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Influence of Cytogenetics on the Outcome of Patients With High-Risk Myelodysplastic Syndrome Including Deletion 5q Treated With Azacitidine With or Without Lenalidomide 细胞遗传学对阿扎胞苷联合或不联合来那度胺治疗包括5q缺失的高危骨髓增生异常综合征患者预后的影响
IF 3.1 2区 医学 Q2 GENETICS & HEREDITY Pub Date : 2025-02-08 DOI: 10.1002/gcc.70029
Bengt Rasmussen, Lars Nilsson, Magnus Tobiasson, Martin Jädersten, Hege Garelius, Ingunn Dybedal, Kirsten Grønbaek, Elisabeth Ejerblad, Fryderyk Lorenz, Max Flogegård, Claus Werenberg Marcher, Lucia Cavalier, Freja Ebeling, Astrid Marta Olsnes, Jan Maxwell Nørgaard, Leonie Saft, Lars Möllgård, Eva Hellström-Lindberg, Brigitte Schlegelberger, Gudrun Göhring

In myelodysplastic syndromes (MDS), cytogenetic characteristics of the malignant bone marrow cells influence the clinical course. The aim of this study was to evaluate whether cytogenetics is useful to predict outcome and response in patients with del(5q) under azacitidine (AZA) ± lenalidomide (LEN) therapy. We therefore performed comprehensive cytogenetic analyses in MDS patients with del(5q) treated within the randomized phase II trial NMDSG10B. Seventy-two patients were enrolled in the study and 46 patients (64%) had sufficient cytogenetics at inclusion and response evaluation. Karyotyping was significantly more sensitive during follow-up to detect del(5q) compared to FISH, 34 patients (97%) versus 27 patients (77%) (p = 0.027). The overall response rate (ORR) did not differ between the 11 patients with < 3 aberrations (median 1 aberration) and the 59 patients with ≥ 3 aberrations (median 7 aberrations, range 3–16), while ≥ 3 aberrations were associated with shorter overall survival (OS), 9.9 months versus 25.2 months (p = 0.004). OS was significantly shorter in patients with unbalanced translocation of 5q than patients with del (5)(q14q34), 8.4 months versus 21.1 months (p = 0.004). Both complex karyotype and multi-hit TP53 alterations were more frequent in patients with unbalanced translocations of 5q versus del (5)(q14q34), 98% and 88% versus 67% and 47% (each p = < 0.001). Most patients with cytogenetic progression had multi-hit TP53 alterations at inclusion. Cytogenetic progression occurred at a similar frequency in the AZA arm and in the AZA + LEN arm. In summary, this study in homogenously treated MDS patients with different abnormalities of 5q demonstrates the influence of cytogenetics on treatment results.

Trial Registration: EudraCT number: 2011-001639-21; ClinicalTrials.gov identifier: NCT01556477.

在骨髓增生异常综合征(MDS)中,恶性骨髓细胞的细胞遗传学特征影响临床病程。本研究的目的是评估细胞遗传学是否有助于预测阿扎胞苷(AZA)±来那度胺(LEN)治疗下del(5q)患者的预后和反应。因此,我们对随机II期试验NMDSG10B中接受del(5q)治疗的MDS患者进行了全面的细胞遗传学分析。72名患者入组研究,46名患者(64%)在纳入和反应评估中具有足够的细胞遗传学。在随访期间,核型检测del(5q)的敏感性明显高于FISH, 34例(97%)对27例(77%)(p = 0.027)。11例<; 3个畸变(中位1个畸变)患者和59例≥3个畸变(中位7个畸变,范围3 - 16)患者的总有效率(ORR)无差异,而≥3个畸变与较短的总生存期(OS)相关,9.9个月比25.2个月(p = 0.004)。5q易位不平衡患者的生存期明显短于del (5)(q14q34)患者,分别为8.4个月和21.1个月(p = 0.004)。在5q易位不平衡的患者中,复杂核型和多点TP53改变更常见,分别为98%和88%,而del (5)(q14q34)易位不平衡的患者为67%和47% (p = < 0.001)。大多数细胞遗传学进展的患者在纳入时都有多处TP53改变。在AZA组和AZA + LEN组中,细胞遗传学进展发生的频率相似。综上所述,本研究在5q异常不同的MDS患者中均质治疗,证明了细胞遗传学对治疗结果的影响。试验注册号:稿号:2011-001639-21;ClinicalTrials.gov识别码:NCT01556477。
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引用次数: 0
Novel PDGFRB Gene Fusions in Two Cases of Infantile Myofibromatosis 新型PDGFRB基因融合在2例婴儿肌纤维瘤病中的作用。
IF 3.1 2区 医学 Q2 GENETICS & HEREDITY Pub Date : 2025-01-28 DOI: 10.1002/gcc.70028
Federica Boccia, Sabina Barresi, Silvia Vallese, Valentina Di Martino, Sabrina Bombaci, Stefania Massuras, Andrea Gazzin, Diana Carli, Paola Coppo, Rocco Roma, Isabella Giovannoni, Alessandro Mussa, Rita Alaggio

