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中国局限性和局部晚期前列腺癌患者的同源重组修复基因突变

Homologous recombination repair gene mutations in Chinese localized and locally advanced prostate cancer patients.

作者信息

Jiang Xingran, Hu Xiumei, Gu Yajuan, Li Yunlong, Jin Mulan, Zhao Hongying, Gao Ruixia, Huang Zhan, Lu Jun

机构信息

Department of Pathology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, 100020, China.

Amoy Diagnostics Co., Ltd, Xiamen, China.

出版信息

Pathol Res Pract. 2021 Aug;224:153507. doi: 10.1016/j.prp.2021.153507. Epub 2021 May 29.

Abstract

BACKGROUND

Homologous recombination repair gene (HRR) mutations have been proven to be effective biomarkers for PARP inhibitor therapy for metastatic castration resistant prostate cancer. However, the frequency of HRR mutations in patients with localized and locally advanced prostate cancer is still unclear. This study investigated the profile of HRR gene mutations in Chinese localized and locally advanced prostate cancer patients.

MATERIALS AND METHODS

74 patients with localized and locally advanced prostate cancer patients in Beijing Chaoyang Hospital between May 2018 and September 2019 were retrospectively included. Matched prostate cancer and histologically normal tissues were subjected to next-generation sequencing. Pathogenic alterations of 19 HRR genes were examined.

RESULTS

Ten deleterious and suspected deleterious mutations (4 germline and 6 somatic mutations) were detected in 9 of 74 (12.16 %) patients, occurred in seven HRR-related genes, including CDK12, NBN, ATM, ATR, BRCA2, PALB2 and RAD51C. The mutation frequency of HRR genes in this study (12.16 %) was higher than TCGA cohort (7.29 %), and the mutation sites in 7 HRR genes detected in this cohort were different from those of TCGA data. Patients with HRR gene mutations had higher Gleason grade (≥ 3) (P = 0.03) and risk level (very-high) (P = 0.03). Postoperative prostate specific antigen level and positive surgical margin rate was not associated with HRR gene mutation status.

CONCLUSIONS

This study illustrated the mutation patterns of HRR genes in Chinese population with localized and locally advanced prostate cancer. These results provide further evidence that HRR gene mutations were more prevalent in patients with higher Gleason grade, or with very-high-risk level. Patients with these clinicopathologic characteristics may need more precise stratification through molecular detection.

摘要

背景

同源重组修复基因(HRR)突变已被证明是转移性去势抵抗性前列腺癌PARP抑制剂治疗的有效生物标志物。然而,局限性和局部晚期前列腺癌患者中HRR突变的频率仍不清楚。本研究调查了中国局限性和局部晚期前列腺癌患者的HRR基因突变情况。

材料与方法

回顾性纳入2018年5月至2019年9月在北京朝阳医院就诊的74例局限性和局部晚期前列腺癌患者。对配对的前列腺癌组织和组织学正常的组织进行二代测序。检测19个HRR基因的致病性改变。

结果

在74例患者中的9例(12.16%)检测到10个有害和疑似有害突变(4个胚系突变和6个体细胞突变),发生在7个与HRR相关的基因中,包括CDK12、NBN、ATM、ATR、BRCA2、PALB2和RAD51C。本研究中HRR基因的突变频率(12.16%)高于TCGA队列(7.29%),且该队列中检测到的7个HRR基因的突变位点与TCGA数据不同。HRR基因突变的患者Gleason分级更高(≥3)(P = 0.03)且风险水平更高(极高)(P = 0.03)。术后前列腺特异性抗原水平和手术切缘阳性率与HRR基因突变状态无关。

结论

本研究阐明了中国局限性和局部晚期前列腺癌患者HRR基因的突变模式。这些结果进一步证明,HRR基因突变在Gleason分级较高或极高风险水平的患者中更为普遍。具有这些临床病理特征的患者可能需要通过分子检测进行更精确的分层。

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