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BRCA2 germline mutation carrier with five malignancies: a case report.
IF 2 4区 医学 Q3 ONCOLOGY Pub Date : 2024-12-19 DOI: 10.1186/s13053-024-00302-7
Elena Su, Yann Christinat, Thomas McKee, Silvia Azzarello-Burri, Wolfram Jochum, Stefanie Fischer, Christian Rothermundt

Background: BRCA2 germline mutations are known to predispose carriers to various cancer types, including breast, ovarian, pancreatic and prostate cancer. An association with melanoma has also been reported. However, the full tumour spectrum associated with BRCA2 mutations, particularly in patients with other concurrent pathogenetic mutations, is unexplored.

Case presentation: We present a 70-year-old female patient with a pathogenic BRCA2 c.5946del variant. Over a period of 15 years, she has developed two independent breast cancers, well-differentiated liposarcoma, clear cell renal cell carcinoma and myeloproliferative neoplasia. This unusual tumour spectrum and the staggered occurrence of these tumours required multiple rounds of genetic testing and led to a delayed diagnosis of the BRCA2-associated tumour predisposition. In addition to the BRCA2 mutation, extended germline testing revealed an APC c.3920T > A variant and variants of unknown significance in the BRIP1 and ATR genes. The molecular analysis of the tumours revealed distinct profiles with differences in HRD status and in copy number variations, indicating no common origin.

Conclusions: Our case study revealed that the pathogenic BRCA2 c.5946del germline variant can be associated with an unusual tumour spectrum, which may lead to a delayed diagnosis of a hereditary tumour predisposition. Thus, upfront genetic testing using large multigene panels or whole-genome sequencing in encouraged, especially in cases with a prominent family history.

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引用次数: 0
A genome-wide association study in Swedish colorectal cancer patients with gastric- and prostate cancer in relatives. 瑞典结直肠癌患者与胃癌和前列腺癌亲属的全基因组关联研究。
IF 2 4区 医学 Q3 ONCOLOGY Pub Date : 2024-11-14 DOI: 10.1186/s13053-024-00299-z
Johanna Samola Winnberg, Litika Vermani, Wen Liu, Veronika Soller, Jessada Thutkawkorapin, Mats Lindblad, Annika Lindblom

Background: A complex inheritance has been suggested in families with colorectal-, gastric- and prostate cancer. Therefore, we conducted a genome-wide association study (GWAS) in colorectal cancer patients, who's relatives had prostate-, and/or gastric cancer.

Methods: The GWAS analysis consisted of 685 cases of colorectal cancer and 4780 healthy controls from Sweden. A sliding window haplotype analysis was conducted using a logistic regression model. Thereafter, we performed sequencing to find candidate variants, finally to be tested in a nested case-control study.

Results: Candidate loci/genes on ten chromosomal regions were suggested with odds ratios between 1.71-3.62 and p-values < 5 × 10-8 in the analysis. The regions suggested were 1q32.2, 3q29, 4q35.1, 4p15.31, 4q26, 8p23.1, 13q33.3, 13q13.3, 16q23.3 and 22q11.21. All regions, except one on 1q32.2, had protein coding genes, many already shown to be involved in cancer, such as ZDHHC19, SYNPO2, PCYT1A, MYO16, TXNRD2, COMT, and CDH13. Sequencing of DNA from 122 colorectal cancer patients with gastric- and/or prostate cancer in their families was performed to search for candidate variants in the haplotype regions. The identified candidate variants were tested in a nested case-control study of similar colorectal cancer cases and controls. There was some support for an increased risk of colorectal-, gastric-, and/or prostate cancer in all the six loci tested.

Conclusions: This study demonstrated a proof of principle strategy to identify risk variants found by GWAS, and identified ten candidate loci that could be associated with colorectal, gastric- and prostate cancer.

