BRAF mutations in metanephric adenoma of the kidney

肾脏后肾腺瘤中的 BRAF 突变

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作者:Toni K Choueiri, John Cheville, Emanuele Palescandolo, André P Fay, Philip W Kantoff, Michael B Atkins, Jesse K McKenney, Victoria Brown, Megan E Lampron, Ming Zhou, Michelle S Hirsch, Sabina Signoretti

Background

Metanephric adenoma (MA) of the kidney is a rare, indolent tumor that may be difficult to differentiate from other small renal masses (SRMs). Genetic alterations associated with MA remain largely unknown.

Conclusions

BRAF V600E mutations are present in approximately 90% of all MA cases, serving as a potential valuable diagnostic tool in the differential diagnosis of SRMs undergoing a percutaneous biopsy. The presence of BRAF V600E and mitogen-activated protein kinase activation in a largely benign tumor supports the necessity for secondary events (e.g., p16 loss) in BRAF-driven oncogenesis.

Objective

We aimed at defining genetic events in MA of the kidney and determining their influence in the management of this disease. Design, setting, and participants: Multiplexed mass spectrometric genotyping was performed on 29 MA cases after tumor DNA extraction. We also conducted a mutational screen in an additional 129 renal neoplasms. Immunohistochemistry was performed on the MA cases to assess molecular markers of signaling pathway activation. Patients' baseline characteristics, as well as follow-up data, were captured. Outcome measurements and statistical analysis: We used descriptive statistics for baseline clinical characteristics and incidence of mutations. The Wilcoxon rank-sum test was used to correlate patient characteristics with mutational status.

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