Skip to main content

Advertisement

Log in

Neurofibromatosis type 1-related gastrointestinal stromal tumors: a special reference to loss of heterozygosity at 14q and 22q

  • Original Paper
  • Published:
Journal of Cancer Research and Clinical Oncology Aims and scope Submit manuscript

Abstract

Purpose

Multiple gastrointestinal stromal tumors (GISTs) rarely occur in patients with neurofibromatosis type 1 (NF-1). In contrast to sporadic GISTs characterized by frequent allelic losses of 1p, 14q and 22q and mutations of KIT or PDGFRA gene with the activation of the downstream RAS-MAPK pathway, the molecular pathogenetic mechanisms of NF-1-related GISTs (NF-1 GISTs) remain unclear.

Methods

Thirty-one GISTs and two foci of Cajal cell hyperplasia (CCH) were obtained from five patients with NF-1. Phospho-MAPK p44/42 expression was examined by immunohistochemical stain. KIT and PDGFRA mutations were analyzed by PCR and direct sequencing methods. Loss of heterozygosity (LOH) was analyzed by PCR-based method with microsatellite markers on 14q and 22q.

Results

Immunohistochemical expression of phospho-MAPK p44/42 was frequently found in NF-1 GISTs (23/25 cases, 92%). Neither the KIT nor PDGFRA mutation was detected in 25 NF-1 GISTs and 2 CCH. Among the informative cases, LOH was seen at 14q and 22q in 7/8 (87.5%) and 5/12 (41.7%) NF-1 GISTs, respectively. Such LOH was not detected in CCH, whereas it was detected in small GIST less than 1 cm in diameter.

Conclusions

Our results support that KIT and PDGFRA mutations are very rare events in NF-1 GIST. Rather, activation of the Ras-MAPK pathway associated with the inactivation of the NF1 gene may play an important role in the cell proliferation of NF-1 GIST. Additionally, LOH at 14q and 22q may contribute to the relatively early phase of tumor development of NF-1 GIST.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  • Andersson J, Sihto H, Meis-Kindblom JM, Joensuu H, Nupponen N, Kindblom LG (2005) NF1-associated gastrointestinal stromal tumors have unique clinical, phenotypic, and genotypic characteristics. Am J Surg Pathol 29:1170–1176. doi:10.1097/01.pas.0000159775.77912.15

    Article  PubMed  Google Scholar 

  • Antonescu CR, Sommer G, Sarran L, Tschernyavsky SJ, Riedel E, Woodruff JM, Robson M, Maki R, Brennan MF, Ladanyi M, DeMatteo RP, Besmer P (2003) Association of KIT exon 9 mutations with nongastric primary site and aggressive behavior: KIT mutation analysis and clinical correlates of 120 gastrointestinal stromal tumors. Clin Cancer Res 9:3329–3337

    PubMed  CAS  Google Scholar 

  • Breiner JA, Meis-Kindblom J, Kindblom LG, McComb E, Liu J, Nelson M, Bridge JA (2000) Loss of 14q and 22q in gastrointestinal stromal tumors (pacemaker cell tumors). Cancer Genet Cytogenet 120:111–116. doi:10.1016/S0165-4608(00)00212-0

    Article  PubMed  CAS  Google Scholar 

  • Chen H, Hirota S, Isozaki K, Sun H, Ohashi A, Kinoshita K, O’Brien P, Kapusta L, Dardick I, Obayashi T, Okazaki T, Shinomura Y, Matsuzawa Y, Kitamura Y (2002) Polyclonal nature of diffuse proliferation of interstitial cells of Cajal in patients with familial and multiple gastrointestinal stromal tumours. Gut 51:793–796. doi:10.1136/gut.51.6.793

    Article  PubMed  CAS  Google Scholar 

  • Chompret A, Kannengiesser C, Barrois M, Terrier P, Dahan P, Tursz T, Lenoir GM, Bressac-De Paillerets B (2004) PDGFRA germline mutation in a family with multiple cases of gastrointestinal stromal tumor. Gastroenterology 126:318–321. doi:10.1053/j.gastro.2003.10.079

    Article  PubMed  CAS  Google Scholar 

  • Duensing A, Medeiros F, McConarty B, Joseph NE, Panigrahy D, Singer S, Fletcher CD, Demetri GD, Fletcher JA (2004) Mechanisms of oncogenic KIT signal transduction in primary gastrointestinal stromal tumors (GISTs). Oncogene 23:3999–4006. doi:10.1038/sj.onc.1207525

