Risk factors for lymph node metastasis of ovarian, fallopian tube and primary peritoneal cancer in hereditary breast and ovarian cancer syndrome
Risk factors for lymph node metastasis of ovarian, fallopian tube and primary peritoneal cancer in hereditary breast and ovarian cancer syndrome
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DOI：
10.1093/jjco/hyaa124
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发表时间：
2020-12-01
影响因子：
2.4
通讯作者：
Nakamura, Seigo
中科院分区：
文献类型：
--
作者：
Mitamura, Takashi;Sekine, Masayuki;Nakamura, Seigo
背景资料：为携带生殖系BRCA 1和BRCA 2致病性变异的卵巢癌患者建立个性化的淋巴结切除术策略（BRCA 1+和BRCA 2+），我们研究了参与淋巴结转移风险增加的临床病理特征。我们回顾性分析了在日本遗传性乳腺癌和卵巢癌联盟数据库中登记的日本妇女的数据，结果：对所有患者进行BRCA 1和BRCA 2基因检测，并对患者的年龄、病变部位、组织学亚型、2014 FIGO分期、个人乳腺癌史和家族史等信息进行淋巴结转移预测; BRCA-（无致病性变异）、BRCA 1+和BRCA 2+组分别为233、153和32例患者。BRCA-（20.0%）、BRCA 1+（18.4%）和BRCA 2+（26.2%）的淋巴结转移率无显著性差异。多因素分析显示，无卵巢癌家族史是BRCA 1+患者淋巴结转移风险增加的独立预测因素，有和无卵巢癌家族史组的淋巴结转移患病率分别为11.7%和42.0%。这个没有卵巢癌家族史的亚组与BRCA 1的特定变体没有任何相关性，包括c.188 T > A和c.2800 C> T的两种常见变体。这项研究表明，与遗传性乳腺癌和卵巢癌综合征发病率相关的某些遗传因素改变了BRCA 1+卵巢癌的淋巴结转移频率，和家族史可能有助于淋巴结切除术的个体化适应症。
Background: To establish an individualized surgical strategy for lymphadenectomy in ovarian cancer patients with the germline BRCA1 and BRCA2 pathogenic variants (BRCA1+ and BRCA2+), we investigated the clinicopathological characteristics that are involved in the increased risk of lymph node metastasis.Methods: We retrospectively reviewed the data of Japanese women registered in the database of the Japanese Hereditary Breast and Ovarian Cancer Consortium, who underwent BRCA1 and BRCA2 genetic testing.Results: We evaluated the predictors of lymph node metastasis in all patients with the information of age at the diagnosis, disease site, histological subtype, 2014 FIGO stage, personal breast cancer history and family history; 233, 153 and 32 patients in the BRCA- (no pathogenic variant), BRCA1+ and BRCA2+ groups, respectively. The prevalence of lymph node metastasis was not markedly different between BRCA- (20.0%), BRCA1+ (18.4%) and BRCA2+ (26.2%). Multivariate analysis revealed an absence of a family history of ovarian cancer as an independent predictor for an increased risk of lymph node metastasis in BRCA1+, and the prevalence of lymph node metastasis was 11.7 and 42.0% in the groups with and without a family history of ovarian cancer, respectively. This subgroup without a family history of ovarian cancer did not show any correlation with a particular variant of BRCA1, including two common variants of c.188 T > A and c.2800C > T.Conclusions: This study suggested that certain genetic factors related to the penetrance of hereditary breast and ovarian cancer syndrome altered the frequency of lymph node metastasis in BRCA1+ ovarian cancer, and family history may be useful to personalize the indication of lymphadenectomy.