Infantile myofibromatosis (IM) comprises a wide clinical spectrum, ranging from solitary or multicentric lesions to generalized life-threatening forms. IM is mostly linked to germline or somatic heterozygous mutations in the PDGFRβ tyrosine kinase, encoded by the PDGFRB gene. Treatments for IM range from wait and see approach to systemic chemotherapy, according to the clinical context. Targeted therapies, such as tyrosine kinase inhibitors (TKIs) like Imatinib, show promise in treating IM lesions with PDGFRB gain-of-function mutations. Here, we report the first evidence of two sporadic, multifocal IM with PDGFRB gene fusions. RNA sequencing analysis revealed two novel fusion transcripts involving the protein kinase domain of PDGFRB, with UBE2I and FN1 genes, respectively. Although gene fusions are frequent and potent oncogenic drivers in soft-tissue neoplasia, fusion genes involving PDGFRB have not previously been linked to IM. DNA-based NGS panel testing may not detect chromosomal rearrangements, such as translocations, emphasizing the critical role of comprehensive molecular profiling, including RNA sequencing, in diagnosing and managing children with IM.

婴儿肌纤维瘤病(IM)包括广泛的临床范围,从孤立或多中心病变到全身危及生命的形式。IM主要与PDGFRB基因编码的PDGFRB β酪氨酸激酶的种系或体细胞杂合突变有关。根据临床情况,IM的治疗范围从静观其变到全身化疗。靶向治疗,如酪氨酸激酶抑制剂(TKIs),如伊马替尼,在治疗PDGFRB功能获得突变的IM病变方面显示出希望。在这里,我们报告了两个散发的多灶性IM与PDGFRB基因融合的第一个证据。RNA测序分析发现两个新的融合转录物涉及PDGFRB蛋白激酶结构域,分别与UBE2I和FN1基因融合。虽然基因融合在软组织肿瘤中是频繁和有效的致癌驱动因素,但涉及PDGFRB的融合基因以前并未与IM联系起来。基于dna的NGS面板检测可能无法检测染色体重排,如易位,强调综合分子谱分析(包括RNA测序)在诊断和治疗IM儿童中的关键作用。
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引用次数: 0
Rhabdomyosarcoma With EWSR1::NF2 Gene Fusion: A Case Report Potentially Expanding Its Genetic Spectrum 横纹肌肉瘤与EWSR1::NF2基因融合:一个病例报告可能扩大其遗传谱。
IF 3.1 2区 医学 Q2 GENETICS & HEREDITY Pub Date : 2025-01-28 DOI: 10.1002/gcc.70025
Carla Saoud, Gunes Gundem, Dylan Domenico, Juan E. Arango-Ossa, Damon Reed, Max Vaynrub, Elli Papaemmanouil, Tejus A. Bale, Konstantinos Linos

