BRCA-1和 MycmRNA 联合检测在乳腺癌诊断中的价值

目的:荧光定量聚合酶链反应(FQ-PCR)法检测乳腺癌易感基因(breast cancer susceptibility gene 1,BRCA-1)和核内原癌基因(nuclear oncogene,Myc)表达水平,探讨其联合检测在乳腺癌诊断和治疗监测中的应用。方法:建立FQ-PCR法,并以β2-微球蛋白为内对照测定35例健康女性体检者、40例良性乳腺肿瘤和96例乳腺癌外周血中BRCA-1和Myc的表达量。结果:正常对照组、良性乳腺疾病和乳腺癌组BRCA-1和Myc表达水平在正常对照组和良性乳腺疾病组间差异无显著性意义(P>0.05),BRCA-1在乳腺癌组显著低于正常对照组和良性乳腺疾病组(P<0.05),Myc在乳腺癌组显著高于正常对照组和良性乳腺疾病组(P<0.05),β2-微球蛋白在三组间差异无显著性意义(P>0.05)。96例乳腺癌患者中BRCA-1和Myc的阳性数分别为46和41例,阳性率分别为47.9%和42.7%;BRCA-1和Myc联合检测的阳性数为55例,阳性率为57.3%,两者联合检测的灵敏度高于单个基因的检测。结论:FQ-PCR技术是高度灵敏、高度特异的快速定量检测BRCA-1和Myc的方法,两者联合检测可提高对乳腺癌诊断的灵敏度。     

186例乳腺癌患者BRCA1基因突变检测

目的 分析186例散发乳腺癌患者肿瘤易感基因BRCA1（breast and orarian cancer susceptibility gene,BRCA1)突变情况及突变位置。方法 应用PCR－SSCP（single-stranded canformational polymorphs,SSCP)和直接测序方法定位,检测乳腺癌部分患者部分BRCA1基因外显子和内含子与外显子之间接拼区突变及突变位置。结果 186例患者中,有13例发生BRCA1基因突变,突变例数占总例数的7．0％,其中8例突变位置在内含子与外显子的拼接区,5例突变位置在外显子上。结论 筛查BRCA1基因突变对于乳腺癌患病风险评估、发病检测、早期诊断及基因治疗具有重要的临床意义。     

苏州地区乳腺癌患者BRCA1和BRCA2基因突变的分析

目的 探讨中国苏州地区乳腺癌患者乳腺癌易感基因1(BRCA1)和乳腺癌易感基因2(BRCA2)基因的突变位点及携带情况,并对携带致病突变基因患者的家系成员进行基因筛查和风险管理。方法 收集2018年7月至2021年10月确诊的85例乳腺癌患者,其中早发性乳腺癌40例,家族性乳腺癌36例,三阴性乳腺癌35例。采用高通量测序技术,对患者外周血中BRCA1和BRCA2基因的外显子及其部分内含子序列进行检测,将检测到的致病突变与ClinVar数据库进行对照,确定是否为新发现的致病突变。通过对家系先证者进行遗传咨询和肿瘤易感基因检测,进一步对携带致病基因患者的健康家系成员进行BRCA基因突变筛查。结果 85例乳腺癌患者中BRCA1和BRCA2的总致病突变率为21.2%(18/85),其中BRCA1致病突变率为11.8%(10/85), BRCA2致病突变率为9.4%(8/85)。在18例致病性突变患者中发现3个新发位点,分别为BRCA1基因c.1559dupA,BRCA2基因c.8939-8941delinsT和BRCA2基因c.3677-3678insATGAAAT。进一步对携带BRCA1/B...     

