Masaya Uno: resources, data curation, writing–review, and editing. Mitsuya Ishikawa: resources, data curation, writing–review, and editing. Kouya Shiraishi: conceptualization, methodology, formal analysis, investigation, resources, data curation, writing–original draft, writing–review and editing. Tomoyasu Kato: resources, data curation, writing–review, and editing.
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This study was conducted in accordance with the Declaration of Helsinki and Good Clinical Practice and was approved (2017–136) by the institutional review board of the National Cancer Center, Tokyo, Japan.
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428_2021_3234_MOESM1_ESM.tif
Supplementary Fig. 1 Pathological findings of Cases 2 and 3. In case 2, a dilated cyst contains tumor cell is observed in the deep cervical stroma (a). Endometrioid carcinoma exhibits glandular and papillary structure in the cyst of adenomyosis (b). Case 3: Endometrioid carcinoma shows fused glands and solid nests (c). Tumor cells do not show diffuse strong p16 positivity (d).
Supplementary file1 (TIF 5542 KB)
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Yoshida, H., Asami, Y., Kobayashi-Kato, M. et al. Genetic features of endometrioid-type endometrial carcinoma arising in uterine adenomyosis. Virchows Arch 481, 117–123 (2022). https://doi.org/10.1007/s00428-021-03234-y
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DOI: https://doi.org/10.1007/s00428-021-03234-y