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Racial Differences in Oncogene Mutations Detected in Early-Stage Low-Grade Endometrial Cancers
  1. Michele L. Cote, PhD*,,
  2. Govindaraja Atikukke, PhD,
  3. Julie J. Ruterbusch, MPH*,,
  4. Sara H. Olson, PhD,
  5. Shawnita Sealy-Jefferson, PhD§,
  6. Benjamin A. Rybicki, PhD,
  7. Sharon Hensley Alford, PhD,
  8. Mohammad A. Elshaikh, MD,
  9. Arthur R. Gaba, MD,
  10. Daniel Schultz, MD,
  11. Ramsi Haddad, PhD*,,,
  12. Adnan R. Munkarah, MD and
  13. Rouba Ali-Fehmi, MD*,
  1. *Barbara Ann Karmanos Cancer Institute, Detroit, MI;
  2. Department of Oncology, Wayne State University School of Medicine Detroit, MI;
  3. Memorial Sloan-Kettering Cancer Center, New York, NY;
  4. §University of Michigan School of Public Health, Ann Arbor, MI;
  5. Henry Ford Health System, Detroit, MI; and
  6. Results Genomics, Ontario, Canada.
  1. Address correspondence and reprint requests to Michele L. Cote, PhD, 4100 John R. Mailstop: MM04EP, Detroit, MI 48201. E-mail: cotem{at}


Objective To describe the pattern and frequency of oncogene mutations in white and African American women with endometrial cancer and to determine if racial differences in oncogene mutations exist among women with pathologically similar tumors.

Methods Patients with endometrial cancer from a large urban hospital were identified through medical records, and representative formalin-fixed paraffin-embedded tumor blocks were retrieved. The study sample included 150 patients (84 African Americans) who underwent total abdominal hysterectomy for endometrial cancer. The Sequenom MassARRAY system and the OncoCarta Assay version 1.0 (Sequenom) were used to test for 238 mutations in 19 common oncogenes. The χ2 test and the Fisher exact test were used to assess differences in distribution of variables by race and oncogene mutation status.

Results There were 20 mutations identified in 2 oncogenes (PIK3CA and KRAS) in tumors from 19 women (12.7%). Most of the mutations were found in PIK3CA (16/20). Thirteen percent of endometrioid tumors harbored mutations (11 PIK3CA and 2 KRAS) as did 29% of the malignant mixed Mullerian tumors (3 PIK3CA and 1 KRAS). There were no observed mutations in serous, clear cell, or mucinous tumor types. Among low-grade endometrioid cancers, tumors from African American patients were significantly associated with harboring either a KRAS or PIK3CA mutation (P = 0.04), with 7 PIK3CA mutations and all 4 KRAS mutations identified in African American women.

Conclusions This study provides preliminary evidence that oncogene mutation frequency of some subtypes of histologically similar endometrial carcinoma differ by race. Additional studies are needed to further explore this phenomenon in patients with endometrial carcinoma.

  • Endometrial cancer
  • Race
  • Oncogene mutation

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  • This work was funded in part by the Institute for Population Studies in Health Assessment, Administration, Services, and Economics.

  • The authors declare no conflicts of interest.