乳腺癌易感基因BRCA1和BRCA2的突变检测及其临床意义

乳腺癌易感基因BRCA1、BRCA2在家族性和遗传性乳腺癌中突变率较高。现就其功能、检测及临床应用方面的研究进展作一综述。     

ccnd1基因表达和其它肿瘤标志物在乳腺癌诊断中的应用

目的:探讨ccnd1基因表达水平在乳腺癌诊断和治疗监测中的应用.方法:采用荧光定量PCR(FQ-PCR)技术检测20例健康女性体检者、30例良性乳腺肿瘤和56例乳腺癌外周血中ccnd1基因表达量,用化学发光法检测其CA153、CA125和CEA,并进行对比分析.结果:ccnd1对乳腺癌诊断灵敏度显著高于CA153、CA125和CEA.4种指标在手术后均较术前显著下降.结论:ccnd1的基因表达水平可有效监测乳腺癌的诊断、治疗和预后.     

荧光定量聚合酶链反应检测大肠癌患者外周血癌细胞角蛋白20 mRNA

目的探讨荧光定量聚合酶链反应(FQ-PCR)检测大肠癌患者外周血癌细胞角蛋白20 mRNA(CK20 mRNA)的表达水平及临床价值。方法采用FQ-PCR法测定136例结直肠癌及其肝脏转移患者外周血癌细胞CK20 mRNA的表达水平,系统研究了FQ-PCR法测定CK20 mRNA的重复性、定量范围和扩增效率,分析比较其与传统RT-PCR、免疫组化法检测结果的一致性。结果FQ- PCR法测定CK20 mRNA的批内CV为3.6%,批间CV为5.3%,定量范围为10~3～10~8 copies/ml,扩增效率为87.4%。与传统RT-PCR和免疫组化法相比较,Kappa值分别为0.87和0.83。结直肠癌患者外周血癌细胞CK20 mRNA的表达水平为(3.52×10~4±1.47×10~4)copies/ml,表达阳性率为48.5%;75例对照者均无CK20 mRNA表达。Dukes A、B、C、D期大肠癌患者外周血癌细胞CK20 mRNA的阳性率分别为9.5%、25.0%、48.8%和87.5%,各组间差异有统计学意义(P<0.05)。肝脏转移者CK20 mRNA阳性率为87.5%,显著高于肝脏无转移者(32.3%,P<0.05)。35例结直肠癌患者术后1、3、5周内CK20 mRNA表达水平呈下降趋势,但术后1、3周与术前比较,差异无统计学意义(P>0.05),术后5周显著低于术前(P<0.05)。结论FQ-PCR是较灵敏的快速定量检测CK20 mRNA的方法。大肠癌患者外周血癌细胞CK20 mRNA的表达与肿瘤的复发和转移有关,CK20 mRNA检测将有助于大肠癌血源性播散的监测。     

乳腺癌易感基因BRCA1和BRCA2的突变检测及其临床意义

乳腺癌易感基因BRCA1、BRCA2在家族性和遗传性乳腺癌中突变率较高.现就其功能、检测及临床应用方面的研究进展作一综述.     

CK19和Ccnd1 mRNA联合检测在乳腺癌诊断中的临床研究*

目的:建立荧光定量聚合酶链反应（FQ-PCR）法检测细胞角蛋白19（CK19）和细胞周期蛋白D1（Ccnd1）基因表达水平,探讨其联合检测在乳腺癌诊断和治疗监测中的应用。方法:建立FQ-PCR 法,并以β 2- 微球蛋白为内对照测定15例健康女性体检者、30例良性乳腺疾病患者和81例乳腺癌患者外周血中CK19和Ccnd1 的表达量。结果:正常对照组、良性乳腺疾病和乳腺癌组CK19表达水平分别为（1.42± 0.12,1.46± 0.11,3.29± 2.12）× 10-3,Ccnd1 表达水平分别（1.44± 0.11,1.46± 0.10,3.76± 0.39）× 10-3,两种基因表达水平在正常对照组和良性乳腺疾病组间无显著性差异（P>0.05）,乳腺癌组均高于前两组（P<0.05）,β 2- 微球蛋白在三组间差异无显著性意义（P>0.05）。 81例乳腺癌患者中CK19和Ccnd1 的阳性数分别为44例和41例,阳性率分别为54.3% 和40.7% ,良性乳腺疾病组阳性数为0。CK19和Ccnd1 联合检测的阳性数49例,阳性率为60.5% ,两者联合检测的灵敏度高于单个基因的检测。结论:FQ-PCR 技术是高度灵敏、高度特异的快速定量检测CK19和Ccnd1 方法,两者联合检测可有效提高对乳腺癌诊断的灵敏度。      

