Department of OB/GYN and Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.
Cancer Med. 2019 Apr;8(4):1875-1881. doi: 10.1002/cam4.2000. Epub 2019 Mar 1.
We investigated the prevalence of germline BRCA mutations in a population-based cohort of Austrian women diagnosed with ovarian cancer and its association with family history of cancer. We prospectively collected family pedigrees of 443 Austrian ovarian cancer patients who had been tested for the presence of a germline BRCA or 2 mutations and correlated the familial breast and ovarian cancer burden with the prevalence of BRCA mutations and disease onset. The probability of carrying a gBRCA mutation in patients without family history of cancer is 14% (95% CI 9%-22%), as opposed to 45% (95% CI 31%-59%) of patients with at least one family member with ovarian cancer, and 47% (95% CI 40%-54%) if other relatives have developed breast cancer. If both breast and ovarian cancer are diagnosed in the family, the probability of carrying a germline BRCA1 or 2 mutations is 60% (95% CI 50%-68%). germline BRCA1 or mutations in families with ovarian cancer only are commonly located in the Ovarian Cancer Cluster Regions when compared to families with both breast and ovarian cancer (P = 0.001, and P = 0.020, respectively). While gBRCA mutation carriers with ovarian cancer do not have a significantly different age at onset than patients with a family history of cancer, gBRCA1 carriers in general have an earlier onset than gBRCA2 carriers (P = 0.002) and patients without a mutation (P = 0.006). The rate of germline BRCA1 or 2 mutations in ovarian cancer patients without a family history or breast or ovarian cancer is low. However, in women with additional family members affected, the prevalence is considerably higher than previously reported.
我们在一项基于人群的奥地利女性卵巢癌队列中调查了胚系 BRCA 突变的流行率及其与癌症家族史的关系。我们前瞻性地收集了 443 名经检测存在胚系 BRCA 或 2 突变的奥地利卵巢癌患者的家族系谱,并将家族性乳腺癌和卵巢癌负担与 BRCA 突变的流行率和疾病发病相关联。无癌症家族史的患者携带 gBRCA 突变的概率为 14%(95%CI 9%-22%),而至少有一名卵巢癌家族成员的患者为 45%(95%CI 31%-59%),其他亲属患有乳腺癌的患者为 47%(95%CI 40%-54%)。如果家族中同时诊断出乳腺癌和卵巢癌,则携带胚系 BRCA1 或 2 突变的概率为 60%(95%CI 50%-68%)。与同时患有乳腺癌和卵巢癌的家族相比,仅患有卵巢癌的家族中的 BRCA1 或突变通常位于卵巢癌簇区域(P=0.001 和 P=0.020)。虽然携带卵巢癌的 gBRCA 突变患者的发病年龄与有癌症家族史的患者无显著差异,但 gBRCA1 携带者的发病年龄一般早于 gBRCA2 携带者(P=0.002)和无突变患者(P=0.006)。无家族史或无乳腺癌或卵巢癌的卵巢癌患者中胚系 BRCA1 或 2 突变的发生率较低。然而,在有其他家族成员患病的女性中,其发生率明显高于先前报道的水平。