231例乳腺癌患者乳腺癌易感基因 BRCA1 的突变检测及分析

目的：研究中国妇女BRCA1基因突变与遗传性、家族性和早发性乳腺癌的关系。方法：选取231例乳腺癌患者石蜡标本,显微切割提取癌组织,酚抽提法提取DNA,紫外分光光度仪测定DNA纯度及含量,PCR扩增exon2、exon11和exon20片段直接测序,与基因库序列比对分析其突变情况。结果：231例乳腺癌中发现突变33例,突变率为14．28％,统计分析发现,≤35岁年龄组与36－45岁组比较,P值为0．724,无统计学差异。46－55岁年龄组与＞55岁组比较,P 值为0．868,亦无统计学差异。将上述两组合并后统计发现,≤45岁年龄组患者突变率高于＞45岁组患者,P值为0．002,有显著统计学差异。结论：BRCA1突变与乳腺癌尤其是早发性乳腺癌密切相关。     

38例散发乳腺癌患者BRCA1基因突变检测

目的：分析３８例散发乳腺癌患者ＢＲＣＡ１基因突变情况及突变位置。方法：应用ＰＣＲ－ＳＳＣＰ（Ｓｉｎｇｌｅ－ｓｔｒａｎｄｅｄ ｃｏｎｆｏｒｍａｔｉｏｎａｌ ｐｏｌｙｍｏｒｐｈｉｓｍ,ＳＳＣＰ）和直接测序方法。结果：４／３８例患者ＢＲＣＡ１基因有突变,突变例数占总例和的１０．５％,其中３例突变位置在内含子的拼接区,一例突变位置在１１号外显子上。结论：筛查ＢＲＣＡ１基因突变对于乳腺癌患病风险评估,发病检     

中国乳腺癌家族BRCA1突变分析

为了探讨中国乳腺癌家族中BRCAl基因突变情况,我们收集了15个乳腺癌家系,共41个对象,其中23例为乳腺癌患者,采用聚合酶链反应-单链构像多态性分析(PCR-SSCP)、直接DNA测序法对BRCA1编码基因进行了全序列分析。结果发现在15个家系中有4例(3种)基因突变,突变比例为26.7％(4/15)。其中一例2228insC为插入突变,致编码子711处蛋白截短;另3例(2种)突变为1884A→T和3232 A→G,分别引起单个氨基酸改变。我们认为BRCA1为家族性乳腺癌的遗传基因;在BRCA1以外还存在其他的乳腺癌易感基因。     

100例遗传性乳腺癌胚系基因BRCA1/2突变研究

目的探讨遗传性乳腺癌患者胚系基因BRCA1/2的外显子区域突变情况及其与临床病理特征的关系。 方法本研究为回顾性研究。根据纳入和排除标准,选择2014年2月至2016年2月山西省人民医院乳腺外科确诊的100例遗传性乳腺癌患者作为研究对象,采用二代测序技术检测患者胚系基因BRCA1/2突变的情况,并收集其年龄、组织学分级、淋巴结状态以及ER、PR、HER-2状态等临床病理资料。然后,采用Fisher确切概率检验比较BRCA1与BRCA2基因突变类型的差异,并用χ²检验分析BRCA1/2基因突变与乳腺癌患者临床病理特征的关系。 结果在100例遗传性乳腺癌患者中,有6例患者携带BRCA1基因突变,11例患者携带BRCA2基因突变。而在6例BRCA1基因突变者中,发生移码突变和无义突变者分别占4/6、2/6;在11例BRCA2基因突变者中,发生移码突变和无义突变者分别占4/11、7/11;2组间比较,基因突变类型的差异无统计学意义(P＝0.335)。在组织学分级1、2级的患者中,携带BRCA1、BRCA2基因突变者以及不携带BRCA1/2基因突变者分别占4.4%(4/91)、8.8%(8/91)和86.8%(79/91),而在组织学分级为3级的患者中,携带BRCA1、BRCA2基因突变者及不携带BRCA1/2基因突变者分别占2/9、3/9和4/9,组间比较,差异有统计学意义(χ²＝9.398,P＝0.007)。在HER-2阴性乳腺癌患者中,携带BRCA1、BRCA2基因突变者及不携带BRCA1/2基因突变者分别占10.7%(6/56)、16.1%(9/56)和73.2%(41/56),而在HER-2阳性乳腺癌患者中,携带BRCA1、BRCA2基因突变者及不携带BRCA1/2基因突变者分别占0(0/44)、4.5%(2/44)和95.5%(42/44),组间比较,差异有统计学意义(χ²＝9.072,P＝0.007)。 结论遗传性乳腺癌患者胚系基因BRCA1/2突变在不同组织学分级、不同HER-2状态的患者间存在差异。本研究在丰富遗传性乳腺癌临床遗传学资料的同时,可能为后期的个体化精准治疗奠定一定的理论依据。     