Rhabdomyosarcoma (RMS) is the most common soft tissue sarcoma in children, presenting with heterogeneous clinical and molecular subtypes. While gene fusions are predominantly associated with alveolar RMS, spindle cell RMS, especially congenital and intraosseous variants, are also linked to specific gene fusions. Furthermore, recently, FGFR1 kinase-driven RMSs were published. Here, we describe a case of RMS harboring an EWSR1::NF2 gene fusion, a deletion-driven genetic alteration that has not been previously documented in RMS or other soft tissue tumors. The patient was a 29-year-old female who presented with a lobulated ankle mass. Histologic examination revealed a malignant round cell tumor extensively infiltrating large nerve bundles. Immunohistochemical analysis demonstrated rhabdomyoblastic differentiation, consistent with rhabdomyosarcoma. While some areas showed features resembling the sclerosing and others the embryonal subtypes, the overall findings were considered unclassifiable. Targeted RNA sequencing revealed EWSR1(exon 9):: NF2(exon 7) gene fusion, which was confirmed on whole genome and targeted DNA sequencing. The latter did not yield specific diagnostic insights but revealed mutations in TSC2 (p.T1330M), ZFHX3 (p.A301T), and a NOTCH3 rearrangement, all of unknown oncogenic significance. MYC gene amplification was detected, but there was no evidence of chromosome 8 amplification or chromosome 11p15 loss of heterozygosity. Whole genome sequencing revealed a low tumor mutation burden (2.69/Mb) and showed no other significant potentially oncogenic events. DNA methylation studies using dimensionality reduction and unsupervised clustering placed the case within the embryonal RMS subtype. Although the absence of other oncogenic driver alterations suggests that the fusion may have played a pivotal role in pathogenesis, we cannot exclude the possibility that it represents a passenger alteration rather than a true driver mutation. If the former is true, further studies will be required to determine whether this fusion represents a novel RMS subtype or a rare driver in existing subtypes of RMS.

横纹肌肉瘤(Rhabdomyosarcoma, RMS)是儿童中最常见的软组织肉瘤,具有不同的临床和分子亚型。虽然基因融合主要与肺泡RMS相关,梭形细胞RMS,特别是先天性和骨内变异,也与特定的基因融合有关。此外,最近发表了FGFR1激酶驱动的RMSs。在这里,我们描述了一例RMS携带EWSR1::NF2基因融合的病例,这是一种缺失驱动的遗传改变,以前在RMS或其他软组织肿瘤中没有记录。患者为29岁女性,表现为分叶状踝关节肿块。组织学检查显示恶性圆细胞瘤广泛浸润大神经束。免疫组化分析显示横纹肌母细胞分化,与横纹肌肉瘤一致。虽然一些区域显示出类似于硬化的特征,而其他区域则显示出胚胎亚型,但总体发现被认为是无法分类的。靶向RNA测序显示EWSR1(外显子9)::NF2(外显子7)基因融合,全基因组和靶向DNA测序证实了这一点。后者没有产生具体的诊断见解,但揭示了TSC2 (p.T1330M)、ZFHX3 (p.A301T)和NOTCH3重排的突变,所有这些都是未知的致癌意义。检测到MYC基因扩增,但未发现8号染色体扩增或11p15染色体杂合性缺失。全基因组测序显示肿瘤突变负担低(2.69/Mb),未发现其他显著的潜在致癌事件。使用降维和无监督聚类的DNA甲基化研究将病例置于胚胎RMS亚型内。虽然没有其他致癌驱动突变表明融合可能在发病机制中起关键作用,但我们不能排除它代表乘客改变而不是真正的驱动突变的可能性。如果前者是正确的,则需要进一步的研究来确定这种融合是代表一种新的RMS亚型,还是代表现有RMS亚型中的罕见驱动因素。
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引用次数: 0
Spindle Cell Sarcoma With Novel JAZF1::NUDT5 Gene Fusion: Report of a Previously Undescribed Neoplasm 新型JAZF1::NUDT5基因融合的梭形细胞肉瘤:一种以前未被描述的肿瘤的报道。
IF 3.1 2区 医学 Q2 GENETICS & HEREDITY Pub Date : 2025-01-28 DOI: 10.1002/gcc.70026
Rebecca Fliorent, Syed T. Hoda, George Jour, Jose G. Mantilla

