Abstract. Somatic mitochondrial DNA (mtDNA) mutations have been found in a subset of endometrial cancers (EC) from different populations. We have investigated the relationship between mtDNA changes and clinical and pathological variables of women affected by EC. mtDNA mutations were detected both in early (3/32; 9%) and in advanced (1/8; 12%) stages of uterine tumors. However, patients carrying the mtDNA mutations or the normal mtDNA sequence had indistinguishable clinicopathological data, including age, clinical stage, histological grade and type or depth of myometrial invasion. It is noteworthy that mtDNA mutations were not detected in hyperplastic endometrial tissues or in ECs coexisting with hyperplasia, nor in a single case of endometrial stromal sarcoma. LOH at the tumor suppressor genes RB1 and TP53 as well as p16 INK4A alterations (LOH, gene deletion) were found in tumors carrying mtDNA mutations. These results suggest that somatic mtDNA mutations are detected in a subset of ECs, although they are unrelated to clinicopathological variables of cancer.
IntroductionEndometrial cancer is one of the most frequently occurring gynecological malignancies in the Western World, and its incidence has increased significantly during the last decade in Poland (1). In general, clinicopathological, immunohistochemical, biochemical and molecular genetic analyses have provided valuable information for dividing ECs into two different subtypes, estrogen-dependent (type I) and estrogenindependent (type II) (2-4). Factors associated with unopposed estrogenic stimulation and the presence of hyperplastic endometrial lesions (concomitant with neoplasia) are linked with the most common type of carcinoma, endometrioid-type I tumor (5-6). On the other hand, USC and clear cell carcinoma of the endometrium, which are not linked to estrogenic stimulation and are not associated with endometrial hyperplasia, are considered type II tumors (5,6). These sub-types differ not only in clinicoprognostical features but also in various molecular genetic alterations detected in oncogenes, tumor suppressor genes and mismatch-repair genes (5). For example, pRb1-cyclin D1-cdk4/6-p16 INK4A pathway alterations were described in endometrioid-type ECs whereas they were uncommon in USCs in humans (7).Mitochondria play important roles in cell homeostasis, actively participating in energy metabolism, generation of reactive oxygen species, aging and initiation of programmed cell death (8,9). Mitochondrial failure has been described at all levels of structure and function, including abnormal ultrastructure, metabolic deregulation and genetic alterations (10). In general, mtDNA point mutations, gene deletions and mtMSI have been reported in human neoplasms and cell lines, but the frequency of these alterations differs in various tumors (11-13). The most well-known disorders caused by mtDNA mutations are LHON (Leber's Hereditary Optic Neuropathy), MELAS (Mitochondrial Encephalopathy, Lactic Acidosis and Stroke-like episodes), MERRF (Myoclonic Epilepsy with Rag...