山东东部地区家族性和早发性乳腺癌BRCA1基因突变的研究

目的:研究家族性和早发性乳腺癌BRCA1基因突变情况.方法:选取52例来自不同家系家族性和早发性乳腺癌患者,提取外周血基因组DNA,对BRCA1基因的全部编码序列及外显子与内含子的拼接区进行PCR基因扩增,扩增产物经变性高效液相色谱分析(DHPLC)除筛后,对发现异常的片断进行DNA直接测序证实.结果:在52例家族性和早发性乳腺癌患者中发现4例(7.7%)BRCA1致病性突变(2257C＞G,2229del1AA,3413de1T),其中BRCA1的2229de1AA在两个不同的家系重复出现.3413de1T突变未在Breast Cancer Information Core(BIC)数据库和相关的文献报道过.家族性乳腺癌突变率为12%(3/25);单纯早发性乳腺癌突变率为3.7%(1/27).结论:BRCA1突变在山东东部地区家族性乳腺癌的发病中发挥重要作用,对具有家族史的乳腺癌家系进行BRCA1基因突变筛查具有重要意义.     

110例维吾尔族及汉族乳腺癌中BRCA1基因突变及P53蛋白表达的研究

目的研究维吾尔族及汉族乳腺癌患者BRCA1基因突变及P53蛋白的表达。方法选取70例维吾尔族和40例汉族乳腺癌根治标本,对照组为32例维汉族乳腺良性病变(纤维腺病及纤维腺瘤)及乳腺癌旁非癌组织;运用PCR-SSCP和DNA序列测定的方法检测BRCA1基因突变及Evision二步法检测P53蛋白的表达。结果(1)110例维吾尔族及汉族乳腺癌中发现BRCA1突变的14个新位点。(2)110例维吾尔族及汉族乳腺癌BRCA1的突变率为10%,其中22例维吾尔族早发性乳腺癌(≤35岁)BRCA1突变率为31.82%,高于维吾尔族晚发性乳腺癌(P<0.01)。(3)110例维吾尔族及汉族乳腺癌中发现11例BRCA1基因核苷酸多态性位点。(4)BRCA1基因突变相关性乳腺癌中P53蛋白阳性表达率高于对照组,其淋巴结转移率高于对照组,其发病年龄小于对照组(P<0.01)。结论BRCA1基因突变与新疆维吾尔族早发性乳腺癌密切相关,且BRCA1突变相关性乳腺癌具有P53阳性率高、发病年龄趋于年轻化、淋巴结转移率高的趋势,这些特点有可能为基因检测前的筛选提供参考依据。     

新疆女性乳腺癌657例临床病理分析

目的:比较维族与汉族乳腺癌患者的临床病理信息,旨在了解两民族之间乳腺癌临床病理特征的差异。方法:收集汉族病例407例,维族病例250例,对临床病理资料、,应用免疫组化En Vision两步法检测ER、PR、Her-2、BRCA1进行对比分析。结果:汉族及维族乳腺癌患者的年龄、淋巴结转移情况无统计学差异(P0.05),汉族及维族患者乳腺癌的肿瘤大小、肿瘤组织学分级、ER、PR、Her-2及BRCA1的表达有统计学差异(P0.05),维汉民族间三阴性乳腺癌的比例有显著统计学差异(P=0.0000)。维汉民族三阴性乳腺癌与BRCA1的表达存在相关性。结论:维汉民族间乳腺癌的临床病理特征存在差异,维族患者三阴性乳腺癌明显多于患者患者,维汉民族患者三阴性乳腺癌均与BRCA1基因突变有关。     

BRCA基因突变型乳腺癌研究进展

乳腺癌是女性最常见的恶性肿瘤,BRCA基因是乳腺癌最常见的易感基因,与遗传性乳腺癌的发生密切相关,BRCA基因在维护染色体完整性方面具有重要作用。从功能上看,BRCA基因是肿瘤的抑制基因,它的关键区域突变使其抑制功能失去,因而导致肿瘤的发生。目前伴随诊断和靶向治疗是癌症领域研究的热点,BRCA基因突变型为家族性乳腺癌治疗的重要靶点,为其个性化治疗提供了新方向。主要对BRCA基因突变型乳腺癌临床诊断方法及相关治疗进行综述。     