Gene fusions involving JAZF1 are a recurrent event in low grade endometrial stromal sarcoma, and have been more recently described in few instances of endometrial stromal sarcoma-like tumors in the genitourinary tract of men. In this article, we describe a previously unreported spindle cell sarcoma harboring an in-frame JAZF1::NUDT5 gene fusion, arising in the chest wall of a 51-year-old man. The tumor had unique morphologic features resembling both endometrial stromal sarcoma and endometrial stromal sarcoma-like tumors, consisting of a mixture of cytologically bland and pleomorphic spindle cells with brisk mitotic activity, within an alternating myxoid and fibrous stroma. It had diffuse immunohistochemical expression of CD10, CD34 and CD56, and variable expression of androgen receptor. To our knowledge, neoplasms with these clinico-pathologic characteristics and novel gene fusion have not been previously reported in the English language literature.

涉及JAZF1的基因融合是低级别子宫内膜间质肉瘤的复发事件,最近在男性泌尿生殖道子宫内膜间质肉瘤样肿瘤的少数病例中被描述。在这篇文章中,我们描述了一个以前未报道的梭形细胞肉瘤,包含框架内JAZF1::NUDT5基因融合,发生在51岁男性的胸壁。肿瘤具有独特的形态特征,类似于子宫内膜间质肉瘤和子宫内膜间质肉瘤样肿瘤,由细胞学上平淡和多形性梭形细胞组成,具有活跃的有丝分裂活性,在粘液样和纤维样间质中交替存在。CD10、CD34、CD56弥漫性免疫组化表达,雄激素受体表达变化。据我们所知,具有这些临床病理特征和新型基因融合的肿瘤在英语文献中尚未报道。
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引用次数: 0
Structural Variant Analysis of Complex Karyotype Myelodysplastic Neoplasia Through Optical Genome Mapping 利用光学基因组图谱分析复杂核型骨髓增生异常瘤的结构变异。
IF 3.1 2区 医学 Q2 GENETICS & HEREDITY Pub Date : 2025-01-25 DOI: 10.1002/gcc.70024
Andriana Valkama, Sandra Vorimo, Anna Tervasmäki, Hannele Räsänen, Eeva-Riitta Savolainen, Katri Pylkäs, Tuomo Mantere

Myelodysplastic neoplasia with complex karyotype (CK-MDS) poses significant clinical challenges and is associated with poor survival. Detection of structural variants (SVs) is crucial for diagnosis, prognostication, and treatment decision-making in MDS. However, the current standard-of-care (SOC) cytogenetic testing, relying on karyotyping, often yields ambiguous results in cases with CK. Here, SV detection by novel optical genome mapping (OGM) technique was explored in 15 CK-MDS cases, which collectively harbored 85 chromosomes with abnormalities reported by SOC. Additionally, OGM was utilized in the discovery of novel SVs. Altogether, OGM detected corresponding > 5 Mbp alterations for 73 out of 85 SOC reported abnormalities, resulting in an 86% concordance rate. OGM provided further specification of these abnormalities, revealing that 64% of the altered chromosomes were affected by multiple SVs or chromoanagenesis. Prominently, only 5% of missing chromosomes reported by SOC were true monosomies. In addition, OGM detected alterations in chromosomes not reported as abnormal by karyotyping in 93% of cases and provided clinically relevant gene-level information, such as SVs in TP53, MECOM, NUP98, IKZF1, and ETV6. Analysis of novel SVs revealed two previously unreported gene-fusions (SCFD1::ZNF592 and VPS8::LRBA), both confirmed by transcriptome sequencing. Furthermore, the repositioning of CCDC26 (8q24.21) was identified as a potential cause of inappropriate gene activation in two cases, affecting MECOM and SOX7, respectively. This study shows that OGM can significantly enhance the diagnostic analysis of SVs in CK-MDS and highlights the utility of OGM identifying novel SVs in complex cancer genomes.