背景:有研究表明,结直肠癌、胃癌和前列腺癌家族具有复杂的遗传性。因此,我们对亲属患有前列腺癌和/或胃癌的结直肠癌患者进行了全基因组关联研究(GWAS):GWAS 分析包括来自瑞典的 685 例结直肠癌病例和 4780 例健康对照。利用逻辑回归模型进行了滑动窗口单倍型分析。之后,我们进行了测序,以找到候选变异,最后在巢式病例对照研究中进行检测:结果:我们发现了十个染色体区域的候选位点/基因,其几率比在 1.71-3.62 之间,P 值为结论:这项研究证明了一种识别 GWAS 发现的风险变异的原理性策略,并确定了可能与结直肠癌、胃癌和前列腺癌相关的 10 个候选位点。
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引用次数: 0
Breast cancer and ATM mutations: treatment implications. 乳腺癌与 ATM 基因突变:治疗意义。
IF 2 4区 医学 Q3 ONCOLOGY Pub Date : 2024-11-14 DOI: 10.1186/s13053-024-00300-9
Marta Seca, Steven A Narod

Genetic testing for breast cancer predisposing genes has expanded beyond BRCA1 and BRCA2 and now includes panels of 20 or more genes. It is now recommended that all women diagnosed with breast cancer at age 65 or below be offered testing for an extended gene panel. The rationale for testing includes personalizing the management of breast cancer according to the mutation found. For BRCA1 and BRCA2 carriers, the finding of a mutation has clear implications for cancer management, but for other genes, such as ATM, the management implications are less clear. Women with an ATM mutation have a lifetime risk of breast cancer of approximately 25%, the majority of which are ER-positive. The risk of ovarian cancer is approximately 5%. It is not yet clear how the identification of an ATM mutation in a patient newly diagnosed with breast cancer should impact on her treatment and follow-up. At present, these women are treated in the same way as women without a mutation. It is important that large prospective studies be conducted looking at various treatment modalities in women with breast cancer and an ATM mutation in order to optimize outcomes.

乳腺癌易感基因的基因检测已超出 BRCA1 和 BRCA2 的范围,现在包括 20 个或更多基因的检测。现在建议所有 65 岁或 65 岁以下确诊为乳腺癌的妇女接受扩展基因组检测。检测的理由包括根据发现的基因突变对乳腺癌进行个性化治疗。对于 BRCA1 和 BRCA2 基因携带者来说,突变的发现对癌症的治疗有明确的影响,但对于其他基因,如 ATM 基因,其治疗影响就不那么明确了。有 ATM 基因突变的女性一生中患乳腺癌的风险约为 25%,其中大部分为 ER 阳性。罹患卵巢癌的风险约为 5%。目前还不清楚在新诊断的乳腺癌患者中发现 ATM 基因突变会对其治疗和随访产生什么影响。目前,对这些妇女的治疗方法与未发现突变的妇女相同。重要的是,应开展大型前瞻性研究,对乳腺癌和 ATM 基因突变女性患者的各种治疗方式进行研究,以优化治疗效果。
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引用次数: 0
Meeting abstracts from the Annual Conference "Clinical Genetics of Cancer 2023". 2023 年癌症临床遗传学 "年会的会议摘要。
IF 2 4区 医学 Q3 ONCOLOGY Pub Date : 2024-11-12 DOI: 10.1186/s13053-024-00294-4
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引用次数: 0
Validation of a guidelines-based digital tool to assess the need for germline cancer genetic testing. 验证基于指南的数字工具,以评估是否需要进行种系癌症基因检测。
IF 2 4区 医学 Q3 ONCOLOGY Pub Date : 2024-11-08 DOI: 10.1186/s13053-024-00298-0
Callan D Russell, Ashley V Daley, Durand R Van Arnem, Andi V Hila, Kiley J Johnson, Jill N Davies, Hanah S Cytron, Kaylene J Ready, Cary M Armstrong, Mark E Sylvester, Colleen A Caleshu

Background: Efficient and scalable solutions are needed to identify patients who qualify for germline cancer genetic testing. We evaluated the clinical validity of a brief, patient-administered hereditary cancer risk assessment digital tool programmed to assess if patients meet criteria for germline genetic testing, based on personal and family history, and in line with national guidelines.

Methods: We applied the tool to cases seen in a nationwide telehealth genetic counseling practice. Validity of the tool was evaluated by comparing the tool's assessment to that of the genetic counselor who saw the patient. Patients' histories were extracted from genetic counselor-collected pedigrees and input into the tool by the research team to model how a patient would complete the tool. We also validated the tool's assessment of which specific aspects of the personal and family history met criteria for genetic testing. Descriptive statistics were used.