CK19和myc mRNA联合检测在乳腺癌诊断中的临床研究

目的:建立荧光定量聚合酶链反应(FQ-PCR)法检测细胞角蛋白19(CK19)和myc基因表达水平,探讨其联合检测在乳腺癌诊断和治疗监测中的应用。方法:建立FQ-PCR法,并以β2-微球蛋白为内对照测定15名健康女性体检者、30例良性乳腺疾病患者和151例乳腺癌患者外周血中CK19和myc的表达量。结果:CK19和myc表达水平在正常对照组和良性乳腺疾病组间差异无显著性意义(P>0.05),乳腺癌组均高于前两组(P<0.05),β2-微球蛋白在三组间差异无显著性意义(P>0.05)。CK19和myc联合检测的灵敏度高于单个基因的检测。结论:FQ-PCR技术是高度灵敏、高度特异的快速定量检测CK19和myc方法,两者联合检测可有效提高对乳腺癌诊断的灵敏度。     

CK19和myc mRNA联合检测在乳腺癌诊断中的临床研究

目的：建立荧光定量聚合酶链反应（FQ-PCR）法检测细胞角蛋白19（CK19）和myc基因表达水平,探讨其联合检测在乳腺癌诊断和治疗监测中的应用。方法：建立FQ-PCR法,并以β2-微球蛋白为内对照测定15名健康女性体检者、30例良性乳腺疾病患者和151例乳腺癌患者外周血中CK19和myc的表达量。结果：CK19和myc表达水平在正常对照组和良性乳腺疾病组间差异无显著性意义（P〉0.05）,乳腺癌组均高于前两组（P〈0.05）,β2-微球蛋白在三组间差异无显著性意义（P〉0.05）。CK19和myc联合检测的灵敏度高于单个基因的检测。结论：FQ-PCR技术是高度灵敏、高度特异的快速定量检测CK19和myc方法,两者联合检测可有效提高对乳腺癌诊断的灵敏度。     

Predictors of contralateral breast cancer in BRCA1 and BRCA2 mutation carriers

Purpose:

The objective of this study was to estimate the risk of contralateral breast cancer in BRCA1 and BRCA2 carriers; and measure the extent to which host, family history, and cancer treatment-related factors modify the risk.

Patients and methods:

Patients were 810 women, with stage I or II breast cancer, for whom a BRCA1 or BRCA2 mutation had been identified in the family. Patients were followed from the initial diagnosis of cancer until contralateral mastectomy, contralateral breast cancer, death, or last follow-up.

Results:

Overall, 149 subjects (18.4%) developed a contralateral breast cancer. The 15-year actuarial risk of contralateral breast cancer was 36.1% for women with a BRCA1 mutation and was 28.5% for women with a BRCA2 mutation. Women younger than 50 years of age at the time of breast cancer diagnosis were significantly more likely to develop a contralateral breast cancer at 15 years, compared with those older than 50 years (37.6 vs 16.8% P=0.003). Women aged <50 years with two or more first-degree relatives with early-onset breast cancer were at high risk of contralateral breast cancer, compared with women with fewer, or no first-degree relatives with breast cancer (50 vs 36% P=0.005). The risk of contralateral breast cancer was reduced with oophorectomy (RR 0.47; 95% CI 0.30–0.76; P=0.002).