具有复杂核型的骨髓增生异常瘤(CK-MDS)带来了重大的临床挑战,并与较差的生存率相关。结构变异(SVs)的检测对于MDS的诊断、预后和治疗决策至关重要。然而,目前的标准护理(SOC)细胞遗传学检测,依赖于核型,往往产生模棱两可的结果与CK的情况下。本文利用新型光学基因组定位(OGM)技术对15例CK-MDS病例进行了SV检测,这些病例共包含85条SOC异常染色体。此外,OGM还被用于发现新的sv。总体而言,OGM检测到85例SOC报告异常中有73例发生了相应的bbb50 Mbp变化,一致性率为86%。OGM为这些异常提供了进一步的说明,显示64%的改变的染色体受到多个sv或染色体变性的影响。值得注意的是,SOC报告的缺失染色体中只有5%是真正的单体。此外,OGM在93%的病例中通过核型检测到未报告异常的染色体的改变,并提供了临床相关的基因水平信息,如TP53、MECOM、NUP98、IKZF1和ETV6中的SVs。分析新的sv发现了两个以前未报道的基因融合(SCFD1::ZNF592和VPS8::LRBA),均通过转录组测序证实。此外,在两个病例中,CCDC26 (8q24.21)的重新定位被确定为基因不适当激活的潜在原因,分别影响MECOM和SOX7。本研究表明,OGM可以显著增强CK-MDS中sv的诊断分析,并突出了OGM在复杂癌症基因组中鉴定新型sv的实用性。
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引用次数: 0
MicroRNA Expression in High-Grade B-Cell Lymphoma With 11q Aberration MicroRNA在11q畸变高级别b细胞淋巴瘤中的表达。
IF 3.1 2区 医学 Q2 GENETICS & HEREDITY Pub Date : 2025-01-23 DOI: 10.1002/gcc.70021
Gioia Di Stefano, Anja Fischer, Emil Chteinberg, Susanne Bens, Rabea Wagener, Dmitriy Abramov, Patrick Adam, Stephan H. Bernhart, Arndt Borkhardt, Birgit Burkhardt, Coral Del-Val, Michael C. Frühwald, Raffaella Guazzo, Jessica I. Hoell, Michael Hummel, Heike Horn, Wolfram Klapper, Jens Krugmann, Katrin S. Kurz, Stefano Lazzi, Abner Jr. Louissaint, Anja Mottok, Ilske Oschlies, Raffaella Santi, Kristian Schafernak, Annette M. Staiger, Yanming Zhang, Andreas Rosenwald, Lorenz Trümper, Lorenzo Leoncini, German Ott, Reiner Siebert

Mature aggressive B-cell lymphomas, such as Burkitt lymphoma (BL) and Diffuse large B-cell lymphoma (DLBCL), show variations in microRNA (miRNA) expression. The entity of High-grade B-cell lymphoma with 11q aberration (HGBCL-11q) shares several biological features with both BL and DLBCL but data on its miRNA expression profile are yet scarce. Hence, this study aims to analyze the potential differences in miRNA expression of HGBCL-11q compared to BL and DLBCL. We evaluated the expression profiles of 2083 miRNAs in 25 HGCBL-11q, 7 BL, 131 DLBCL, and tonsils using the HTG EdgeSeq miRNA whole transcriptome assay. Uniform manifold approximation and projection (UMAP) and differential gene expression analyses based on DESeq2 were carried out. UMAP analysis of miRNA expression did not reveal distinct groups among the studied lymphomas. However, differential gene expression investigations detected sets of overexpressed miRNAs in HGBCL-11q when compared to BL (miR-9-3p, miR-9-5p, miR-3919, miR-129-1-3p, miR-129-2-3p, miR-331-3p, miR-196b-5p, and miR-28-5p) and DLBCL (miR-3919, miR-1290, miR-4538, and miR-4791), respectively. Notably, miR-3919 showed heterogeneous but significantly higher expression (p-value < 0.001) in HGBCL-11q than in both, BL and DLBCL. We identified a group of differentially expressed miRNAs between HGBCL-11q vs. BL and DLBCL, with miR-3919 as the most commonly and recurrently overexpressed miRNA in HGBCL-11q.

