BRCA1和BRCA2在卵巢癌中的作用。
The contribution of BRCA1 and BRCA2 to ovarian cancer.
作者信息
Ramus Susan J, Gayther Simon A
机构信息
Gynaecological Cancer Research Laboratory, UCL EGA Institute for Women's Health, Paul O'Gorman Building, University College London, 72 Huntley Street, London, United Kingdom.
出版信息
Mol Oncol. 2009 Apr;3(2):138-50. doi: 10.1016/j.molonc.2009.02.001. Epub 2009 Feb 10.
Germline mutations of the BRCA1 and BRCA2 genes confer a high life-time risk of ovarian cancer. They represent the most significant and well characterised genetic risk factors so far identified for the disease. The frequency with which BRCA1/2 mutations occur in families containing multiple cases of ovarian cancer or breast and ovarian cancer, and in population-based ovarian cancer series varies geographically and between different ethnic groups. There are differences in the frequency of common mutations and in the presence of specific founder mutations in different populations. BRCA1 and BRCA2 are responsible for half of all families containing two or more ovarian cancer cases. In population-based studies, BRCA1 and BRCA2 mutations are present in 5-15% of all ovarian cancer cases. Often, individuals in which mutations are identified in unselected cases have no family history of either ovarian or breast cancer. The ability to identify BRCA1/2 mutations has been one of the few major success stories over the last few years in the clinical management of ovarian cancer. Currently, unaffected individuals can be screened for mutations if they have a family history of the disease. If a mutation is identified in the family, and if an individual is found be a mutation carrier, they can be offered clinical intervention strategies that can dramatically reduce their ovarian cancer risks. In some populations with frequent founder mutations screening may not be dependent on whether a mutation is identified in an affected relative.
BRCA1和BRCA2基因的种系突变会使卵巢癌终生发病风险升高。它们是目前已确定的该疾病最重要且特征明确的遗传风险因素。BRCA1/2突变在有多例卵巢癌或乳腺癌和卵巢癌病例的家族中,以及在基于人群的卵巢癌系列中的发生频率因地域和不同种族群体而异。不同人群中常见突变的频率以及特定始祖突变的存在情况存在差异。在所有有两例或更多例卵巢癌病例的家族中,BRCA1和BRCA2导致的占一半。在基于人群的研究中,所有卵巢癌病例中有5%-15%存在BRCA1和BRCA2突变。通常,在未经过选择的病例中检测到突变的个体并无卵巢癌或乳腺癌家族史。在过去几年卵巢癌的临床管理中,识别BRCA1/2突变的能力是少数几个重大成功案例之一。目前,如果未患病个体有该疾病的家族史,就可以对其进行突变筛查。如果在家族中检测到突变,并且发现某个个体是突变携带者,就可以为他们提供能够显著降低其卵巢癌风险的临床干预策略。在一些有频繁始祖突变的人群中,筛查可能不取决于在患病亲属中是否检测到突变。