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波兰和乌克兰的基因检测:是否应推荐对乳腺癌和卵巢癌女性进行全面胚系检测?

Genetic testing in Poland and Ukraine: should comprehensive germline testing of and be recommended for women with breast and ovarian cancer?

机构信息

Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Australia.

Department of Clinical Pathology, The University of Melbourne, Melbourne, Australia.

出版信息

Genet Res (Camb). 2020 Aug 10;102:e6. doi: 10.1017/S0016672320000075.

Abstract

PURPOSE

To characterize the spectrum of BRCA1 and BRCA2 pathogenic germline variants in women from south-west Poland and west Ukraine affected with breast or ovarian cancer. Testing in women at high risk of breast and ovarian cancer in these regions is currently mainly limited to founder mutations.

METHODS

Unrelated women affected with breast and/or ovarian cancer from Poland (n = 337) and Ukraine (n = 123) were screened by targeted sequencing. Excluded from targeted sequencing were 34 Polish women who had previously been identified as carrying a founder mutation in BRCA1. No prior testing had been conducted among the Ukrainian women. Thus, this study screened BRCA1 and BRCA2 in the germline DNA of 426 women in total.

RESULTS

We identified 31 and 18 women as carriers of pathogenic/likely pathogenic (P/LP) genetic variants in BRCA1 and BRCA2, respectively. We observed five BRCA1 and eight BRCA2 P/LP variants (13/337, 3.9%) in the Polish women. Combined with the 34/337 (10.1%) founder variants identified prior to this study, the overall P/LP variant frequency in the Polish women was thus 14% (47/337). Among the Ukrainian women, 16/123 (13%) women were identified as carrying a founder mutation and 20/123 (16.3%) were found to carry non-founder P/LP variants (10 in BRCA1 and 10 in BRCA2).

CONCLUSIONS

These results indicate that genetic testing in women at high risk of breast and ovarian cancer in Poland and Ukraine should not be limited to founder mutations. Extended testing will enhance risk stratification and management for these women and their families.

摘要

目的

描述波兰西南部和乌克兰西部患有乳腺癌或卵巢癌的女性中 BRCA1 和 BRCA2 种系致病性变异的谱。在这些地区,对乳腺癌和卵巢癌高危女性的检测目前主要限于热点突变。

方法

对来自波兰(n=337)和乌克兰(n=123)的患有乳腺癌和/或卵巢癌的无血缘关系的女性进行靶向测序筛选。波兰的 34 名女性之前已被确定携带 BRCA1 热点突变,不进行靶向测序。乌克兰女性之前没有进行过检测。因此,这项研究总共筛选了 426 名女性的种系 DNA 中的 BRCA1 和 BRCA2。

结果

我们分别鉴定出 31 名和 18 名女性为 BRCA1 和 BRCA2 致病性/可能致病性(P/LP)遗传变异携带者。我们在波兰女性中观察到 5 个 BRCA1 和 8 个 BRCA2 P/LP 变异(337 名中的 13%)。结合本研究之前确定的 34/337(10.1%)热点突变,波兰女性的总体 P/LP 变异频率为 14%(47/337)。在乌克兰女性中,16/123(13%)女性携带热点突变,20/123(16.3%)携带非热点 P/LP 变异(BRCA1 中有 10 个,BRCA2 中有 10 个)。

结论

这些结果表明,波兰和乌克兰乳腺癌和卵巢癌高危女性的基因检测不应仅限于热点突变。扩展检测将增强这些女性及其家庭的风险分层和管理。

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