关键词: BARD1 BRIP1 CHEK2 Hereditary MUTYH PALB2 RAD51C

Mesh : Adult Aged Biomarkers, Tumor / genetics Biopsy Breast Neoplasms / genetics pathology Checkpoint Kinase 2 / genetics DNA Glycosylases / genetics DNA Mutational Analysis DNA-Binding Proteins / genetics Fallopian Tube Neoplasms / genetics pathology Fanconi Anemia Complementation Group N Protein / genetics Fanconi Anemia Complementation Group Proteins / genetics Female Genetic Predisposition to Disease Germ-Line Mutation Heredity Humans Middle Aged Neoplastic Syndromes, Hereditary / genetics pathology Ovarian Neoplasms / genetics pathology Pedigree Phenotype Prognosis RNA Helicases / genetics Tumor Suppressor Proteins / genetics Ubiquitin-Protein Ligases / genetics

来  源:   DOI:10.1016/j.humpath.2017.06.018   PDF(Sci-hub)

Abstract:
Germline BRCA mutations account for a significant proportion of genetic/familial risk of breast and ovarian cancer (GBOC) susceptibility, but a broader spectrum of GBOC susceptibility genes has emerged in recent years. Genotype-to-phenotype correlations are known for some established forms of GBOC; however, whether such correlations exist for less common GBOC variants is unclear. We reviewed our institution\'s experience with non-BRCA GBOC, looking specifically for trends in pathologic and clinical features. Eighteen women with deleterious germline mutations in RAD51C (5 patients), BARD1 (1 patient), BRIP1 (2 patients), PALB2 (3 patients), MUTYH (2 patients), or CHEK2 (5 patients) were identified between January 2011 and December 2016. Thirteen (72%) of 18 patients developed carcinoma of the breast, fallopian tube, or ovary, with 1 patient developing 2 separate primary neoplasms. Twelve (86%) of 14 tumors occurred in the breast. One (7%) arose in the fallopian tube and another (7%) arose in the ovary. Evidence of genotype-phenotype correlation was not identified. However, some data suggest that the type of alteration in select genes may influence tumor behavior and patient outcome. In our PALB2 mutation cohort, 2 patients with frameshift mutations led to early onset and rapid progression to stage IV breast cancer in contrast to stage IA breast cancer in 1 patient with a nonsense mutation. Despite no apparent genotype-phenotype trends, our data indicate that some loss-of-function variants in PALB2 may lead to differences in tumor behavior and patient outcome.
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