Results: Of the 152 cases (80% female, mean age 52.3), 56% had a personal history of cancer and 66% met genetic testing criteria. The tool and genetic counselor agreed in 96% of cases. Most disagreements (4/6; 67%) occurred because the genetic counselor's assessment relied on details the tool was not programmed to collect since patients typically don't have access to the relevant information (pathology details, risk models). We also found complete agreement between the tool and research team on which specific aspects of the patient's history met criteria for genetic testing.

Conclusion: We observed a high level of agreement with genetic counselor assessments, affirming the tool's clinical validity in identifying individuals for hereditary cancer predisposition testing and its potential for increasing access to hereditary cancer risk assessment.

背景:我们需要高效且可扩展的解决方案来确定哪些患者有资格进行种系癌症基因检测。我们评估了一个简短的、由患者管理的遗传性癌症风险评估数字工具的临床有效性,该工具是根据个人和家族病史以及国家指导方针设计的,用于评估患者是否符合种系遗传检测的标准:我们将该工具应用于全国范围内远程医疗遗传咨询实践中的病例。方法:我们将该工具应用于全国范围内的远程医疗遗传咨询实践中的病例,通过将该工具的评估结果与为患者看病的遗传咨询师的评估结果进行比较,来评估该工具的有效性。研究小组从遗传咨询师收集的血统中提取了患者的病史,并将其输入该工具,以模拟患者如何完成该工具。我们还验证了该工具对个人和家族病史中哪些具体方面符合基因检测标准的评估。我们使用了描述性统计方法:在 152 个病例中(80% 为女性,平均年龄 52.3 岁),56% 有个人癌症病史,66% 符合基因检测标准。在 96% 的病例中,工具和遗传咨询师意见一致。大多数分歧(4/6;67%)发生的原因是遗传咨询师的评估依赖于工具程序无法收集的细节,因为患者通常无法获得相关信息(病理细节、风险模型)。我们还发现,在患者病史的哪些具体方面符合基因检测标准的问题上,该工具与研究团队的意见完全一致:我们观察到该工具与遗传咨询师的评估结果高度一致,这肯定了该工具在识别遗传性癌症易感性检测个体方面的临床有效性,以及它在增加遗传性癌症风险评估机会方面的潜力。
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引用次数: 0
Molecular analysis of BRCA1 and BRCA2 genes in La Rioja (Spain): five new variants. 拉里奥哈(西班牙)BRCA1 和 BRCA2 基因的分子分析:五个新变体。
IF 2 4区 医学 Q3 ONCOLOGY Pub Date : 2024-10-22 DOI: 10.1186/s13053-024-00296-2
Raquel Salazar Saez, Miriam Zorrilla, Rosa Sánchez, Ana Cebollero, Isabel Manrique, Alfonso Martín, Leticia de Ávila, Alejandra Lacalle-Emborujo, Samuel Martin-Rodriguez, Iván Bernardo-González, Martina Alonso

Background: To study BRCA1/2 gene variants in La Rioja in the northcentral area of Spain.

Methods: We performed a molecular analysis of BRCA1 and BRCA2 in 642 individuals from 427 different families from June 2008 to December 2019.

Results: We identified 71 families with pathogenic variants in these genes, 32 families with BRCA1 variants and 39 families with BRCA2 variants. The pathogenic variants c.959delG in BRCA1 and c.1363_1369delTCAGAGA, c.1397dupA, c.4234_4236delACTinsC and c.8387delC in BRCA2 have not been previously described. The c.81-2 A > T variant in BRCA1, detected in two unrelated families, has not been reported previously in the Spanish population. Two large genomic deletions were found in the BRCA1 gene in exons (Ex) 23-24 and Ex1A-1B-2, and one deletion was found in the BRCA2 gene in Ex2. The pathogenic variant c.5123 C > A in BRCA1 was detected in 8 unrelated families and was the most frequent pathogenic variant in our population. The c.6024dupG mutation in BRCA2 was detected in 6 unrelated families; the c.2808_2011delACAA mutation in BRCA2 was found in 5 different families; the c.211 A > G mutation in BRCA1 was found in three different families; and the c.68_69delAG, c81-2 A > T, c.4038_4039delAA, and c.5266dupC variants in BRCA1 and the c.2457delA, c.2701delC, c.5116_5119delAATA, c.6275delTT, c.7558 C > T and c.7617 + 1G > A variants in BRCA2 were found in two different families.

