3.Detection and clinical significance of NTRK in digestive system neoplasms.
X J HOU ; Y FU ; X H PU ; X S FAN
Chinese Journal of Pathology 2023;52(8):876-880
7.Effects of interferon regulatory factor 9 on the biological phenotypes in PML-RARα-induced promyelocytic leukemia.
Xue YANG ; Hai Yan XING ; Ke Jing TANG ; Zheng TIAN ; Qing RAO ; Min WANG ; Jian Xiang WANG
Chinese Journal of Hematology 2022;43(5):370-375
Objective: To investigate the prognostic significance of interferon regulatory factor 9 (IRF9) expression and identify its role as a potential therapeutic target in acute promyelocytic leukemia (APL) . Methods: The gene expression profile and survival data applied in the bioinformatic analysis were obtained from The Cancer Genome Atlas and Beat acute myeloid leukemia (AML) cohorts. A dox-induced lentiviral system was used to induce the expression of PML-RARα (PR) in U937 cells, and the expression level of IRF9 in U937 cells treated with or without ATRA was examined. We then induced the expression of IRF9 in NB4, a promyelocytic leukemia cell line. In vitro studies focused on leukemic phenotypes triggered by IRF9 expression. Results: ①Bioinformatic analysis of the public database demonstrated the lowest expression of IRF9 in APL among all subtypes of AML, with lower expression associated with worse prognosis. ②We successfully established a PR-expression-inducible U937 cell line and found that IRF9 was downregulated by the PR fusion gene in APL, with undetectable expression in NB4 promyelocytic cells. ③An IRF9-inducible NB4 cell line was successfully established. The inducible expression of IRF9 promoted the differentiation of NB4 cells and had a synergistic effect with lower doses of ATRA. In addition, the inducible expression of IRF9 significantly reduced the colony formation capacity of NB4 cells. Conclusion: In this study, we found that the inducible expression of PR downregulates IRF9 and can be reversed by ATRA, suggesting a specific regulatory relationship between IRF9 and the PR fusion gene. The induction of IRF9 expression in NB4 cells can promote cell differentiation as well as reduce the colony forming ability of leukemia cells, implying an anti-leukemia effect for IRF9, which lays a biological foundation for IRF9 as a potential target for the treatment of APL.
Cell Differentiation
;
Humans
;
Interferon-Stimulated Gene Factor 3, gamma Subunit/metabolism*
;
Leukemia, Myeloid, Acute/drug therapy*
;
Leukemia, Promyelocytic, Acute/genetics*
;
Oncogene Proteins, Fusion/metabolism*
;
Phenotype
;
Tretinoin/therapeutic use*
;
U937 Cells
8.Research progression of gene fusion detection technology based on next generation sequencing in tumor companion diagnostics.
Xi Wen JIANG ; San Xi LI ; Zhi Kun LIANG ; Wei Lin LI ; Jia Hui CHEN ; Chun Ting ZHENG ; Peng FANG
Chinese Journal of Preventive Medicine 2022;56(12):1880-1888
Gene fusion is one of the mechanisms that promote tumor development. It is also an important cause for the poor prognosis of patients. The detection of gene fusion is crucial for the recognition of tumor biomarker, cancer subtype classification, and clinical medication guidance. Appropriate methods can help the early diagnosis and avoid ineffective medication. Traditional tests include fluorescence in situ hybridization (FISH), immunohistochemistry (IHC), reverse transcription of PCR (RT-PCR), and next generation sequencing (NGS). The next generation sequencing (NGS) mainly includes: whole genome sequencing (WGS), whole transcriptome sequencing (WTS) and target sequencing (hybridization capture method/amplicon method). In clinical concomitant diagnostic applications, some factors such as operability, time/money costs, and the level of expertise required for data analysis should be considered. This article concludes with a discussion of the technical principles of different detection methods and advantages/limitations. Meanwhile, it provides reference opinions for the detection methods of gene fusion.
Humans
;
High-Throughput Nucleotide Sequencing/methods*
;
In Situ Hybridization, Fluorescence
;
Neoplasms/genetics*
;
Gene Fusion
;
Technology
;
Lung Neoplasms/diagnosis*
9.Comparison of the methods for detecting NTRK gene fusion variations in papillary thyroid carcinoma.
