Full text
11,593 characters
· extracted from
oa-doi-fallback
· click to expand
Zusammenfassung
Seit die molekularbiologische Labortechnologie in der Lage ist, sämtliche Gene zu identifizieren und ihre genomischen und nichtgenomischen Aktionen in den einzelnen zellulären Mechanismen zu charakterisieren, erschließt sich ein neues, bisweilen völlig anderes Krankheitsverständnis. Die Kenntnis der exakten Hintergründe einer Erkrankung ermöglicht eine andere Sichtweise und bereitet das Feld für neue ursächliche und individuell maßgeschneiderte Therapieoptionen. Die veränderte Sichtweise und die molekularen Hintergründe benigner gynäkologischer Erkrankungen sollen hier erörtert werden, am Beispiel von Endometriose, Adenomyose und uterinen Tumoren.
Abstract
Ever since molecular laboratory technology has been able to identify all genes and to characterize their specific genomic and nongenomic modes of action in the individual cellular mechanisms, a completely new understanding of diseases has become possible. Knowledge of the exact background of a disease enables another viewpoint and prepares the field for new causal and individually tailored treatment options. The altered viewpoint and the molecular background of benign gynecological diseases are discussed in this article, particularly with respect to endometriosis, adenomyosis and uterine tumors.
Similar content being viewed by others
Literatur
Anglesio MS, Papadopoulos N, Ayhan A, Nazeran TM, Noë M, Horlings HM, Lum A, Jones S, Senz J, Seckin T, Ho J, Wu RC, Lac V, Ogawa H, Tessier-Cloutier B, Alhassan R, Wang A, Wang Y, Cohen JD, Wong F, Hasanovic A, Orr N, Zhang M, Popoli M, McMahon W, Wood LD, Mattox A, Allaire C, Segars J, Williams C, Tomasetti C, Boyd N, Kinzler KW, Gilks CB, Diaz L, Wang TL, Vogelstein B, Yong PJ, Huntsman DG, Shih IM (2017) Cancer-associated mutations in endometriosis without cancer. N Engl J Med 376(19):1835–1848. https://doi.org/10.1056/NEJMoa1614814
Inoue S, Hirota Y, Ueno T, Fukui Y, Yoshida E, Hayashi T, Kojima S, Takeyama R, Hashimoto T, Kiyono T, Ikemura M, Taguchi A, Tanaka T, Tanaka Y, Sakata S, Takeuchi K, Muraoka A, Osuka S, Saito T, Oda K, Osuga Y, Terao Y, Kawazu M, Mano H (2019) Uterine adenomyosis is an oligoclonal disorder associated with KRAS mutations. Nat Commun 10(1):5785. https://doi.org/10.1038/s41467-019-13708-y
Suda K, Nakaoka H, Yoshihara K, Ishiguro T, Tamura R, Mori Y, Yamawaki K, Adachi S, Takahashi T, Kase H, Tanaka K, Yamamoto T, Motoyama T, Inoue I, Enomoto T (2018) Clonal expansion and diversification of cancer-associated mutations in endometriosis and normal endometrium. Cell Rep 24(7):1777–1789. https://doi.org/10.1016/j.celrep.2018.07.037
Němejcová K, Kenny SL, Laco J, Škapa P, Staněk L, Zikán M, Kleiblová P, McCluggage WG, Dundr P (2015) Atypical polypoid adenomyoma of the uterus: an immunohistochemical and molecular study of 21 cases. Am J Surg Pathol 39(8):1148–1155. https://doi.org/10.1097/PAS.0000000000000428 (PMID: 25828387)
Schoenmakers EF, Wanschura S, Mols R, Bullerdiek J, Van den Berghe H, Van de Ven WJ (1995) Recurrent rearrangements in the high mobility group protein gene, HMGI‑C, in benign mesenchymal tumours. Nat Genet 10(4):436–444. https://doi.org/10.1038/ng0895-436
Mäkinen N, Mehine M, Tolvanen J, Kaasinen E, Li Y, Lehtonen HJ, Gentile M, Yan J, Enge M, Taipale M, Aavikko M, Katainen R, Virolainen E, Böhling T, Koski TA, Launonen V, Sjöberg J, Taipale J, Vahteristo P, Aaltonen LA (2011) MED12, the mediator complex subunit 12 gene, is mutated at high frequency in uterine leiomyomas. Science 334(6053):252–255. https://doi.org/10.1126/science.1208930
Markowski DN, Bartnitzke S, Löning T, Drieschner N, Helmke BM, Bullerdiek J (2012) MED12 mutations in uterine fibroids—Their relationship to cytogenetic subgroups. Int J Cancer 131(7):1528–1536. https://doi.org/10.1002/ijc.27424