Conclusions: The spectrum of pathogenic variants in the BRCA1/2 genes in La Rioja is similar to that in other Spanish regions, with some unique characteristics. The pathogenic c.6024dupG variant in the BRCA2 gene was detected in a large number of families and could have a founding effect in the Ebro riverside areas in the regions of La Rioja and Navarra.

Trial registration: Not applicable.

背景:研究西班牙中北部地区拉里奥哈的 BRCA1/2 基因变异:研究西班牙中北部地区拉里奥哈的 BRCA1/2 基因变异:2008年6月至2019年12月,我们对来自427个不同家庭的642人进行了BRCA1和BRCA2的分子分析:结果:我们发现71个家庭存在这些基因的致病变异,其中32个家庭存在BRCA1变异,39个家庭存在BRCA2变异。BRCA1 中的 c.959delG、BRCA2 中的 c.1363_1369delTCAGAGA、c.1397dupA、c.4234_4236delACTinsC 和 c.8387delC 等致病变异以前未被描述过。BRCA1 中的 c.81-2 A > T 变体在两个没有血缘关系的家庭中发现,此前在西班牙人群中也未见报道。在 BRCA1 基因的 23-24 号外显子和 Ex1A-1B-2 号外显子中发现了两个大的基因组缺失,在 BRCA2 基因的 Ex2 号外显子中发现了一个缺失。在 8 个无血缘关系的家庭中发现了 BRCA1 基因中的 c.5123 C > A 致病变异,这是我们人群中最常见的致病变异。在 6 个无关家庭中检测到 BRCA2 中的 c.6024dupG 突变;在 5 个不同的家庭中发现 BRCA2 中的 c.2808_2011delACAA 突变;在 3 个不同的家庭中发现 BRCA1 中的 c.211 A > G 突变;以及 c.6869delAG、c81-2 A > T、c.4038_4039delAA和c.5266dupC变异;BRCA1中的c.2457delA、c.2701delC、c.5116_5119delAATA、c.6275delTT、c.7558 C > T和c.7617 + 1G > A变异在两个不同的家族中发现:拉里奥哈的 BRCA1/2 基因致病变异谱与西班牙其他地区相似,但也有一些独特之处。BRCA2 基因中的 c.6024dupG 致病变体在许多家庭中被检测到,可能对拉里奥哈和纳瓦拉地区的埃布罗河沿岸地区产生创始效应:试验注册:不适用。
{"title":"Molecular analysis of BRCA1 and BRCA2 genes in La Rioja (Spain): five new variants.","authors":"Raquel Salazar Saez, Miriam Zorrilla, Rosa Sánchez, Ana Cebollero, Isabel Manrique, Alfonso Martín, Leticia de Ávila, Alejandra Lacalle-Emborujo, Samuel Martin-Rodriguez, Iván Bernardo-González, Martina Alonso","doi":"10.1186/s13053-024-00296-2","DOIUrl":"https://doi.org/10.1186/s13053-024-00296-2","url":null,"abstract":"<p><strong>Background: </strong>To study BRCA1/2 gene variants in La Rioja in the northcentral area of Spain.</p><p><strong>Methods: </strong>We performed a molecular analysis of BRCA1 and BRCA2 in 642 individuals from 427 different families from June 2008 to December 2019.</p><p><strong>Results: </strong>We identified 71 families with pathogenic variants in these genes, 32 families with BRCA1 variants and 39 families with BRCA2 variants. The pathogenic variants c.959delG in BRCA1 and c.1363_1369delTCAGAGA, c.1397dupA, c.4234_4236delACTinsC and c.8387delC in BRCA2 have not been previously described. The c.81-2 A > T variant in BRCA1, detected in two unrelated families, has not been reported previously in the Spanish population. Two large genomic deletions were found in the BRCA1 gene in exons (Ex) 23-24 and Ex1A-1B-2, and one deletion was found in the BRCA2 gene in Ex2. The pathogenic variant c.5123 C > A in BRCA1 was detected in 8 unrelated families and was the most frequent pathogenic variant in our population. The c.6024dupG mutation in BRCA2 was detected in 6 unrelated families; the c.2808_2011delACAA mutation in BRCA2 was found in 5 different families; the c.211 A > G mutation in BRCA1 was found in three different families; and the c.68_69delAG, c81-2 A > T, c.4038_4039delAA, and c.5266dupC variants in BRCA1 and the c.2457delA, c.2701delC, c.5116_5119delAATA, c.6275delTT, c.7558 C > T and c.7617 + 1G > A variants in BRCA2 were found in two different families.</p><p><strong>Conclusions: </strong>The spectrum of pathogenic variants in the BRCA1/2 genes in La Rioja is similar to that in other Spanish regions, with some unique characteristics. The pathogenic c.6024dupG variant in the BRCA2 gene was detected in a large number of families and could have a founding effect in the Ebro riverside areas in the regions of La Rioja and Navarra.</p><p><strong>Trial registration: </strong>Not applicable.</p>","PeriodicalId":55058,"journal":{"name":"Hereditary Cancer in Clinical Practice","volume":"22 1","pages":"22"},"PeriodicalIF":2.0,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11495111/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142513271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Current advances and challenges in Managing Hereditary Diffuse Gastric Cancer (HDGC): a narrative review. 治疗遗传性弥漫性胃癌 (HDGC) 的最新进展和挑战:综述。
IF 2 4区 医学 Q3 ONCOLOGY Pub Date : 2024-10-08 DOI: 10.1186/s13053-024-00293-5
L van der Sluis, J M van Dieren, R S van der Post, T M Bisseling

