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, Castro-Vega et al. 2015 , Favier et al. 2015 , Fishbein et al. 2017 , Fishbein & Wilkerson 2018 ). Tumors with gene mutations of SDH subunits fall into cluster 1, which is characterized by pseudohypoxic signaling and metabolism ( Eisenhofer et
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Department of Internal Medicine III, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Dresden, Germany
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-associated cluster 1 is subdivided into cluster 1A (Krebs cycle-related) and cluster 1B (hypoxia signaling related). Cluster 1-related mutations lead to hypoxia-inducible factor (HIF) 2α stabilization and accumulation which promote angiogenesis, tumor cell migration
Department of Laboratory Medicine, Department of Radiation Oncology, Department of Endocrinology, Division of Vascular Medicine, Department of Pathology, Department of Pathology, Department of Internal Medicine III, Department of Internal Medicine
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Department of Laboratory Medicine, Department of Radiation Oncology, Department of Endocrinology, Division of Vascular Medicine, Department of Pathology, Department of Pathology, Department of Internal Medicine III, Department of Internal Medicine
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). These ‘cluster 1’ tumors are distinct from ‘cluster 2’ tumors, which include RET - and NF1 -related and another subset of sporadic PGLs ( Dahia et al . 2005 ). This latter cluster is characterized by the deregulation of the RAS/RAF/MAP kinase
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/PGLs into cluster 1 and 2 within the neuroendocrine tumor (NET) grading classification system, as seen in the classification of gastroenteropancreatic (GEP) and bronchopulmonary (BP) tumors ( Favier et al. 2015 ). NETs of the GEP and BP systems have a
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studies showed a strong genotype–phenotype correlation in PPGLs ( Eisenhofer et al. 2011 , Crona et al. 2019 ). Tumors with pathogenic variants (PVs) in genes that lead to activation of hypoxia signaling pathways (cluster 1), such as genes encoding
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method ( Ma & Dai 2011 ). The expression data was reduced to three PCs that visualized three clusters ( Fig. 1 ). Cluster 1 contained 11 primary tumors; cluster 2 contained five LN metastases, and cluster 3 contained seven primary tumors, 12 LN metastases
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Department of Experimental Diabetology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
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German Consortium for Translational Cancer Research (DKTK), partner site Essen/Düsseldorf, Düsseldorf, Germany
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( Fishbein et al. 2017 , Fliedner et al. 2018 , Crona et al. 2019 ). PPGLs with activation of pseudohypoxic pathways (cluster-1) comprise those with mutations in genes encoding the von Hippel–Lindau ( VHL ) tumor suppressor, succinate dehydrogenase
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al. 2022 ). Based on gene expression profiling, three molecular subgroups of PPGL have been identified ( Fishbein et al. 2017 , Juhlin 2021 ). Cluster 1 tumors demonstrate a pseudohypoxia expression profile, exhibit a hypermethylation phenotype
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Cardiology Department, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
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SDHB and 1 MAX ) ( Fig. 1 ). Using gene expression profiling, PPGLs can be classified in two clusters: Cluster 1 (hypoxia cluster) containing SDHx -, FH - and VHL -related tumors, and Cluster 2 (kinase signaling cluster) including MAX- , NF1
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clusters characterized by distinct expression signatures ( Gimenez-Roqueplo et al. 2012 ). Cluster 1 (comprising mutations of SDHx , FH , VHL , or HIF2A ( EPAS1 )) presents a pseudo-hypoxia signature characterized by a switch from oxidative