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基因突变谱分析及其在肾细胞癌患者中的临床意义。

Gene mutation profiling and clinical significances in patients with renal cell carcinoma.

机构信息

Department of Urology, Southwest Hospital, Third Military Medical University (Army Medical University), Shapingba District, Chongqing, China.

Medicine Department, Nanjing Geneseeq Technology Inc, Nanjing, Jiangsu, China.

出版信息

Clinics (Sao Paulo). 2023 Jan-Dec;78:100259. doi: 10.1016/j.clinsp.2023.100259. Epub 2023 Jul 27.

Abstract

OBJECTIVES

The pathological mechanisms of patients with Renal Cell Carcinoma (RCC) remain defined. This study aimed to evaluate relationships between the landscape of gene mutations and their clinical significance in RCC patients.

METHODS

Tissue and peripheral blood samples of 42 patients with RCC were collected and performed for the Next Generation Sequencing (NGS) with Geneseeq PrimeTM 425-gene panel probes. Their landscapes of gene mutation were analyzed. We also carried out an evaluation of Tumor-Node-Metastasis (TNM) staging, RENAL nephelometry score, surgery, and targeted drug treatment of patients. Then we compared the correlations of landscape in gene mutations and the prognosis.

RESULTS

The most common gene alternations, including BAP1, PBRM1, SETD2, CSF1R, NPM1, EGFR, POLE, RB1, and VHL genes, were identified in tissue and blood samples of 75% of patients. EGFR, POLE, and RB1 gene mutations frequently occurred in relapsed and metastatic patients. BAP1, CCND2, KRAS, PTPN11, ERBB2/3, JAK2, and POLE were presented in the patients with > 9 RENAL nephelometry score. Univariable analysis indicated that SETD2, BAP1, and PBRM1 genes were key factors for Disease-Free Survival (DFS). Multivariable analysis confirmed that mutated SETD1, NPM1, and CSF1R were critical factors for the Progression Free Survival (PFS) of RCC patients with target therapy.

CONCLUSIONS

Wild-type PBRM1 and mutated BAP1 in patients with RCC were strongly associated with the outcomes of the patient. The PFS of the patients with SETD2, NPM1, and CSF1R mutations were significantly shorter than those patients without variants.

摘要

目的

肾细胞癌(RCC)患者的病理机制仍未确定。本研究旨在评估 RCC 患者基因突变谱及其临床意义之间的关系。

方法

收集 42 例 RCC 患者的组织和外周血样本,采用 Geneseeq PrimeTM 425 基因panel 探针进行下一代测序(NGS)。分析其基因突变谱。我们还对患者的肿瘤-淋巴结-转移(TNM)分期、RENAL 肾图评分、手术和靶向药物治疗进行了评估。然后我们比较了基因突变谱与预后的相关性。

结果

在 75%的患者的组织和血液样本中发现了最常见的基因改变,包括 BAP1、PBRM1、SETD2、CSF1R、NPM1、EGFR、POLE、RB1 和 VHL 基因。EGFR、POLE 和 RB1 基因突变常发生于复发和转移患者。BAP1、CCND2、KRAS、PTPN11、ERBB2/3、JAK2 和 POLE 基因在 RENAL 肾图评分>9 的患者中出现。单变量分析表明,SETD2、BAP1 和 PBRM1 基因是无病生存(DFS)的关键因素。多变量分析证实,突变的 SETD1、NPM1 和 CSF1R 是 RCC 患者靶向治疗无进展生存(PFS)的关键因素。

结论

野生型 PBRM1 和突变型 BAP1 与 RCC 患者的预后密切相关。SETD2、NPM1 和 CSF1R 突变患者的 PFS 明显短于无变异患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3ed6/10410166/58704174ea52/gr1.jpg

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