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Liu Y, Yang H, Fu X, Zhong L, Xu P, Fang F, Liu Y, Li Q, Yan Y, Wei S, Wang J, Zhang C. BRCA2, PALB2, RECQL4 Germline Pathogenic Variants, and Somatic TP53 Mutation in Triple Metachronous Malignancies: A Case Report and Literature Review. Int Med Case Rep J 2024; 17:23-29. [PMID: 38223534 PMCID: PMC10788051 DOI: 10.2147/imcrj.s440132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 12/30/2023] [Indexed: 01/16/2024] Open
Abstract
Background Multiple primary cancer (MPC) refers to the presence of more than one cancer in an individual. Triple primary malignancies are uncommon. Case We report the case of a 50-year-old postmenopausal woman in our gynecology department, diagnosed with endometrial cancer, ovarian cancer, and unilateral breast cancer. She carried germline mutations in BRCA2, PALB2, and RECQL4, along with a somatic pathogenic variant in TP53. Endometrial cancer patients harboring germline pathogenic variants in BRCA2 exhibit a heightened risk of ovarian and breast cancer. BRCA2 is known to play a role in the development of ovarian and breast cancer, while PALB2 is identified as a gene associated with breast cancer susceptibility. RECQL4 has been linked to breast cancer, cervical cancer, and other tumors. Conclusion Genetic testing may be imperative for identifying MPC in endometrial cancer patients. For individuals with BRCA2 and other gene pathogenic variants, routine examination and monitoring of the endometrium, ovaries, breasts, and other sites prone to polygenic cancer are recommended.
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Affiliation(s)
- Yang Liu
- Department of Gynaecology, Affiliated Hospital of YangZhou University Huai ‘an Maternal and Child Health Care Center, Huai’an, Jiangsu, People’s Republic of China
- Department of Gynaecology, The Huai’an Maternity and Child Clinical College of Xuzhou Medical University, Huai’an, Jiangsu, People’s Republic of China
| | - Hui Yang
- Department of Gynaecology, Affiliated Hospital of YangZhou University Huai ‘an Maternal and Child Health Care Center, Huai’an, Jiangsu, People’s Republic of China
- Department of Gynaecology, The Huai’an Maternity and Child Clinical College of Xuzhou Medical University, Huai’an, Jiangsu, People’s Republic of China
| | - Xueshu Fu
- Department of Gynaecology, Affiliated Hospital of YangZhou University Huai ‘an Maternal and Child Health Care Center, Huai’an, Jiangsu, People’s Republic of China
- Department of Gynaecology, The Huai’an Maternity and Child Clinical College of Xuzhou Medical University, Huai’an, Jiangsu, People’s Republic of China
| | - Luting Zhong
- Department of Gynaecology, Affiliated Hospital of YangZhou University Huai ‘an Maternal and Child Health Care Center, Huai’an, Jiangsu, People’s Republic of China
- Department of Gynaecology, The Huai’an Maternity and Child Clinical College of Xuzhou Medical University, Huai’an, Jiangsu, People’s Republic of China
| | - Ping Xu
- Department of Gynaecology, Affiliated Hospital of YangZhou University Huai ‘an Maternal and Child Health Care Center, Huai’an, Jiangsu, People’s Republic of China
- Department of Gynaecology, The Huai’an Maternity and Child Clinical College of Xuzhou Medical University, Huai’an, Jiangsu, People’s Republic of China
| | - Fang Fang
- Department of Gynaecology, Affiliated Hospital of YangZhou University Huai ‘an Maternal and Child Health Care Center, Huai’an, Jiangsu, People’s Republic of China
- Department of Gynaecology, The Huai’an Maternity and Child Clinical College of Xuzhou Medical University, Huai’an, Jiangsu, People’s Republic of China
| | - Ying Liu
- Department of Gynaecology, Affiliated Hospital of YangZhou University Huai ‘an Maternal and Child Health Care Center, Huai’an, Jiangsu, People’s Republic of China
- Department of Gynaecology, The Huai’an Maternity and Child Clinical College of Xuzhou Medical University, Huai’an, Jiangsu, People’s Republic of China
| | - Qing Li
