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BRCA1 基因座杂合性缺失与乳腺癌的侵袭性和不良预后显著相关。

Loss of heterozygosity at BRCA1 locus is significantly associated with aggressiveness and poor prognosis in breast cancer.

机构信息

Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.

出版信息

Ann Surg Oncol. 2012 May;19(5):1499-507. doi: 10.1245/s10434-011-2166-5. Epub 2011 Dec 17.

Abstract

BACKGROUND

BRCA1 and BRCA2 are two major tumor suppressor genes for hereditary breast and ovarian cancer. In sporadic breast cancer, although somatic mutations of these genes are rare, loss of heterozygosity (LOH) at BRCA1 and BRCA2 loci is common.

METHODS

LOH at BRCA1 and BRCA2 loci were investigated in 202 Japanese invasive breast cancer patients. The relationships between LOH at these gene loci and clinicopathologic characteristics were analyzed.

RESULTS

Among 166 informative cases for both BRCA1 and BRCA2 loci, 69 (41.6%) and 52 (31.3%) tumors revealed LOH at BRCA1 and BRCA2 loci, respectively. LOH at BRCA1 LOH or BRCA2 locus was associated with higher nuclear grade (P < 0.0001, P = 0.0187). LOH at BRCA1 locus was associated with estrogen receptor and progesterone receptor negativity (P = 0.001 and P = 0.015) and significantly shorter disease-free survival (P < 0.0001), distant metastasis-free survival (P < 0.0001), and overall survival (P < 0.0001). In contrast, LOH at BRCA2 locus had no associations with estrogen receptor or progesterone receptor status and prognosis. LOH at BRCA1 locus was independently associated with poor prognosis in terms of disease-free survival (hazard ratio 3.08, 95% confidence interval [CI] 1.58-6.18, P = 0.0009), distant metastasis-free survival (hazard ratio 5.18, 95% CI 2.35-12.19, P < 0.0001), and overall survival (hazard ratio 4.97, 95% CI 1.84-15.1, P = 0.0013).

CONCLUSIONS

LOH at BRCA1 locus could be an independent prognostic biomarker useful in identifying a subgroup of patients with poor prognosis.

摘要

背景

BRCA1 和 BRCA2 是遗传性乳腺癌和卵巢癌的两个主要肿瘤抑制基因。在散发性乳腺癌中,尽管这些基因的体细胞突变很少见,但 BRCA1 和 BRCA2 基因座的杂合性丢失(LOH)很常见。

方法

在 202 例日本浸润性乳腺癌患者中研究了 BRCA1 和 BRCA2 基因座的 LOH。分析了这些基因座 LOH 与临床病理特征之间的关系。

结果

在 BRCA1 和 BRCA2 基因座均为信息性的 166 例病例中,分别有 69 例(41.6%)和 52 例(31.3%)肿瘤显示 BRCA1 和 BRCA2 基因座的 LOH。BRCA1 LOH 或 BRCA2 基因座的 LOH 与核分级较高相关(P<0.0001,P=0.0187)。BRCA1 基因座的 LOH 与雌激素受体和孕激素受体阴性相关(P=0.001 和 P=0.015),并且与无病生存期(P<0.0001)、无远处转移生存期(P<0.0001)和总生存期(P<0.0001)显著缩短相关。相比之下,BRCA2 基因座的 LOH 与雌激素受体或孕激素受体状态和预后无关。BRCA1 基因座的 LOH 是无病生存期(风险比 3.08,95%置信区间[CI]1.58-6.18,P=0.0009)、无远处转移生存期(风险比 5.18,95%CI2.35-12.19,P<0.0001)和总生存期(风险比 4.97,95%CI1.84-15.1,P=0.0013)的独立预后因素。

结论

BRCA1 基因座的 LOH 可能是一种独立的预后生物标志物,有助于识别预后不良的患者亚组。

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