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对 1320 例神经系统肿瘤的 BRAF V600E 突变分析显示,在多形性黄色星形细胞瘤、神经节胶质瘤和脑外毛细胞星形细胞瘤中突变频率较高。

Analysis of BRAF V600E mutation in 1,320 nervous system tumors reveals high mutation frequencies in pleomorphic xanthoastrocytoma, ganglioglioma and extra-cerebellar pilocytic astrocytoma.

机构信息

Department of Neurosurgery, Medical Faculty of the Ruprecht-Karls-University Heidelberg, Mannheim, Germany.

出版信息

Acta Neuropathol. 2011 Mar;121(3):397-405. doi: 10.1007/s00401-011-0802-6. Epub 2011 Jan 29.

Abstract

Missense mutations of the V600E type constitute the vast majority of tumor-associated somatic alterations in the v-RAF murine sarcoma viral oncogene homolog B1 (BRAF) gene. Initially described in melanoma, colon and papillary thyroid carcinoma, these alterations have also been observed in primary nervous system tumors albeit at a low frequency. We analyzed exon 15 of BRAF spanning the V600 locus by direct sequencing in 1,320 adult and pediatric tumors of the nervous system including various types of glial, embryonal, neuronal and glioneuronal, meningeal, adenohypophyseal/sellar, and peripheral nervous system tumors. A total of 96 BRAF mutations were detected; 93 of the V600E type and 3 cases with a three base pair insertion between codons 599 and 600. The highest frequencies of BRAF (V600E) mutations were found in WHO grade II pleomorphic xanthoastrocytomas (42/64; 66%) and pleomorphic xanthoastrocytomas with anaplasia (15/23; 65%), as well as WHO grade I gangliogliomas (14/77; 18%), WHO grade III anaplastic gangliogliomas (3/6) and pilocytic astrocytomas (9/97; 9%). In pilocytic astrocytomas BRAF (V600E) mutation was strongly associated with extra-cerebellar location (p = 0.009) and was most frequent in diencephalic tumors (4/12; 33%). Glioblastomas and other gliomas were characterized by a low frequency or absence of mutations. No mutations were detected in non-glial tumors, including embryonal tumors, meningiomas, nerve sheath tumors and pituitary adenomas. The high mutation frequencies in pleomorphic xanthoastrocytomas, gangliogliomas and extra-cerebellar pilocytic astrocytomas implicate BRAF (V600E) mutation as a valuable diagnostic marker for these rare tumor entities. Future clinical trials should address whether BRAF (V600E) mutant brain tumor patients will benefit from BRAF (V600E)-directed targeted therapies.

摘要

V600E 型错义突变构成 v-RAF 鼠肉瘤病毒致癌基因同源物 B1(BRAF)基因中肿瘤相关体细胞改变的绝大多数。最初在黑色素瘤、结肠和甲状腺乳头状癌中描述,这些改变也在原发性神经系统肿瘤中观察到,尽管频率较低。我们通过直接测序分析了 BRAF 的外显子 15,跨越 V600 基因座,该分析包括各种类型的神经胶质、胚胎、神经元和神经胶质神经元、脑膜、腺垂体/垂体肿瘤和周围神经系统肿瘤,涉及 1320 例成人和儿童神经系统肿瘤。共检测到 96 个 BRAF 突变;93 个为 V600E 型,3 个为密码子 599 和 600 之间的三个碱基插入。BRAF(V600E)突变的最高频率见于 WHO 级 II 型多形性黄色星形细胞瘤(64/42;66%)和间变性多形性黄色星形细胞瘤(23/15;65%),以及 WHO 级 I 型神经节细胞瘤(77/14;18%)、WHO 级 III 级间变性神经节细胞瘤(6/3)和毛细胞星形细胞瘤(97/9;9%)。在毛细胞星形细胞瘤中,BRAF(V600E)突变与小脑外位置强烈相关(p=0.009),并且在间脑肿瘤中最为常见(12/4;33%)。胶质母细胞瘤和其他胶质瘤的突变频率较低或无突变。非神经胶质肿瘤中未检测到突变,包括胚胎肿瘤、脑膜瘤、神经鞘瘤和垂体腺瘤。多形性黄色星形细胞瘤、神经节细胞瘤和小脑外毛细胞星形细胞瘤中的高突变频率表明 BRAF(V600E)突变是这些罕见肿瘤实体的有价值的诊断标志物。未来的临床试验应探讨 BRAF(V600E)突变脑肿瘤患者是否会受益于 BRAF(V600E)定向靶向治疗。

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