More than 25 years ago, CDH1 pathogenic variants (PVs) were identified as the primary cause of hereditary diffuse gastric cancer (HDGC), an inherited cancer syndrome that increases the lifetime risk of developing diffuse gastric cancer (DGC) and lobular breast cancer (LBC). Since DGC is associated with a poor prognosis, a prophylactic total gastrectomy (PTG) is currently the gold standard for reducing the risk of DGC in CDH1 PV carriers. However, as germline genetic testing becomes more widespread, many CDH1 PV carriers have been identified, including in families with lower penetrance levels or without a history of gastric cancer (GC). When including these families, recent findings suggest that the cumulative lifetime risk of developing advanced DGC is much lower than previously thought and is now estimated to be 13-19%. This lower risk, combined with the fact that around one third of the CDH1 PV carriers decline PTG due to potential lifelong physical and psychological consequences, raises critical questions about the current uniformity in recommending PTG to all CDH1 PV carriers. As a result, there is a growing need to consider alternative strategies, such as endoscopic surveillance. However, despite the currently lower estimated risk of infiltrative (advanced) DGC, almost every PTG specimen shows the presence of small low-stage (pT1a) signet ring cell (SRC) lesions of which the behaviour is unpredictable but often are considered indolent or premalignant stages of DGC. Therefore, the primary goal of surveillance should be to identify atypical, deeper infiltrating lesions rather than every SRC lesion. Understanding the progression from indolent to more infiltrative lesions, and recognizing their endoscopic and histological features, is crucial in deciding the most suitable management option for each individual.

25 年前,CDH1 致病变异体 (PV) 被确定为遗传性弥漫性胃癌 (HDGC) 的主要病因,这是一种遗传性癌症综合征,会增加终生罹患弥漫性胃癌 (DGC) 和小叶乳腺癌 (LBC) 的风险。由于弥漫性胃癌的预后较差,预防性全胃切除术(PTG)是目前降低 CDH1 PV 携带者罹患弥漫性胃癌风险的金标准。然而,随着种系基因检测的普及,许多 CDH1 PV 携带者已被发现,包括渗透性较低或无胃癌(GC)病史的家族。如果将这些家族包括在内,最近的研究结果表明,患晚期 DGC 的累积终生风险比以前认为的要低得多,现在估计为 13-19%。这种较低的风险,再加上约三分之一的 CDH1 PV 携带者因潜在的终生生理和心理后果而拒绝接受 PTG 这一事实,使人们对目前向所有 CDH1 PV 携带者统一推荐 PTG 的做法产生了严重的质疑。因此,越来越有必要考虑其他策略,如内镜监测。然而,尽管目前浸润性(晚期)DGC 的估计风险较低,但几乎每一份 PTG 标本都显示存在低分期(pT1a)的小标志环细胞(SRC)病变,这些病变的表现难以预测,但通常被认为是 DGC 的轻度或恶性前分期。因此,监测的主要目标应该是识别不典型的、浸润较深的病变,而不是每一个SRC病变。了解病变从不发火到浸润较深的发展过程,并识别其内镜和组织学特征,对于决定最适合每个人的治疗方案至关重要。
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引用次数: 0
PMS2 mutation spectra in Norway and risk of cancer for carriers of pathogenic variants. 挪威的 PMS2 基因突变谱与致病变体携带者罹患癌症的风险。
IF 2 4区 医学 Q3 ONCOLOGY Pub Date : 2024-09-27 DOI: 10.1186/s13053-024-00292-6
Wenche Sjursen, Hanne K Hyldebrandt, Liss Anne S Lavik, Bjørn Ivar Haukanes, Sarah Ariansen, Siri Briskemyr, Anna E Sylvander, Marianne T Haavind, Maren F Olsen, Elin S Røyset, Hildegunn Vetti, Astrid Stormorken, Eli Marie Grindedal

