Wilms tumors with
WT1 mutations [
WT1(–)] have a stromal-predominant histology with varying extents of rhabdomyogenesis. These tumors also frequently have mutations in the beta-catenin gene (
CTNNB1). We have investigated the molecular events that may explain the origins of rhabdomyogenesis in
WT1(–) tumors. Of 35 Wilms tumors, we identified 12 with
WT1 mutations, of which 9 carried
CTNNB1 mutations. We compared WT1 wild-type tumors [
WT1(+)] with
WT1(–) tumors for histological features, localization of beta-catenin, Bcl-2 expression, and apoptosis using an in-situ end-labeling technique.
WT1(+) tumors showed triphasic and blastemal- and epithelial predominant-histology. Expression of WT1, beta-catenin, and Bcl-2 recapitulated those of normal kidney epithelial development. Localization of beta-catenin was observed in the cytoplasm and cytoplasmic membrane of early glomerular epithelial structures. Bcl-2 is also expressed in condensing blastema and early glomerular epithelial structures which had little apoptosis.
WT1(–) tumors, regardless of whether
CTNNB1 mutations were detected or not, showed a stromal-rich phenotype with abundant expression of beta-catenin in the nucleus of the rhabdomyoblasts. Bcl-2 was expressed in rhabdomyoblasts, but not in blastemal cells undergoing apoptosis, suggesting that WT1 regulates Bcl-2 positively in the epithelial pathway, but negatively in the myogenic pathway. These data indicate that mutations in
WT1 might alter the Wnt signaling pathway and Bcl-2 related-apoptosis. In
WT1(–) tumors, the nuclear accumulation of beta-catenin and Bcl-2 expression are associated with rhabdomyogenesis, and dysregulation of Bcl-2 may be a mechanism by which the histogenesis (loss of blastemal component, muscle differentiation) may be explained.
Keywords Bcl-2 - beta-catenin - nephroblastoma - WT1