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Zhou XP, Waite KA, Pilarski R, Hampel H, Fernandez MJ, Bos C, Dasouki M, Feldman GL, Greenberg LA, Ivanovich J, Matloff E, Patterson A, Pierpont ME, Russo D, Nassif NT, Eng C. Germline PTEN promoter mutations and deletions in Cowden/Bannayan-Riley-Ruvalcaba syndrome result in aberrant PTEN protein and dysregulation of the phosphoinositol-3-kinase/Akt pathway. Am J Hum Genet 2003; 73:404-11. [PMID: 12844284 PMCID: PMC1180378 DOI: 10.1086/377109] [Citation(s) in RCA: 227] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2003] [Accepted: 05/22/2003] [Indexed: 01/18/2023] Open
Abstract
Germline intragenic mutations in PTEN are associated with 80% of patients with Cowden syndrome (CS) and 60% of patients with Bannayan-Riley-Ruvalcaba syndrome (BRRS). The underlying genetic causes remain to be determined in a considerable proportion of classic CS and BRRS without a polymerase chain reaction (PCR)-detectable PTEN mutation. We hypothesized that gross gene deletions and mutations in the PTEN promoter might alternatively account for a subset of apparently mutation-negative patients with CS and BRRS. Using real time and multiplex PCR techniques, we identified three germline hemizygous PTEN deletions in 122 apparently mutation-negative patients with classic CS (N=95) or BRRS (N=27). Fine mapping suggested that one deletion encompassed the whole gene and the other two included exon 1 and encompassed exons 1-5 of PTEN, respectively. Two patients with the deletion were diagnosed with BRRS, and one patient with the deletion was diagnosed with BRRS/CS overlap (features of both). Thus 3 (11%) of 27 patients with BRRS or BRRS/CS-overlap had PTEN deletions. Analysis of the PTEN promoter revealed nine cases (7.4%) harboring heterozygous germline mutations. All nine had classic CS, representing almost 10% of all subjects with CS. Eight had breast cancers and/or benign breast tumors but, otherwise, oligo-organ involvement. PTEN protein analysis, from one deletion-positive and five PTEN-promoter-mutation-positive samples, revealed a 50% reduction in protein and multiple bands of immunoreactive protein, respectively. In contrast, control samples showed only the expected band. Further, an elevated level of phosphorylated Akt was detected in the five promoter-mutation-positive samples, compared with controls, indicating an absence of or marked reduction in functional PTEN. These data suggest that patients with BRRS and CS without PCR-detected intragenic PTEN mutations be offered clinical deletion analysis and promoter-mutation analysis, respectively.
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Affiliation(s)
- Xiao-Ping Zhou
- Clinical Cancer Genetics and Human Cancer Genetics Programs, Comprehensive Cancer Center, Division of Human Genetics, Department of Internal Medicine, Division of Human Cancer Genetics, Department of Molecular Virology, Immunology and Medical Genetics, The Ohio State University, Columbus; Ferguson Inherited Colon Cancer Registry, Grand Rapids, MI; Division of Genetics, Children’s Mercy Hospital, Kansas City, MO; Molecular Medicine and Genetics and Karmanos Cancer Center Institute, Detroit Medical Center/Wayne State University School of Medicine, Detroit; Cancer Genetics Program, Bennett Cancer Center, Stamford Hospital, Stamford, CT; Pediatric Clinic, Washington University School of Medicine, St. Louis; Department of Genetics, Yale Cancer Center, New Haven, CT; University of Texas Southwestern Medical Center, Dallas; Children’s Hospital, St. Paul; University of Minnesota, Minneapolis; Cancer Genetics Program, NYP Columbia Presbyterian Hospital, New York; Cancer Research Laboratories, South West Sydney Clinical School, University of New South Wales, Liverpool Hospital, Liverpool, Australia; and Cancer Research UK Human Cancer Genetics Research Group, University of Cambridge, Cambridge, United Kingdom
| | - Kristin A. Waite
