Intravenous leiomyomatosis is inclined to a solid entity different from uterine leiomyoma based on RNA-seq analysis with RT-qPCR validation

Cancer Med. 2020 Jul;9(13):4581-4592. doi: 10.1002/cam4.3098. Epub 2020 May 5.

Abstract

Introduction: Intravenous leiomyomatosis (IVL) is currently regarded as a special variant of the common uterine leiomyoma (LM). Though IVL shows a similar histological morphology to LM, IVL is characterized by unique intravenous growth patterns and low-grade malignant potential, which are quite different from LM. There are currently few studies underlying the molecular alterations of IVL, though this information is important for understanding the pathogenesis of the disease, and for identifying potential biomarkers.

Method: We carried out a high-throughput whole transcriptome sequencing of tumor and normal tissue samples from five IVL patients and five LM patients and compared the differentially expressed genes (DEGs) between IVL and leiomyoma. We performed multiple different enrichment and target analyses, and the expression of selected DEGs was validated using RT-qPCR in formalin-fixed samples.

Results: Our study identified substantial different genes and pathways between IVL and LM, and functional enrichment analyses found several important pathways, such as angiogenesis and antiapoptosis pathways, as well as important related genes, including SH2D2A, VASH2, ADAM8, GATA2, TNF, and the lncRNA GATA6-AS1, as being significantly different between IVL and LM (P = .0024, P = .0195, P = .0212, P = .0435, P = .0401, and P = .0246, respectively). CXCL8, LIF, CDKN2A, BCL2A1, COL2A1, IGF1, and HMGA2 were also differently expressed between IVL and LM groups, but showed no statistical difference (P = .2409, P = .1773, P = .0596, P = .2737, P = .1553, P = .1045, and P = .1847, respectively) due to the large differences among individuals. Furthermore, RT-qPCR results for five selected DEGs in IVL tissues and adjacent nontumor tissues were mainly consistent with our sequencing results.

Conclusion: Our results indicated that IVL may be a solid entity that is unique and different from LM, proving consistent with previous studies. Furthermore, we identified DEGs, particularly within angiogenesis and antiapoptosis pathway-related genes that may play crucial roles in the development and pathogenesis of IVL and may be potential specific biomarkers.

Keywords: angiogenesis; differentially expressed genes; high-throughput whole transcriptome resequencing; intravenous leiomyomatosis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Apoptosis / genetics
  • Case-Control Studies
  • Exome Sequencing
  • Female
  • Humans
  • Immunohistochemistry
  • Leiomyomatosis / blood supply
  • Leiomyomatosis / diagnostic imaging
  • Leiomyomatosis / genetics*
  • Leiomyomatosis / pathology
  • Middle Aged
  • Neovascularization, Pathologic / genetics
  • RNA-Seq / methods*
  • Reverse Transcriptase Polymerase Chain Reaction*
  • Uterine Neoplasms / blood supply
  • Uterine Neoplasms / diagnostic imaging
  • Uterine Neoplasms / genetics*
  • Uterine Neoplasms / pathology
  • Vascular Neoplasms / blood supply
  • Vascular Neoplasms / diagnostic imaging
  • Vascular Neoplasms / genetics*
  • Vascular Neoplasms / pathology