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BRCA1 和 BRCA2 基因突变谱及中国早发性乳腺癌患者的临床病理特征。

The spectrum of BRCA1 and BRCA2 mutations and clinicopathological characteristics in Chinese women with early-onset breast cancer.

机构信息

Department of Breast Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian, China.

Fujian Center for Disease Control and Prevention, Fuzhou, China.

出版信息

Breast Cancer Res Treat. 2020 Apr;180(3):759-766. doi: 10.1007/s10549-020-05573-x. Epub 2020 Feb 18.

Abstract

PURPOSE

BRCA1/2 mutations represent a high risk of breast cancer and are related to early-onset breast cancer. However, few studies have reported the relationship between BRCA1/2 mutations and their clinical characteristics in early-onset breast cancers. This study is the first article that characterizes the risk factor profiles in Chinese patients selected by the age of onset (≤ 40 years old). We found some differences in the prevalence of germline BRCA1/2 mutations between Asian and Western countries.

METHODS

A total of 1371 consecutive unselected Chinese early-onset breast cancer patients were enrolled from the Fujian Medical University Union Hospital, China, and screened for germline BRCA1/2 mutations. Full-exome sequencing in next-generation sequencing technology was performed in all patients to examine BRCA1/2 mutations.

RESULTS

In our study, 25 (1.8%) and 61 (4.4%) patients were identified with BRCA1 and BRCA2 mutations, respectively, among the unselected early-onset breast cancer patients. BRCA1 mutations were associated with pregnancies (p = 0.026), and BRCA1 carriers had a higher likelihood of being HR positive (p < 0.001), HER2 negative (p < 0.001), or high grade (p = 0.002) than noncarriers. Among BRCA2 mutations, the age of onset was younger in carriers than in noncarriers (p = 0.017), and BRCA2 carriers were more likely to have lymph node metastasis (p = 0.004). HR-positive or HER2-negative patients were likely to be positive for BRCA2 mutations (p < 0.001). Overall, 14 BRCA1 mutations and 8 BRCA2 mutations were first reported in our study CONCLUSION: This study provided some information about the spectrum of BRCA1/2 mutations and characterized the risk factors for early-onset breast cancer in China.

摘要

目的

BRCA1/2 突变代表了乳腺癌的高风险,并且与早发性乳腺癌相关。然而,很少有研究报告 BRCA1/2 突变与早发性乳腺癌的临床特征之间的关系。本研究是第一篇通过发病年龄(≤40 岁)来描述中国患者风险因素特征的文章。我们发现亚洲和西方国家之间在种系 BRCA1/2 突变的流行率上存在一些差异。

方法

我们从中国福建医科大学附属协和医院连续招募了 1371 例未经选择的早发性乳腺癌患者,并对其进行种系 BRCA1/2 突变筛查。所有患者均进行下一代测序技术的全外显子组测序以检查 BRCA1/2 突变。

结果

在我们的研究中,在未经选择的早发性乳腺癌患者中,分别有 25(1.8%)和 61(4.4%)例患者被确定为 BRCA1 和 BRCA2 突变。BRCA1 突变与妊娠有关(p=0.026),BRCA1 携带者更有可能是 HR 阳性(p<0.001)、HER2 阴性(p<0.001)或高级别(p=0.002),而非携带者。在 BRCA2 突变中,携带者的发病年龄比非携带者年轻(p=0.017),BRCA2 携带者更有可能发生淋巴结转移(p=0.004)。HR 阳性或 HER2 阴性患者更有可能存在 BRCA2 突变(p<0.001)。总体而言,本研究首次报道了 14 个 BRCA1 突变和 8 个 BRCA2 突变。

结论

本研究提供了有关 BRCA1/2 突变谱的一些信息,并描述了中国早发性乳腺癌的风险因素。

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