Genomic instability in breast cancer: pathogenesis and clinical implications.

Genomic instability in breast cancer: pathogenesis and clinical implications.
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DOI:
10.1016/j.molonc.2010.04.001
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发表时间:
2010-06
期刊:
影响因子:
6.6
通讯作者:
Pollack JR
Pollack JR
中科院分区:
医学2区
文献类型:
--
作者:
Kwei KA;Kung Y;Salari K;Holcomb IN;Pollack JR

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乳腺癌是一种异质性疾病,通过分子标记、基因表达谱和最近的基因组改变模式可以看出。特别是,基因组图谱揭示了DNA拷贝数变化的三种不同模式:一种是整个染色体臂几乎没有增减的“简单”型,一种是具有焦点高水平DNA扩增的“放大”型,以及一种以大量低幅度变化和拷贝数转换为标志的“复杂”型。这三种模式与不同的基因表达亚型相关,并优先针对基因组中的不同位置(涉及不同的癌症基因)。此外,不同的改变模式意味着不同的基因组不稳定的潜在机制。尽管新的数据显示持续的“放大器”不稳定,但这种放大模式可能是由一过性端粒功能障碍引起的。这种复杂的模式与具有胚系BRCA1突变的乳腺癌相似,也表现出“基底样”的表达谱和复杂的基因组模式,提示BRCA1相关的DNA双链断裂修复可能存在缺陷。因此,靶向假定的DNA修复缺陷是临床研究的一个有前途的领域。未来的研究将通过扩增和复杂模式基因组阐明乳腺癌的发病机制,并可能发现新的治疗机会。
Breast cancer is a heterogeneous disease, appreciable by molecular markers, gene expression profiles, and most recently, patterns of genomic alteration. In particular, genomic profiling has revealed three distinct patterns of DNA copy number alteration: a “simple” type with few gains or losses of whole chromosome arms, an “amplifier” type with focal high-level DNA amplifications, and a “complex” type marked by numerous low-amplitude changes and copy-number transitions. The three patterns are associated with distinct gene-expression subtypes, and preferentially target different loci in the genome (implicating distinct cancer genes). Moreover, the different patterns of alteration imply distinct underlying mechanisms of genomic instability. The amplifier pattern may arise from transient telomere dysfunction, although new data suggest ongoing “amplifier” instability. The complex pattern shows similarity to breast cancers with germline BRCA1 mutation, which also exhibit “basal-like” expression profiles and complex-pattern genomes, implicating a possible defect in BRCA1-associated repair of DNA double-strand breaks. As such, targeting presumptive DNA repair defects represents a promising area of clinical investigation. Future studies should clarify the pathogenesis of breast cancers with amplifier and complex pattern genomes, and will likely identify new therapeutic opportunities.
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