Conclusion:

The risk of contralateral breast cancer risk in BRCA mutation carriers declines with the age of diagnosis and increases with the number of first-degree relatives affected with breast cancer. Oophorectomy reduces the risk of contralateral breast cancer in young women with a BRCA mutation.     

散发性乳腺癌患者BRCA1基因突变分析

目的 :探讨BRCA1基因突变在散发性乳腺癌发生和发展中的作用及在乳腺癌临床诊断和治疗中的应用前景。方法 :应用PCR SSCP和直接测序法检测 3 0例散发性乳腺癌和 15例正常乳腺组织中BR CA1基因外显子 2、11和 2 0的突变情况。结果 :15例正常乳腺组织在 3个外显子上都未显示电泳异常 ,3 0例乳腺癌中有 6例在外显子 2上显示电泳条带异常 ,其中 4例经测序证实有突变 ,1例在外显子 2上 ,3例在内含子拼接区。BRCA1基因突变率在初诊年龄、临床分期和肿瘤体积上差异无统计学意义 ,但与肿瘤转移密切相关。结论 :BRCA1基因突变与散发性乳腺癌的发生和发展密切相关 ,该基因突变筛查可作为一种预后指标。     

华东地区乳腺癌散发病例BRCA1、BRCA2基因突变

目的：探讨华东地区乳腺癌散发病例BRCA1及BRCA2基因突变情况。方法：应用PCR-SSCP-Sequencing方法,对复旦大学附属肿瘤医院79例随机乳腺癌患者的癌组织及癌旁正常乳腺组织的标本进行BRCA1和BRCA2部分基因的突变检测,共6个外显子（BRCA1中的第2、11、22外显子,BRCA2中的第9,14,22外显子）23对引物。结果：发现在BRCA1和cDNA 2430碱基处存在一个T→C的单个碱基的变化,应用RFLP方法在人群中证实为一单核苷酸多态。此SNP的分布在病例及对照中等位基因频率存在差异,但并未达到显著性水平。结论：提示华东地区人群的乳腺癌群体中的BRCA1及BRCA2的突变十分罕见。     

A role for BRCA1 in sporadic breast cancer

To test the hypothesis that altered expression of BRCA1 protein may play an important role in sporadic breast cancer development, 50 randomly selected primary breast cancers (frozen sections, 5 years' median follow-up) were immunolabelled with two monoclonal BRCA1 antibodies (MS110 and MS13). MS110 labelling was exclusively nuclear showing no relation to outcome or tumour pathology. Western blotting demonstrated crossreactivity, suggesting antibody nonspecificity. MS13 labelling was predominantly cytoplasmic. Intense labelling predicted decreased overall survival (P=0.012), disease-free survival (P=0.029), oestrogen receptor negativity (P=0.0004) and c-erbB-2 overexpression (P=0.006). Western blotting detected a 110 kDa molecule consistent with BRCA1 delta11b splice variant. BRCA1 protein is postulated to function as a tumour suppressor. We demonstrate cytoplasmic localisation in sporadic breast cancer suggesting excess delta11b splice variant production, reduced production of full-length BRCA1 and thus postulate reduced tumour suppressor activity. BRCA1 protein appears to have a significant role in both sporadic and hereditary breast cancers.     

Diabetes and breast cancer among women with BRCA1 and BRCA2 mutations

BACKGROUND:

Hyperinsulinemia and the metabolic syndrome are both risk factors for breast cancer. It is not clear if diabetes is associated with the risk of breast cancer in women with a BRCA1 or BRCA2 mutation.

METHODS:

The authors reviewed the medical histories of 6052 women with a BRCA1 or BRCA2 mutation, half of whom had been diagnosed with breast cancer. They estimated the odds ratio for breast cancer, given a self‐report of diabetes. They then estimated the hazard ratio for a new diagnosis of diabetes associated with a history of breast cancer.