- Clinical Cancer Genetics and Human Cancer Genetics Programs, Comprehensive Cancer Center, Division of Human Genetics, Department of Internal Medicine, Division of Human Cancer Genetics, Department of Molecular Virology, Immunology and Medical Genetics, The Ohio State University, Columbus; Ferguson Inherited Colon Cancer Registry, Grand Rapids, MI; Division of Genetics, Children’s Mercy Hospital, Kansas City, MO; Molecular Medicine and Genetics and Karmanos Cancer Center Institute, Detroit Medical Center/Wayne State University School of Medicine, Detroit; Cancer Genetics Program, Bennett Cancer Center, Stamford Hospital, Stamford, CT; Pediatric Clinic, Washington University School of Medicine, St. Louis; Department of Genetics, Yale Cancer Center, New Haven, CT; University of Texas Southwestern Medical Center, Dallas; Children’s Hospital, St. Paul; University of Minnesota, Minneapolis; Cancer Genetics Program, NYP Columbia Presbyterian Hospital, New York; Cancer Research Laboratories, South West Sydney Clinical School, University of New South Wales, Liverpool Hospital, Liverpool, Australia; and Cancer Research UK Human Cancer Genetics Research Group, University of Cambridge, Cambridge, United Kingdom
| | - Robert Pilarski
- Clinical Cancer Genetics and Human Cancer Genetics Programs, Comprehensive Cancer Center, Division of Human Genetics, Department of Internal Medicine, Division of Human Cancer Genetics, Department of Molecular Virology, Immunology and Medical Genetics, The Ohio State University, Columbus; Ferguson Inherited Colon Cancer Registry, Grand Rapids, MI; Division of Genetics, Children’s Mercy Hospital, Kansas City, MO; Molecular Medicine and Genetics and Karmanos Cancer Center Institute, Detroit Medical Center/Wayne State University School of Medicine, Detroit; Cancer Genetics Program, Bennett Cancer Center, Stamford Hospital, Stamford, CT; Pediatric Clinic, Washington University School of Medicine, St. Louis; Department of Genetics, Yale Cancer Center, New Haven, CT; University of Texas Southwestern Medical Center, Dallas; Children’s Hospital, St. Paul; University of Minnesota, Minneapolis; Cancer Genetics Program, NYP Columbia Presbyterian Hospital, New York; Cancer Research Laboratories, South West Sydney Clinical School, University of New South Wales, Liverpool Hospital, Liverpool, Australia; and Cancer Research UK Human Cancer Genetics Research Group, University of Cambridge, Cambridge, United Kingdom
| | - Heather Hampel
- Clinical Cancer Genetics and Human Cancer Genetics Programs, Comprehensive Cancer Center, Division of Human Genetics, Department of Internal Medicine, Division of Human Cancer Genetics, Department of Molecular Virology, Immunology and Medical Genetics, The Ohio State University, Columbus; Ferguson Inherited Colon Cancer Registry, Grand Rapids, MI; Division of Genetics, Children’s Mercy Hospital, Kansas City, MO; Molecular Medicine and Genetics and Karmanos Cancer Center Institute, Detroit Medical Center/Wayne State University School of Medicine, Detroit; Cancer Genetics Program, Bennett Cancer Center, Stamford Hospital, Stamford, CT; Pediatric Clinic, Washington University School of Medicine, St. Louis; Department of Genetics, Yale Cancer Center, New Haven, CT; University of Texas Southwestern Medical Center, Dallas; Children’s Hospital, St. Paul; University of Minnesota, Minneapolis; Cancer Genetics Program, NYP Columbia Presbyterian Hospital, New York; Cancer Research Laboratories, South West Sydney Clinical School, University of New South Wales, Liverpool Hospital, Liverpool, Australia; and Cancer Research UK Human Cancer Genetics Research Group, University of Cambridge, Cambridge, United Kingdom
| | - Magali J. Fernandez
