Novel PTCH1 and concurrent TP53 mutations in four patients with numerous non-syndromic basal cell carcinomas: The paradigm of oncogenic synergy

Exp Dermatol. 2022 May;31(5):736-742. doi: 10.1111/exd.14510. Epub 2021 Dec 17.

Abstract

There has been a significant increase in basal cell carcinoma (BCC) incidence, the most common cancer in humans and the age of presentation with the first diagnosis of BCC has decreased in past decades. In this study, we investigated the possibility of genetic markers that can lead to earlier and closer observation of patients at high risk for development of multiple BCCs. The overall goal is to decrease the morbidity and the economic burden of diagnosis and treatment of recurring and/or advanced BCCs. Four patients with numerous BCCs, some of them exceptionally large, were included in this study. A sample of representative BCCs, normal non-sun-exposed skin and blood samples were obtained from each patient. Whole-exome sequencing of DNA was conducted on all samples, and a series of bioinformatics filtering was performed to identify potentially pathogenic sequence variants. The analysis of the data resulted in detection of oncogenic mutations in PTCH1, two of which being novel, and concurrent mutations in TP53 in BCC tumours of all four patients. Such mutations may explain the numerous and postexcision recurring nature of the BCCs of exceptionally large size observed in all these patients, and they can be suggested to serve as a genetic marker for high-risk patients for early detection, prognostication and close follow-up.

Keywords: Patched 1 (PTCH1); Tumour protein P53 (TP53); basal cell carcinoma; concurrent mutations; whole-exome sequencing.

MeSH terms

  • Carcinogenesis
  • Carcinoma, Basal Cell* / genetics
  • Carcinoma, Basal Cell* / pathology
  • Humans
  • Mutation
  • Neoplasm Recurrence, Local
  • Patched-1 Receptor / genetics
  • Skin Neoplasms* / genetics
  • Skin Neoplasms* / pathology
  • Tumor Suppressor Protein p53 / genetics

Substances

  • PTCH1 protein, human
  • Patched-1 Receptor
  • TP53 protein, human
  • Tumor Suppressor Protein p53