Clinical analysis of BRCA mutations in patients with recurrent serous ovarian cancer

Abstract

Objective To investigate the BRCA1 and BRCA2 gene mutations in patients with recurrent serous ovarian cancer and their clinical significances. Methods A total of 57 patients with recurrent serous ovarian cancer in the First Affiliated Hospital of Nanchang University from January 2016 to January 2018 were collected. High-throughput second-generation sequencing technology was used to detect BRCA1 and BRCA2 mutations in patients' blood. Statistical analysis was performed on the relationship between BRCA mutations and clinicopathological factors and prognosis. Results Of the 57 patients with recurrent serous ovarian cancer, 16 patients (28.07%) had BRCA mutations, among which 3 patients (5.26%) had nonsense mutations, 7 patients (12.28%) had frameshift mutations, and 7 patients (12.28%) had missense mutations. There was no significant difference in BRCA mutation rate among patients with different American Obstetrics and Gynecology Union (FIGO) stage, lymphatic metastasis, tissue differentiation and age stratification (all P > 0.05). Patients with family history of ovarian cancer or breast cancer had a higher BRCA mutation rate than patients without family history (7/12 vs. 9/45, χ2 = 5.13, P = 0.02), and patients who were sensitive to first-line platinum treatment had a higher BRCA mutation rate than those with drug resistant (16/45 vs. 0/12, P = 0.04). Patients with BRCA mutation had a lower serum CA125 level than patients with BRCA wild-type [(774±548)×103 U/L vs. (1 522±1 269)×103 U/L, t = 3.106, P = 0.003], and a longer median progression-free survival (PFS) time (20.5 months vs. 12.0 months, P = 0.01). Conclusions Serous ovarian cancer patients with BRCA mutations have higher sensitivity to platinum-based chemotherapeutic drugs and better PFS. Detection of BRCA mutations helps to judge prognosis and guide medication. Key words: Ovarian neoplasms; Recurrence; Mutation; BRCA gene