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PIK3CA gene mutations in endometrial carcinoma: correlation with PTEN and K-RAS alterations
Ana Velasco1, Elena Bussaglia, Judit Pallares
1Department of Pathology and Molecular Genetics, Hospital Universitari Arnau de Vilanova, University of Lleida, Lleida, Spain.
Abstract:
Alterations in the phosphatidylinositol 3-kinase (PI3K)/AKT signaling pathway are common in endometrial carcinoma. Inactivation of the tumor suppressor gene PTEN leads to a constitutively active PI3K pathway, which plays a role in the early steps of endometrial tumorigenesis. Other alterations in the PI3K/AKT pathway are mutations in the PIK3CA gene, which encode the p110alpha catalytic subunit of PI3K. PIK3CA mutations cluster to the helical (exon 9) and the kinase (exon 20) domains of the gene. In endometrial carcinomas, PIK3CA mutations have been found to coexist frequently with PTEN mutations, but it is not clear whether they occur in cells with monoallelic or biallelic inactivation of PTEN. In the present study we have evaluated PIK3CA mutational status in a series of 33 endometrial carcinomas, previously screened for microsatellite instability and mutations in PTEN, K-RAS, and CTNNB-1. The tumors were also evaluated for loss of heterozygosity on 10q23 and hypermethylation of the promoter region of PTEN/psiPTEN to assess the monoallelic or biallelic inactivation status of PTEN. PIK3CA mutations were detected in 8 (24%) of the 33 cases. Seven mutations were located in exon 20 and 1 in exon 9. PTEN alterations were found in 19 cases (57%). Biallelic inactivation of PTEN was demonstrated in 11 tumors, whereas 8 tumors exhibited alteration in only 1 of the 2 alleles. PIK3CA mutations coexisted with monoallelic alterations of PTEN in 4 cases (2 mutations and 2 allelic imbalances), with biallelic PTEN inactivation in 1 case (mutation and promoter methylation), and 3 tumors showed PIK3CA mutations in association with wild-type PTEN. PIK3CA mutations did not correlate with microsatellite instability or mutations in CTNNB-1. However, PIK3CA and K-RAS mutations (8 cases) were mutually exclusive alterations. In summary, the results confirm that PIK3CA mutations are frequent in endometrial carcinoma and support the hypothesis that PIK3CA mutations may have an additive effect to PTEN monoallelic inactivation in endometrial carcinoma.
Insights
Mutations in the PIK3CA gene are common in endometrial cancer and often occur alongside PTEN gene alterations. These PIK3CA mutations may contribute to tumor development, especially when PTEN is only partially inactivated.
Area of Science:
- Oncology
- Molecular Biology
- Genetics
Background:
- Alterations in the phosphatidylinositol 3-kinase (PI3K)/AKT pathway are frequent in endometrial carcinoma.
- PTEN tumor suppressor gene inactivation and PIK3CA gene mutations are key events in endometrial tumorigenesis.
- The interplay between PIK3CA mutations and PTEN inactivation status (monoallelic vs. biallelic) in endometrial cancer requires further elucidation.
Purpose of the Study:
- To investigate the frequency and spectrum of PIK3CA mutations in endometrial carcinomas.
- To assess the relationship between PIK3CA mutational status and PTEN alterations (including monoallelic and biallelic inactivation).
- To explore the correlation of PIK3CA mutations with microsatellite instability and mutations in other key genes like K-RAS and CTNNB-1.
Main Methods:
- Analysis of PIK3CA mutational status in 33 endometrial carcinoma samples.
- Assessment of PTEN alterations, including loss of heterozygosity and promoter hypermethylation, to determine inactivation status.
- Screening for microsatellite instability and mutations in PTEN, K-RAS, and CTNNB-1.
Main Results:
- PIK3CA mutations were detected in 24% of endometrial carcinomas, predominantly in exon 20.
- PTEN alterations were found in 57% of cases, with 11 exhibiting biallelic inactivation and 8 showing monoallelic alteration.
- PIK3CA mutations were observed in conjunction with both monoallelic and biallelic PTEN inactivation, as well as in tumors with wild-type PTEN. PIK3CA and K-RAS mutations were mutually exclusive.
Conclusions:
- PIK3CA mutations are a frequent event in endometrial carcinoma.
- PIK3CA mutations may exert an additive effect on tumorigenesis, particularly in the context of PTEN monoallelic inactivation.
- These findings highlight the complex genetic landscape of endometrial cancer and the significance of the PI3K/AKT pathway.
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