    Article  PubMed  CAS  Google Scholar 

  • El-Rifai W, Sarlomo-Rikala M, Andersson LC, Knuutila S, Miettinen M (2000) DNA sequence copy number changes in gastrointestinal stromal tumors: tumor progression and prognostic significance. Cancer Res 60:3899–3903

    PubMed  CAS  Google Scholar 

  • Fletcher CD, Berman JJ, Corless C, Gorstein F, Lasota J, Longley BJ, Miettinen M, O’Leary TJ, Remotti H, Rubin BP, Shmookler B, Sobin LH, Weiss SW (2002) Diagnosis of gastrointestinal stromal tumors: a consensus approach. Hum Pathol 33:459–465. doi:10.1053/hupa.2002.123545

    Article  PubMed  Google Scholar 

  • Fukasawa T, Chong JM, Sakurai S, Koshiishi N, Ikeno R, Tanaka A, Matsumoto Y, Hayashi Y, Koike M, Fukayama M (2000) Allelic loss of 14q and 22q, NF2 mutation, and genetic instability occur independently of c-kit mutation in gastrointestinal stromal tumor. Jpn J Cancer Res 91:1241–1249

    PubMed  CAS  Google Scholar 

  • Gunawan B, Schulten HJ, von Heydebreck A, Schmidt B, Enders C, Höer J, Langer C, Schüler P, Schindler CG, Kuhlgatz J, Füzesi L (2004) Site-independent prognostic value of chromosome 9q loss in primary gastrointestinal stromal tumours. J Pathol 202:421–429. doi:10.1002/path.1537

    Article  PubMed  Google Scholar 

  • Handra-Luca A, Bilal H, Bertrand JC, Fouret P (2003) Extra-cellular signal-regulated ERK-1/ERK-2 pathway activation in human salivary gland mucoepidermoid carcinoma: association to aggressive tumor behavior and tumor cell proliferation. Am J Pathol 163:957–967

    PubMed  CAS  Google Scholar 

  • Heinrich MC, Corless CL, Duensing A, McGreevey L, Chen CJ, Joseph N, Singer S, Griffith DJ, Haley A, Town A, Demetri GD, Fletcher CD, Fletcher JA (2003a) PDGFRA activating mutations in gastrointestinal stromal tumors. Science 299:708–710. doi:10.1126/science.1079666

    Article  PubMed  CAS  Google Scholar 

  • Heinrich MC, Corless CL, Demetri GD, Blanke CD, von Mehren M, Joensuu H, McGreevey LS, Chen CJ, Van den Abbeele AD, Druker BJ, Kiese B, Eisenberg B, Roberts PJ, Singer S, Fletcher CD, Silberman S, Dimitrijevic S, Fletcher JA (2003b) Kinase mutations and imatinib response in patients with metastatic gastrointestinal stromal tumor. J Clin Oncol 21:4342–4349. doi:10.1200/JCO.2003.04.190

    Article  PubMed  CAS  Google Scholar 

  • Hirota S, Isozaki K, Moriyama Y, Hashimoto K, Nishida T, Ishiguro S, Kawano K, Hanada M, Kurata A, Takeda M, Muhammad Tunio G, Matsuzawa Y, Kanakura Y, Shinomura Y, Kitamura Y (1998) Gain-of-function mutations of c-kit in human gastrointestinal stromal tumors. Science 279:577–580. doi:10.1126/science.279.5350.577

    Article  PubMed  CAS  Google Scholar 

  • Hirota S, Ohashi A, Nishida T, Isozaki K, Kinoshita K, Shinomura Y, Kitamura Y (2003) Gain-of-function mutations of platelet-derived growth factor receptor alpha gene in gastrointestinal stromal tumors. Gastroenterology 125:660–667. doi:10.1016/S0016-5085(03)01046-1

    Article  PubMed  CAS  Google Scholar 

  • Ingram DA, Yang FC, Travers JB, Wenning MJ, Hiatt K, New S, Hood A, Shannon K, Williams DA, Clapp DW (2000) Genetic and biochemical evidence that haploinsufficiency of the Nf1 tumor suppressor gene modulates melanocyte and mast cell fates in vivo. J Exp Med 191:181–188. doi:10.1084/jem.191.1.181

    Article  PubMed  CAS  Google Scholar 

  • Joensuu H, Roberts PJ, Sarlomo-Rikala M, Andersson LC, Tervahartiala P, Tuveson D, Silberman S, Capdeville R, Dimitrijevic S, Druker B, Demetri GD (2001) Effect of the tyrosine kinase inhibitor STI571 in a patient with a metastatic gastrointestinal stromal tumor. N Engl J Med 344:1052–1056. doi:10.1056/NEJM200104053441404