Background: In Norway, we have offered testing of PMS2 since 2006, and have a large national cohort of carriers. The aim of this study was to describe all PMS2 variants identified, and to describe frequency, spectrum and penetrance of cancers in carriers of class 4/5 variants.

Methods: All detected PMS2 variants were collected from the diagnostic laboratories and reclassified according to ACMG criteria and gene specific guidelines. Data on variant, gender, cancer diagnosis, age at diagnosis, and age at last known follow-up was collected on all carriers of class 4/5 variants from electronic patient records. The Kaplan-Meier algorithm was used to calculate cumulative risk of any cancer, colorectal cancer and endometrial cancer.

Results: In total, 220 different PMS2 variants were detected. Twenty nine class 4/5 variants were identified in 482 carriers. The most common pathogenic variant was the founder mutation c.989-1G > T, detected in 204 patients from 58 families. Eighty seven out of 482 (18.0%) had been diagnosed with colorectal cancer, 10 of these (11.8%) before 40 years. Cumulative risk at 70 years in our cohort was 34.7% for colorectal cancer and 26.1% for endometrial cancer.

Conclusions: After 15 years of genetic testing, 29 different class 4/5 variants have been detected in Norway. Almost half of Norwegian PMS2 carriers have the founder variant 989-1G > T. Penetrance of colorectal cancer in our cohort was moderate but variable, as 11.5% of those diagnosed were younger than 40 years.

