BRAF/KRAS gene sequencing of sebaceous neoplasms after mismatch repair protein analysis.

Cornejo, Kristine M; Hutchinson, Lloyd; Deng, April; Tomaszewicz, Keith; Welch, Matthew; Lyle, Stephen; Dresser, Karen; Cosar, Ediz F

Cornejo, Kristine M; Hutchinson, Lloyd; Deng, April; Tomaszewicz, Keith; Welch, Matthew; Lyle, Stephen; Dresser, Karen; Cosar, Ediz F.

Afiliación

Cornejo KM; Department of Pathology, University of Massachusetts Medical School, UMass Memorial Medical Center, Worcester, MA 01605. Electronic address: kcornejo@partners.org.
Hutchinson L; Department of Pathology, University of Massachusetts Medical School, UMass Memorial Medical Center, Worcester, MA 01605.
Deng A; Department of Pathology, University of Massachusetts Medical School, UMass Memorial Medical Center, Worcester, MA 01605.
Tomaszewicz K; Department of Pathology, University of Massachusetts Medical School, UMass Memorial Medical Center, Worcester, MA 01605.
Welch M; Department of Pathology, University of Massachusetts Medical School, UMass Memorial Medical Center, Worcester, MA 01605.
Lyle S; Department of Pathology, University of Massachusetts Medical School, UMass Memorial Medical Center, Worcester, MA 01605.
Dresser K; Department of Pathology, University of Massachusetts Medical School, UMass Memorial Medical Center, Worcester, MA 01605.
Cosar EF; Department of Pathology, University of Massachusetts Medical School, UMass Memorial Medical Center, Worcester, MA 01605.

Hum Pathol ; 45(6): 1213-20, 2014 Jun.

Article en En | MEDLINE | ID: mdl-24767862

RESUMEN

Sebaceous neoplasms are cutaneous markers for the autosomal-dominant Muir-Torre syndrome (MTS). This phenotypic variant of Lynch syndrome (LS) is caused by germline mutations in DNA mismatch repair (MMR) genes. Microsatellite instability or loss of protein expression suggests a mutation or promoter hypermethylation in 1 of the MMR genes. BRAF gene sequencing may help to distinguish between patients with sporadic and LS-associated colorectal carcinomas with loss of MLH1 expression. LS-associated carcinomas are virtually negative for BRAF mutations, but a subset harbors KRAS mutations. The aim of our study was to test sebaceous neoplasms for V600E BRAF or KRAS mutations to determine if these mutations are associated with somatic or germline MMR defects, analogous to colorectal carcinomas. Over a 4-year period, 32 cases comprising 21 sebaceous adenomas, 3 sebaceomas, and 8 sebaceous carcinomas with sufficient material for testing were collected. MMR immunohistochemistry showed that 7 neoplasms had combined loss of MLH1-PMS2, 16 neoplasms had combined loss of MSH2-MSH6, 2 neoplasms had solitary loss of MSH6, and 7 sebaceous neoplasms had intact protein expression. BRAF/KRAS testing revealed all sebaceous neoplasms contained a wild-type BRAF gene. Two (15%) of 13 patients with MTS were found to harbor a KRAS mutation and loss of MLH1 expression. We conclude that a V600E BRAF mutation may not be helpful in distinguishing sporadic from MTS-associated sebaceous neoplasms. Further studies are needed to determine if KRAS mutations are restricted to patients with MTS or are also present in sporadic sebaceous neoplasms.

Asunto(s)

Proteínas Adaptadoras Transductoras de Señales/genética; Reparación de la Incompatibilidad de ADN; Proteínas Nucleares/genética; Proteínas Proto-Oncogénicas B-raf/genética; Proteínas Proto-Oncogénicas/genética; Neoplasias de las Glándulas Sebáceas/genética; Proteínas ras/genética; Adulto; Anciano; Anciano de 80 o más Años; Femenino; Humanos; Inmunohistoquímica; Masculino; Persona de Mediana Edad; Homólogo 1 de la Proteína MutL; Proteínas Proto-Oncogénicas p21(ras); Reacción en Cadena en Tiempo Real de la Polimerasa

Palabras clave

BRAF; KRAS; Lynch syndrome; Microsatellite instability; Mismatch repair genes; Muir-Torre syndrome; Sebaceous neoplasms

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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias de las Glándulas Sebáceas / Proteínas Nucleares / Proteínas Proto-Oncogénicas / Proteínas ras / Proteínas Proto-Oncogénicas B-raf / Proteínas Adaptadoras Transductoras de Señales / Reparación de la Incompatibilidad de ADN Límite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Hum Pathol Asunto de la revista: PATOLOGIA Año: 2014 Tipo del documento: Article Pais de publicación: Estados Unidos

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