    Article  PubMed  CAS  Google Scholar 

  • Kinoshita K, Hirota S, Isozaki K, Ohashi A, Nishida T, Kitamura Y, Shinomura Y, Matsuzawa Y (2004) Absence of c-kit gene mutations in gastrointestinal stromal tumours from neurofibromatosis type 1 patients. J Pathol 202:80–85. doi:10.1002/path.1487

    Article  PubMed  CAS  Google Scholar 

  • Largaespada DA, Brannan CI, Jenkins NA, Copeland NG (1996) Nf1 deficiency causes Ras-mediated granulocyte/macrophage colony stimulating factor hypersensitivity and chronic myeloid leukaemia. Nat Genet 12:137–143. doi:10.1038/ng0296-137

    Article  PubMed  CAS  Google Scholar 

  • Lasota J, Wozniak A, Kopczynski J, Dansonka-Mieszkowska A, Wasag B, Mitsuhashi T, Sarlomo-Rikala M, Lee JR, Schneider-Stock R, Stachura J, Limon J, Miettinen M (2005) Loss of heterozygosity on chromosome 22q in gastrointestinal stromal tumors (GISTs): a study on 50 cases. Lab Invest 85:237–247. doi:10.1038/labinvest.3700218

    Article  PubMed  CAS  Google Scholar 

  • Lee JL, Kim JY, Ryu MH, Kang HJ, Chang HM, Kim TW, Lee H, Park JH, Kim HC, Kim JS, Kang YK (2006) Response to imatinib in KIT- and PDGFRA-wild type gastrointestinal stromal associated with neurofibromatosis type 1. Dig Dis Sci 51:1043–1046. doi:10.1007/s10620-006-8003-1

    Article  PubMed  Google Scholar 

  • Li Y, Bollag G, Clark R, Stevens J, Conroy L, Fults D, Ward K, Friedman E, Samowitz W, Robertson M, Bradley P, McCormick F, White R, Cawthon R (1992) Somatic mutations in the neurofibromatosis 1 gene in human tumors. Cell 69:275–281. doi:10.1016/0092-8674(92)90408-5

    Article  PubMed  CAS  Google Scholar 

  • Maertens O, Prenen H, Debiec-Rychter M, Wozniak A, Sciot R, Pauwels P, De Wever I, Vermeesch JR, de Raedt T, De Paepe A, Speleman F, van Oosterom A, Messiaen L, Legius E (2006) Molecular pathogenesis of multiple gastrointestinal stromal tumors in NF1 patients. Hum Mol Genet 15:1015–1023. doi:10.1093/hmg/ddl016

    Article  PubMed  Google Scholar 

  • Malik SN, Brattain M, Ghosh PM, Troyer DA, Prihoda T, Bedolla R, Kreisberg JI (2002) Immunohistochemical demonstration of phospho-Akt in high Gleason grade prostate cancer. Clin Cancer Res 8:1168–1171

    PubMed  Google Scholar 

  • Martin GA, Viskochil D, Bollag G, McCabe PC, Crosier WJ, Haubruck H, Conroy L, Clark R, O’Connell P, Cawthon RM, Innis MA, McCormick F (1990) The GAP-related domain of the neurofibromatosis type 1 gene product interacts with ras p21. Cell 63:843–849. doi:10.1016/0092-8674(90)90150-D

    Article  PubMed  CAS  Google Scholar 

  • Maruta H, Burgess AW (1994) Regulation of the Ras signalling network. Bioessays 16:489–496. doi:10.1002/bies.950160708

    Article  PubMed  CAS  Google Scholar 

  • Mendel DB, Laird AD, Xin X, Louie SG, Christensen JG, Li G, Schreck RE, Abrams TJ, Ngai TJ, Lee LB, Murray LJ, Carver J, Chan E, Moss KG, Haznedar JO, Sukbuntherng J, Blake RA, Sun L, Tang C, Miller T, Shirazian S, McMahon G, Cherrington JM (2003) In vivo antitumor activity of SU11248, a novel tyrosine kinase inhibitor targeting vascular endothelial growth factor and platelet-derived growth factor receptors: Determination of a pharmacokinetic/pharmacodynamic relationship. Clin Cancer Res 9:327–337

    PubMed  CAS  Google Scholar 

  • Miettinen M, Fetsch JF, Sobin LH, Lasota J (2006) Gastrointestinal stromal tumors in patients with neurofibromatosis 1: a clinicopathologic and molecular genetic study of 45 cases. Am J Surg Pathol 30:90–96. doi:10.1097/01.pas.0000176433.81079.bd

