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201例未经选择的卵巢癌样本中BRCA1和BRCA2的体细胞突变——单机构研究

Somatic mutations in BRCA1&2 in 201 unselected ovarian carcinoma samples - single institution study.

作者信息

Kowalik Artur, Zalewski Kamil, Kopczyński Janusz, Siołek Monika, Lech Magda, Hińcza Kinga, Kalisz Joanna, Chrapek Magdalena, Zięba Sebastian, Furmańczyk Jowita, Jedliński Michał, Chłopek Małgorzata, Misiek Marcin, Góźdź Stanisław

机构信息

Department of Molecular Diagnostics, Holycross Cancer Centre, Kielce, Poland.

Department of Gynecologic Oncology, Holycross Cancer Center, Kielce, Poland.

出版信息

Pol J Pathol. 2019;70(2):115-126. doi: 10.5114/pjp.2019.82905.

Abstract

Ovarian cancer (OC) is the most lethal among gynecologic malignancies worldwide. Unfortunately, in around 70% of cases cancer is diagnosed in late stages (III-IV) which decreases the 5-year survival rate to 25%. The standard of care in ovarian cancer is debulking surgery followed by chemotherapy regimens based on platinum salts. Since 2014 PARP inhibitors became available for OC patients with germline or/and somatic mutations in BRCA1/2, including maintenance therapy. BRCA1/2 Next Generation Sequencing (NGS)-based analysis of formalin-fixed paraffin-embedded (FFPE) ovarian cancer samples becomes the standard of care. The aim of the present study was to evaluate the frequency of mutations in 201 unselected ovarian cancer tissues using the NGS method. In total, pathogenic mutations in both genes were detected in 24% (49/201) of the ovarian cancer cases tested. For 41 patients the results of testing of DNA isolated from blood sample revealed that 17% (35/201) mutations were germline origin, whereas 3% (6/201) mutations were somatic. In 4% (8/201) cases blood sample was inaccessible. The presence of pathogenic mutations was correlated with younger age at diagnosis and serous subtype. Close cooperation between many specialists (gynecologist, pathologist, oncologist, clinical genetics and molecular biologist) is indispensable for efficient and on-time BRCA1/2 ovarian tumor tissue testing.

摘要

卵巢癌(OC)是全球妇科恶性肿瘤中致死率最高的。不幸的是,约70%的病例在晚期(III - IV期)被诊断出癌症,这使得5年生存率降至25%。卵巢癌的标准治疗方法是肿瘤细胞减灭术,随后是基于铂盐的化疗方案。自2014年以来,PARP抑制剂可用于患有BRCA1/2种系或/和体细胞突变的OC患者,包括维持治疗。基于BRCA1/2下一代测序(NGS)对福尔马林固定石蜡包埋(FFPE)卵巢癌样本进行分析已成为标准治疗手段。本研究的目的是使用NGS方法评估201例未经选择的卵巢癌组织中的突变频率。在总共检测的201例卵巢癌病例中,24%(49/201)检测到两个基因均存在致病性突变。对于41例患者,从血样中分离的DNA检测结果显示,17%(35/201)的突变起源于种系,而3%(6/201)的突变是体细胞性的。在4%(8/201)的病例中无法获取血样。致病性突变的存在与诊断时年龄较小和浆液性亚型相关。许多专家(妇科医生、病理学家、肿瘤学家、临床遗传学家和分子生物学家)之间的密切合作对于高效、及时地进行BRCA1/2卵巢肿瘤组织检测是必不可少的。

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