- Department of Gynaecology, Affiliated Hospital of YangZhou University Huai ‘an Maternal and Child Health Care Center, Huai’an, Jiangsu, People’s Republic of China
- Department of Gynaecology, The Huai’an Maternity and Child Clinical College of Xuzhou Medical University, Huai’an, Jiangsu, People’s Republic of China
| | - Ya’nan Yan
- Department of Gynaecology, Affiliated Hospital of YangZhou University Huai ‘an Maternal and Child Health Care Center, Huai’an, Jiangsu, People’s Republic of China
- Department of Gynaecology, The Huai’an Maternity and Child Clinical College of Xuzhou Medical University, Huai’an, Jiangsu, People’s Republic of China
| | - Shanchuang Wei
- Department of Gynaecology, Affiliated Hospital of YangZhou University Huai ‘an Maternal and Child Health Care Center, Huai’an, Jiangsu, People’s Republic of China
- Department of Gynaecology, The Huai’an Maternity and Child Clinical College of Xuzhou Medical University, Huai’an, Jiangsu, People’s Republic of China
| | - Junqing Wang
- Department of Gynaecology, Affiliated Hospital of YangZhou University Huai ‘an Maternal and Child Health Care Center, Huai’an, Jiangsu, People’s Republic of China
- Department of Gynaecology, The Huai’an Maternity and Child Clinical College of Xuzhou Medical University, Huai’an, Jiangsu, People’s Republic of China
| | - Chunhua Zhang
- Department of Gynaecology, Affiliated Hospital of YangZhou University Huai ‘an Maternal and Child Health Care Center, Huai’an, Jiangsu, People’s Republic of China
- Department of Gynaecology, The Huai’an Maternity and Child Clinical College of Xuzhou Medical University, Huai’an, Jiangsu, People’s Republic of China
- Department of Integrated Traditional Chinese & Western Clinical Medicine, Macau University of Science and Technology, Macau, People’s Republic of China
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Tabassum S, Munir F, Al Awadh AA, Anwar Z. PATHOLOGICAL SIGNIFICANCE OF CDH1/E-CADHERIN GERMLINE SEQUENCE VARIANTS IN BREAST CANCER PATIENTS. Exp Oncol 2023; 45:170-179. [PMID: 37824775 DOI: 10.15407/exp-oncology.2023.02.170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Indexed: 10/14/2023]
Abstract
BACKGROUND Germline alterations of the CDH1 (E-cadherin) tumor suppressor gene have been reported in several epithelial malignancies like hereditary diffuse gastric cancer and lobular breast cancer. E-cadherin plays a central role in proliferation, maintenance of cell-to-cell adhesion, polarity, and epithelial-mesenchymal transition of tissue cells. It is necessary to analyze the impact of the CDH1 germline sequence variants on protein and predict its clinical significance in breast cancer (BC) progression. The aim of the current study was to evaluate the impact and association of CDH1 gene potentially pathogenic variants/likely pathogenic variants (PVs/LPVs) with the initiation and progression of BC. MATERIALS AND METHODS In this study, the clinical data of 200 BC patients have been analyzed based on the type of BC, age, grade, stage, hormonal status, and risk factors. Blood samples from 50 healthy donors were used as a control. Furthermore, CDH1 gene molecular analysis, along with in silico analysis, was provided to assess the invasiveness and progression of BC caused by the E-cadherin protein. RESULTS Four variants were identified by genetic screening within the CDH1 gene that included variations in exons 7, 8, 10, 11, and 13. Exon 10 had splice site mutation at position c.1337C>A, affecting the protein structure. In exon 11, there was an insertion of T base at position 1669, resulting in truncated protein compared to a normal one that can lead to the disease-causing non- sense-mediated decay and exon 13 variant c.2076T>C has already known polymorphism. In silico analysis of CDH1 showed the presence of the different variants that indicated the overall disruption of protein structure and function. CONCLUSIONS The further functional analysis of these variants and their association with BC can be ensured by increasing the sample size and in vivo studies using mouse models.
