title: A systematic study of gene mutations in urothelial carcinoma; inactivating mutations in TSC2 and PIK3R1.
abstract: BACKGROUND
  Urothelial carcinoma (UC) is characterized by frequent gene mutations of which activating mutations in FGFR3 are the most frequent. Several downstream targets of FGFR3 are also mutated in UC, e.g., PIK3CA, AKT1, and RAS. Most mutation studies of UCs have been focused on single or a few genes at the time or been performed on small sample series. This has limited the possibility to investigate co-occurrence of mutations.
  
  
  RESULTS
  We performed mutation analyses of 16 genes, FGFR3, PIK3CA, PIK3R1 PTEN, AKT1, KRAS, HRAS, NRAS, BRAF, ARAF, RAF1, TSC1, TSC2, APC, CTNNB1, and TP53, in 145 cases of UC. We show that FGFR3 and PIK3CA mutations are positively associated. In addition, we identified PIK3R1 as a target for mutations. We demonstrate a negative association at borderline significance between FGFR3 and RAS mutations, and show that these mutations are not strictly mutually exclusive. We show that mutations in BRAF, ARAF, RAF1 rarely occurs in UC. Our data emphasize the possible importance of APC signaling as 6% of the investigated tumors either showed inactivating APC or activating CTNNB1 mutations. TSC1, as well as TSC2, that constitute the mTOR regulatory tuberous sclerosis complex were found to be mutated at a combined frequency of 15%.
  
  
  CONCLUSIONS
  Our data demonstrate a significant association between FGFR3 and PIK3CA mutations in UC. Moreover, the identification of mutations in PIK3R1 further emphasizes the importance of the PI3-kinase pathway in UC. The presence of TSC2 mutations, in addition to TSC1 mutations, underlines the involvement of mTOR signaling in UC.
authors.affiliation: Department of Clinical Sciences, Oncology, Lund University, Skåne University Hospital, Lund, Sweden.
authors.forename: Gottfrid
authors.initials: G
authors.lastname: Sjödahl
authors.forename: Martin
authors.initials: M
authors.lastname: Lauss
authors.forename: Sigurdur
authors.initials: S
authors.lastname: Gudjonsson
authors.forename: Fredrik
authors.initials: F
authors.lastname: Liedberg
authors.forename: Christer
authors.initials: C
authors.lastname: Halldén
authors.forename: Gunilla
authors.initials: G
authors.lastname: Chebil
authors.forename: Wiking
authors.initials: W
authors.lastname: Månsson
authors.forename: Mattias
authors.initials: M
authors.lastname: Höglund
authors.forename: David
authors.initials: D
authors.lastname: Lindgren
mesh_terms: D006801:Humans; D009154:Mutation; D019869:Phosphatidylinositol 3-Kinases / Q000235:genetics*; D000077005:Tuberous Sclerosis Complex 2 Protein; D025521:Tumor Suppressor Proteins / Q000235:genetics*; D001749:Urinary Bladder Neoplasms / Q000235:genetics*
chemical_list: C000624653:TSC2 protein, human; D000077005:Tuberous Sclerosis Complex 2 Protein; D025521:Tumor Suppressor Proteins; D019869:Phosphatidylinositol 3-Kinases