- Clinical Cancer Genetics and Human Cancer Genetics Programs, Comprehensive Cancer Center, Division of Human Genetics, Department of Internal Medicine, Division of Human Cancer Genetics, Department of Molecular Virology, Immunology and Medical Genetics, The Ohio State University, Columbus; Ferguson Inherited Colon Cancer Registry, Grand Rapids, MI; Division of Genetics, Children’s Mercy Hospital, Kansas City, MO; Molecular Medicine and Genetics and Karmanos Cancer Center Institute, Detroit Medical Center/Wayne State University School of Medicine, Detroit; Cancer Genetics Program, Bennett Cancer Center, Stamford Hospital, Stamford, CT; Pediatric Clinic, Washington University School of Medicine, St. Louis; Department of Genetics, Yale Cancer Center, New Haven, CT; University of Texas Southwestern Medical Center, Dallas; Children’s Hospital, St. Paul; University of Minnesota, Minneapolis; Cancer Genetics Program, NYP Columbia Presbyterian Hospital, New York; Cancer Research Laboratories, South West Sydney Clinical School, University of New South Wales, Liverpool Hospital, Liverpool, Australia; and Cancer Research UK Human Cancer Genetics Research Group, University of Cambridge, Cambridge, United Kingdom
| | - Cindy Bos
- Clinical Cancer Genetics and Human Cancer Genetics Programs, Comprehensive Cancer Center, Division of Human Genetics, Department of Internal Medicine, Division of Human Cancer Genetics, Department of Molecular Virology, Immunology and Medical Genetics, The Ohio State University, Columbus; Ferguson Inherited Colon Cancer Registry, Grand Rapids, MI; Division of Genetics, Children’s Mercy Hospital, Kansas City, MO; Molecular Medicine and Genetics and Karmanos Cancer Center Institute, Detroit Medical Center/Wayne State University School of Medicine, Detroit; Cancer Genetics Program, Bennett Cancer Center, Stamford Hospital, Stamford, CT; Pediatric Clinic, Washington University School of Medicine, St. Louis; Department of Genetics, Yale Cancer Center, New Haven, CT; University of Texas Southwestern Medical Center, Dallas; Children’s Hospital, St. Paul; University of Minnesota, Minneapolis; Cancer Genetics Program, NYP Columbia Presbyterian Hospital, New York; Cancer Research Laboratories, South West Sydney Clinical School, University of New South Wales, Liverpool Hospital, Liverpool, Australia; and Cancer Research UK Human Cancer Genetics Research Group, University of Cambridge, Cambridge, United Kingdom
| | - Majed Dasouki
- Clinical Cancer Genetics and Human Cancer Genetics Programs, Comprehensive Cancer Center, Division of Human Genetics, Department of Internal Medicine, Division of Human Cancer Genetics, Department of Molecular Virology, Immunology and Medical Genetics, The Ohio State University, Columbus; Ferguson Inherited Colon Cancer Registry, Grand Rapids, MI; Division of Genetics, Children’s Mercy Hospital, Kansas City, MO; Molecular Medicine and Genetics and Karmanos Cancer Center Institute, Detroit Medical Center/Wayne State University School of Medicine, Detroit; Cancer Genetics Program, Bennett Cancer Center, Stamford Hospital, Stamford, CT; Pediatric Clinic, Washington University School of Medicine, St. Louis; Department of Genetics, Yale Cancer Center, New Haven, CT; University of Texas Southwestern Medical Center, Dallas; Children’s Hospital, St. Paul; University of Minnesota, Minneapolis; Cancer Genetics Program, NYP Columbia Presbyterian Hospital, New York; Cancer Research Laboratories, South West Sydney Clinical School, University of New South Wales, Liverpool Hospital, Liverpool, Australia; and Cancer Research UK Human Cancer Genetics Research Group, University of Cambridge, Cambridge, United Kingdom
| | - Gerald L. Feldman
