title: TERT promoter hotspot mutations are recurrent in myxoid liposarcomas but rare in other soft tissue sarcoma entities.
abstract: BACKGROUND
  Recently, recurrent point mutations in the telomerase reverse transcriptase (TERT) promoter region have been found in many human cancers, leading to a new transcription factor binding site, increased induction of TERT and subsequently to telomere maintenance. We determined the prevalence of TERT promoter mutations in soft tissue sarcomas of 341 patients comprising 16 entities and in 16 sarcoma cell lines covering 7 different soft tissue sarcoma types.
  
  
  METHODS
  The sarcoma tissue samples were collected from the archives of the Institute of Pathology, University of Heidelberg and were composed of 39 myxoid liposarcomas (MLS), 61 dedifferentiated liposarcomas, 15 pleomorphic liposarcomas, 27 leiomyosarcomas, 25 synovial sarcomas (SS), 35 malignant peripheral nerve sheath tumors (MPNST), 40 undifferentiated pleomorphic sarcomas, 17 myxofibrosarcomas, 9 low grade fibromyxoid sarcomas, 10 cases of dermatofibrosarcoma protuberans, 31 solitary fibrous tumors (SFT), 8 extraskeletal myxoid chondrosarcomas, 9 angiosarcomas, 6 alveolar soft part sarcomas, 5 clear cell sarcomas and 4 epithelioid sarcomas. Sarcoma cell lines were obtained from the raising laboratories. A 193 bp fragment of the TERT promoter region covering the hot-spot mutations C228T and C250T was amplified, and direct sequencing of the PCR products was performed.
  
  
  RESULTS
  TERT promoter mutations were detected in 36/341 sarcomas. They were highly recurrent in MLS (29/39; 74%) and were in the present MLS series not associated with the phenotype (myxoid vs. round cell variant), tumor grade, tumor site and patients' median age or gender. In the remaining cases, TERT promoter mutations were found only in 7/302 sarcoma samples and confined to SFTs (4/31; 13%), MPNSTs (2/35; 6%), and SSs (1/25; 4%). Within the collection of sarcoma cell lines examined, TERT promoter mutations were detected in two MLS and in one of three MPNST cell lines.
  
  
  CONCLUSIONS
  TERT promoter mutations are frequent in MLSs including their round cell variants, representing the most prevalent mutation identified in this sarcoma entity to date, and in a minor fraction of SFTs, MPNSTs and SSs. The majority of sarcomas are devoid of TERT promoter hotspot mutations. These data suggest that telomere maintenance through increased expression of telomerase plays an important role in the pathogenesis especially of MLS.
authors.forename: Christian
authors.initials: C
authors.lastname: Koelsche
authors.forename: Marcus
authors.initials: M
authors.lastname: Renner
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Hartmann
authors.forename: Regine
authors.initials: R
authors.lastname: Brandt
authors.forename: Burkhard
authors.initials: B
authors.lastname: Lehner
authors.forename: Nina
authors.initials: N
authors.lastname: Waldburger
authors.forename: Ingo
authors.initials: I
authors.lastname: Alldinger
authors.forename: Thomas
authors.initials: T
authors.lastname: Schmitt
authors.forename: Gerlinde
authors.initials: G
authors.lastname: Egerer
authors.forename: Roland
authors.initials: R
authors.lastname: Penzel
authors.forename: Eva
authors.initials: E
authors.lastname: Wardelmann
authors.forename: Peter
authors.initials: P
authors.lastname: Schirmacher
authors.forename: Andreas
authors.initials: A
authors.lastname: von Deimling
authors.affiliation: Department of General Pathology, Institute of Pathology, University Hospital, Im Neuenheimer Feld 224, Heidelberg D-69120, Germany. gunhild.mechtersheimer@med.uni-heidelberg.de.
authors.forename: Gunhild
authors.initials: G
authors.lastname: Mechtersheimer
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001483:Base Sequence; D005260:Female; D056726:Genetic Association Studies; D006801:Humans; D018208:Liposarcoma, Myxoid / Q000201:enzymology / Q000235:genetics*; D008297:Male; D008875:Middle Aged; D017354:Point Mutation; D011401:Promoter Regions, Genetic; D017422:Sequence Analysis, DNA; D012983:Soft Tissue Neoplasms / Q000235:genetics*; D019098:Telomerase / Q000235:genetics*; D059505:Telomere Homeostasis; D055815:Young Adult
chemical_list: C509186:TERT protein, human; D019098:Telomerase
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