title: Genetic alterations and their relationship in the phosphatidylinositol 3-kinase/Akt pathway in thyroid cancer.
abstract: OBJECTIVE
  To investigate the overall occurrence and relationship of genetic alterations in the phosphatidylinositol 3-kinase (PI3K)/Akt pathway in thyroid tumors and explore the scope of this pathway as a therapeutic target for thyroid cancer.
  
  
  METHODS
  We examined collectively the major genetic alterations and their relationship in this pathway, including PIK3CA copy number gain and mutation, Ras mutation, and PTEN mutation, in a large series of primary thyroid tumors.
  
  
  RESULTS
  Occurrence of any of these genetic alterations was found in 25 of 81 (31%) benign thyroid adenoma (BTA), 47 of 86 (55%) follicular thyroid cancer (FTC), 21 of 86 (24%) papillary thyroid cancer (PTC), and 29 of 50 (58%) anaplastic thyroid cancer (ATC), with FTC and ATC most frequently harboring these genetic alterations. PIK3CA copy gain was associated with increased PIK3CA protein expression. A mutual exclusivity among these genetic alterations was seen in BTA, FTC, and PTC, suggesting an independent role of each of them through the PI3K/Akt pathway in the tumorigenesis of the differentiated thyroid tumors. However, coexistence of these genetic alterations was increasingly seen with progression from differentiated tumor to undifferentiated ATC. Their coexistence with BRAF mutation was also frequent in PTC and ATC.
  
  
  CONCLUSIONS
  The data provide strong genetic implication that aberrant activation of PI3K/Akt pathway plays an extensive role in thyroid tumorigenesis, particularly in FTC and ATC, and promotes progression of BTA to FTC and to ATC as the genetic alterations of this pathway accumulate. Progression of PTC to ATC may be facilitated by coexistence of PI3K/Akt pathway-related genetic alterations and BRAF mutation. The PI3K/Akt pathway may thus be a major therapeutic target in thyroid cancers.
authors.affiliation: Division of Endocrinology and Metabolism, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287, USA.
authors.forename: Peng
authors.initials: P
authors.lastname: Hou
authors.forename: Dingxie
authors.initials: D
authors.lastname: Liu
authors.forename: Yuan
authors.initials: Y
authors.lastname: Shan
authors.forename: Shuiying
authors.initials: S
authors.lastname: Hu
authors.forename: Kimberley
authors.initials: K
authors.lastname: Studeman
authors.forename: Stephen
authors.initials: S
authors.lastname: Condouris
authors.forename: Yangang
authors.initials: Y
authors.lastname: Wang
authors.forename: Ariel
authors.initials: A
authors.lastname: Trink
authors.forename: Adel K
authors.initials: AK
authors.lastname: El-Naggar
authors.forename: Giovanni
authors.initials: G
authors.lastname: Tallini
authors.forename: Vasily
authors.initials: V
authors.lastname: Vasko
authors.forename: Mingzhao
authors.initials: M
authors.lastname: Xing
mesh_terms: D019943:Amino Acid Substitution; D001483:Base Sequence; D058534:Class I Phosphatidylinositol 3-Kinases; D018628:Gene Dosage; D011905:Genes, ras; D006801:Humans; D009154:Mutation; D051058:Oncogene Protein v-akt / Q000235:genetics* / Q000378:metabolism; D051059:PTEN Phosphohydrolase / Q000235:genetics; D019869:Phosphatidylinositol 3-Kinases / Q000235:genetics* / Q000378:metabolism; D015398:Signal Transduction / Q000235:genetics; D013964:Thyroid Neoplasms / Q000201:enzymology* / Q000235:genetics*
chemical_list: D019869:Phosphatidylinositol 3-Kinases; D058534:Class I Phosphatidylinositol 3-Kinases; C484760:PIK3CA protein, human; D051058:Oncogene Protein v-akt; D051059:PTEN Phosphohydrolase; C494929:PTEN protein, human