乳腺癌患者BRCA1 基因启动子区甲基化模式的初步研究

目的：探讨在散发性乳腺癌患者中乳腺癌易感基因1（breast cancer1,BRCA1)启动子区13个CpG二核苷酸甲基化模式与肿瘤发生的关系。方法：用新发展的甲基化敏感单链构象分析法（methylation-sensitive-single-strand conformation analysis,MS-SSCA)及DNA测序技术,对66例乳腺癌患者的癌组织、癌旁组织、外周血细胞中的BR-CA1基因启动子区甲基化模式进行研究。结果：发现有3种不同的甲基化模式。其中16例（24.2%)为高度甲基化,3例（4.5%)为部分甲基化,其余为未甲基化。结论：在部分散发性乳腺癌中BRCA1基因是高度甲基化的,它可能是BRACA1基因表达下降的机制之一。     

BRCA1和BRCA2基因与乳腺癌相关的研究进展

BRCA1和BRCA2基因是与乳腺癌尤其是遗传性乳腺癌发生发展密切相关的抑癌基因.研究表明,部分乳腺癌患者存在BRCA1和BRCA2基凶突变,而且出现这两个基因突变的乳腺癌表现出不同的病理学特点.通过检测乳腺癌患者BRCA1和BRCA2基因的突变情况,将有助于对乳腺癌患者预后的早期评估.     

乳腺癌易感基因1的临床研究进展

乳腺癌易感基因1(BRCA1)突变与乳腺癌、卵巢癌等许多癌症发生密切相关.近年来越来越多的研究提示,在化疗疗效、放疗敏感性及手术效果等方面,BRCA1突变乳腺癌与其他乳腺癌相比有显著差异.BRCA1的研究为其今后在临床上的应用提供了方向.     

乳腺癌BRCA1 基因突变的筛查研究

 目的 研究BRCA1基因在散发性乳腺癌中的突变情况，探讨BRCA1基因突变与乳腺癌的关系。方法 应用PCR-SSCP（single-strand conformation polymorphism analysis）分析和DNA直接测序法，检测65例散发性乳腺癌BRCAI第2，3，5，8，10，12，13，14，15，16，17，18，19，20和21外显子基因突变情况。结果 65例中共检测出4例突变，其中1例为5外显子的错义突变（287A〉T），1例为12外显子的错义突变（4285G〉A），1例为17外显子的错义突变（5115T〉C），1例为18外显子的错义突变（5206T〉A）。乳腺癌BRCA1的基因突变率为6．2％（4／65）。结论 BRCA1基因突变与散发性乳腺癌有密切关系。     