RESULTS:

There was no excess of diabetes in the period before the diagnosis of breast cancer, compared with controls with no diagnosis of breast cancer. The risk of diabetes was doubled among BRCA carriers in the 15‐year period after the diagnosis of breast cancer (relative risk, 2.0; 95% confidence interval [CI], 1.4‐2.8; P = .0001), compared with carriers without cancer. The risk was particularly high for women with a body mass index (BMI) >25.0 kg/m² (odds ratio, 5.8; 95% CI, 4.0‐8.6; P = .0001).

CONCLUSIONS:

After a diagnosis of breast cancer, women with a BRCA1 or BRCA2 mutation face a 2‐fold increase in the risk of diabetes, which is exacerbated by a high BMI. Cancer 2011. © 2010 American Cancer Society.     

Contralateral breast cancer risk in BRCA1 and BRCA2 mutation carriers in a large cohort of unselected Chinese breast cancer patients

To estimate the cumulative risk of contralateral breast cancer (CBC) in BRCA1/2 carriers in a large cohort of unselected Chinese breast cancer patients. Our study comprised 9,401 unselected Chinese breast cancer patients and BRCA1/2 germline mutations were determined in all patients. After a median follow-up of 5.7 years, 181 patients developed CBC in this cohort. Compared to noncarriers, BRCA1 and BRCA2 carriers had a 4.52-fold (95% CI, 2.63–7.76) and 5.54-fold (95% CI, 3.51–8.74) increased risk of CBC, respectively. The 10-year cumulative risk of CBC was 15.5% (95% CI, 9.9–24.2) for BRCA1 carriers, 17.5% (95% CI, 10.9–28.0) for BRCA2 carriers and 3.2% (95% CI, 2.5–4.1) for noncarriers. Younger age at first breast cancer diagnosis was significantly associated with an increased 10-year risk of CBC for BRCA1 carriers (≤40 years vs. >40 years: 21.5% vs. 11.9%, unadjusted hazard ratio [HR] = 2.51, 95% CI, 1.03–6.15, p = 0.044), but not for BRCA2 carriers and noncarriers. The 10-year cumulative CBC risk was significantly higher in both BRCA1 and BRCA2 carriers who had a family history of breast cancer than in those who did not (BRCA1: 27.5% vs. 9.4%, adjusted HR = 2.64, 95% CI, 1.01–6.97, p = 0.049; BRCA2: 27.1% vs. 12.8%, adjusted HR = 2.29, 95% CI, 1.04–5.06, p = 0.040). In conclusion, the risk of CBC was a substantial high in BRCA1/2 carriers in unselected Chinese breast cancer patients, and CBC risk is much more remarkable in both BRCA1 and BRCA2 carriers who had a family history of breast cancer. Younger age at first breast cancer diagnosis also enhanced CBC risk in BRCA1 carriers.     

Collaboration of breast cancer clinic and genetic counseling division for BRCA1 and BRCA2 mutation family in Japan

BACKGROUND: BRCA1 and BRCA2 mutations cause high breast cancer incidence rates as high as 80% Although prophylactic therapy is still controversial, several prophylactic therapies have been proposed and tried for BRCA1 and BRCA2 mutation carriers. Prophylactic surgery, chemo-prevention and precise screening have been proposed as prophylactic therapy. All BRCA1 and BRCA2 mutation carriers need knowledge about their disease and the countermeasures that are used to protect against onset of disease. Counseling plays an important role in this regard for people with genetic diseases. Therefore, collaboration between breast cancer clinics and genetic counseling services is the most important issue in clinical practice. Our group consists of three national universities and a general hospital. In this article we describe our trial to construct a clinical system against hereditary breast cancer as an interim report for the Japanese Ministry of Health, Labour and Welfare. PATIENTS AND METHODS: Twenty familial breast cancer patients were registered in this study. The whole sequence of BRCA1 and BRCA2 were analyzed. If pathological mutations were detected, their first degree families were introduced to the counseling division at each institute when candidates visited counseling divisions. RESULTS AND DISCUSSION: Four cases of a deleterious mutation in BRCA1 or BRCA2 were detected among 20 cases. Their first degree relatives are now under consideration for visiting counseling divisions. The clinical system described in this study should play a role to protect BRCA1 or BRCA2 mutation carriers in Japan.     

