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一名原发性管腔型/人表皮生长因子受体2阴性且存在错配修复缺陷的乳腺癌患者。

A primary luminal/HER2 negative breast cancer patient with mismatch repair deficiency.

作者信息

Yang Xue, Smirnov Artem, Buonomo Oreste Claudio, Mauriello Alessandro, Shi Yufang, Bischof Julia, Woodsmith Jonathan, Melino Gerry, Candi Eleonora, Bernassola Francesca

机构信息

Department of Experimental Medicine, TOR, University of Rome Tor Vergata, 00133, Rome, Italy.

The Third Affiliated Hospital of Soochow University, Institutes for Translational Medicine, Soochow University, Suzhou, 215000, China.

出版信息

Cell Death Discov. 2023 Oct 2;9(1):365. doi: 10.1038/s41420-023-01650-4.

Abstract

Here, we present the case of a 47-year-old woman diagnosed with luminal B breast cancer subtype and provide an in-depth analysis of her gene mutations, chromosomal alterations, mRNA and protein expression changes. We found a point mutation in the FGFR2 gene, which is potentially hyper-activating the receptor function, along with over-expression of its ligand FGF20 due to genomic amplification. The patient also harbors somatic and germline mutations in some mismatch repair (MMR) genes, with a strong MMR mutational signature. The patient displays high microsatellite instability (MSI) and tumor mutational burden (TMB) status and increased levels of CTLA-4 and PD-1 expression. Altogether, these data strongly implicate that aberrant FGFR signaling, and defective MMR system might be involved in the development of this breast tumor. In addition, high MSI and TMB in the context of CTLA-4 and PD-L1 positivity, suggest the potential benefit of immune checkpoint inhibitors. Accurate characterization of molecular subtypes, based on gene mutational and expression profiling analyses, will be certainly helpful for individualized treatment and targeted therapy of breast cancer patients, especially for those subtypes with adverse outcome.

摘要

在此,我们报告一例47岁被诊断为腔面B型乳腺癌亚型的女性病例,并对其基因突变、染色体改变、mRNA和蛋白质表达变化进行深入分析。我们发现FGFR2基因存在一个点突变,该突变可能会过度激活受体功能,同时由于基因组扩增导致其配体FGF20过表达。该患者在一些错配修复(MMR)基因中还存在体细胞和种系突变,具有强烈的MMR突变特征。患者表现出高微卫星不稳定性(MSI)和肿瘤突变负荷(TMB)状态,以及CTLA-4和PD-1表达水平升高。总之,这些数据强烈表明,异常的FGFR信号传导和有缺陷的MMR系统可能参与了该乳腺肿瘤的发生发展。此外,在CTLA-4和PD-L1阳性的情况下,高MSI和TMB提示免疫检查点抑制剂可能有益。基于基因突变和表达谱分析对分子亚型进行准确表征,肯定有助于乳腺癌患者的个体化治疗和靶向治疗,特别是对于那些预后不良的亚型。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cfd3/10545677/04dd0fd7520c/41420_2023_1650_Fig1_HTML.jpg

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