乳腺增生病p53基因第5外显子突变及其蛋白表达

目的：探讨p53基因在乳腺癌发生早期的作用。方法：用免疫组化方法检测36例乳腺单纯性增生、31例不典型增生、14例原位癌和16例浸润癌中p53蛋白的表达，用PCR－SSCP检测了上述组织中p53基因第5外显子突变。结果：p53蛋白在单纯性增生、不典型增生、导管内癌、浸润癌中的表达率分别为0、22.6%(7/31)、42.8%(6/14)、50％（8／16），PCR－SSCP在各组中均未检测到该基因第5外显子突变。结论：乳腺癌发生早期阶段有p53基因的参与，但与第5外显子突变无明显关系。     

127例PKU患者PAH基因第12外显子点突变及其频率研究

目的　了解中国人苯丙酮尿症 ( phenylketonuria,PKU)患者的苯丙氨酸羟化酶( phenylalanine hydroxylase,PAH)基因第 12外显子点突变种类和频率。方法　应用单链构象多态性( single strand conformation polymorphism,SSCP)、变性梯度凝胶电泳 ( denaturing gradient gelelectrophoresis,DGGE)、DNA测序分析了 12 7例 PKU患者的 PAH基因第 12外显子点突变种类及频率。结果　 DNA测序分析显示 10例患者存在 R4 13P、S4 11X、R4 0 8W、R4 0 8Q 4种杂合突变 ,其突变频率分别为 2 .76 %、0 .39%、0 .39%、0 .39% ,S4 11X突变为中国人中首次报道。 SSCP分析仅发现 2例 R4 13P杂合突变 ,DGGE分析显示 10例出现 3种类型的异常电泳带型。R4 13P突变在南北方人之间、在经典型 PKU和高苯丙氨酸血症之间的分布差异无显著性。结论　 DGGE对 PAH基因第 12外显子点突变检出率明显高于 SSCP。 DGGE结合 DNA测序是明确 PAH基因第 12外显子点突变种类和频率较好的方法。 R4 13P突变在南北方人中分布无明显差异     

中国人Wilson病WD基因12号外显子突变研究

目的研究中国人Wilson病(WD)基因第12外显子突变特征. 方法应用聚合酶链反应-单链构象多态型(PCR-SSCP)银染技术研究70例无亲缘关系的WD患者和30例正常组的WD基因12外显子,对有异常泳动者经DNA自动测序技术证实其突变性质和位置.结果正常组未见异常.患者组发现11例异常(11/70占15.7%),二种错义突变,其中9例为Thr935Met突变(9/70,占12.9 %),2例为Lys952Arg突变(2/70占2.8%).结论第12外显子是中国人WD基因突变热区之一,发现一种未见报道的新型错义突变.     

汉族家族性中枢神经系统海绵状血管畸形致病基因的一个新突变位点

目的 探查汉族家族性中枢神经系统海绵状血管畸形(CCM)的突变基因。方法 选择经神经科确诊的2个家系(A及B)和8例散发性中枢神经系统海绵状血管畸形病例。所有受检对象临床表现有癫痫、突发头痛;2例伴有皮肤病变。候选基因为已确认的Krit-1,对该基因的16个编码外显子进行PCR扩增,扩增产物进行直接测序。结果 受检的A家系在第14外显子的第1289(从起始密码子计算,或2308即从mRNA的第一个碱基计算)位核苷酸一个拷贝有C→G的取代,出现编码改变(S430X),形成终止密码子(UGA),使翻译过程提前终止,导致的基因异常属无义点突变。同法筛查,A家族中有1名成员突变未获得遗传;散发病例发现一个正常多态性变化,未见到突变。结论 发现第1例汉族人CCM基因的点突变,也是国际上未见报道的新位点。这一点突变将会导致一种截短蛋白,是CCM发生的基本原因。研究结果可用于症状前基因诊断。     

早发性帕金森病parkin基因第1～6外显子缺失突变的初步研究

目的 探讨中国人早发性帕金森病（ｐｒａｅｃｏｘ Ｐａｒｋｉｎｓｏｎ ｄｉｓｅａｓｅ,ＰＰＤ）中ｐａｒｋｉｎ基因第１～６外显子是否存在突变,及其与该病临床特点的关系。方法 用ＰＰＤ患者外周血液提取ＤＮＡ,通过ＰＣＲ扩增,琼脂糖凝胶电泳鉴定ｐａｒｋｉｎ基因外显子缺失突变,并结合临床资料分析。结果 ２１中层得中发现有２例第１外显子缺失,２例第４外显子缺失,１例第６外显子缺失;发生基因缺失突变的病例年龄为     

