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上皮性卵巢癌的肿瘤内基因异质性及其对肿瘤分子诊断的意义。

Genetic intra-tumour heterogeneity in epithelial ovarian cancer and its implications for molecular diagnosis of tumours.

作者信息

Khalique L, Ayhan A, Weale M E, Jacobs I J, Ramus S J, Gayther S A

机构信息

Translational Research Laboratory, Department of Gynaecological Oncology, Institute for Women's Health, University College London, UK.

出版信息

J Pathol. 2007 Feb;211(3):286-95. doi: 10.1002/path.2112.

Abstract

Genetic analysis of solid tumours using DNA or cDNA expression microarrays may enable individualized treatment based on the profiles of genetic changes that are identified from each patient. This could result in better response to adjuvant chemotherapy and, consequently, improved clinical outcome. So far, most research studies that have tested the efficacy of such an approach have sampled only single areas of neoplastic tissue from tumours; this assumes that the genetic profile within solid tumours is homogeneous throughout. The aim of this study was to evaluate the extent of genetic intra-tumour heterogeneity (ITH) within a series of epithelial ovarian cancers. Several different regions (five to eight regions) of tumour tissue from 16 grade 3, serous epithelial ovarian cancers were analysed for genetic alterations using a combination of microsatellite analysis and single nucleotide polymorphism (SNP) analysis, in order to establish the extent of ITH. Maximum parsimony tree analysis was applied to the genetic data from each tumour to evaluate the clonal relationship between different regions within tumours. Extensive ITH was identified within all ovarian cancers using both microsatellite and SNP analysis. Evolutionary analysis of microsatellite data suggested that the origin of all tumours was monoclonal, but that subsequent clonal divergence created mixed populations of genetically distinct cells within the tumour. SNP analysis suggested that ITH was not restricted to random genetic changes, but affected genes that have an important functional role in ovarian cancer development. The frequent occurrence of ITH within epithelial ovarian cancers may have implications for the interpretation of genetic data generated from emerging technologies such as DNA and mRNA expression microarrays, and their use in the clinical management of patients with ovarian cancer. The basis of genetic ITH and the possible implications for molecular approaches to clinical diagnosis of ovarian cancers may apply to other tumour types.

摘要

使用DNA或cDNA表达微阵列对实体瘤进行基因分析,可能有助于根据每个患者所识别出的基因变化图谱进行个体化治疗。这可能会使患者对辅助化疗产生更好的反应,从而改善临床结局。到目前为止,大多数检验这种方法疗效的研究仅从肿瘤的单个肿瘤组织区域取样;这假定实体瘤内的基因图谱在整个肿瘤中是均匀一致的。本研究的目的是评估一系列上皮性卵巢癌内肿瘤基因异质性(ITH)的程度。使用微卫星分析和单核苷酸多态性(SNP)分析相结合的方法,对16例3级浆液性上皮性卵巢癌的肿瘤组织的几个不同区域(5至8个区域)进行基因改变分析,以确定ITH的程度。对每个肿瘤的基因数据应用最大简约树分析,以评估肿瘤内不同区域之间的克隆关系。使用微卫星和SNP分析在所有卵巢癌中均发现了广泛的ITH。微卫星数据的进化分析表明,所有肿瘤均起源于单克隆,但随后的克隆分歧在肿瘤内产生了基因不同的细胞混合群体。SNP分析表明,ITH不仅限于随机的基因变化,还影响在卵巢癌发生中具有重要功能作用的基因。上皮性卵巢癌中ITH的频繁出现可能对从DNA和mRNA表达微阵列等新兴技术产生的基因数据的解释及其在卵巢癌患者临床管理中的应用产生影响。基因ITH的基础以及对卵巢癌临床诊断分子方法的可能影响可能适用于其他肿瘤类型。

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