Yang Yang JIANG ; Hui CHEN ; Bing Lei XU ; Shuang WANG
Chinese Journal of Pathology 2022;51(8):726-732
Objective: To investigate the frequency of neurotrophic tyrosine receptor kinase (NTRK) gene variations in papillary thyroid carcinoma (PTC) and to analyze the feasibility of detecting tropomyosin receptor kinase (TRK) proteins using immunohistochemistry (IHC) to predict the fusion variation of NTRK. Methods: A cohort of 848 PTC cases was collected at the Department of Pathology, Shenzhen People's Hospital from June 2017 to June 2020. The expression levels of TRK proteins were detected using IHC in 848 PTC samples, and the DNA-based next generation sequencing (NGS) was performed to detect NTRK rearrangements in 150 PTCs. Results: There were 242 males and 606 females, with an age range of 9-83 years. In 120 cases with TRK expression detected by IHC, 13 cases were confirmed to harbor a NTRK gene fusion by NGS. The frequency of NTRK fusion in PTC was 1.5% (13/848). The sensitivity and specificity of TRK-IHC positivity for screening NTRK fusion in PTC were 100% and 21.9%, respectively. The specificity of weak-, moderate- and strong-positive stains of TRK IHC were 23.8%, 76.9% and 93.8%, respectively. The specificity of NTRK gene fusion was predicted to increase with the enhanced intensity of IHC staining. In BRAF V600E negative PTC samples, the specificity of weak-and moderate-positive stains of TRK IHC increased to 62.5% and 96.8%, respectively. Seven NTRK fusion partners were found in the PTC, including EML4, ETV6, CDH1, GJD2, TPR, TFG and SQSTM1. Conclusions: There is a low variation frequency of NTRK gene fusion in PTC. TRK IHC can be used as a screening method for NTRK fusion variation in PTC. The specificity of TRK IHC predicting NTRK fusion can be further enhanced by increasing the cutoff value of the positive cell number and staining intensity of TRK-IHC staining, or being combined with BRAF V600E negativity.
Adolescent
;
Adult
;
Aged
;
Aged, 80 and over
;
Child
;
Female
;
Gene Fusion
;
Humans
;
Immunohistochemistry
;
Male
;
Middle Aged
;
Proto-Oncogene Proteins B-raf/genetics*
;
Receptor Protein-Tyrosine Kinases/genetics*
;
Receptor, trkA/genetics*
;
Thyroid Cancer, Papillary/genetics*
;
Thyroid Neoplasms/pathology*
;
Young Adult
10.Clinicopathological characteristics of H3K27-altered diffuse midline glioma and evaluation of NTRK as its therapeutic target.
Ze Jun DUAN ; Jing FENG ; Kun YAO ; Ze Juan HU ; Zhong MA ; Lei XIANG ; Xu Fei ZHANG ; Xue Ling QI
Chinese Journal of Pathology 2022;51(11):1115-1122
Objective: To investigate the clinicopathological characteristics of H3K27-altered diffuse midline glioma (DMG), and to analyze DMG's prognostic factors, and subsequently, to study the possibility of using NTRK as a therapeutic target for DMG. Methods: A total of 232 DMG diagnosed at the Sanbo Brain Hospital, Capital Medical University, Beijing, China from July 2016 to March 2021 were collected. Their clinical, radiological and pathological features, the ratio of MGMT promoter methylation, expression of NTRK, and characteristics of NTRK gene fusion were analyzed. The prognostic values of different factors were also studied, including age, tumor location, histological grade, gene and protein expression of NTRK, and postoperative adjuvant therapy. Results: Among the 232 DMG cases, there were 8 patients with both primary and relapse tumors on the record. Thus, a total of 224 patients were analyzed, including 118 males and 106 females. There were 126 adults (>18 years of age) and 98 children (≤18 years of age). Notably, the most frequent location was thalamus (41/126, 32.5%) in adults, but brainstem (59/96, 60.2%) in children. The lesions showed T1 hypointensity or isointensity, and T2 hyperintensity. However, contrast enhancement patterns of the tumors varied, with many tumors lacking contrast-enhancing. The histological grades included grade 2 (9/224, 4.0%), grade 3 (41/224, 18.3%) and grade 4 (174/224, 77.7%). Two hundred and twenty-four DMGs were diffusely positive for H3K27M and negative for H3K27me3. The ratio of MGMT promoter methylation was low (1/45, 2.2%). One hundred and seventy-seven of the 224 cases (177/224, 79.0%) were positive for NTRK. Fifty cases were analyzed using fluorescence in situ hybridization. Among them, five DMGs (positive rate, 10.0%) were NTRK fusion positive. This study showed that there were no differences between adult and pediatric DMGs in histological grading, expression of NTRK, and NTRK gene fusion. One hundred and fifty-nine patients were included in the follow-up analysis (P>0.05). During the follow-up period, 109/159 patients (69.6%) died of the disease, with a median survival time of 12 months (range 1 to 55 months). Univariate log-rank analysis showed that age, location, surgical procedure and postoperative adjuvant therapy were associated with overall survivals of the DMG patients (P<0.05). Conclusions: The prognosis of DMG is poor overall. There are differences between adult and pediatric DMGs in anatomic location and prognosis, but not in other features. NTRK1 gene fusion is detected in 10.0% of the tumors. It suggests that TRK inhibitor might be a choice for treating DMG.
Adult
;
Male
;
Female
;
Humans
;
Child
;
Aged, 80 and over
;
In Situ Hybridization, Fluorescence
;
Glioma/pathology*
;
Prognosis
;
Gene Fusion
;
Promoter Regions, Genetic

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