Chevrier Sandy, Arnould Laurent, Ghiringhelli François, Coudert Bruno, Fumoleau Pierre, Boidot Romain
Department of Biology and Pathology of Tumors, Centre Georges-François Leclerc, 21079 Dijon, France.
Department of Medical Oncology, Centre Georges-François Leclerc, 21079 Dijon, France.
Int J Oncol. 2014 Sep;45(3):1167-74. doi: 10.3892/ijo.2014.2528. Epub 2014 Jun 27.
The development of targeted therapies in cancer has accelerated the development of molecular diagnosis. This new cancer discipline is booming, with an increasing number of gene alterations to analyze in a growing number of patients. To deal with this fast-developing activity, current analysis techniques (Sanger sequencing, allelic discrimination and high resolution melting) take more and more time. In recent years, next generation sequencing (NGS) technologies have appeared and given new perspectives in oncology. In this study, we analyzed FFPE lung and colon carcinomas using the Truseq Cancer Panel, which analyzes the mutation hotspots of 48 genes. We also tested the use of whole-genome amplification before NGS analysis. NGS results were compared with the data obtained from routine diagnosis. All of the alterations routinely observed were identified by NGS. Moreover, NGS revealed mutations in the KRAS and EGFR genes in patients diagnosed as wild-type by routine techniques. NGS also identified concomitant mutations in EGFR and KRAS or BRAF mutations, and a 15-nt deletion in exon 19 of EGFR in colon carcinomas. The study of the other genes sequenced in the Panel revealed 14 genes altered by 27 different mutations and three SNP with a possible role in cancer susceptibility or in the response to treatment. In conclusion, this study showed that NGS analysis could be used for the analysis of gDNA extracted from FFPE tissues. However, given the high sensitivity of this technology, high-throughput clinical trials are needed to confirm its reliability for the molecular diagnosis of cancer.
癌症靶向治疗的发展加速了分子诊断的发展。这一新兴的癌症学科蓬勃发展,需要分析的基因改变数量在不断增加,患者数量也在不断增多。为了应对这种快速发展的情况,目前的分析技术(桑格测序、等位基因鉴别和高分辨率熔解)耗时越来越长。近年来,新一代测序(NGS)技术应运而生,并为肿瘤学带来了新的前景。在本研究中,我们使用Truseq癌症检测板分析福尔马林固定石蜡包埋(FFPE)的肺癌和结肠癌组织,该检测板可分析48个基因的突变热点。我们还在NGS分析之前测试了全基因组扩增的应用。将NGS结果与常规诊断获得的数据进行比较。所有常规观察到的改变都能被NGS识别。此外,NGS还在常规技术诊断为野生型的患者中发现了KRAS和EGFR基因的突变。NGS还鉴定出EGFR和KRAS的伴随突变或BRAF突变,以及结肠癌中EGFR第19外显子的15个核苷酸缺失。对检测板中其他测序基因的研究发现,有14个基因发生了27种不同的突变以及3个单核苷酸多态性,它们可能在癌症易感性或治疗反应中发挥作用。总之,本研究表明NGS分析可用于分析从FFPE组织中提取的基因组DNA。然而,鉴于该技术的高敏感性,需要进行高通量临床试验来证实其在癌症分子诊断中的可靠性。