Chromosome 5 imbalance mapping in breast tumors from BRCA1 and BRCA2 mutation carriers and sporadic breast tumors

Comparative genomic hybridization (CGH) analysis has shown that chromosome 5q deletions are the most frequent aberration in breast tumors from BRCA1 mutation carriers. To map the location of putative 5q tumor suppressor gene(s), 26 microsatellite markers covering chromosome 5 were used in loss of heterozygosity (LOH) analysis of breast tumors from BRCA1 (n = 42) and BRCA2 mutation carriers (n = 67), as well as in sporadic cases (n = 65). High-density array CGH was also used to map chromosome 5 imbalance in 10 BRCA1 tumors. A high LOH frequency was found in BRCA1 tumors (range 19-82%), as compared to BRCA2 and sporadic tumors (ranges 11-44% and 7-43%, respectively). In all, 11 distinct chromosome 5 regions with LOH were observed, the most frequent being 5q35.3 (82%), 5q14.2 (71%) and 5q33.1 (69%) in BRCA1 tumors; 5q35.3 (44%), 5q31.3 (43%) and 5q13.3 (43%) in BRCA2 tumors and 5q31.3 (43%) in sporadic tumors. Array CGH analysis confirmed the very high frequency of 5q deletions, including candidate tumor suppressor genes such as XRCC4, RAD50, RASA1, APC and PPP2R2B. In addition, 2 distinct homozygous deletions were identified, spanning regions of 0.7-1.5 Mbp on 5q12.1 and 5q12.3-q13.1, respectively. These regions include only a few genes, most notably BRCC3/DEPDC1B (pleckstrin/G protein interacting and RhoGAP domains) and PIK3R1 (PI3 kinase P85 regulatory subunit). Significant association (p < or = 0.05) was found between LOH at certain 5q regions and factors of poor prognosis, including negative estrogen and progesterone receptor status, high grade, large tumor size and high portion of cells in S-phase. In conclusion, our results confirm a very high prevalence of chromosome 5q alterations in BRCA1 tumors, pinpointing new regions and genes that should be further investigated.     

Tamoxifen and contralateral breast cancer in BRCA1 and BRCA2 carriers: an update

Women with a mutation in BRCA1 or BRCA2 face a lifetime risk of breast cancer of approximately 80%, and following the first diagnosis the 10-year risk of contralateral breast cancer is approximately 30%. It has been shown that both tamoxifen and oophorectomy prevent contralateral breast cancer, but it is not clear whether there is a benefit in giving tamoxifen to women who have previously undergone an oophorectomy. Furthermore, the relative degree of protection in BRCA1 and BRCA2 carriers has not been well evaluated. We studied 285 women with bilateral breast cancer and a BRCA1 or BRCA2 mutation, and 751 control women with unilateral breast cancer and a BRCA1 or BRCA2 mutation in a matched case-control study. Control women were of similar age and had a similar age of diagnosis of breast cancer and had been followed for as long as the case for a second primary breast cancer. The history of tamoxifen use for treating the first breast cancer was compared between bilateral and unilateral cases. The multivariate odds ratio for contralateral breast cancer associated with tamoxifen use was 0.50 for carriers of BRCA1 mutations (95% CI, 0.30-0.85) and was 0.42 for carriers of BRCA2 mutations (95% CI, 0.17-1.02). The protective effect of tamoxifen was not seen among women who had undergone an oophorectomy (OR = 0.83; 95%CI, 0.24-2.89) but this subgroup was small. In contrast, a strong protective effect of tamoxifen was apparent among women who were premenopausal or who had undergone natural menopause (OR = 0.44; 95% CI, 0.27-0.65).