背景:挪威自2006年起开始提供PMS2检测,并拥有一个庞大的全国携带者队列。本研究的目的是描述所有已发现的PMS2变异,并描述4/5类变异携带者患癌症的频率、范围和渗透性:方法:从诊断实验室收集所有检测到的 PMS2 变体,并根据 ACMG 标准和基因特定指南进行重新分类。从电子病历中收集了所有 4/5 类变异体携带者的变异体、性别、癌症诊断、诊断年龄和最后一次已知随访年龄的数据。采用 Kaplan-Meier 算法计算任何癌症、结直肠癌和子宫内膜癌的累积风险:结果:共检测到 220 个不同的 PMS2 变异。在 482 名携带者中发现了 29 个 4/5 类变异。最常见的致病变异是创始变异 c.989-1G > T,在来自 58 个家族的 204 名患者中检测到。482 例患者中有 87 例(18.0%)被诊断出患有结直肠癌,其中 10 例(11.8%)在 40 岁之前。在我们的队列中,70 岁时患结直肠癌的累积风险为 34.7%,患子宫内膜癌的累积风险为 26.1%:经过15年的基因检测,挪威已发现29种不同的4/5类变异。近一半的挪威PMS2基因携带者具有989-1G > T的创始变异。在我们的队列中,结肠直肠癌的发病率适中,但存在变异,因为11.5%的确诊患者年龄小于40岁。
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引用次数: 0
Blood molybdenum level as a marker of cancer risk on BRCA1 carriers 作为 BRCA1 携带者癌症风险标志物的血钼水平
IF 1.7 4区 医学 Q3 ONCOLOGY Pub Date : 2024-09-19 DOI: 10.1186/s13053-024-00291-7
Milena Matuszczak, Adam Kiljańczyk, Wojciech Marciniak, Róża Derkacz, Klaudia Stempa, Piotr Baszuk, Marta Bryśkiewicz, Cezary Cybulski, Tadeusz Dębniak, Gronwald Jacek, Tomasz Huzarski, Marcin Lener, Anna Jakubowska, Sandra Pietrzak, Marek Szwiec, Małgorzata Stawicka-Niełacna, Dariusz Godlewski, Artur Prusaczyk, Andrzej Jasiewicz, Tomasz Kluz, Joanna Tomiczek-Szwiec, Ewa Kilar-Kobierzycka, Monika Siołek, Renata Posmyk, Joanna Jarkiewicz-Tretyn, Rodney Scott, Steven Narod, Jan Lubiński
To investigate whether Molybdenum blood level is a marker of cancer risk on BRCA1 carriers. A prospective cohort study was conducted among 989 initially unaffected women with a BRCA1 mutation. Blood samples were collected to measure molybdenum levels, and participants were followed for an average of 7.5 years. Cox proportional hazards models were used to assess the association between blood molybdenum levels and cancer incidence, adjusting for potential confounders. High blood molybdenum levels (> 0.70 µg/L) were significantly associated with an increased risk of developing ovarian cancer (HR = 5.55; 95%CI: 1.59–19.4; p = 0.007) and any cancer (HR = 1.74; 95%CI: 1.17–2.61; p = 0.007) but not breast cancer (HR = 1.46, CI = 0.91–2.33; p = 0.12). The cumulative incidence of ovarian cancer at ten years was 1.2% for the lowest molybdenum tertile, 4.2% for the middle tertile, and 8.7% for the highest tertile. Elevated blood molybdenum levels are associated with an increased risk of ovarian cancer on BRCA1 mutation carriers. Lowering molybdenum levels may potentially reduce cancer risk in this population, and high molybdenum levels could serve as a marker for considering preventive oophorectomy in BRCA1 carriers. Further research is warranted to confirm these findings and explore interventions targeting molybdenum levels as a preventive measure for ovarian cancer in BRCA1 mutation carriers.
研究钼的血液水平是否是 BRCA1 基因携带者癌症风险的标志物。研究人员对 989 名最初未受影响的 BRCA1 基因突变女性进行了前瞻性队列研究。研究人员采集了血液样本以测量钼水平,并对参与者进行了平均 7.5 年的随访。在对潜在的混杂因素进行调整后,采用 Cox 比例危险模型评估血钼水平与癌症发病率之间的关系。高血钼(> 0.70 µg/L)与卵巢癌(HR = 5.55;95%CI:1.59-19.4;p = 0.007)和任何癌症(HR = 1.74;95%CI:1.17-2.61;p = 0.007)的发病风险增加显著相关,但与乳腺癌(HR = 1.46,CI = 0.91-2.33;p = 0.12)的发病风险增加无关。十年后卵巢癌的累积发病率为:钼含量最低的三等分组为1.2%,中等的三等分组为4.2%,最高的三等分组为8.7%。血液中钼水平升高与 BRCA1 基因突变携带者罹患卵巢癌的风险增加有关。降低钼水平有可能降低这一人群的癌症风险,而钼水平过高可作为一个标记,考虑对 BRCA1 基因携带者进行预防性输卵管切除术。我们有必要开展进一步的研究来证实这些发现,并探索以钼水平为目标的干预措施,以预防 BRCA1 基因突变携带者患卵巢癌。
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引用次数: 0
Universal screening of colorectal tumors for lynch syndrome: a survey of patient experiences and opinions. 林奇综合征结直肠肿瘤的普遍筛查:患者经验和意见调查。
IF 2 4区 医学 Q3 ONCOLOGY Pub Date : 2024-09-05 DOI: 10.1186/s13053-024-00290-8
Alexander T Petterson, Jennifer Garbarini, Maria J Baker

Background: Lynch syndrome represents the most common hereditary cause of both colorectal and endometrial cancer. It is caused by defects in mismatch repair genes, as well as EPCAM. Universal screening of colon tumors for Lynch syndrome via microsatellite instability (MSI) and/or immunohistochemistry (IHC) can identify patients and families at risk to develop further cancers and potentially impact surveillance and treatment options. The approach to implementation of universal screening, taking ethical considerations into account, is critical to its effectiveness, with patient perspectives providing valuable insight.

Methods: Patients whose colon tumors underwent universal screening at Penn State Hershey Medical Center over a period of 2.5 years were mailed a survey on universal screening in 2017. Along with the survey, they received a recruitment letter and a summary explanation of research. The survey included both multiple choice and free-response questions that covered topics including respondent knowledge of Lynch syndrome, attitudes toward universal screening and experiences with the screening protocol as implemented.