乳腺癌组织中EGFR/KRAS/BRAF基因突变检测与分析

[目的]检测乳腺癌组织中表皮生长因子受体(EGFR)以及其下游KRAS、BRAF基因的突变类型和突变率,分析其各突变类型之间有无相关性,以期为乳腺癌药物靶点筛选和乳腺癌患者的分子靶向治疗提供更多依据。[方法]取自2016～2017年间宜昌市中心人民医院病理科收集的乳腺癌患者术后冰冻肿瘤组织样本60例以及健康人群DNA样本30例,分别提取基因组DNA,采用PCR扩增和基因测序的方法对基因组中的EGFR外显子18～21,KRAS外显子2、3以及BRAF外显子15进行基因突变分析。[结果]在检测的60例乳腺癌组织样本中,总计有8例样本存在错义突变。其中EGFR突变率为11.7%(7/60例),均为外显子18和20突变。包括第18号外显子P699A突变3例,突变率为5.0%;第20号外显子L778M、V819A突变各4例,突变率6.7%。并包含3例L778M合并V819A突变,另有2例中分别出现了I780M合并S783C和L788V合并L815F突变。BRAF外显子15仅出现了1例T599P突变,突变率为1.7%(1/60例)。30例正常人群对照组未检测到错义突变。[结论]EGFR在乳腺癌中的突变主要以外显子18和20为主,存在P699A、L778M、V819A突变且突变率高达11.7%。BRAF在乳腺癌中的突变率极低,仅为1.7%。未检测到乳腺癌组织中KRAS突变。与正常组织相比较,EGFR外显子18和20的高突变率提示其与乳腺癌的发病存在密切关系,EGFR突变是潜在的抗乳腺癌治疗靶点。     

中国人先天性巨结肠RET基因突变特征研究

为了研究中国人先天性巨结肠(HD)RET基因突变特征,从分子水平探讨先天性巨结肠症(HD)的发病机理,揭示中国人群HD与RET基因突变的关系。我们应用聚合酶链反应-单链构象多态性(PCR-SSCP)-DNA测序方法,对50例HD患儿和30例无便秘正常对照者,进行RET基因第13外显子突变筛查,并对第13外显子突变阳性患儿家系作研究。结果发现在50例HD患儿中,有7例第13外显子扩增片段在SSCP分析时出现泳动变位。经DNA测序证实,有3种点突变类型(错义、同义和移码),第13外显子突变率为14%(7/50)。在7例第13外显子突变的患儿中,发现2例患儿的父亲存在与其子相同的突变。实验表明中国先天性巨结肠人群存在着RET基因突变,且以杂和性点突变为主,HD具有一定的遗传性。     

中国人先天性巨结肠RET基因突变特征研究

为了研究中国人先天性巨结肠(HD)RET基因突变特征,从分子水平探讨先天性巨结肠症(HD)的发病机理,揭示中国人群HD与RET基因突变的关系。我们应用聚合酶链反应-单链构象多态性(PCR—SSCP)-DNA测序方法,对50例HD患儿和30例无便秘正常对照者,进行RET基因第13外显子突变筛查,并对第13外显子突变阳性患儿家系作研究。结果发现在50例HD患儿中,有7例第13外显子扩增片段在SSCP分析时出现泳动变位。经DNA测序证实,有3种点突变类型(错义、同义和移码),第13外显子突变率为14％(7／50)。在7例第13外显子突变的患儿中,发现2例患儿的父亲存在与其子相同的突变。实验表明中国先天性巨结肠人群存在着RET基因突变,且以杂和性点突变为主,HD具有一定的遗传性。     

乳腺癌易感基因BRCA1/BRCA2研究发展及乳腺癌的诊断治疗展望

BRCA1/BRCA2是DNA同源重组途径中的重要因子。BRCA1/BRCA在维护染色体完整性有着重要作用,BRCA1、BRCA2基因的关键区域突变会增加细胞敏感性,导致肿瘤突变。本综述从基因组水平及分子水平对BRCA1/2的基因结构功能,修复中的作用机制以及在乳腺癌个性化诊疗手段等方面进行介绍,并阐述了国内外与乳腺癌BRCA基因突变相关的研究现状及BRCA基因突变几种有效的检测方法,希望针对携带BRCA1/BRCA2基因突变的新型药物和靶向治疗方案日益完善,最后对未来乳腺癌更"个性化"、"先进化"的治疗方案进行了展望。     

FAM160A2功能缺失性突变可能诱发心房颤动

心房颤动(atrial fibrillation, AF)是临床最常见的心律失常,对AF致病基因的研究,有助于AF早期筛查。本文旨在家族性AF人群和散发性AF人群中筛选具有潜在发病意义的易感基因,并对其在AF发生机制进行初步探讨。首先对4名家族性AF进行全外显子组测序(WES),鉴定AF相关基因。然后用Sanger测序在非家族性AF人群和健康人群中证实易感基因突变情况,应用Western印迹分析其蛋白质表达情况,利用膜片钳技术分析突变基因对外向钾离子电流的影响。家族共有39人,其中有4人发生AF,这4名AF患者存在2个共有的突变基因FAM160A2(纯合突变,rs77726581 c.1375C>T)和MUC5B(杂合突变,rs199736618 c.12272C>T)。在52例非家族性AF患者中,有5例存在FAM160A2相同位点杂合突变,在健康人群中未发现此突变;而MUC5B在非家族性AF人群和健康人群中均发生杂合突变。FAM160A2蛋白在非家族性AF散发人群和健康人群中表达水平并无显著性差异。FAM160A2基因突变明显降低外向钾离子电流(与野生型比较,P<0...     

