NTRK3 overexpression in undifferentiated sarcomas with YWHAE and BCOR genetic alterations Journal Article


Authors: Kao, Y. C.; Sung, Y. S.; Argani, P.; Swanson, D.; Alaggio, R.; Tap, W.; Wexler, L.; Dickson, B. C.; Antonescu, C. R.
Article Title: NTRK3 overexpression in undifferentiated sarcomas with YWHAE and BCOR genetic alterations
Abstract: The BCOR family of tumors includes a number of undifferentiated sarcomas, occurring in various age groups and anatomic sites, characterized by a spindle and round cell phenotype and diffuse immunoreactivity for BCOR. Prior RNA sequencing data revealed that NTRK3 was a top-upregulated gene in BCOR-CCNB3 sarcomas. In this study, we investigate a large cohort of tumors harboring BCOR/YWHAE genetic alterations for NTRK3 upregulation at both the mRNA and protein levels, compared with other sarcoma types. Pan-Trk immunohistochemistry was assessed for intensity and extent. A correlation between NTRK3 expression and the type of BCOR alteration and BCOR immunoreactivity was also performed. Most soft tissue undifferentiated round cell sarcomas with YWHAE or BCOR rearrangements or BCOR internal tandem duplications (ITD) showed NTRK3, but not NTRK1 or NTRK2, upregulation by RNA sequencing data analysis. Cytoplasmic pan-Trk immunoreactivity was also observed in most soft tissue round cell sarcomas with YWHAE rearrangements (100%), BCOR ITD (80%), and BCOR-CCNB3 fusions (67%), as well as clear cell sarcomas of kidney (75%), another BCOR family tumor, and ossifying fibromyxoid tumors with ZC3H7B-BCOR fusion (100%), with variable staining intensity and extent. Pan-Trk staining was also seen in solitary fibrous tumors (100%) and less frequently in synovial sarcoma and Ewing sarcoma, but rarely in other sarcomas tested. Tumors harboring rare fusion variants of BCOR, such as BCOR-CHD9, a novel fusion identified by targeted RNA sequencing, and KMT2D-BCOR, were also positive for pan-Trk staining and NTRK3 overexpression. In conclusion, NTRK3 upregulation resulting in pan-Trk overexpression is common in the BCOR family of tumors as well as in subsets of BCOR-expressing sarcomas through alternative mechanisms. The therapeutic implication of this finding awaits further investigation. © 2020, The Author(s), under exclusive licence to United States & Canadian Academy of Pathology.
Keywords: immunohistochemistry; controlled study; human cell; gene overexpression; cohort analysis; angiosarcoma; immunoreactivity; ewing sarcoma; sarcoma; gene rearrangement; messenger rna; soft tissue sarcoma; gene duplication; upregulation; synovial sarcoma; tumor gene; chondrosarcoma; clear cell sarcoma; correlational study; myxosarcoma; fibromyxosarcoma; kidney sarcoma; human; priority journal; article; rna sequencing; ntrk3 gene; bcor gene; whole transcriptome sequencing; ywhae gene
Journal Title: Modern Pathology
Volume: 33
Issue: 7
ISSN: 0893-3952
Publisher: Nature Research  
Date Published: 2020-07-01
Start Page: 1341
End Page: 1349
Language: English
DOI: 10.1038/s41379-020-0495-2
PUBMED: 32034283
PROVIDER: scopus
PMCID: PMC7329614
DOI/URL:
Notes: Article -- Export Date: 3 August 2020 -- Source: Scopus
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MSK Authors
  1. Leonard H Wexler
    191 Wexler
  2. Cristina R Antonescu
    895 Antonescu
  3. William Douglas Tap
    372 Tap
  4. Yun Shao Sung
    124 Sung