Gynecologic Oncology Unit, Department of Obstetrics and Gynecology, Meir Medical Center, Kfar Saba, Israel.
Int J Gynecol Cancer. 2010 Oct;20(7):1148-53. doi: 10.1111/IGC.0b013e3181ef622d.
Whether and to what extent germline mutations in the BRCA1 and BRCA2 genes increase the risk for developing uterine serous carcinoma (USC) remain controversial. We assessed the rate of the 3 predominant BRCA1/2 mutations in Jewish patients with USC and the relevance of carrier status to clinicopathological features and survival.
Jewish patients with histologically confirmed USC diagnosed between April 1997 and December 2007 were genotyped for the 3 predominant BRCA1 (185delAG and 5382insC) and BRCA2 (6174delT) mutations. Clinical characteristics were abstracted from the patients' medical records. The Kaplan-Meier method and log-rank tests were used for survival analyses.
Overall, 8 (25.8%) of 31 Jewish patients with USC who participated in the study were mutation carriers: 4 were BRCA2 (6174delT) carriers and 2 each carried the BRCA1 mutations (185delAG and 5382insC). The median ages of the carriers and the noncarriers were 66 and 74 years, respectively (P = 0.124). Four (50%) of the mutation carriers and 2 (8%) of the noncarriers had a family history of breast-ovarian cancer (P = 0.026). With a median follow-up of 76 months, the overall median survival time was 25 months. No significant differences in the median survival time, 2-year survival, or progression-free survival were noted between the mutation carriers and the noncarriers.
The high rate of the predominant BRCA1/2 mutations in unselected Jewish USC patients, if confirmed by future studies, suggests that USC could be considered an expression of the hereditary breast-ovarian cancer syndrome.
BRCA1 和 BRCA2 基因种系突变是否以及在何种程度上增加了发生子宫浆液性癌(USC)的风险仍存在争议。我们评估了犹太裔 USC 患者中 3 种主要 BRCA1/2 突变的发生率,以及携带者状态与临床病理特征和生存的相关性。
对 1997 年 4 月至 2007 年 12 月间经组织学确诊的犹太裔 USC 患者进行了 3 种主要 BRCA1(185delAG 和 5382insC)和 BRCA2(6174delT)突变的基因分型。从患者的病历中提取临床特征。采用 Kaplan-Meier 方法和对数秩检验进行生存分析。
在参加研究的 31 名犹太裔 USC 患者中,共有 8 名(25.8%)为突变携带者:4 名为 BRCA2(6174delT)携带者,2 名各携带 BRCA1 突变(185delAG 和 5382insC)。携带者和非携带者的中位年龄分别为 66 岁和 74 岁(P = 0.124)。4 名(50%)突变携带者和 2 名(8%)非携带者有乳腺癌-卵巢癌家族史(P = 0.026)。中位随访 76 个月时,总中位生存时间为 25 个月。携带者和非携带者的中位生存时间、2 年生存率或无进展生存率均无显著差异。
未选择的犹太裔 USC 患者中主要 BRCA1/2 突变的高发生率,如果在未来的研究中得到证实,表明 USC 可能被认为是遗传性乳腺癌-卵巢癌综合征的表现。