Article
Author: Shimoda Igawa, Yukiko ; Torasawa, Masahiro ; Goto, Yasushi ; Yamaguchi, Yoh ; Matsushita, Hirokazu ; Yamaura, Takumi ; Hirata, Makoto ; Imoto, Issei ; Kamatani, Yoichiro ; Shiraishi, Yuichi ; Cho, Hourin ; Okubo, Kenichi ; Machida, Erika ; Kawai, Yosuke ; Goto, Koichi ; Tanaka, Kazumi ; Ono, Hanako ; Inaba Higashiyama, Ryoko ; Inazawa, Johji ; Daigo, Yataro ; Yatabe, Yasushi ; Iwasaki, Motoki ; Miyagi, Yohei ; Shimomura, Akihiko ; Mochizuki, Akifumi ; Tateishi, Akiko ; Tokunaga, Katsushi ; Yoshida, Yukihiro ; Matsuda, Koichi ; Goto, Akiteru ; Kaneko, Syuzo ; Imai, Kazuhiro ; Horinouchi, Hidehito ; Takata, Sadaaki ; Kobayashi, Masashi ; Hamamoto, Junko ; Tsuboi, Masahiro ; Aoi, Tomomi ; Minamiya, Yoshihiro ; Kunitoh, Hideo ; Momozawa, Yukihide ; Shimizu, Kimihiro ; Asano, Yoshihiro ; Watanabe, Shun-Ichi ; Ito, Hidemi ; Yoshida, Teruhiko ; Ueki, Michiko ; Gotoh, Masahiro ; Nagashima, Toshiteru ; Hattori, Kotaro ; Suzuki, Hiroyuki ; Shimada, Yoko ; Takano, Atsushi ; Matsuo, Keitaro ; Sunami, Kuniko ; Ohtaki, Yoichi ; Ohe, Yuichiro ; Yoshida, Tatsuya ; Yasuda, Hiroyuki ; Kohno, Takahshi ; Saito, Motonobu ; Miyazaki, Yasunari ; Fukami, Maki ; Honda, Takayuki ; Kuchiba, Aya ; Matsumoto, Shingo ; Murakami, Yoshinori ; Ozaki, Kouichi ; Shiraishi, Kouya ; Hamamoto, Ryuji
INTRODUCTION:Up to 54% of all lung adenocarcinoma (LADC) cases in Asian populations occur in never-smoking women, suggesting that the impact of smoking and other environmental factors on the risk of early-onset LADC is minimal. Genetic factors may play a crucial role in disease development.
METHODS:The prevalence of germline pathogenic variants (GPVs) of 454 hereditary cancer and DNA repair genes was evaluated by whole-exome and whole-genome sequencing of 348 early-onset LADC (aged ≤ 40 y) and 1425 later-onset LADC (aged ≥ 41 y) cases. A case-control study comprising 10,302 LADC cases and 7898 healthy controls was performed to identify moderate-risk genetic factors for the disease. Analysis of somatic mutations in 1278 patients with LADC, including 31 patients with GPVs, was also performed.
RESULTS:The frequency of GPVs of TP53 and BRCA2 was significantly higher in those with early-onset LADC than in those with later-onset LADC. The detection rates for TP53 and BRCA2 GPVs were 2.9% and 1.7%, respectively, in patients with early-onset LADC, and 0.14% and 0.21%, respectively, in patients with later-onset LADC. Patients with BRCA1 GPVs exhibited a high incidence of concurrent TP53 somatic mutations. Patients with BRCA2 GPVs exhibited deficient homologous recombination in tumors by means of loss of the wild-type allele. A germline ALKBH2 variant, p.Glu35Alafs∗54, was associated with the risk of early-onset LADC, and patients with a deleterious variant exhibited a correlation between SBS4-related somatic mutations and the Brinkman index.
CONCLUSION:TP53 and BRCA2 GPVs and the ALKBH2 novel variant are associated with early-onset LADC in Asians.