河北省家族性和散发性乳腺癌易感基因1/2突变的研究

目的探讨河北省家族性和散发性乳腺癌患者乳腺癌易感基因(BRCA)1/2的突变位点及携带情况。方法采用聚合酶链反应-单链构象多态性分析和基因测序技术对18例家族性乳腺癌患者、50例散发性乳腺癌患者、23例乳腺良性疾病患者及20例健康对照组血样标本的基因组DNA进行BRCA1/2基因突变的检测。定性资料采用χ2检验和Fisher's确切概率法进行分析,定量资料采用t检验进行分析。结果 68例乳腺癌患者基因突变率为7.35%(5/68),均发生在BRCA1基因(162ATTTTT;4142GTTGTG;4196CAACAT;4196delA,4142GTTGTG;5379GAAAAA),无BRCA2基因突变,BRCA1基因的突变率高于BRCA2基因(χ2=4.829,P=0.028);其中,18例家族性乳腺癌基因突变3例,50例散发性乳腺癌突变2例,二者间差异无统计学意义(χ2=3.117,P=0.111)。乳腺良性疾病患者未见BRCA1/2基因突变。健康对照组未见BRCA1基因突变,但有1例BRCA2基因突变[TTTCAGA-TGTCAA(6291insG,6294delG)]。家族性乳腺癌患者、散发性乳腺癌患者、乳腺良性疾病患者和健康对照组的BRCA1基因突变率差异有统计学意义(χ2=8.248,P=0.041)。在1例家族性乳腺癌标本中发现1个核苷酸多态性位点,位于BRCA1第20外显子下游第35个碱基处GA(IVS20+35GA)。结论本研究丰富了中国人群BRCA1/2基因的突变谱,并为将来乳腺癌的普查和临床基因检测提供了筛查模式。     

BRCA1基因在原发性卵巢癌组织中突变的研究

探讨ＢＲＣ１基因突变在原发性卵巢癌发生中的作用。方法应用聚合酶链反应－单链构像多态银染技术及ＰＣＲ产物直接序列测定的方法检测了５６例原发生性卵巢癌ＢＲＣＡ１基因第２、５、１１、２１外显子区域上的突变情况。结果１１例存在ＰＣＲ－ＳＳＣＰ电泳条带异常,经测序确证了ＢＲＣＡ１基因突变的性质。ＢＲＣＡ１基因突变率在初诊年龄和临床分期上无显著差异。结论ＢＲＣＡ１基因突变与原发性卵巢癌的发生紧密相关。     

Identification of Mutation in Exon11 of BRCA1 Gene in Bangladeshi Patients with Breast Cancer

Background: Worldwide, breast cancer is the leading cause of cancer death in female, in Bangladesh breast cancer is the second leading cancer in both sexes, and in women it occupied the top position. Highly penetrant mutations in BRCA1 gene constitute high risk of breast cancer. The spectrum of BRCA1 gene mutations varies in different population. The objective of this study was to identify mutation in exon11 of BRCA1 gene in Bangladeshi breast cancer patients. Methods: Genomic DNA was extracted from the histopathologically diagnosed formalin fixed paraffin embedded (FFPE) breast cancer tissues of 65 adult female patients. Two regions of exon11 of the BRCA1 gene were amplified and the amplicons were sequenced using Sanger sequencing. The sequenced nucleotides were analyzed and blast using NCBI nucleoblast. Selected demographic, reproductive and medical histories were collected and analyzed using SPSS version 20. Results: The mean age of the patients was 46 years and the mean age at diagnosis was 44.64 years. The patients were married and had 2.65 ± 1.22 children except one was nulliparous, the mean age of menarche was 12.67 years. All patients had children, breastfed the babies for an average 1.5 years. Only 13.6% of the patients had hypertension and the rest had no comorbidity. The family history for cancer (breast and other cancer) was negative. Three novel mutations were found in a patient. Two among the three mutant sequences had effect on amino acid coding (DNA sequence change g.852G>C and g.709G>A and amino acid changes p.Gln284His and p.Glu237Lys respectively).  Conclusion: We found three novel mutations in Bangladeshi breast cancer patients. This finding indicates the necessity to study the mutation profile of whole BRCA1 gene in our population for cancer risk prediction.     

