Gastric Cancer in BRCA1 Germline Mutation Carriers: Results of Endoscopic Screening and Molecular Analysis of Tumor Tissues

Pathobiology. 2020;87(6):367-374. doi: 10.1159/000511323. Epub 2020 Nov 6.

Abstract

Introduction: There is some evidence suggesting a link between BRCA1/2 germline mutations and increased risk of gastric cancer.

Methods: Endoscopic screening for stomach malignancies was performed in 120 BRCA1 mutation carriers in order to evaluate the probability of detecting the tumor disease.

Results: No instances of gastric cancer were revealed at the first visit. The analysis of atrophic changes performed by OLGA (Operative Link for Gastritis Assessment) criteria revealed that OLGA stages I-IV alterations were observed in 26 of 41 (63%) subjects aged >50 years as compared to 29 of 79 (37%) in younger subjects (p = 0.007, χ2 test). One BRCA1 mutation carrier developed gastric cancer 4 years after the first visit for endoscopic examination. We performed next-generation sequencing analysis for this tumor and additional 4 archival gastric cancers obtained from BRCA1/2 mutation carriers. Somatic loss of the remaining BRCA1/2 allele was observed in 3 out of 5 tumors analyzed; all of these carcinomas, but none of the malignancies with the retained BRCA1/2 copy, showed chromosomal instability.

Conclusion: Taken together, these data justify further studies on the relationships between the BRCA1/2 and gastric cancer.

Keywords: Atrophic gastritis; Endoscopy; Gastric cancer; Mutation; Screening.

MeSH terms

  • Adenocarcinoma / genetics
  • Adult
  • Aged
  • BRCA1 Protein / genetics*
  • Early Detection of Cancer
  • Endoscopy / methods
  • Female
  • Germ-Line Mutation*
  • High-Throughput Nucleotide Sequencing
  • Humans
  • Mass Screening*
  • Middle Aged
  • Stomach Neoplasms / classification
  • Stomach Neoplasms / congenital
  • Stomach Neoplasms / genetics*
  • Stomach Neoplasms / pathology
  • Stomach Neoplasms / prevention & control*
  • Young Adult

Substances

  • BRCA1 Protein
  • BRCA1 protein, human