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下一代测序多基因panel 检测对乳腺癌 BRCA 阴性高危患者的临床贡献。

Clinical Contribution of Next-Generation Sequencing Multigene Panel Testing for BRCA Negative High-Risk Patients With Breast Cancer.

机构信息

Department of Medical Genetic, Ege University Faculty of Medicine, Izmir, Turkey.

Department of General Surgery, Ege University Faculty of Medicine, Izmir, Turkey.

出版信息

Clin Breast Cancer. 2021 Dec;21(6):e647-e653. doi: 10.1016/j.clbc.2021.04.002. Epub 2021 Apr 12.

Abstract

BACKGROUND

Breast cancer is the most common malignancy in women and thought to be hereditary in 10% of patients. Recent next-generation sequencing studies have increased the detection of pathogenic or likely pathogenic (P/LP) variants in genes other than BRCA1/2 in patients with breast cancer. This study evaluated pathogenic variants, likely pathogenic variants, and variants of unknown significance in 18 hereditary cancer susceptibility genes in patients with BRCA1/2-negative breast cancer.

PATIENTS AND METHODS

This retrospective study included 188 high-risk BRCA1/2-negative patients with breast cancer tested with a multigene cancer panel using next-generation sequencing.

RESULTS

Among 188 proband cases, 18 variants in 21 patients (11.1%) were classified as P/LP in PALB2 (n = 6), CHEK2 (n = 5), MUTYH (n = 4), ATM (n = 3), TP53 (n = 2), BRIP1 (n = 1), and MSH2 (n = 1). Three novel P/LP variants were identified. An additional 28 variants were classified as variants of unknown significance and detected in 30 different patients (15.9%).

CONCLUSION

This is one of the largest study from Turkey to investigate the mutation spectrum in non-BRCA hereditary breast cancer susceptibility genes. A multigene panel test increased the likelihood of identifying a molecular diagnosis in patients with BRCA 1/2-negative breast cancer at risk for a hereditary breast cancer syndrome. More studies are needed to enable the clinical interpretation of these P/LP variants in hereditary patients with breast cancer.

摘要

背景

乳腺癌是女性最常见的恶性肿瘤,据认为有 10%的患者具有遗传性。最近的下一代测序研究增加了在乳腺癌患者中除 BRCA1/2 以外的基因中检测到致病性或可能致病性(P/LP)变异的可能性。本研究评估了 188 例 BRCA1/2 阴性乳腺癌高危患者中 18 个遗传性癌症易感性基因中的致病性变异、可能致病性变异和意义不明的变异。

患者和方法

本回顾性研究纳入了 188 例经多基因癌症panel 进行下一代测序检测的 BRCA1/2 阴性乳腺癌高危患者。

结果

在 188 例先证者病例中,21 例患者(11.1%)的 18 个变异被归类为 PALB2(n=6)、CHEK2(n=5)、MUTYH(n=4)、ATM(n=3)、TP53(n=2)、BRIP1(n=1)和 MSH2(n=1)中的 P/LP。发现了 3 个新的 P/LP 变异。另外 28 个变异被归类为意义不明的变异,在 30 名不同的患者中检测到(15.9%)。

结论

这是土耳其最大的研究之一,旨在调查非 BRCA 遗传性乳腺癌易感性基因中的突变谱。多基因panel 检测增加了在 BRCA1/2 阴性乳腺癌高危患者中识别分子诊断的可能性,这些患者有遗传性乳腺癌综合征的风险。需要更多的研究来使这些遗传性乳腺癌患者的 P/LP 变异的临床解释成为可能。

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