成熟侵袭性b细胞淋巴瘤,如伯基特淋巴瘤(BL)和弥漫性大b细胞淋巴瘤(DLBCL),显示microRNA (miRNA)表达的变化。11q畸变的高级别b细胞淋巴瘤(HGBCL-11q)与BL和DLBCL有一些共同的生物学特征,但其miRNA表达谱的数据尚缺乏。因此,本研究旨在分析HGBCL-11q与BL和DLBCL相比miRNA表达的潜在差异。我们使用HTG EdgeSeq miRNA全转录组法评估了2083个miRNA在25个HGCBL-11q、7个BL、131个DLBCL和扁桃体中的表达谱。基于DESeq2进行了均匀流形逼近和投影(UMAP)和差异基因表达分析。UMAP分析miRNA的表达并没有显示不同的组在研究的淋巴瘤。然而,与BL (miR-9-3p、miR-9-5p、miR-3919、miR-129-1-3p、miR-129-2-3p、miR-331-3p、miR-196b-5p和miR-28-5p)和DLBCL (miR-3919、miR-1290、miR-4538和miR-4791)相比,差异基因表达调查在HGBCL-11q中分别检测到多组过表达的mirna。值得注意的是,miR-3919具有异质性,但表达量明显较高(p值)
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引用次数: 0
A Bibliometric Analysis on the Risk Factors of Cancer 癌症危险因素的文献计量学分析。
IF 3.1 2区 医学 Q2 GENETICS & HEREDITY Pub Date : 2025-01-21 DOI: 10.1002/gcc.70019
Shan Chen, Yuanzhao Ding

Given the high lethality of cancer, identifying its risk factors is crucial in both epidemiology and cancer research. This study employs a novel bibliometric analysis method, which uses the tidytext package and tidy tools in R. This approach surpasses traditional tools like VOSviewer, offering more comprehensive and complex keyword data and clearer results compared to Bibliometrix. By using R, researchers can efficiently handle useful keywords, ignore irrelevant terms, adjust specific settings, and correct errors such as repeated evaluations. This study examines 1000 articles sourced from the Web of Science database, using advanced bibliometric tools like R Studio to analyze publication quantity, frequency, and word co-occurrences. The primary goal is to uncover key risk factors associated with cancer and explore the underlying mechanisms that link these factors to cancer development. Risk factors are categorized into exogenous (environmental exposures and lifestyle choices) and endogenous (genetic predispositions and hormonal imbalances). By providing a comprehensive analysis of these factors, the study aims to deepen our understanding of cancer risk. This research contributes valuable insights to the broader field of cancer research and has the potential to inform future studies and strategies for cancer prevention and treatment.

鉴于癌症的高致死率,确定其危险因素在流行病学和癌症研究中都至关重要。本研究采用了一种新颖的文献计量分析方法,该方法使用了r中的tidytext包和tidy工具,这种方法超越了VOSviewer等传统工具,提供了比Bibliometrix更全面复杂的关键字数据和更清晰的结果。通过使用R,研究人员可以有效地处理有用的关键词,忽略不相关的术语,调整特定的设置,并纠正重复评估等错误。这项研究检查了来自Web of Science数据库的1000篇文章,使用先进的文献计量工具(如R Studio)来分析出版数量、频率和单词共现率。主要目标是发现与癌症相关的关键风险因素,并探索将这些因素与癌症发展联系起来的潜在机制。风险因素分为外源性(环境暴露和生活方式选择)和内源性(遗传倾向和激素失衡)。通过对这些因素的全面分析,这项研究旨在加深我们对癌症风险的理解。这项研究为更广泛的癌症研究领域提供了有价值的见解,并有可能为未来的癌症预防和治疗研究和策略提供信息。
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引用次数: 0
Correction to “Temporal Trends and Regional Variability in BRAF and KRAS Genetic Testing in Denmark (2010–2022): Implications for Precision Medicine” 对“丹麦BRAF和KRAS基因检测的时间趋势和区域变异性(2010-2022):对精准医学的影响”的修正。
IF 3.1 2区 医学 Q2 GENETICS & HEREDITY Pub Date : 2025-01-21 DOI: 10.1002/gcc.70020

Frost, MG, Jensen, KJ, Jimenez-Solem, E, Qvortrup, C, Kuhlmann, TP, Andersen, JL, Høgdall, E, Petersen, TS. 2024 Temporal Trends and Regional Variability in BRAF and KRAS Genetic Testing in Denmark (2010–2022): Implications for Precision Medicine. Genes, Chromosomes & Cancer 63(4):e23236. https://doi.org/10.1002/gcc.23236

We apologize for this error.

