PTEN mutation and microsatellite instability are two of the most common genetic alterations in uterine endometrioid carcinoma. Furthermore, previous studies have suggested an association between the two alterations, however the basis and consequence of the association is not understood. Recently it has been shown that 100% of female Pten ؉/؊ mice develop complex atypical hyperplasia by 32 weeks of age that progresses to endometrial carcinoma in ϳ20 to 25% of mice at 40 weeks. In an attempt to expand this mouse model of endometrial tumorigenesis and to further our understanding of the association between Pten mutations and DNA mismatch repair deficiency, we generated Pten heterozygous, Mlh1-null (mismatch repair deficient) mice. Significantly, the majority of Pten ؉/؊ /Mlh1 ؊/؊ mice developed polypoid lesions in the endometrium at 6 to 9 weeks of age. By 14 to 18 weeks, all of the double-mutant mice had lesions histologically similar to those seen in Pten ؉/؊ mice, and two of them exhibited invasive disease. Moreover, the frequency of loss of the wildtype Pten allele in the double-mutant mice at 14 to 18 weeks was similar to that seen in lesions from 40-week-old Pten ؉/؊ mice. Taken together, our results indicate that DNA mismatch repair deficiency can accelerate endometrial tumorigenesis in Pten heterozygous mice and suggests that loss of the wild-type Pten allele is involved in the development/progression of tumors in this setting. To date, the most common genetic alterations identified in uterine endometrioid carcinoma (UEC), the most prevalent type of endometrial cancer, are mutations in the PTEN tumor suppressor gene and the presence of a molecular phenotype called microsatellite instability (MI). PTEN mutations have been detected in 35 to 83% and MI in 20 to 45% of UECs. [1][2][3][4][5][6][7] In addition, both alterations have also been detected in complex atypical hyperplasia (CAH), the direct precursor of UEC. 5,8,9 Together these findings implicate an important and early role for PTEN mutations and DNA mismatch repair (MMR) deficiency, detected as MI, in the pathogenesis of UEC. Moreover, several studies have shown a statistically significant association between PTEN mutations and MI, 1-3,10,11 however the basis and consequence of this association remains unknown.In this and previous studies it has been shown that 100% of 32-week-old female mice lacking one wild-type copy of Pten spontaneously develop lesions that closely resemble CAH in humans. Of note, ϳ20 to 25% of mice at 40 weeks of age develop invasive carcinoma with morphological similarities to UEC. 12,13 To exploit this mouse model of endometrial tumorigenesis and to further our understanding of the association between Pten mutations and DNA MMR deficiency, we developed Pten ϩ/Ϫ / Mlh1 Ϫ/Ϫ double-mutant mice. Here we present data showing that DNA mismatch repair deficiency can accelerate endometrial tumorigenesis in Pten heterozygous mice and that it is associated with loss of the wild-type Pten allele.
Materials and Methods
MiceMale Pten hetero...