肾上腺脑白质营养不良患者ABCD1基因第6外显子突变的初步分析

目的 检测肾上腺脑白质营养不良(adrenoleukodystrophy，ALD)(MIM300100)患者编码ALD蛋白的ABCD1基因[ATP-结合盒(ATP-binding cassette，ABC)超家族中D亚家族1]突变。方法 提取无亲缘关系的14例中国ALD患者及其中2例患者父母基因组DNA。聚合酶链反应(polymerase chainreaction，PCR)扩增ABCD1基因的第6外显子，以琼脂糖凝胶电泳鉴定PCR产物，PCR产物纯化后DNA直接测序。结果 证实3个患者的ABCD1基因第6外显子有突变，其中1例患者为5’末端上游第6个碱基C缺失(1489-6 del C)，推测该突变可能导致剪切错误；1例患者为错义突变1559T→A(L520Q)，这两例患者的母亲均为杂合突变。另1例患者为1548G→A(L516L)的同义突变。结论 首次报告了中国大陆ALD患者ABCD1基因突变．第6外显子无大片段缺失和重组突变。同一血缘族中可有不同的表型存在，提示是否有其它遗传或环境因素参与表型的表达。通过DNA测序方法亦证实其中2例患者之母为ABCD1基因的杂合子。     

Alzheimer病患者早老素-1基因第5外显子突变特征分析

目的　探讨早老素-1 基因突变在散发性Alzheim er 病(sporadic Alzheim er's disease, SAD)患者发病机理中的作用。方法　应用聚合酶链反应-单链构象多态性(polym erase chain reaction-singlestrand conform ation polym orphsim ,PCR-SSCP)及DNA 直接测序技术检测68 例SAD 患者和65 名正常老年人的早老素-1 基因第5 外显子。结果　发现68 例SAD患者中有4 例患者的SSCP发生泳动异常,DNA 序列分析发现:这4 例SAD 患者的130 号密码子发生了CTG→ATG 错义突变(388 位点发生C→A突变),使氨基酸由亮氨酸变为蛋氨酸(Leu 130 Met);157 号密码子发生了GTG→CTG 错义突变(469 位点发生G→C突变),使氨基酸由缬氨酸变为亮氨酸(Val157 Leu);有11 例患者的SSCP表现为一条单链电泳迁移率明显增快,DNA 序列分析发现:这11 例SAD患者的130 号密码子发生了CTG→ATG 错义突变(388 位点发生C→A 突变),使氨基酸由亮氨酸变为蛋氨酸(Leu 130 Met);154 号密码子发生了TGC→TGT 同义突变(462 位点发生C→T)突变。结论　我们发现在SAD患者中存在早老素-1 基因第5 外显子突变,该突变点可能为中国人SAD 患者早老素基因突变点之一。     

原发性肝细胞癌RIT1基因的突变和扩增

目的　探讨 RIT1基因突变和扩增在肝细胞癌 (hepatocellular carcinoma,HCC)的发生情况及其与发病的关系。　方法　采用 PCR直接测序法检测 5 0例原发性 HCC患者的肝癌组织和非癌肝组织RIT1基因在所包含的 6个外显子的全序列寻找突变位点 ;并用荧光定量 PCR法检测 RIT1基因的扩增情况。　结果　在 5 0例肝癌组织中 1例出现第 5外显子编码区 2 4 1位核苷酸 G/ C变异 ,其对应密码子改变为GAG81CAG,编码氨基酸改变为 Glu81Gln,该氨基酸变异位于 GTP结合的保守功能域内 ,该病例的非癌肝组织以及其余 4 9例的肝癌组织和非癌肝组织均未发生此种改变 ;在 5 0例肝癌组织和非癌肝组织中均出现 5′- UTR(起始密码子前 2 1位核苷酸 ) G/ C变异 ;在获得有效扩增数据的 4 3例肝细胞癌患者中 ,11例有 2～2 97倍的 RIT1基因扩增 ,扩增率为 2 5 .6 %。　结论　基因扩增是 RIT1基因在肝细胞癌的激活方式之一 ,可能与肝细胞癌的发病有关 ,而点突变方式可能意义不大。     

