Nuttavut Kantathavorn

Prevalence of Tissue BRCA Gene Mutation in Ovarian, Fallopian Tube, and Primary Peritoneal Cancers: A Multi-Institutional Study

Ovarian, fallopian tube, or primary peritoneal cancer patients with BRCA gene mutation have enhanced sensitivity to platinum-based regimens and PARP inhibitors. However, the knowledge regarding BRCA mutation in Thai patients is limited. This study aimed at identifying the prevalence and characteristics of somatic and germline BRCA 1 and 2 mutations in Thai patients with these cancers. The paraffin blocks of tumors with histology of high grade serous, high grade endometrioid, or clear cell carcinoma obtained between June 2016 and December 2017 were analyzedto evaluate BRCA mutation using next-generation sequencing system. Blood or normal tissue paraffin blocks of positive patients were further tested for germline BRCA mutation. Tissue paraffin blocks of 178 patients were collected but only 139 were analyzed. Positive BRCA mutation was identified in 24 patients (17.3%): BRCA1 in 13 cases, BRCA2 in 10 cases, and BRCA1 and 2 in the rest one. Germline mutation study in blood or normal tissue in 23 positive patients revealed BRCA mutation in 14 cases, BRCA1 in 8 cases and BRCA 2  in 6 cases. Overall, the prevalence of somatic and germline mutation was 6.5% (9 out of 138 patients) and 8.7% (14 out of 138 patients), respectively. The most common histology associated with BRCA mutation was high grade serous cancer (27.3%). No significant difference was found between patients with or without BRCA mutation in terms of stage, outcome, platinum status, and survival outcome. BRCA mutation was demonstrated in less than 10% of Thai ovarian cancer patients. Higher rate of mutation was found in high grade serous cancer..

Risk of CIN2+ in women aged >60 years with abnormal cervical cancer screening: a multicenter retrospective cohort study from the Thai Gynecologic Cancer Society research group

To study patterns of abnormal cervical cancer screening in women aged >60 years and explore the risk and predictors of cervical intraepithelial neoplasia grade 2 or worse (CIN2+). This retrospective cohort study examined 1,596 women aged >60 years with abnormal cervical cancer screening results from eight Thai cancer centers. Those who underwent hysterectomy were excluded. Patient characteristics, previous and current cervical cancer screening results, and histopathology data were collected and analyzed. Mean age was 68.2±7.2 years. The abnormal screening results were normal cytology with positive high-risk human papillomavirus (0.9%), atypical squamous cells of undetermined significance (37.7%), low-grade squamous intraepithelial lesion (12%), atypical squamous cell cannot exclude high-grade lesion (11.7%), high-grade squamous intraepithelial lesion (12.7%), atypical glandular cell (20.1%), squamous cell carcinoma (4.3%), and adenocarcinoma (0.7%). Risk of CIN2+ in women with abnormal screening was 17.9% (95% confidence interval [CI]=16.1-19.8); among those with available histopathology, the risk was 28.8% (95% CI=26.1-31.7). Univariable logistic regression showed that age >70 years, sexual activity within 1 year, previous abnormal/no screening, previous CIN2+ pathology, presence of symptoms, and high-grade cytology were significant predictors of CIN2+. In the multivariable analysis, lack of previous screening (adjusted odds ratio=4.05; 95% CI=1.91-8.60; p60 years should be individualized based on their risk factors, particularly for those who have never been screened.