Frost, MG, Jensen, KJ, Jimenez-Solem, E, Qvortrup, C, Kuhlmann, TP, Andersen, JL, Høgdall, E, Petersen, TS. 2024丹麦BRAF和KRAS基因检测的时间趋势和区域变异(2010-2022):对精准医学的影响。基因、染色体及;癌症63 (4):e23236。https://doi.org/10.1002/gcc.23236我们为这个错误道歉。
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引用次数: 0
A Clinicopathologic and Molecular Reappraisal of Myxoinflammatory Fibroblastic Sarcoma—A Controversial and Pathologically Challenging Low-Grade Sarcoma 黏液炎性纤维母细胞肉瘤的临床病理和分子鉴定-一种有争议和病理挑战性的低级别肉瘤。
IF 3.1 2区 医学 Q2 GENETICS & HEREDITY Pub Date : 2025-01-17 DOI: 10.1002/gcc.70018
Takeshi Hirose, Hsin-Yi Chang, Carla Saoud, Robert A. Lefkowitz, Edward Athanasian, Cristina R. Antonescu

Purpose

Myxoinflammatory fibroblastic sarcoma (MIFS) is a rare, low-grade sarcoma affecting with predilection the acral soft tissues of middle-aged adults. Clinically, MIFS is associated with a high rate of local recurrence but infrequent distant metastases. The diagnosis remains challenging due to their wide histologic spectrum and overlap with reactive, benign, and low-grade malignant lesions. Moreover, a significant limitation is that molecular confirmation is achieved in only a subset of cases, due to its broad range of genetic alterations which requires a multiplatform approach. Thus, a definitive diagnosis, especially at nonacral sites and in molecularly negative cases, remains uncertain. Our goal was to perform a detailed clinicopathologic and molecular reappraisal of MIFS managed at a single tertiary cancer center with dedicated orthopedic oncology expertise. Additionally, we examined potential outcomes correlating with specific genetic alterations.

Patients and Methods

A cohort of 33 patients (12 males, 21 females, median age 52 years) was selected. Tumors were tested by FISH, Archer, and/or targeted NGS.

Results

VGLL3 amplification was detected in 84%, BRAF fusions in 33% and combined TGFBR3/MGEA5 rearrangements in 32% of cases. Two novel fusions were detected, RRAGB::CCNB3 and FGFR1::ZBTB47. Other events included a YAP1::MAML2 fusion in two cases, one co-existing with a BRAF fusion. Overall, 8 (24%) patients recurred, 4 more than once, while 4 (12%) patients developed metastasis (3 locoregional, 1 pulmonary), all associated with VGLL3 gene amplification.

Conclusion

Positive margin status was associated with increased recurrence and reduced disease-free survival (DFS, p = 0.02). Moreover, it emphasizes the impact of multiplatform molecular testing in confirming the diagnosis. The lack of both local recurrence and metastatic potential outside VGLL3 amplifications requires further investigation.

