Cited by 629Endometriosis Research and TreatmentCancer Genomics and DiagnosticsChromatin Remodeling and Cancer

Cancer-associated mutations in endometriosis without cancer

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Anglesio, Michael S., Papadopoulos, Nickolas, Ayhan, Ayse, Nazeran, Tayyebeh M., Noë, Michaël, Horlings, Hugo M., Lum, Amy, Jones, Siân +32 more·2017·New England Journal of Medicine

Abstract

BACKGROUND: Endometriosis, defined as the presence of ectopic endometrial stroma and epithelium, affects approximately 10% of reproductive-age women and can cause pelvic pain and infertility. Endometriotic lesions are considered to be benign inflammatory lesions but have cancerlike features such as local invasion and resistance to apoptosis. METHODS: We analyzed deeply infiltrating endometriotic lesions from 27 patients by means of exomewide sequencing (24 patients) or cancer-driver targeted sequencing (3 patients). Mutations were validated with the use of digital genomic methods in microdissected epithelium and stroma. Epithelial and stromal components of lesions from an additional 12 patients were analyzed by means of a droplet digital polymerase-chain-reaction (PCR) assay for recurrent activating KRAS mutations. RESULTS: Exome sequencing revealed somatic mutations in 19 of 24 patients (79%). Five patients harbored known cancer driver mutations in ARID1A, PIK3CA, KRAS, or PPP2R1A, which were validated by Safe-Sequencing System or immunohistochemical analysis. The likelihood of driver genes being affected at this rate in the absence of selection was estimated at P=0.001 (binomial test). Targeted sequencing and a droplet digital PCR assay identified KRAS mutations in 2 of 3 patients and 3 of 12 patients, respectively, with mutations in the epithelium but not the stroma. One patient harbored two different KRAS mutations, c.35G→T and c.35G→C, and another carried identical KRAS c.35G→A mutations in three distinct lesions. CONCLUSIONS: We found that lesions in deep infiltrating endometriosis, which are associated with virtually no risk of malignant transformation, harbor somatic cancer driver mutations. Ten of 39 deep infiltrating lesions (26%) carried driver mutations; all the tested somatic mutations appeared to be confined to the epithelial compartment of endometriotic lesions.

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  • While nucleotide variants or mutations were noted sporadically in the epithelial component of ovarian endometriomas or deep-infiltrating endometriosis, stromal cells consistently lack any somatic mutations.

    “While nucleotide variants or mutations were noted sporadically in the epithelial component of ovarian endometriomas or deep-infiltrating endometriosis, stromal cells consistently lack any somatic mutations (Anglesio et al., 2017).”

    From Endometriosis and nuclear receptors (2019) · cites this paper as Anglesio et al., 2017

    The Results report somatic mutations in epithelial cells but not stroma in the compartments tested, and the Conclusions say that all tested somatic mutations appeared confined to epithelium. The claim overstates this as a finding that stromal cells consistently lack any somatic mutations; the paper does not establish that for every stromal cell or lesion. It also reports earlier ovarian-endometriosis mutation findings without establishing the same epithelial–stromal comparison for ovarian endometriomas. (LLM, conf=0.88)

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  • Molecular biology techniques using next-generation sequencing have provided clues to the origin of endometriosis and pathogenesis that cannot be elucidated by epidemiological investigations alone.

    “Recently, molecular biology techniques using a next‐generation sequencing have also provided clues to the origin of endometriosis and pathogenesis that cannot be elucidated by epidemiological investigations alone.”

    From Extra-pelvic endometriosis: a review. (2020) · cites this paper as [104]

  • Mutations in cancer-associated genes such as PIK3CA, KRAS, and ARID1A have been identified in extraovarian endometriosis.

    “Cancer genomic mutations have also been reported for extraovarian endometriosis in recent years, and mutations in cancer-associated genes, such as PIK3CA, KRAS, and ARID1A, have been identified [106].”
  • Cancer genomic mutations have been reported for extraovarian endometriosis.

    “Cancer genomic mutations have also been reported for extraovarian endometriosis in recent years, and mutations in cancer-associated genes, such as PIK3CA, KRAS, and ARID1A, have been identified [106].”

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Authors
Anglesio, M. S., Papadopoulos, N., Ayhan, A., Nazeran, T. M., Noë, M., Horlings, H. M., Lum, A., Jones, S., Senz, J., Seckin, T., Ho, J., Wu, R.-C., Lac, V., Ogawa, H., Tessier-Cloutier, B., Alhassan, R., Wang, A., Wang, Y., Cohen, J. D., Wong, F., Hasanovic, A., Orr, N., Zhang, M., Popoli, M., McMahon, W., Wood, L. D., Mattox, A., Allaire, C., Segars, J., Williams, C., Tomasetti, C., Boyd, N., Kinzler, K. W., Gilks, C. B., Diaz, L., Wang, T.-L., Vogelstein, B., Yong, P. J., Huntsman, D. G., & Shih, I.-M.
Affiliations
  • University of British Columbia (CA)
  • Hiroshima University (JP)
  • BC Cancer Agency (CA)
  • Howard Hughes Medical Institute (US)
Venue
New England Journal of Medicine
Published
2017-05-11
Volume
376
Issue
19
Pages
1835-1848
ISSN
  • 0028-4793 (ISSN-L)
  • 1533-4406
OpenAlex
W2612851374
Cited by
628
References
50
Citations by year
2026: 57 · 2025: 62 · 2024: 51 · 2023: 75 · 2022: 72 · 2021: 75 · 2020: 80 · 2019: 68 · 2018: 69 · 2017: 19
FWCI
74.93
Type
journal article
Language
en
Open access
Locations
  • New England Journal of Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Cancer Institute (R01CA215483, U01CA200469, R01CA057345, T32CA009243, P50CA062924, R37CA057345, P30CA006973)
  • National Institute of General Medical Sciences (T32GM007309, T32GM007184)
Topics
  • Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Cancer Research › Cancer Genomics and Diagnostics
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Chromatin Remodeling and Cancer
Keywords
endometriosis, deep infiltrating endometriosis, somatic mutations, cancer driver mutations, KRAS mutation, ARID1A, PIK3CA, PPP2R1A, malignant transformation risk, droplet digital PCR
MeSH terms
Adult, Cell Transformation, Neoplastic, DNA Mutational Analysis, DNA-Binding Proteins, Endometriosis, Endometrium, Female, Humans, Middle Aged, Mutation, Nuclear Proteins, Transcription Factors, Polymerase Chain Reaction, Proto-Oncogene Proteins p21(ras), Phosphatidylinositol 3-Kinases, Protein Phosphatase 2, Class I Phosphatidylinositol 3-Kinases, Exome

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