霍奇金淋巴瘤IκBα基因第5外显子突变初步分析

目的分析单个霍奇金淋巴瘤细胞IκBα基因第5外显子的碱基序列,探讨IκBα基因突变与霍奇金淋巴瘤的关系。方法用免疫组织化学EnVision法检测7例霍奇金淋巴瘤CD30抗原,采用激光显微切割技术捕获CD30阳性表达的单个霍奇金淋巴瘤细胞和其周围反应性增生的淋巴细胞,以这些标本的基因组DNA为模板,用半巢式聚合酶链反应(PCR)方法扩增IκBα基因的第5外显子,PCR产物经纯化后直接测序。结果分析测序图发现3例霍奇金淋巴瘤细胞IκBα第5外显子出现点突变,均形成TGA终止密码子。结论霍奇金淋巴瘤中IκBα基因第5外显子出现点突变,可能是霍奇金淋巴瘤恶性转化过程中除EB病毒感染外另一重要分子机制。     

Mutation analysis of CCM1, CCM2 and CCM3 genes in a cohort of Italian patients with cerebral cavernous malformation

Cerebral cavernous malformations (CCMs) are vascular lesions of the CNS characterized by abnormally enlarged capillary cavities. CCMs can occur as sporadic or familial autosomal dominant form. Familial cases are associated with mutations in CCM1[K-Rev interaction trapped 1 (KRIT1)], CCM2 (MGC4607) and CCM3 (PDCD10) genes. In this study, a three-gene mutation screening was performed by direct exon sequencing, in a cohort of 95 Italian patients either sporadic or familial, as well as on their at-risk relatives. Sixteen mutations in 16 unrelated CCM patients were identified,nine mutations are novel: c.413T > C; c.601C > T; c.846 + 2T > G; c.1254delA; c.1255-4delGTA; c.1682-1683 delTA in CCM1; c.48A > G; c.82-83dupAG in CCM2; and c.395 + 1G > A in CCM3 genes [corrected].The samples, negative to direct exon sequencing, were investigated by MLPA to search for intragenic deletions or duplications. One deletion in CCM1 exon 18 was detected in a sporadic patient. Among familial cases 67% had a mutation in CCM1, 5.5% in CCM2, and 5.5% in CCM3, whereas in the remaining 22% no mutations were detected, suggesting the existence of either undetectable mutations or other CCM genes. This study represents the first extensive research program for a comprehensive molecular screening of the three known genes in an Italian cohort of CCM patients and their at-risk relatives.     

Deep intronic KRIT1 mutation in a family with clinically silent multiple cerebral cavernous malformations

Loss‐of‐function mutations in CCM1/KRIT1, CCM2/MGC4607 and CCM3/PDCD10 genes are identified in the vast majority of familial cases with multiple cerebral cavernous malformations (CCMs). However, genomic DNA sequencing combined to large rearrangement screening fails to detect a mutation in 5% of those cases. We report a family in which CCM lesions were discovered fortuitously because of the investigation of a developmental delay in a boy. Three members of the family on three generations had typical multiple CCM lesions and no clinical signs related to CCM. No mutation was detected using genomic DNA sequencing and quantitative multiplex PCR of short fluorescent fragments (QMPSF). cDNA sequencing showed a 99‐nucleotide insertion between exons 5 and 6 of CCM1, resulting from a mutation located deep into intron 5 (c.262+132_262+133del) that activates a cryptic splice site. This pseudoexon leads to a premature stop codon. These data highly suggest that deep intronic mutations explain part of the incomplete mutation detection rate in CCM patients and underline the importance of analyzing the cDNA to provide comprehensive CCM diagnostic tests. This kind of mutation may be responsible for apparent sporadic presentations due to a reduced penetrance.     

中国人共济失调毛细血管扩张症ATM基因突变研究

目的　探讨中国人共济失调毛细血管扩张症(ataxia- telangiectasia,AT) ATM基因的突变特点。方法　应用聚合酶链反应、逆转录-聚合酶链反应、聚丙烯酰胺凝胶电泳结合DNA序列分析方法对2例中国人临床诊断AT的患者ATM基因进行突变的筛选与检测。结果　在1例患者中发现第11外显子的1346 (G>C)的错义突变,为一种纯合突变;在另1例患者中发现第6外显子的6 10 (G>T)的无义突变和第4 7外显子的6 6 79(C>T)的错义突变,为一种复合性杂合突变。突变位点均位于ATM基因功能域。结论　在2例中国人AT患者中发现了3种新的ATM基因突变。     

Highly variable penetrance in subjects affected with cavernous cerebral angiomas (CCM) carrying novel CCM1 and CCM2 mutations.

