Department of Surgery, Center for Prostate Disease Research, Uniformed Services University of the Health Sciences, Rockville, MD, USA.
John P Murtha Cancer Center, Walter Reed National Military Medical Center, Bethesda, MD, USA.
Prostate Cancer Prostatic Dis. 2019 Sep;22(3):406-410. doi: 10.1038/s41391-018-0114-1. Epub 2018 Dec 12.
BACKGROUND: Germline mutations in BRCA2 have been linked to a higher risk of prostate cancer (PCa), and high frequency of BRCA1 and BRCA2 (BRCA1/2) gene alterations was recently reported in metastatic castration-resistant PCa specimens. Mutations in BRCA2 vary in racial and ethnic groups including African-American (AA) and Caucasian-American (CA) populations. METHODS: BRCA1 and BRCA2 genes were sequenced (Ion AmpliSeq targeted sequencing) in archived blood DNA specimens in 1240 PCa patients, including 30% AA patients, in three different cohorts: localized early stage (T2) PCa (N = 935); advanced PCa (50% T3-4) (N = 189); and metastatic PCa (N = 116). The sequences were analyzed for known and novel mutations in BRCA1/2. Statistical analyses were performed to determine associations of the mutations with clinico-pathological parameters. RESULTS: BRCA2 mutations with known pathogenic annotation were significantly more prevalent in men with advanced and metastatic PCa (3.1%) compared to patients with an organ-confined disease (0.7%). AA patients carried more frequently BRCA1/2 variants of unknown significance (VUS) when compared to Caucasian Americans (4.6 vs. 1.6%, respectively). Significantly, pathogenic BRCA2 mutations in men with localized early stage PCa increased the risk of distant metastasis. CONCLUSIONS: Germline variants of unknown significance in BRCA1/2 are more frequent in AA than CA PCa patients; however, the prevalence of pathogenic mutations were similar across the races. Patients carrying BRCA2 pathogenic mutations are more likely to progress to metastasis.
背景:BRCA2 种系突变与前列腺癌(PCa)风险增加相关,最近在转移性去势抵抗性 PCa 标本中报道了 BRCA1 和 BRCA2(BRCA1/2)基因改变的高频率。BRCA2 突变在包括非裔美国人(AA)和高加索裔美国人(CA)在内的不同种族和民族群体中存在差异。
方法:在三个不同的队列中,对 1240 名 PCa 患者(包括 30%的 AA 患者)的存档血液 DNA 标本进行了 BRCA1 和 BRCA2 基因测序(Ion AmpliSeq 靶向测序):局限性早期(T2)PCa(N=935);晚期 PCa(50%为 T3-4)(N=189);转移性 PCa(N=116)。对 BRCA1/2 的已知和新突变进行了序列分析。进行了统计学分析,以确定突变与临床病理参数的关联。
结果:与局限于器官的疾病患者(0.7%)相比,具有已知致病性注释的 BRCA2 突变在晚期和转移性 PCa 男性中更为常见(3.1%)。与高加索裔美国人相比,AA 患者携带更多的 BRCA1/2 意义不明的变异(VUS)(分别为 4.6%和 1.6%)。重要的是,局限性早期 PCa 男性中的种系 BRCA2 突变增加了远处转移的风险。
结论:BRCA1/2 中的种系意义不明的变异在 AA 比 CA PCa 患者中更为常见;然而,不同种族之间的致病性突变的流行率相似。携带 BRCA2 致病性突变的患者更有可能进展为转移。
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