BRCA1基因与乳腺癌

乳腺癌易感基因1(BRCA1)是具有遗传倾向的乳腺癌和卵巢癌的易感基因,且是一种抑癌基因.BRCA1基因的突变与家族性乳腺癌及它在细胞周期的调节,DNA损伤修复,基因的转录调控和诱导细胞凋亡方面起着重要作用.BRCA1基因的突变与家族性乳腺癌及卵巢癌的发生密切相关,对BRCA1分子功能的研究,将有利于阐明肿瘤发生的机理关.BRCA1的启动子甲基化与散发性乳腺癌有关.本文拟对BRCA1的结构,功能以及它的甲基化,突变,杂合性丢失对乳腺癌的影响作一综述.     

Characterization of common BRCA1 and BRCA2 variants

Many missense variants identified in BRCA1 and BRCA2, two genes responsible for the majority of hereditary breast and ovarian cancer, are of unclear clinical significance. Characterizing the significance of such variants is important for medical management of patients in whom they are identified. The aim of this study was to characterize eight of the most common reported missense mutations in BRCA1 and BRCA2 occurring in patients tested for hereditary risk of breast and ovarian cancers. The prevalence of each variant in a control population, co-segregation of the variant with cancer within families, location of the variant within the gene, the nature of the amino acid substitution and conservation of the wild-type amino acid among species were considered. In a control population, the BRCA1 variants M1652I, R1347G, and S1512I, were each observed at a frequency of 4.08%, 2.04%, and 2.04%, respectively, and the BRCA2 variants A2951T, V2728I, and D1420Y, were seen at 1.02%, 0.68%, and 0.34%, respectively. Although the BRCA2 variants T598A and R2034C were not seen in this group of controls, other clinical and published observations indicate that these variants are not deleterious. Based on epidemiological and biological criteria, we therefore conclude that the BRCA1 missense mutations R1347G, S1512I and M1652I, and the BRCA2 missense mutations T598A, D1420Y, R2034C, V2728I, and A2951T, are not deleterious mutations.     

New complexities for BRCA1 and BRCA2

A large number of diverse functions have been attributed to the BRCA1 and BRCA2 breast cancer susceptibility genes. Here we review recent progress in the field.     

Functional assays for BRCA1 and BRCA2

Genetic testing for the two major breast cancer susceptibility genes has now been available for several years with more than 70,000 people tested in the USA alone. While the current genetic testing identifies many sequence alterations there are problems with both sensitivity and specificity of the assay. In particular, the genetic testing is limited in its ability to determine which of the many missense mutations identified in BRCA1 and BRCA2 actually predispose to cancer and which are simply neutral alterations. Here we will focus on the limitations in test result interpretation and we will explore how biochemistry and cell biology can help to clarify these issues. Although we limit our discussion to genetic testing of BRCA1 and BRCA2, the problem is common to an expanding group of genes, including ATM and MSH2, in which germ-line missense mutations may also confer increased risk of cancer. Here we advocate the use of functional assays to complement genetic data in the analysis of unclassified missense mutations and propose a set of standards to conduct and interpret these assays.     

BRCA1 and BRCA2 in hereditary breast cancer

The hereditary breast and ovarian cancer susceptibility genes, BRCA1 and BRCA2, have established roles in genome integrity maintenance and in the control of homologous recombination. Recent work has produced valuable insights into the mechanisms of action of the gene products. This review summarizes some of these advances, and attempts to place them in the context of known functions of the genes.     

The predictive value of BRCA1 and BRCA2 mutation testing

Genetic testing for mutations in BRCA1 and BRCA2, two genes predisposing to breast and ovarian cancers, is available to women with a relevant family history. The aim of this study was to estimate the positive and negative predictive value of clinical sequence analysis of these genes. A reference graph showing positive and negative predictive values over a range of pre-test risk was derived, taking into account the sensitivity and specificity of a full-sequence analysis test. High positive and negative predictive values were found for women with pre-test risk between 4% and 40%, a range of risk commonly seen in clinical testing. The predictive value of full sequence and single-site analysis of BRCA1 and BRCA2, therefore, compares favorably with other diagnostic medical tests. Our results provide a numerical estimate of the predictive value of BRCA testing, and as such, provide a valuable tool to healthcare providers and families as they interpret BRCA1 and BRCA2 test results.     

Effects of BRCA1 and BRCA2 mutations on female fertility

Women with BRCA1/2 mutations have a significantly higher lifetime risk of developing breast or ovarian cancer. We suggest that female mutation carriers may have improved fitness owing to enhanced fertility relative to non-carriers. Here we show that women who are carriers of BRCA1/2 mutations living in natural fertility conditions have excess fertility as well as excess post-reproductive mortality in relation to controls. Individuals who tested positive for BRCA1/2 mutations who linked into multi-generational pedigrees within the Utah Population Database were used to identify putative obligate carriers. We find that women born before 1930 who are mutation carriers have significantly more children than controls and have excess post-reproductive mortality risks. They also have shorter birth intervals and end child-bearing later than controls. For contemporary women tested directly for BRCA1/2 mutations, an era when modern contraceptives are available, differences in fertility and mortality persist but are attenuated. Our findings suggest the need to re-examine the wider role played by BRCA1/2 mutations. Elevated fertility of female mutation carriers indicates that they are more fecund despite their elevated post-reproductive mortality risks.