目的:研究华南地区黑色素瘤的癌基因突变谱,为黑色素瘤分子靶向治疗策略的优化提供理论依据。方法:本研究收集中山大学肿瘤防治中心2000年3月至2009年4月黑色素瘤病理组织蜡块86例,其中肢端黑色素瘤28例、黏膜黑色素瘤28例、非慢性阳光损伤型黑色素瘤30例,采用Sequenom平台(OncoCarta Panel v1.0和MassARRAY体系)研究黑色素瘤癌基因的突变谱。结果:有38.4%(33/86)的黑色素瘤病灶可见基因突变,突变的基因包括:BRAF(16.3%)、NRAS(10.5%)、KIT(5.8%)、EGFR(4.7%)、HRAS(2.3%)、KRAS(2.3%)、MET(2.3%)和PIK3CA(1.2%)。其中BRAF突变型患者与野生型相比发病年龄早[(45.7±15.3)岁vs.(55.9±12.7)岁,P=0.01],NRAS突变型患者与野生型相比溃疡表现率高(88.9%vs.48.1%,P=0.049)。结论:本研究是对华南地区黑色素瘤癌基因突变谱的综合分析,有利于进一步指导华南地区黑色素瘤的个体化治疗。
Objective:To examine the oncogenic mutations involved in melanoma in Southern China and to provide a theoretical basis for the development of melanoma molecular targeted therapy strategy. Methods:The Sequenom platform (OncoCarta Panel v1.0 and MassARRAY System) was used to determine the prevalence of oncogene mutations in 28 acral melanoma samples, 28 mucosal mel-anoma samples, and 30 non-chronic sun-induced-damage (no-CSD) melanoma samples from Southern China. Results:At least one mu-tation was detected in 33 of the 86 melanomas (38.4%) with mutations observed in BRAF (16.3%), NRAS (10.5%), KIT (5.8%), EGFR (4.7%), HRAS (2.3%), KRAS (2.3%), MET (2.3%), and PIK3CA (1.2%). In BRAF, the age of patients with mutations was significantly lower than those without BRAF mutation (45.7±15.3 vs. 55.9±12.7, P=0.01). Patients with mutations in NRAS were more likely to have ulceration compared with patients without NRAS mutations (88.9%vs. 48.1%, P=0.049). Conclusions:This study represents a compre-hensive and concurrent analysis of the major recurrent oncogenic mutations involved in melanoma cases from Southern China areas. The data have implications for both clinical trial designs and therapeutic strategies.