期刊
NATURE GENETICS
卷 47, 期 3, 页码 257-+出版社
NATURE PUBLISHING GROUP
DOI: 10.1038/ng.3202
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资金
- BRAINchild Canada
- Canadian Institute of Health Research [MOP123268, FRN131596]
- Wellcome Trust Senior Clinical and Basic Research Fellowships
- Wellcome Trust Research Training Fellowship
- SickKids Restracomp award
- Cancer Research UK [21145] Funding Source: researchfish
DNA replication-associated mutations are repaired by two components: polymerase proofreading and mismatch repair. The mutation consequences of disruption to both repair components in humans are not well studied. We sequenced cancer genomes from children with inherited biallelic mismatch repair deficiency (bMMRD). High-grade bMMRD brain tumors exhibited massive numbers of substitution mutations (>250/Mb), which was greater than all childhood and most cancers (>7,000 analyzed). All ultra-hypermutated bMMRD cancers acquired early somatic driver mutations in DNA polymerase epsilon or delta. The ensuing mutation signatures and numbers are unique and diagnostic of childhood germ-line bMMRD (P < 10(-13)). Sequential tumor biopsy analysis revealed that bMMRD/polymerase-mutant cancers rapidly amass an excess of simultaneous mutations (similar to 600 mutations/cell division), reaching but not exceeding similar to 20,000 exonic mutations in <6 months. This implies a threshold compatible with cancer-cell survival. We suggest a new mechanism of cancer progression in which mutations develop in a rapid burst after ablation of replication repair.
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