Markowski DN, Helmke BM, Bartnitzke S, Löning T, Bullerdiek J (2014) Uterine fibroids: do we deal with more than one disease? Int J Gynecol Pathol 33(6):568–572. https://doi.org/10.1097/PGP.0000000000000096
Pérot G, Croce S, Ribeiro A, Lagarde P, Velasco V, Neuville A, Coindre JM, Stoeckle E, Floquet A, MacGrogan G, Chibon F (2012) MED12 alterations in both human benign and malignant uterine soft tissue tumors. PLoS One 7(6):e40015. https://doi.org/10.1371/journal.pone.0040015
Tallini G, Vanni R, Manfioletti G, Kazmierczak B, Faa G, Pauwels P, Bullerdiek J, Giancotti V, Van Den Berghe H, Dal Cin P (2000) HMGI‑C and HMGI(Y) immunoreactivity correlates with cytogenetic abnormalities in lipomas, pulmonary chondroid hamartomas, endometrial polyps, and uterine leiomyomas and is compatible with rearrangement of the HMGI‑C and HMGI(Y) genes. Lab Invest 80(3):359–369. https://doi.org/10.1038/labinvest.3780040
Kazmierczak B, Dal Cin P, Wanschura S, Borrmann L, Fusco A, Van den Berghe H, Bullerdiek J (1998) HMGIY is the target of 6p21.3 rearrangements in various benign mesenchymal tumors. Genes Chromosomes Cancer 23(4):279–285
Hennig Y, Wanschura S, Deichert U, Bartnitzke S, Bullerdiek J (1996) Rearrangements of the high mobility group protein family genes and the molecular genetic origin of uterine leiomyomas and endometrial polyps. Mol Hum Reprod 2(4):277–283. https://doi.org/10.1093/molehr/2.4.277
Koontz JI, Soreng AL, Nucci M, Kuo FC, Pauwels P, van Den Berghe H, Dal Cin P, Fletcher JA, Sklar J (2001) Frequent fusion of the JAZF1 and JJAZ1 genes in endometrial stromal tumors. Proc Natl Acad Sci U S A 98(11):6348–6353. https://doi.org/10.1073/pnas.101132598
Nucci MR, Harburger D, Koontz J, Dal Cin P, Sklar J (2007) Molecular analysis of the JAZF1-JJAZ1 gene fusion by RT-PCR and fluorescence in situ hybridization in endometrial stromal neoplasms. Am J Surg Pathol 31(1):65–70. https://doi.org/10.1097/01.pas.0000213327.86992.d1
McCluggage WG, Connolly L, McBride HA (2010) HMGA2 is a sensitive but not specific immunohistochemical marker of vulvovaginal aggressive angiomyxoma. Am J Surg Pathol 34(7):1037–1042. https://doi.org/10.1097/PAS.0b013e3181e32a11
Kazmierczak B, Dal Cin P, Wanschura S, Bartnitzke S, Van den Berghe H, Bullerdiek J (1998) Cloning and molecular characterization of part of a new gene fused to HMGIC in mesenchymal tumors. Am J Pathol 152(2):431–435
Nucci MR, Weremowicz S, Neskey DM, Sornberger K, Tallini G, Morton CC, Quade BJ (2001) Chromosomal translocation t(8;12) induces aberrant HMGIC expression in aggressive angiomyxoma of the vulva. Genes Chromosomes Cancer 32(2):172–176. https://doi.org/10.1002/gcc.1179
Bulun SE (2009) Endometriosis. N Engl J Med 360(3):268–279. https://doi.org/10.1056/NEJMra0804690
Brosens I, Pijnenborg R, Benagiano G (2013) Defective myometrial spiral artery remodelling as a cause of major obstetrical syndromes in endometriosis and adenomyosis. Placenta 34(2):100–105. https://doi.org/10.1016/j.placenta.2012.11.017
Xue Q, Lin Z, Cheng YH, Huang CC, Marsh E, Yin P, Milad MP, Confino E, Reierstad S, Innes J, Bulun SE (2007) Promoter methylation regulates estrogen receptor 2 in human endometrium and endometriosis. Biol Reprod 77(4):681–687. https://doi.org/10.1095/biolreprod.107.061804
Cheng YH, Yin P, Xue Q, Yilmaz B, Dawson MI, Bulun SE (2008) Retinoic acid (RA) regulates 17beta-hydroxysteroid dehydrogenase type 2 expression in endometrium: interaction of RA receptors with specificity protein (SP) 1/SP3 for estradiol metabolism. J Clin Endocrinol Metab 93(5):1915–1923. https://doi.org/10.1210/jc.2007-1536
Küpker W, Agic A (2020) Endometriose und Malignität – gibt es ein erhöhtes Risiko? In: Diedrich K, Ludwig M, Griesinger G (Hrsg) Reproduktionsmedizin, 2. Aufl. Springer Berlin, Heidelberg, S 358. https://doi.org/10.1007/978-3-662-57636-6
Brinton LA, Gridley G, Persson I et al (1997) Cancer risk after a hospital discharge diagnosis of endometriosis. Am J Obstet Gynecol 176:572–579
