Fred A Litwin Centre for Cancer Genetics, Samuel Lunenfeld Research Institute, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada.
J Mol Diagn. 2012 Sep;14(5):467-75. doi: 10.1016/j.jmoldx.2012.03.006. Epub 2012 Aug 6.
Individuals and families carrying mutations in BRCA1 and BRCA2 (BRCA1/2) have a markedly elevated risk of developing breast and ovarian cancers. The first-generation of BRCA1/2 mutation analysis targeted only the coding exons and has implicated protein-truncating mutations (indel, nonsense) in BRCA1/2 inactivation. Recently, heritable breast cancers have also been attributed to other exonic mutations (missense, silent) and mutations in introns and untranslated regions. However, analysis of these alterations has been prohibitively laborious and cost intensive, and the proportion of cases carrying mutations in unscreened regions of BRCA1/2 and other predisposition genes is unknown. We have developed and validated a next-generation sequencing (NGS) approach for BRCA1/2 mutation analysis by applying long-range PCR and deep sequencing. Genomic DNA from familial breast cancer patients (N = 12) were screened and NGS successfully identified all 19 distinct (51 total) BRCA1 and 35 distinct (63 total) BRCA2 sequence alterations detectable by the Sanger sequencing, with no false-negative or positive results. In addition, we report the robust detection of variants from introns and untranslated regions. These results illustrate that NGS can provide comprehensive genetic information more quickly, accurately, and at a lower cost than conventional approaches, and we propose NGS to be a more effective method for BRCA1/2 mutational analysis. Advances in NGS will play an important role in enabling molecular diagnostics and personalized treatment of breast and ovarian cancers.
个体和家族携带有 BRCA1 和 BRCA2(BRCA1/2)基因突变,显著增加了罹患乳腺癌和卵巢癌的风险。第一代 BRCA1/2 基因突变分析仅针对编码外显子,并且已经证实 BRCA1/2 失活与蛋白截断突变(缺失、无义)有关。最近,遗传性乳腺癌也归因于其他外显子突变(错义、沉默)以及内含子和非翻译区的突变。然而,对这些改变的分析非常繁琐且成本高昂,并且未知 BRCA1/2 和其他易感性基因未筛选区域携带突变的病例比例。我们已经开发并验证了一种应用长距离 PCR 和深度测序的用于 BRCA1/2 基因突变分析的下一代测序(NGS)方法。对家族性乳腺癌患者(N=12)的基因组 DNA 进行了筛选,NGS 成功地鉴定了所有 19 个不同的(51 个总)BRCA1 和 35 个不同的(63 个总)BRCA2 序列改变,Sanger 测序可检测到这些改变,没有假阴性或阳性结果。此外,我们还报告了来自内含子和非翻译区的变体的稳健检测。这些结果表明,NGS 可以比传统方法更快、更准确、更经济地提供全面的遗传信息,我们提出 NGS 是一种更有效的 BRCA1/2 突变分析方法。NGS 的进步将在促进乳腺癌和卵巢癌的分子诊断和个性化治疗方面发挥重要作用。