Hayden Mark A, Ordulu Zehra, Gallagher C Scott, Quade Bradley J, Anchan Raymond M, Middleton Nia Robinson, Srouji Serene S, Stewart Elizabeth A, Morton Cynthia C
Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women's Hospital, Boston, MA 02115, USA.
Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women's Hospital, Boston, MA 02115, USA; Harvard Medical School, Boston, MA 02115, USA.
Cancer Genet. 2018 Apr;222-223:1-8. doi: 10.1016/j.cancergen.2018.01.001. Epub 2018 Feb 19.
Black women are disproportionately affected by uterine leiomyomata (UL), or fibroids, compared to other racial groups, having a greater lifetime risk of developing UL and an earlier age of diagnosis. In order to elucidate molecular and genetic mechanisms responsible for the increased prevalence and morbidity associated with UL in black women, clinical, pathologic, cytogenetic, and select molecular profiling (MED12 mutation analysis) of 75 self-reported black women undergoing surgical treatment for UL was performed. Our observations are broadly representative of previous cytogenetic studies of UL: karyotypically abnormal tumors were detected in 30.7% of women and 17.4% of analyzed tumors. No notable association was observed between race and increased occurrence of cytogenetic abnormalities that might contribute to any population-specific morbidity or prevalence rate. Our data on MED12 mutation analyses (73.2% of tumors harbored a MED12 mutation) provide additional support for a significant role of MED12 in tumorigenesis. Although the effect of MED12-mediated tumorigenesis appears significant irrespective of race, other genetic events such as the distribution of karyotypic abnormalities appear differently in black women. This case series indicates that presently recognized genetic and molecular characteristics of UL do not appear to explain the increased prevalence and morbidity of UL in black women.
与其他种族群体相比,黑人女性受子宫平滑肌瘤(UL)或纤维瘤的影响尤为严重,患UL的终生风险更高,诊断年龄更早。为了阐明导致黑人女性中UL患病率和发病率增加的分子和遗传机制,我们对75名自述因UL接受手术治疗的黑人女性进行了临床、病理、细胞遗传学和特定分子分析(MED12突变分析)。我们的观察结果广泛代表了先前关于UL的细胞遗传学研究:在30.7%的女性和17.4%的分析肿瘤中检测到核型异常肿瘤。未观察到种族与可能导致任何特定人群发病率或患病率的细胞遗传学异常发生率增加之间存在显著关联。我们关于MED12突变分析的数据(73.2%的肿瘤存在MED12突变)为MED12在肿瘤发生中的重要作用提供了额外支持。尽管MED12介导的肿瘤发生效应似乎与种族无关,但其他遗传事件,如核型异常的分布,在黑人女性中表现不同。这个病例系列表明,目前公认的UL遗传和分子特征似乎无法解释黑人女性中UL患病率和发病率的增加。