目的:黏液炎性纤维母细胞肉瘤(MIFS)是一种罕见的低级别肉瘤,多发于中年人的肢端软组织。临床上,MIFS与高局部复发率相关,但很少发生远处转移。由于其广泛的组织学谱和与反应性、良性和低级别恶性病变重叠,诊断仍然具有挑战性。此外,一个重要的限制是,由于其广泛的遗传改变需要多平台的方法,仅在一小部分病例中实现了分子确认。因此,明确的诊断,特别是在非肢端部位和分子阴性病例,仍然不确定。我们的目标是对MIFS进行详细的临床病理和分子重新评估,并在一家三级癌症中心进行专门的骨科肿瘤专家管理。此外,我们研究了与特定基因改变相关的潜在结果。患者和方法:入选33例患者(男性12例,女性21例,中位年龄52岁)。采用FISH、Archer和/或靶向NGS检测肿瘤。结果:84%的病例检测到VGLL3扩增,33%的病例检测到BRAF融合,32%的病例检测到TGFBR3/MGEA5合并重排。检测到两个新的融合体,RRAGB::CCNB3和FGFR1::ZBTB47。其他事件包括2例YAP1::MAML2融合,1例与BRAF融合共存。总体而言,8例(24%)患者复发,4例超过一次,4例(12%)患者发生转移(3例局部,1例肺),均与VGLL3基因扩增相关。结论:切缘阳性与复发率增加和无病生存期降低相关(DFS, p = 0.02)。此外,它强调了多平台分子检测在确诊中的作用。缺乏局部复发和转移的可能性以外的VGLL3扩增需要进一步的研究。
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引用次数: 0
SMARCA4 Deficiency in Lung Cancer: From Signaling Pathway to Potential Therapeutic Targets 肺癌中SMARCA4缺失:从信号通路到潜在治疗靶点
IF 3.1 2区 医学 Q2 GENETICS & HEREDITY Pub Date : 2025-01-15 DOI: 10.1002/gcc.70022
Mingzhu Zhang, Youhong Dong, Rui Meng, Dongdong Zhang

SMARCA4-deficient lung cancer, including thoracic SMARCA4-deficient undifferentiated tumors and SMARCA4-deficient nonsmall-cell lung carcinomas, is a rare and aggressive disease characterized by rapid progression and poor prognosis. This cancer was identified as a distinct entity with specific morphologic and molecular features in the 2021 WHO Classification of Thoracic Tumors. Molecular alterations in SMARCA4 are specific to this type of lung cancer. Deficiency in SMARCA4 suppresses the SWI/SNF tumor suppressor complex, driving tumor progression. Due to the lack of standardized treatment, most patients succumb to the disease within 6 months. This study provides a detailed analysis of the SMARCA4 pathway and its role in lung cancer. We analyzed potential therapeutic targets and agents to offer insights for the precise and effective treatment of SMARCA4-deficient lung cancer.

smarca4缺陷型肺癌,包括胸椎smarca4缺陷型未分化肿瘤和smarca4缺陷型非小细胞肺癌,是一种罕见的侵袭性疾病,其特点是进展迅速,预后差。在2021年WHO胸部肿瘤分类中,该癌症被确定为具有特定形态和分子特征的独特实体。SMARCA4的分子改变是这种类型肺癌所特有的。SMARCA4缺失会抑制SWI/SNF肿瘤抑制复合物,从而驱动肿瘤进展。由于缺乏标准化的治疗,大多数患者在6个月内死亡。本研究详细分析了SMARCA4通路及其在肺癌中的作用。我们分析了潜在的治疗靶点和药物,为精确有效地治疗smarca4缺陷肺癌提供见解。
{"title":"SMARCA4 Deficiency in Lung Cancer: From Signaling Pathway to Potential Therapeutic Targets","authors":"Mingzhu Zhang,&nbsp;Youhong Dong,&nbsp;Rui Meng,&nbsp;Dongdong Zhang","doi":"10.1002/gcc.70022","DOIUrl":"10.1002/gcc.70022","url":null,"abstract":"<div>\u0000 \u0000 <p>SMARCA4-deficient lung cancer, including thoracic SMARCA4-deficient undifferentiated tumors and SMARCA4-deficient nonsmall-cell lung carcinomas, is a rare and aggressive disease characterized by rapid progression and poor prognosis. This cancer was identified as a distinct entity with specific morphologic and molecular features in the 2021 WHO Classification of Thoracic Tumors. Molecular alterations in SMARCA4 are specific to this type of lung cancer. Deficiency in SMARCA4 suppresses the SWI/SNF tumor suppressor complex, driving tumor progression. Due to the lack of standardized treatment, most patients succumb to the disease within 6 months. This study provides a detailed analysis of the SMARCA4 pathway and its role in lung cancer. We analyzed potential therapeutic targets and agents to offer insights for the precise and effective treatment of SMARCA4-deficient lung cancer.</p>\u0000 </div>","PeriodicalId":12700,"journal":{"name":"Genes, Chromosomes & Cancer","volume":"64 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142983294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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Genes, Chromosomes & Cancer
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