Přestože je výskyt BRCA pozitivity v populaci dlouhodobě stabilní, je význam tohoto nálezu především u žen stále častěji diskutován. Důvodem je velmi vysoké celoživotní riziko vzniku karcinomu prsu a ovaria. Postižení pacienti musejí být pečlivě sledováni onkology a gynekology a naopak při podezření na možnost hereditárně podmíněného tumoru je nutné doplnit genetické vyšetření k určení možné přítomnosti mutace BRCA. Je však důležité neredukovat tento problém pouze na otázku profylaktické oboustranné mastektomie. Pro karcinom prsu i v této situaci lze využít modifikovaného screeningového programu a prognóza i léčba tohoto onemocnění je téměř shodná s nádory u ostatních žen, u karcinomu ovaria neexistují možnosti jeho časnějšího záchytu a většina nemocných na něj zemře. V tomto článku je zmíněna potřeba většího uvědomění u gynekologů vedoucí ke změně trendu upřednostnit profylaktickou chirurgii gynekologickou před výše zmíněnou mastektomií., BRCA1 and BRCA2 mutations Although incidence of BRCA positivity in population seems to be long-term stable this finding is especialy in women discussed more and more often. The reason is extremely high lifelong risk of breast and ovarian cancer development. Affected patients have to be precisely followed by oncologists and gynecologists and on the contrary it is necesary to provide genetic testing for BRCA mutation positivity if some posibility of hereditary conditioned tumor exists. However, it is important not to reduce this problem on the question of prophylactic bilateral mastectomy only. Even in this situation we can use some modified screening program for breast cancer but there are no posibilities for earlier detection of ovarian cancer and the majority of patients will die because of this disease. There is a need of greater awareness by gynecologists leading to the trend change of preferring prophylactic gynecological surgery over mastectomy mentioned above. salpingo-ooforectomy and hysterectomy, CA125 tumor marker, PARP inhibitors., Ivan Šubrt, Jiří Presl, Tomáš Svoboda, and Literatura
The aim of the present study was to introduce methods for exome sequencing of two ATP-binding cassette (ABC) transporters ABCC8 and ABCD2 recently suggested to play a putative role in breast cancer progression and prognosis of patients. We performed next generation sequencing targeted at analysis of all exons in ABCC8 and ABCD2 genes and surrounding noncoding sequences in blood DNA samples from 24 patients with breast cancer. The revealed alterations were characterized by in silico tools. We then compared the most frequent functionally relevant polymorphism rs757110 in ABCC8 with clinical data of patients. In total, the study identified 113 genetic alterations (>70 % novel ones) in both genes. Of these alterations, 83 were noncoding, 13 synonymous, 10 frameshifts and 7 were missense alterations. Four in silico programs predicted pathogenicity of two polymorphisms and four newly identified alterations. Rs757110 polymorphism in ABCC8 did not significantly associate with clinical data of the patients. In conclusion, exome sequencing identified several functionally relevant alterations in ABCC8 and ABCD2 genes that may further be used for a larger follow-up study aiming to assess their clinical significance., P. Soucek, V. Hlavac, K. Elsnerova, R. Vaclavikova, R. Kozevnikovova, K. Raus., and Obsahuje bibliografii