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282例胃腺癌患者癌症易感基因突变特征

Characteristics of cancer susceptibility genes mutations in 282 patients with gastric adenocarcinoma.

作者信息

Ji Ke, Ao Sheng, He Liu, Zhang Lijiao, Feng Li, Lyu Guoqing

机构信息

Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Center of Gastrointestinal Surgery, Peking University Cancer Hospital & Institute, Beijing 100142, China.

Department of Gastrointestinal Surgery, Peking University Shenzhen Hospital, Shenzhen 518036, China.

出版信息

Chin J Cancer Res. 2020 Aug;32(4):508-515. doi: 10.21147/j.issn.1000-9604.2020.04.08.

Abstract

OBJECTIVE

To reveal the distribution signature of cancer susceptibility genes in patients with gastric adenocarcinoma, offering a diagnostic and prognostic surrogate for disease risk management and therapeutic decisions.

METHODS

A total of 282 patients with gastric adenocarcinoma (182 males and 100 females) were enrolled in this study, with peripheral blood genomic DNA extracted. Mutations of 69 canonical cancer susceptibility genes or presumably tumor-related genes were analyzed by targeted capture-based high-throughput sequencing. Candidate mutations were particularly selected for discussion on tumor pathogenesis according to the American College of Medical Genetics and Genomics (ACMG) guidelines.

RESULTS

In this study, 7.1% (20/282) of patients with gastric adenocarcinoma were found to harbor mutations of canonical or presumable cancer susceptibility genes. The detection rate in male patients (3.8%, 7/182) was significantly lower than that in female patients (13%, 13/100) (P=0.004). The most recurrent mutations were in A-T mutated () (1.1%, 3/282), followed by , , all showed a detection rate of 0.7% (2/282). Mutations in three genes associated with hereditary gastric cancer syndromes were detected, namely, and associated with Lynch syndrome and associated with hereditary diffuse gastric cancer. The detection frequencies were all 0.4% (1/282). Notwithstanding no significant difference observed, the age of patients with pathogenic mutations or likely pathogenic mutations is slightly younger than that of non-carriers (median age: 58.5 . 60.5 years old), while the age of patients with mutations was the youngest overall (median age: 49.3 years old).

CONCLUSIONS

Our study shed more light on the distribution signature and pathogenesis of mutations in gastric cancer susceptibility genes, and found the detection rate of pathogenic and likely pathogenic mutations in male patients was significantly lower than that in female patients. Some known and unidentified mutations were found in gastric cancer, which allowed us to gain more insight into the hereditary gastric cancer syndromes from the molecular perspective.

摘要

目的

揭示胃腺癌患者癌症易感基因的分布特征,为疾病风险管理和治疗决策提供诊断和预后替代指标。

方法

本研究共纳入282例胃腺癌患者(男性182例,女性100例),提取外周血基因组DNA。通过靶向捕获高通量测序分析69个经典癌症易感基因或推测的肿瘤相关基因的突变情况。根据美国医学遗传学与基因组学学会(ACMG)指南,特别挑选候选突变进行肿瘤发病机制的讨论。

结果

本研究中,7.1%(20/282)的胃腺癌患者被发现携带经典或推测的癌症易感基因突变。男性患者的检测率(3.8%,7/182)显著低于女性患者(13%,13/100)(P = 0.004)。最常见的突变发生在A-T突变()(1.1%,3/282),其次是、,检测率均为0.7%(2/282)。检测到与遗传性胃癌综合征相关的三个基因的突变,即与林奇综合征相关的和以及与遗传性弥漫性胃癌相关的。检测频率均为0.4%(1/282)。尽管未观察到显著差异,但携带致病突变或可能致病突变的患者年龄略低于非携带者(中位年龄:58.5岁对60.5岁),而携带突变的患者总体年龄最小(中位年龄:49.3岁)。

结论

我们的研究进一步阐明了胃癌易感基因突变的分布特征和发病机制,发现男性患者致病和可能致病突变的检测率显著低于女性患者。在胃癌中发现了一些已知和未知的突变,这使我们能够从分子角度更深入地了解遗传性胃癌综合征。

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