The context-specific role of germline pathogenicity in tumorigenesis.

The context-specific role of germline pathogenicity in tumorigenesis.
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DOI:
10.1038/s41588-021-00949-1
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发表时间:
2021-11
期刊:
影响因子:
30.8
通讯作者:
Taylor BS
Taylor BS
中科院分区:
生物学1区
文献类型:
--
作者:
Srinivasan P;Bandlamudi C;Jonsson P;Kemel Y;Chavan SS;Richards AL;Penson AV;Bielski CM;Fong C;Syed A;Jayakumaran G;Prasad M;Hwee J;Sumer SO;de Bruijn I;Li X;Gao J;Schultz N;Cambria R;Galle J;Mukherjee S;Vijai J;Cadoo KA;Carlo MI;Walsh MF;Mandelker D;Ceyhan-Birsoy O;Shia J;Zehir A;Ladanyi M;Hyman DM;Zhang L;Offit K;Robson ME;Solit DB;Stadler ZK;Berger MF;Taylor BS

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人类癌症由环境、遗传和躯体因素引起,但这些机制如何在肿瘤发生中相互作用尚不清楚。研究了17,152例前瞻性测序的癌症患者,我们发现了癌症易感基因的致病性种系变异,并评估了它们的合子性和伴随肿瘤中共同发生的体细胞改变。肿瘤发生的两条主要途径是明显的。在高外显率基因(5.1%)的致病种系变异携带者中,双等位基因失活的谱系依赖模式导致肿瘤表现出机制特异性的体细胞表型和更少的额外体细胞致癌驱动因素。然而,这些患者中27%的癌症,以及大多数具有低外显率基因致病性种系变异的患者的肿瘤,缺乏与种系等位基因相关的肿瘤发生的特殊标志。肿瘤对致病种系变异的依赖性是可变的,通常由外显率和谱系决定,这一发现对临床管理具有指导意义。
Human cancers arise from environmental, heritable, and somatic factors, but how these mechanisms interact in tumorigenesis is poorly understood. Studying 17,152 prospectively sequenced cancer patients, we identified pathogenic germline variants in cancer predisposition genes and assessed their zygosity and co-occurring somatic alterations in the concomitant tumors. Two major routes to tumorigenesis were apparent. In carriers of pathogenic germline variants in high penetrance genes (5.1% overall), lineage-dependent patterns of biallelic inactivation led to tumors exhibiting mechanism-specific somatic phenotypes and fewer additional somatic oncogenic drivers. Nevertheless, 27% of cancers in these patients, and most tumors in patients with pathogenic germline variants in lower penetrance genes, lacked particular hallmarks of tumorigenesis associated with the germline allele. The dependence of tumors on pathogenic germline variants is variable and often dictated by both penetrance and lineage, a finding with implications for clinical management.
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