Peirce CL, Templeman C, Rossing MA (2012) Association between endometriosis and risk of histological subtypes of ovarian cancer: a pooled analysis of case-control studies. Lancet Oncol 13:385–394 (On behalf of the Ovarian Cancer Association Consortium)
Dinulescu DM, Ince TA, Quade BJ, Shafer SA, Crowley D, Jacks T (2005) Role of K‑ras and Pten in the development of mouse models of endometriosis and endometrioid ovarian cancer. Nat Med 11(1):63–70. https://doi.org/10.1038/nm1173
Chapron C, Tosti C, Marcellin L, Bourdon M, Lafay-Pillet MC, Millischer AE, Streuli I, Borghese B, Petraglia F, Santulli P (2017) Relationship between the magnetic resonance imaging appearance of adenomyosis and endometriosis phenotypes. Hum Reprod 32(7):1393–1401. https://doi.org/10.1093/humrep/dex088
Bullerdiek J, Rommel B (2018) Factors targeting MED12 to drive tumorigenesis? F1000Res 7:359. https://doi.org/10.12688/f1000research.14227.2
Santamaria X, Mas A, Cervelló I, Taylor H, Simon C (2018) Uterine stem cells: from basic research to advanced cell therapies. Hum Reprod Update 24(6):673–693. https://doi.org/10.1093/humupd/dmy028
Bulun SE, Moravek MB, Yin P, Ono M, 5th Coon JS, Dyson MT, Navarro A, Marsh EE, Zhao H, Maruyama T, Chakravarti D, Kim JJ, Wei JJ (2015) Uterine leiomyoma stem cells: linking progesterone to growth. Semin Reprod Med 33(5):357–365. https://doi.org/10.1055/s-0035-1558451
Holzmann C, Saager C, Mechtersheimer G, Koczan D, Helmke BM, Bullerdiek J (2018) Malignant transformation of uterine leiomyoma to myxoid leiomyosarcoma after morcellation associated with ALK rearrangement and loss of 14q. Oncotarget 9(45):27595–27604. https://doi.org/10.18632/oncotarget.25137
Micci F, Panagopoulos I, Bjerkehagen B, Heim S (2006) Deregulation of HMGA2 in an aggressive angiomyxoma with t(11;12)(q23;q15). Virchows Arch 448(6):838–842. https://doi.org/10.1007/s00428-006-0186-5
Harkness R, McCluggage WG (2021) HMGA2 is a useful marker of vulvovaginal aggressive angiomyxoma but may be positive in other mesenchymal lesions at this site. Int J Gynecol Pathol 40(2):185–189. https://doi.org/10.1097/PGP.0000000000000689
Oliva E, de Leval L, Soslow RA, Herens C (2007) High frequency of JAZF1-JJAZ1 gene fusion in endometrial stromal tumors with smooth muscle differentiation by interphase FISH detection. Am J Surg Pathol 31(8):1277–1284. https://doi.org/10.1097/PAS.0b013e318031f012
Huang HY, Ladanyi M, Soslow RA (2004) Molecular detection of JAZF1-JJAZ1 gene fusion in endometrial stromal neoplasms with classic and variant histology: evidence for genetic heterogeneity. Am J Surg Pathol 28(2):224–232. https://doi.org/10.1097/00000478-200402000-00010
Chiang S, Ali R, Melnyk N, McAlpine JN, Huntsman DG, Gilks CB, Lee CH, Oliva E (2011) Frequency of known gene rearrangements in endometrial stromal tumors. Am J Surg Pathol 35(9):1364–1372. https://doi.org/10.1097/PAS.0b013e3182262743
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Interessenkonflikt
W. Küpker, J. Aizpurua, R.E. Felberbaum und J. Bullerdiek geben an, dass kein Interessenkonflikt besteht.
Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.
Additional information
Redaktion
Thomas Strowitzki, Heidelberg
Klaus Diedrich, Lübeck
QR-Code scannen & Beitrag online lesen
Rights and permissions
About this article
Cite this article
Küpker, W., Aizpurua, J., Felberbaum, R.E. et al. Molekulare Pathologie benigner gynäkologischer Erkrankungen – ist sie hilfreich bei zukünftigen Therapieentscheidungen?. Gynäkologie 55, 409–414 (2022). https://doi.org/10.1007/s00129-022-04951-4
Accepted:
Published:
Version of record:
Issue date:
DOI: https://doi.org/10.1007/s00129-022-04951-4
Text is read by the "Ask this paper" AI Q&A widget below.
Extraction quality varies by source — PMC NXML preserves structure
cleanly, OA-HTML may include some navigation residue, and OA-PDF can
have broken hyphenation. The publisher copy
(via DOI)
is the canonical version.