Journal
BMC CANCER
Volume 15, Issue -, Pages -Publisher
BIOMED CENTRAL LTD
DOI: 10.1186/s12885-015-1872-y
Keywords
Gastrointestinal stromal tumor (GIST); Wild type; KIT; PDGFRA; Succinate dehydrogenase (SDH); NF1; MAX
Categories
Funding
- Kansas Bioscience Authority Eminent Scholar Program
- GIST Cancer Research Fund
- D'Amico family fund
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Background: Approximately 10-15 % of gastrointestinal stromal tumors (GISTs) lack gain of function mutations in the KIT and platelet-derived growth factor receptor alpha (PDGFRA) genes. An alternate mechanism of oncogenesis through loss of function of the succinate-dehydrogenase (SDH) enzyme complex has been identified for a subset of these wild type GISTs. Methods: Paired tumor and normal DNA from an SDH intact wild type GIST case was subjected to whole exome sequencing to identify the pathogenic mechanism(s) in this tumor. Selected findings were further investigated in panels of GIST tumors through Sanger DNA sequencing, quantitative real time PCR, and immunohistochemical approaches. Results: A hemizygous frameshift mutation (p.His2261Leufs*4), in the neurofibromin 1 (NH) gene was identified in the patient's GIST; however, no germline Nil mutation was found. A somatic frameshift mutation (p.Lys54Argfs*31) in the MYC associated factor X (MAX) gene was also identified. Immunohistochemical analysis for MAX on a large panel of GISTs identified loss of MAX expression in the MAX mutated GIST and in a subset of mainly KIT mutated tumors. Conclusion: This study suggests that inactivating Nil mutations outside the context of neurotibromatosis may be the oncogenic mechanism for a subset of sporadic GIST. In addition, loss of function mutation of the MAX gene was identified for the first time in GIST, and a broader role for MAX in GIST progression was suggested.
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