    Article  PubMed  Google Scholar 

  • Nakamura N, Yamamoto H, Yao T, Oda Y, Nishiyama K, Imamura M, Yamada T, Nawata H, Tsuneyoshi M (2005) Prognostic significance of abnormalities of cell-cycle regulatory proteins in gastrointestinal stromal tumor and relevance of the risk-grading system. Hum Pathol 36:828–837. doi:10.1016/j.humpath.2005.03.012

    Article  PubMed  CAS  Google Scholar 

  • Nishida T, Hirota S, Taniguchi M, Hashimoto K, Isozaki K, Nakamura H, Kanakura Y, Tanaka T, Takabayashi A, Matsuda H, Kitamura Y (1998) Familial gastrointestinal stromal tumours with germline mutation of the KIT gene. Nat Genet 19:323–324. doi:10.1038/1209

    Article  PubMed  CAS  Google Scholar 

  • Prenen H, Cools J, Mentens N, Folens C, Sciot R, Schöffski P, Van Oosterom A, Marynen P, Debiec-Rychter M (2006) Efficacy of the kinase inhibitor SU11248 against gastrointestinal stromal tumor mutants refractory to imatinib mesylate. Clin Cancer Res 12:2622–2627. doi:10.1158/1078-0432.CCR-05-2275

    Article  PubMed  CAS  Google Scholar 

  • Pylkkänen L, Sarlomo-Rikala M, Wessman M, Hämäläinen E, Sainio M, Husgafvel-Pursiainen K, Carpén O (2003) Chromosome 22q alterations and expression of the NF2 gene product, merlin, in gastrointestinal stromal tumors. Hum Pathol 34:872–879. doi:10.1016/S0046-8177(03)00349-6

    Article  PubMed  CAS  Google Scholar 

  • Rubin BP, Singer S, Tsao C, Duensing A, Lux ML, Ruiz R, Hibbard MK, Chen CJ, Xiao S, Tuveson DA, Demetri GD, Fletcher CD, Fletcher JA (2001) KIT activation is a ubiquitous feature of gastrointestinal stromal tumors. Cancer Res 61:8118–8121

    PubMed  CAS  Google Scholar 

  • Takazawa Y, Sakurai S, Sakuma Y, Ikeda T, Yamaguchi J, Hashizume Y, Yokoyama S, Motegi A, Fukayama M (2005) Gastrointestinal stromal tumors of neurofibromatosis type I (von Recklinghausen’s Disease). Am J Surg Pathol 29:755–763. doi:10.1097/01.pas.0000163359.32734.f9

    Article  PubMed  Google Scholar 

  • Xu GF, O’Connell P, Viskochil D, Cawthon R, Robertson M, Culver M, Dunn D, Stevens J, Gesteland R, White R, Weiss R (1990) The neurofibromatosis type 1 gene encodes a protein related to GAP. Cell 62:599–608. doi:10.1016/0092-8674(90)90024-9

    Article  PubMed  CAS  Google Scholar 

  • Yamamoto H, Oda Y, Kawaguchi K, Nakamura N, Takahira T, Tamiya S, Saito T, Oshiro Y, Ohta M, Yao T, Tsuneyoshi M (2004) c-kit and PDGFRA mutations in extragastrointestinal stromal tumor (gastrointestinal stromal tumor of the soft tissue). Am J Surg Pathol 28:479–488. doi:10.1097/00000478-200404000-00007

    Article  PubMed  Google Scholar 

  • Yantiss RK, Rosenberg AE, Sarran L, Besmer P, Antonescu CR (2005) Multiple gastrointestinal stromal tumors in type I neurofibromatosis: a pathologic and molecular study. Mod Pathol 18:475–484. doi:10.1038/modpathol.3800334

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgments

This study was supported in part by a Grant-in-Aid for cancer research from the Fukuoka Cancer Society, Fukuoka, Japan (H. Yamamoto) and by a Grant-in-Aid for Scientific Research from the Japan Society of the Promotion of Science (18790248, H. Yamamoto; 18590332, Y. Oda), Tokyo, Japan.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Hidetaka Yamamoto.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Yamamoto, H., Tobo, T., Nakamori, M. et al. Neurofibromatosis type 1-related gastrointestinal stromal tumors: a special reference to loss of heterozygosity at 14q and 22q. J Cancer Res Clin Oncol 135, 791–798 (2009). https://doi.org/10.1007/s00432-008-0514-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00432-008-0514-z

Keywords

Navigation