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Affiliation(s)
- S Tabassum
- Department of Biological Sciences, International Islamic Univeristy, Islamabad 1243, Pakistan
| | - F Munir
- Department of Biological Sciences, International Islamic Univeristy, Islamabad 1243, Pakistan
| | - A A Al Awadh
- Department of Clinical Laboratory Sciences, Najran University, Najran 61441, Saudi Arabia
| | - Z Anwar
- Department of Biochemistry, Medical University of Warsaw, Warsaw 02-097, Poland
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Role of PARP Inhibitors in Cancer Immunotherapy: Potential Friends to Immune Activating Molecules and Foes to Immune Checkpoints. Cancers (Basel) 2022; 14:cancers14225633. [PMID: 36428727 PMCID: PMC9688455 DOI: 10.3390/cancers14225633] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 11/04/2022] [Accepted: 11/13/2022] [Indexed: 11/19/2022] Open
Abstract
Poly (ADP-ribose) polymerase (PARP) inhibitors (PARPi) induce cytotoxic effects as single agents in tumors characterized by defective repair of DNA double-strand breaks deriving from BRCA1/2 mutations or other abnormalities in genes associated with homologous recombination. Preclinical studies have shown that PARPi-induced DNA damage may affect the tumor immune microenvironment and immune-mediated anti-tumor response through several mechanisms. In particular, increased DNA damage has been shown to induce the activation of type I interferon pathway and up-regulation of PD-L1 expression in cancer cells, which can both enhance sensitivity to Immune Checkpoint Inhibitors (ICIs). Despite the recent approval of ICIs for a number of advanced cancer types based on their ability to reinvigorate T-cell-mediated antitumor immune responses, a consistent percentage of treated patients fail to respond, strongly encouraging the identification of combination therapies to overcome resistance. In the present review, we analyzed both established and unexplored mechanisms that may be elicited by PARPi, supporting immune reactivation and their potential synergism with currently used ICIs. This analysis may indicate novel and possibly patient-specific immune features that might represent new pharmacological targets of PARPi, potentially leading to the identification of predictive biomarkers of response to their combination with ICIs.
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Aitmagambetova MA, Smagulova GA, Tuhvatshin RR, Zheksenova AN, Amanzholkyzy A. Genetic and clinical characteristics of BRCA-associated hereditary breast cancer in the West region of Kazakhstan. Carcinogenesis 2022; 43:838-841. [PMID: 35917581 DOI: 10.1093/carcin/bgac068] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Revised: 07/01/2022] [Accepted: 07/28/2022] [Indexed: 11/13/2022] Open
Abstract
Breast cancer is the most common cancer in women and is cause mortality in many countries. The purpose of this article is to determine the BRCA1 BRCA2 gene mutation polymorphisms, as well as to determine the clinical, histopathological and prognostic characteristics in patients with breast cancer in the western region of Kazakhstan. A study was conducted on the genotyping of 278 patients in the MC ZKMU Marat Ospanov with an established diagnosis of breast cancer, which revealed that out of 278 patients, of 3 cases were identified. In the age category up to 50 years, 70 cases were detected (25.1%) after 50 years 208 cases were identified (74%). Number of patients in stage I was 20 (7.1%) in stage second 204 (73%) and in stage third 54 (19%). By tumor size, 30(10%) cases were T1, 194 (69%) cases were T2, 35 (12.5%) cases were T3, and 19 cases were T4 (6.8%). According to metastasis of the lymph nodes, no lymph nodes were detected in 107 (38%) cases, 1-3 L/n (Lymph Nodes) in 95 (34%) cases, 4-9 L/n in 12 (4%) cases, 10 L/n in 4 (1.4%) cases and unknown cases was 60 (21%). In 99.6% of patients no distant metastases was detected. According to the molecular classification of the tumor, Luminal type A is most found in this study 147 (52.8%), then Luminal type B 57 (20.5%), HER-2 positive 26 (9.3%) and Triple negative 48 (17.2%). By ethnicity the Kazakh race is 182 (65%) the Caucasian race was 96 (34%). Large population screening studies involving all BRCA1/2 polymorphisms are required to confirm the penetrance, frequency and significance of a wide range of variations of BRCA1/2 genes in the Kazakh population.
