[1891] Assessment of CGH-Array Usefulness in Metachronous Tumors

Francois Le Loarer, Pauline Lagarde, Agnes Neuville, Jean Michel Coindre, Frederic Chibon. Rouen University Hospital, Rouen, France; Institut Bergonié, Bordeaux, France

Background: Poorly differentiated metachronous tumors challenge pathologists ability to distinguish confidently a recurrence of the first tumor from a distinct tumor event. Traditional approach is based upon conventional morphology supplemented by immunohistochemistry. The use of molecular tools on a routine basis has long been hindered by the requirement of frozen material. CGH-array protocols have been recently adapted to comply with formalin-fixed paraffin-embedded (FFPE) material. We assessed CGH array technical feasability and diagnostic utility in a series of metachronous tumors.
Design: We selected seven consecutive cases of metachronous malignancies submitted for expert review from December 2010 to April 2011. In all cases, the second event was a poorly differentiated sarcomatoid malignant tumor. CGH-array was performed on Agilent platform with 60k oligo-array. The molecular biologist compared blindly the genomic profiles of couples of metachronous tumors to render a diagnosis of recurrence of the first tumor or distinct tumor events.
Results: Two out of seven cases provided poor quality genomic DNA precluding confident CGH analysis. Technical limitations were due to cellularity of one specimen and poor quality fixation step in the other one. Apart these limitations, we reached high quality CGH-array analysis equivalent to frozen sample-based analysis. Genomic-based diagnoses were in accordance with morphology in three cases out of five and contradicted morphology in one case. No definitive genomic diagnosis could be rendered in one case.

Cases review
Gender - Age*Primary siteDate of primaryDiagnosis of primarySecond siteHistologic diagnosisGenomic analysis
female 63maxilla2010sarcomatoid carcinomaadrenal glandmetastasissame tumor
male 56kidney2000clear cell carcinomamaxillapleomorphic sarcomadistinct tumor
male 70tongue2004squamous carcinomagengivarecurrence of carcinomadistinct tumor
female 61meninges2007meningiomaadrenal glandmetastasissame tumor
male 69cervical lymph node2008squamous carcinomabreastmetastasisNA
female 68kidney2008papillary carcinomahumerusmetastasisNA
male 76kidney2007papillary carcinomalivermetastasisuncertain
* age at the primary

Conclusions: According to our results, CGH-array can be fully applied to FFPE material. The technical caveats we met were due to fixation step and cellularity of the sample, emphasizing the need for pre-analytic step standardization. A larger scale use of CGH-array would require further reflection upon the appropriate manner to analyse genomic profiles. We are committed to assess this issue on a larger series.
Category: Special Category - Pan-genomic/Pan-proteomic approaches to Cancer

Tuesday, March 20, 2012 9:30 AM

Poster Session III # 280, Tuesday Morning


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