Results: Sixty-six of 297 possible patients (22.2%) responded to the survey, including 13 whose screening results raised concern for Lynch syndrome. 75.8% of respondents supported universal tumor screening without informed consent. 92.4% preferred receiving screening results regardless of outcome. Respondents described benefits to screening for themselves and their families.

Conclusions: While broadly supporting universal tumor screening without informed consent, respondents also wanted more information shared about the screening policy, as well as their results. These patient preferences should be one of many factors considered when implementing universal screening and can also inform practices regarding both tumor profiling and universal genetic testing, which is becoming more prevalent.

背景:林奇综合征是结直肠癌和子宫内膜癌最常见的遗传性病因。它是由错配修复基因和 EPCAM 的缺陷引起的。通过微卫星不稳定性(MSI)和/或免疫组织化学(IHC)对结肠肿瘤进行林奇综合征的普遍筛查,可以发现有进一步罹患癌症风险的患者和家庭,并对监测和治疗方案产生潜在影响。考虑到伦理因素,实施普遍筛查的方法对其有效性至关重要,患者的观点可提供宝贵的见解:宾夕法尼亚州立赫尔希医疗中心在 2.5 年内对结肠肿瘤患者进行了普遍筛查,并于 2017 年向这些患者邮寄了一份关于普遍筛查的调查问卷。他们在收到调查问卷的同时,还收到了一封招募信和一份研究摘要说明。调查包括多项选择题和自由回答题,涉及的主题包括受访者对林奇综合征的了解、对普遍筛查的态度以及实施筛查方案的经验:297 位可能的患者中有 66 位(22.2%)对调查做出了回复,其中 13 位患者的筛查结果引起了对林奇综合征的担忧。75.8%的受访者支持在没有知情同意的情况下普及肿瘤筛查。92.4%的受访者倾向于接收筛查结果,无论结果如何。受访者描述了筛查对自己和家人的益处:尽管受访者广泛支持在无知情同意的情况下普及肿瘤筛查,但他们也希望分享更多有关筛查政策以及筛查结果的信息。在实施普遍筛查时,患者的这些偏好应成为考虑的众多因素之一,同时也可为肿瘤特征描述和普遍基因检测的实践提供参考,因为这两种检测正变得越来越普遍。
{"title":"Universal screening of colorectal tumors for lynch syndrome: a survey of patient experiences and opinions.","authors":"Alexander T Petterson, Jennifer Garbarini, Maria J Baker","doi":"10.1186/s13053-024-00290-8","DOIUrl":"10.1186/s13053-024-00290-8","url":null,"abstract":"<p><strong>Background: </strong>Lynch syndrome represents the most common hereditary cause of both colorectal and endometrial cancer. It is caused by defects in mismatch repair genes, as well as EPCAM. Universal screening of colon tumors for Lynch syndrome via microsatellite instability (MSI) and/or immunohistochemistry (IHC) can identify patients and families at risk to develop further cancers and potentially impact surveillance and treatment options. The approach to implementation of universal screening, taking ethical considerations into account, is critical to its effectiveness, with patient perspectives providing valuable insight.</p><p><strong>Methods: </strong>Patients whose colon tumors underwent universal screening at Penn State Hershey Medical Center over a period of 2.5 years were mailed a survey on universal screening in 2017. Along with the survey, they received a recruitment letter and a summary explanation of research. The survey included both multiple choice and free-response questions that covered topics including respondent knowledge of Lynch syndrome, attitudes toward universal screening and experiences with the screening protocol as implemented.</p><p><strong>Results: </strong>Sixty-six of 297 possible patients (22.2%) responded to the survey, including 13 whose screening results raised concern for Lynch syndrome. 75.8% of respondents supported universal tumor screening without informed consent. 92.4% preferred receiving screening results regardless of outcome. Respondents described benefits to screening for themselves and their families.</p><p><strong>Conclusions: </strong>While broadly supporting universal tumor screening without informed consent, respondents also wanted more information shared about the screening policy, as well as their results. These patient preferences should be one of many factors considered when implementing universal screening and can also inform practices regarding both tumor profiling and universal genetic testing, which is becoming more prevalent.</p>","PeriodicalId":55058,"journal":{"name":"Hereditary Cancer in Clinical Practice","volume":"22 1","pages":"18"},"PeriodicalIF":2.0,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11378365/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142141853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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Hereditary Cancer in Clinical Practice
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