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Affiliation(s)
- Marzhan A Aitmagambetova
- Department of Oncology and Visual Diagnostics, West Kazakhstan Marat Ospanov State Medical University, Aktobe, Republic of Kazakhstan
| | - Gaziza A Smagulova
- Department of Internal Medicine and Clinical Pharmacology, West Kazakhstan Marat Ospanov State Medical University, Aktobe, Republic of Kazakhstan
| | - Rustem R Tuhvatshin
- Department of Pathological Physiology, Kyrgyz State Medical Institute for Retraining and Further Training named after S.B. Daniyarov, Bishkek, Kyrgyz Republic
| | - Azhar N Zheksenova
- Department of Pathophysiology, West Kazakhstan Marat Ospanov State Medical University, Aktobe, Republic of Kazakhstan
| | - Ainur Amanzholkyzy
- Department of Normal Physiology, West Kazakhstan Marat Ospanov State Medical University, Aktobe, Republic of Kazakhstan
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Germani A, Guadagnolo D, Salvati V, Micolonghi C, Mancini R, Mastromoro G, Sadeghi S, Petrucci S, Pizzuti A, Piane M. Genomic Breakpoints’ Characterization of a Large CHEK2 Duplication in an Italian Family with Hereditary Breast Cancer. Diagnostics (Basel) 2022; 12:diagnostics12071520. [PMID: 35885426 PMCID: PMC9319214 DOI: 10.3390/diagnostics12071520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 06/04/2022] [Accepted: 06/19/2022] [Indexed: 11/29/2022] Open
Abstract
CHEK2 (checkpoint kinase 2; MIM# 604373) is a tumor suppressor gene that encodes a serine threonine kinase involved in pathways such as DNA repair, cell cycle arrest, mitosis, and apoptosis. Pathogenic variants in CHEK2 contribute to a moderately increased risk of breast and other cancers. Several variant classes have been reported, either point mutations or large intragenic rearrangements. However, a significant portion of reported variants has an uncertain clinical significance. We report an intragenic CHEK2 duplication, ranging from intron 5 to intron 13, identified in an Italian family with hereditary breast cancer. Using long range PCR, with duplication-specific primers, we were able to ascertain the genomic breakpoint. We also performed a real-time PCR to assess a possible loss-of-function effect. The genomic characterization of large intragenic rearrangements in cancer susceptibility genes is important for the clinical management of the carriers and for a better classification of rare variants. The molecular definition of breakpoints allows for the prediction of the impact of the variant on transcripts and proteins, aiding in its characterization and clinical classification.
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Affiliation(s)
- Aldo Germani
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, 00185 Rome, RM, Italy; (A.G.); (R.M.); (S.P.); (M.P.)
| | - Daniele Guadagnolo
- Department of Experimental Medicine, Sapienza University of Rome, 00185 Rome, RM, Italy; (C.M.); (G.M.); (S.S.); (A.P.)
- Correspondence:
| | - Valentina Salvati
- Scientific Direction, IRCCS Regina Elena National Cancer Institute, 00128 Rome, RM, Italy;
| | - Caterina Micolonghi
- Department of Experimental Medicine, Sapienza University of Rome, 00185 Rome, RM, Italy; (C.M.); (G.M.); (S.S.); (A.P.)
| | - Rita Mancini
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, 00185 Rome, RM, Italy; (A.G.); (R.M.); (S.P.); (M.P.)
- S. Andrea University Hospital, 00189 Rome, RM, Italy
| | - Gioia Mastromoro
- Department of Experimental Medicine, Sapienza University of Rome, 00185 Rome, RM, Italy; (C.M.); (G.M.); (S.S.); (A.P.)
| | - Soha Sadeghi
- Department of Experimental Medicine, Sapienza University of Rome, 00185 Rome, RM, Italy; (C.M.); (G.M.); (S.S.); (A.P.)
| | - Simona Petrucci
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, 00185 Rome, RM, Italy; (A.G.); (R.M.); (S.P.); (M.P.)
- S. Andrea University Hospital, 00189 Rome, RM, Italy
- Medical Genetics Unit, IRCCS Mendel Casa Sollievo della Sofferenza, 71013 San Giovanni Rotondo, FG, Italy
| | - Antonio Pizzuti
- Department of Experimental Medicine, Sapienza University of Rome, 00185 Rome, RM, Italy; (C.M.); (G.M.); (S.S.); (A.P.)
- Medical Genetics Unit, IRCCS Mendel Casa Sollievo della Sofferenza, 71013 San Giovanni Rotondo, FG, Italy
| | - Maria Piane
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, 00185 Rome, RM, Italy; (A.G.); (R.M.); (S.P.); (M.P.)
- S. Andrea University Hospital, 00189 Rome, RM, Italy
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