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中枢神经系统肿瘤中 BRAF(V600E) 突变的分析。

Analysis of the BRAF(V600E) Mutation in Central Nervous System Tumors.

机构信息

Department of Pathology, Seoul National University Hospital, College of Medicine, Seoul, Republic of Korea.

出版信息

Transl Oncol. 2012 Dec;5(6):430-6. doi: 10.1593/tlo.12328. Epub 2012 Dec 1.

Abstract

BRAF(V600E) mutations are involved in the development of melanoma, colon cancer, and papillary thyroid carcinoma. These mutations are also found in primary brain tumors at low to moderate frequencies. In this study, we investigated a series of brain tumors to determine the prevalence and associated clinicopathologic features of BRAF(V600E) mutations. By direct sequencing, we analyzed 223 brain tumors, including 51 gangliogliomas (GGs), 45 pilocytic astrocytomas (PAs), 12 pleomorphic xanthoastrocytomas (PXAs), 35 glioblastomas (GBs), 28 anaplastic astrocytomas (AAs), 44 oligodendroglial tumors (ODGs), 3 anaplastic oligoastrocytomas, and 5 diffuse astrocytomas. Thirty-six cases (16.1%) exhibited the BRAF(V600E) mutation, including 66.7% of PXAs, 23.5% of GGs, 15.6% of PAs, and 9.7% of the malignant gliomas; the latter included 14.3% of AAs, 8.6% of GBs, and 4.5% of ODGs. Copy number aberration at the 7q34 (BRAF) locus was found in 73.1% of PAs and 50% of PXAs. 9p Homozygous deletion was found in 66.7% of PXAs, but it was not correlated with the BRAF(V600E) mutation. Patients' age, sex, histologic grade, and progression-free survival were also not correlated with the BRAF(V600E) mutation. The BRAF(V600E) mutation in brain tumors did not have prognostic value but is certainly a diagnostic marker and therapeutic target, not only for pediatric low-grade gliomas but also for malignant gliomas, even though the rate of mutation was not high. These results should be verified in a larger study with more cases and a longer follow-up period to overcome the limitation of small sample size.

摘要

BRAF(V600E) 突变参与黑色素瘤、结肠癌和甲状腺乳头状癌的发生。这些突变也以低至中等频率存在于原发性脑肿瘤中。在这项研究中,我们研究了一系列脑肿瘤,以确定 BRAF(V600E) 突变的流行率及其相关的临床病理特征。通过直接测序,我们分析了 223 例脑肿瘤,包括 51 例神经节胶质瘤 (GGs)、45 例毛细胞星形细胞瘤 (PAs)、12 例多形性黄色星形细胞瘤 (PXAs)、35 例胶质母细胞瘤 (GBs)、28 例间变性星形细胞瘤 (AAs)、44 例少突胶质细胞瘤 (ODGs)、3 例间变性少突星形细胞瘤和 5 例弥漫性星形细胞瘤。36 例 (16.1%) 表现出 BRAF(V600E) 突变,包括 66.7%的 PXAs、23.5%的 GGs、15.6%的 PAs 和 9.7%的恶性胶质瘤;后者包括 14.3%的 AAs、8.6%的 GBs 和 4.5%的 ODGs。7q34 (BRAF) 位点的拷贝数缺失在 73.1%的 PAs 和 50%的 PXAs 中发现。9p 纯合性缺失在 66.7%的 PXAs 中发现,但与 BRAF(V600E) 突变无关。患者的年龄、性别、组织学分级和无进展生存期与 BRAF(V600E) 突变也无关。BRAF(V600E) 突变在脑肿瘤中没有预后价值,但肯定是一个诊断标志物和治疗靶点,不仅对儿童低级别胶质瘤,而且对恶性胶质瘤,尽管突变率不高。这些结果应该在更大的研究中通过更多的病例和更长的随访时间来验证,以克服小样本量的限制。

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