Abstract

BackgroundEndometrial cancer (EMCA) is the fifth most common cancer among women in the world. Identification of potentially pathogenic germline variants from individuals with EMCA will help characterize genetic features that underlie the disease and potentially predispose individuals to its pathogenesis.MethodsThe Geisinger Health System’s (GHS) DiscovEHR cohort includes exome sequencing on over 50,000 consenting patients, 297 of whom have evidence of an EMCA diagnosis in their electronic health record. Here, rare variants were annotated as potentially pathogenic.ResultsEight genes were identified as having increased burden in the EMCA cohort relative to the non-cancer control cohort. None of the eight genes had an increased burden in the other hormone related cancer cohort from GHS, suggesting they can help characterize the underlying genetic variation that gives rise to EMCA. Comparing GHS to the cancer genome atlas (TCGA) EMCA germline data illustrated 34 genes with potentially pathogenic variation and eight unique potentially pathogenic variants that were present in both studies. Thus, similar germline variation among genes can be observed in unique EMCA cohorts and could help prioritize genes to investigate for future work.ConclusionIn summary, this systematic characterization of potentially pathogenic germline variants describes the genetic underpinnings of EMCA through the use of data from a single hospital system.

Highlights

  • Endometrial cancer (EMCA) is the fifth most common cancer among women in the world

  • ZFHX3 is a transcription factor, it acts as a tumor suppressor in multiple cancer types [68, 69]. Though these observations are consistent with a previous body of work which has found a connection between developmental processes and cancer [70], we found that rare variants in these genes may be acutely important for understanding EMCA

  • Binning potentially pathogenic variants from the DiscovEHR whole exome sequencing (WES) data into genes illustrated greater overlap between cohorts compared to looking at the overlap of loci

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Summary

Introduction

Endometrial cancer (EMCA) is the fifth most common cancer among women in the world. Type 1 is more common, and is characterized by endometrioid histology, is Miller et al BMC Medical Genomics (2019) 12:59 that represents an increased risk of colon cancer, but an increased risk of EMCA for women [8]. It is characterized by a mutation in one of a group of DNA mismatch repair genes (MSH1, MSH2, MLH6, PMS2 or EpCAM) [9, 10]. Not all families that meet clinical criteria for Lynch syndrome have an identifiable mutation in these genes [11]

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