丽水市家族性乳腺癌患者BRCA1基因突变分析

摘 要：［目的］ 研究丽水市家族性乳腺癌患者BRCA1基因突变及意义。［方法］ 选取丽水市家族性乳腺癌患者32例,其中5例为双侧乳腺癌,抽取入组患者的外周静脉血,抽提全血基因组DNA,应用 PCR 技术对BRCA1的22个外显子基因序列扩增后直接测序。［结果］ 32例家族性乳腺癌患者中共发现7例BRCA1基因突变,其中2例双侧乳腺癌患者检测出BRCA1基因突变,BRCA1基因突变率为21.86％,8个在BIC数据库中均有报道的突变位点。在第3、11、13号外显子发生3例4个位点同义突变,在第11、16号外显子发生6例4个位点错义突变。突变位点多数位于第11号外显子上,其中有2个同义突变、3个错义突变即2731C>T、3232A>G、3667A>G。［结论］ BRCA1基因突变在丽水市家族性乳腺癌患者中有其自身特点,研究将为丽水市乳腺癌患者的一级和二级预防提供参考依据。     

BRCA1 Gene Exon 11 Mutations in Uighur and Han Women with Early-onset Sporadic Breast Cancer in the Northwest Region of China

The prevalence of BRCA1 gene mutations in breast cancer differs between diverse ethnic groups. Relativelylittle information is known about patterns of BRCA1 mutations in early-onset breast cancer in women of Uighuror Han descent, the major ethnic populations of the Xinjiang region in China. The aim of this study was to identifyBRCA1 mutations in Uighur and Han patients with early-onset (age <35 years), and sporadic breast cancer forgenetic predisposition to breast cancer. For detection of BRCA1 mutations, we used a polymerase chain reactionsingle-stranded conformation polymorphism approach, followed by direct DNA sequencing in 22 Uighur and 13Han women with early-onset sporadic breast cancer, and 32 women with benign breast diseases. The prevalenceof BRCA1 mutations in this population was 22.9% (8/35) among early-onset sporadic breast cancer cases. Ofthese, 31.8% (7/22) of Uighur patients and 7.69% (1/13) of Han patients were found to have BRCA1 mutations.In 7 Uighur patients with BRCA1 mutations, there were 11 unique sequence alterations in the BRCA1 gene,including 4 clearly disease-associated mutations on exon 11 and 3 variants of uncertain clinical significance onexon 11, meanwhile 4 neutral variants on intron 20 or 2. None of the 11 BRCA1 mutations identified have beenpreviously reported in the Breast Cancer Information Core database. These findings reflect the prevalence ofBRCA1 mutations in Uighur women with early-onset and sporadic breast cancer, which will allow for provisionof appropriate genetic counseling and treatment for Uighur patients in the Xinjiang region.     

Platinum Sensitivity in a BRCA1 Mutation Carrier with Advanced Breast Cancer

Although BRCA1-associated breast carcinomas are frequently detected in nodal-negative stage, they typically present with an aggressive histopathological phenotype that is reflected by a poor prognosis and an increased risk for distant metastatic spread. Recent in vitro data suggest a high sensitivity of BRCA1-associated carcinomas to platinum-based chemotherapy and a lower sensitivity to anthracyclines and taxanes. This is explained by the key role of BRCA1 in DNA double-strand repair via homologous recombination, thereby leading to a higher sensitivity to DNA intercalating agents, such as platinum. Here we present the case of a woman suffering from BRCA1-associated metastatic breast carcinoma that was resistant to docetaxel, but responded strongly to cisplatin-containing chemotherapy. This supports the rationale of ongoing clinical studies.     

乳腺癌BRCA1基因突变及其蛋白表达研究

目的 :探讨散发性乳腺癌的BRCA1基因突变及其蛋白表达与临床病理因素的关系。方法 :收集乳腺癌患者外周血 10 2份、新鲜肿瘤组织 30份 ,分别采用PCR SSCP、DHPLC和基因测序对BRCA1基因第 2、8- 1、8- 2和 2 0外显子进行突变检测 ;对 10 4例肿瘤组织切片进行免疫组化染色标记BRCA1蛋白表达 ,分析免疫组化结果与临床资料的关系。结果 :分别在外显子 8- 1和 8- 2的 2 882 1和 2 8978位点上发现 3例碱基缺失和置换现象。BRCA1蛋白在乳腺癌组织中表达下降 ,且与患者生存状态有关。结论 :在中国散发性乳腺癌患者中BRCA1基因外显子 2、8和 2 0的突变率较低 (2 3% ) ,可以认为在普通中国人群中乳腺癌的发生与该部分碱基序列突变的关系不大 ,但BRCA1蛋白低表达乳腺癌患者复发的危险性增大     