Cavernous vascular malformations may affect brain and out-of-brain tissues. In most cases, cerebral cavernous malformations (CCMs) involve the brain alone, and are rarely associated with skin hemangiomas, spinal cord, retinal, hepatic or vertebral lesions. CCMs can cause seizures, intracranial and spinal haemorrhages, focal neurological deficits, and migraine-like headaches. After collecting CCM families of Italian origin and investigating the genetic basis of the disorder we disclosed two novel molecular variations in the KRIT1 and MGC4607 genes. We found a novel CCM1 gene mutation (Q66X) in a family with apparently asymptomatic old-aged mutation carriers and patients who either had skin angiomas alone or the full association of cerebral, spinal, and skin lesions. In this family we report the highest variability in mutation penetrance so far described, including the presence of CCM in one subject since birth (surgery at 19 months of age), a condition to our knowledge so far unreported. In a CCM2 affected family, we also report a novel causative mutation, (54_55delAC) in exon 2 of the MGC4607 gene, that produces a truncated protein containing only 22 amino acids. These data describe novel CCM mutations associated with a particularly high variability of the penetrance causing, in some cases, reduced expression of clinical symptoms and sporadic cases with apparent negative family history. Hence they emphasize the importance of DNA-based diagnostics and genetic counseling to identify unaffected mutation carriers subjects, even at advanced age.     

多巴反应性肌张力障碍GCH1基因突变分析

目的探讨多巴反应性肌张力障碍（dopa responsive dystonia,DRD）三磷酸鸟苷环化水解酶Ⅰ基因（guanosinetriphosphate cyclohydrolaseⅠ,GCH1）的突变。方法应用聚合酶链反应、DNA直接测序和限制性内切酶酶切技术对6例散发DRD患者进行GCH1基因的突变分析,对100名健康对照者进行GCH1基因的PCR和限制性内切酶酶切分析。结果1例患者检测出GCH1基因一个新的点突变151（G→A）,为起始密码子突变,导致所编码的起始氨基酸由蛋氨酸变为异亮氨酸（M1I）而不能起始翻译。100名健康对照者等位基因无此突变。结论发现了GCH1基因一个新的杂合型点突变151（G→A）,我国散发DRD患者中存在GCH1基因突变。     

Absence of c-kit gene mutations in gastrointestinal stromal tumours from neurofibromatosis type 1 patients

Most sporadic gastrointestinal stromal tumours (GISTs) have somatic c-kit gene mutations that are considered to be causal. Neurofibromatosis type 1 (NF1) is caused by mutations of the NF1 gene and NF1 patients have an increased risk of developing GISTs. Since most neoplasms are considered to develop as a result of the combination of several gene mutations, these findings suggest that GISTs from NF1 patients might have somatic c-kit gene mutations and that sporadic GISTs from non-NF1 patients might have somatic NF1 gene mutations. The present study analysed 29 GISTs from seven NF1 patients for c-kit gene mutations and ten sporadic GISTs from ten non-NF1 patients for NF1 mutations. Exons 9, 11, 13, and 17 of the c-kit gene were amplified and directly sequenced after the extraction of genomic DNA from wax-embedded tissues from 26 GISTs from five NF1 patients. The whole coding region of the c-kit cDNA and the whole coding region of the NF1 cDNA were amplified and directly sequenced after RNA extraction and cDNA synthesis in three fresh GIST tissues from two NF1 patients and ten fresh GIST tissues from ten non-NF1 patients. Of the ten sporadic GISTs, eight had heterozygous mutations at exon 11, and one at exon 9, of c-kit. Heterozygous NF1 gene mutations were detected in GISTs from the two NF1 patients from whom fresh tissues were available. None of the 29 GISTs derived from NF1 patients had detectable c-kit gene mutations and none of the ten GISTs derived from non-NF1 patients had detectable NF1 mutations. These results suggest that the pathogenesis of GISTs in NF1 patients is different from that in non-NF1 patients.