Nonsense Mutation at Codon 63 of the BRCA1 Gene in Japanese Breast Cancer Patients

The involvement of abnormalities of the BRCA1 gene in breast cancers in Japanese patients without any family history of this cancer was investigated by polymerase chain reaction-based single-strand conformation polymorphism analysis of the DNA sequences corresponding to the zinc finger domain (exons 2, 3 and 5) and the binding domain with Rad51 (exon 11) of the BRCA1 protein. An identical nonsense mutation at codon 63 (TTA to TAA) was found in 2 of 56 (3.5%) breast cancers from independent patients. The nucleotide change was also detected in the DNAs from non-cancerous tissues of both patients and therefore was a germline mutation. One of the patients was a member of a pedigree involving 3 ovarian cancer and 1 gastric cancer patients, while the other patient had no family history of malignancy. The same germline mutation at codon 63 was reported in four other independent Japanese pedigrees with frequent breast cancer, but not in such families in other countries. These observations suggest that the mutation commonly originated from a single Japanese ancestor. No other mutation of the BRCA1 gene was observed in the samples analyzed in this study. A low incidence of germline mutation and the absence of somatic mutation suggest that the aberration of the BRCA1 gene is involved only in a subset of Japanese breast cancers.     

BRCA1 Gene Mutation Screening for the Hereditary Breast and/or Ovarian Cancer Syndrome in Breast Cancer Cases: a First High Resolution DNA Melting Analysis in Indonesia

Specific patterns of the hereditary breast and ovarian cancer (HBOC) syndrome are related to mutations in the BRCA1 gene. One hundred unrelated breast cancer patients were interviewed to obtain clinical symptoms and signs, pedigree and familial history of HBOC syndrome related cancer. Subsequently, data were calculated using the Breast and Ovarian Analysis of Disease Incidence and Carrier Estimation Algorithm (BOADICEA) risk prediction model. Patients with high score of BOADICEA were offered genetic testing. Eleven patients with high score of BOADICEA, 2 patients with low score of BOADICEA, 2 patient's family members and 15 controls underwent BRCA1 genetic testing. Mutation screening using PCR-HRM was carried out in 22 exons (41 amplicons) of BRCA1 gene. Sanger sequencing was subjected in all samples with aberrant graph. This study identified 10 variants in the BRCA1 gene, consisting of 6 missense mutations (c.1480C>A, c.2612C>T, c.2566T>C, c.3113A>G, c.3548 A>G, c.4837 A>G), 3 synonymous mutations (c.2082 C> T, c.2311 T> C and c.4308T>C) and one intronic mutation (c.13435 G>T). All variants tend to be polymorphisms and unclassified variants. However, no known pathogenic mutations were found.     

Risk of Ipsilateral and Contralateral Cancer in BRCA Mutation Carriers with Breast Cancer

BRCA1 and BRCA2 mutation carriers with breast cancer have a high risk of ipsilateral breast cancer tumor recurrence (IBTR) and a high lifetime risk of contralateral breast cancer (CBC). The IBTR risk is significantly higher in women who elect breast conservation. Oophorectomy has a protective effect for both ipsilateral breast tumor recurrence and CBC. Patients with younger age of breast cancer onset have a significantly greater risk of CBC. Given the higher risk of IBTR and CBC, when indicated, patients with breast cancer should undergo genetic counseling early in their treatment course to assist them in their surgical decision-making. Knowledge of expected outcomes for BRCA1/2 mutation carriers following breast cancer treatment can help in appropriately counseling patients and personalizing cancer therapy.