- Clinical Cancer Genetics and Human Cancer Genetics Programs, Comprehensive Cancer Center, Division of Human Genetics, Department of Internal Medicine, Division of Human Cancer Genetics, Department of Molecular Virology, Immunology and Medical Genetics, The Ohio State University, Columbus; Ferguson Inherited Colon Cancer Registry, Grand Rapids, MI; Division of Genetics, Children’s Mercy Hospital, Kansas City, MO; Molecular Medicine and Genetics and Karmanos Cancer Center Institute, Detroit Medical Center/Wayne State University School of Medicine, Detroit; Cancer Genetics Program, Bennett Cancer Center, Stamford Hospital, Stamford, CT; Pediatric Clinic, Washington University School of Medicine, St. Louis; Department of Genetics, Yale Cancer Center, New Haven, CT; University of Texas Southwestern Medical Center, Dallas; Children’s Hospital, St. Paul; University of Minnesota, Minneapolis; Cancer Genetics Program, NYP Columbia Presbyterian Hospital, New York; Cancer Research Laboratories, South West Sydney Clinical School, University of New South Wales, Liverpool Hospital, Liverpool, Australia; and Cancer Research UK Human Cancer Genetics Research Group, University of Cambridge, Cambridge, United Kingdom
| | - Lois A. Greenberg
- Clinical Cancer Genetics and Human Cancer Genetics Programs, Comprehensive Cancer Center, Division of Human Genetics, Department of Internal Medicine, Division of Human Cancer Genetics, Department of Molecular Virology, Immunology and Medical Genetics, The Ohio State University, Columbus; Ferguson Inherited Colon Cancer Registry, Grand Rapids, MI; Division of Genetics, Children’s Mercy Hospital, Kansas City, MO; Molecular Medicine and Genetics and Karmanos Cancer Center Institute, Detroit Medical Center/Wayne State University School of Medicine, Detroit; Cancer Genetics Program, Bennett Cancer Center, Stamford Hospital, Stamford, CT; Pediatric Clinic, Washington University School of Medicine, St. Louis; Department of Genetics, Yale Cancer Center, New Haven, CT; University of Texas Southwestern Medical Center, Dallas; Children’s Hospital, St. Paul; University of Minnesota, Minneapolis; Cancer Genetics Program, NYP Columbia Presbyterian Hospital, New York; Cancer Research Laboratories, South West Sydney Clinical School, University of New South Wales, Liverpool Hospital, Liverpool, Australia; and Cancer Research UK Human Cancer Genetics Research Group, University of Cambridge, Cambridge, United Kingdom
| | - Jennifer Ivanovich
- Clinical Cancer Genetics and Human Cancer Genetics Programs, Comprehensive Cancer Center, Division of Human Genetics, Department of Internal Medicine, Division of Human Cancer Genetics, Department of Molecular Virology, Immunology and Medical Genetics, The Ohio State University, Columbus; Ferguson Inherited Colon Cancer Registry, Grand Rapids, MI; Division of Genetics, Children’s Mercy Hospital, Kansas City, MO; Molecular Medicine and Genetics and Karmanos Cancer Center Institute, Detroit Medical Center/Wayne State University School of Medicine, Detroit; Cancer Genetics Program, Bennett Cancer Center, Stamford Hospital, Stamford, CT; Pediatric Clinic, Washington University School of Medicine, St. Louis; Department of Genetics, Yale Cancer Center, New Haven, CT; University of Texas Southwestern Medical Center, Dallas; Children’s Hospital, St. Paul; University of Minnesota, Minneapolis; Cancer Genetics Program, NYP Columbia Presbyterian Hospital, New York; Cancer Research Laboratories, South West Sydney Clinical School, University of New South Wales, Liverpool Hospital, Liverpool, Australia; and Cancer Research UK Human Cancer Genetics Research Group, University of Cambridge, Cambridge, United Kingdom
| | - Ellen Matloff
- Clinical Cancer Genetics and Human Cancer Genetics Programs, Comprehensive Cancer Center, Division of Human Genetics, Department of Internal Medicine, Division of Human Cancer Genetics, Department of Molecular Virology, Immunology and Medical Genetics, The Ohio State University, Columbus; Ferguson Inherited Colon Cancer Registry, Grand Rapids, MI; Division of Genetics, Children’s Mercy Hospital, Kansas City, MO; Molecular Medicine and Genetics and Karmanos Cancer Center Institute, Detroit Medical Center/Wayne State University School of Medicine, Detroit; Cancer Genetics Program, Bennett Cancer Center, Stamford Hospital, Stamford, CT; Pediatric Clinic, Washington University School of Medicine, St. Louis; Department of Genetics, Yale Cancer Center, New Haven, CT; University of Texas Southwestern Medical Center, Dallas; Children’s Hospital, St. Paul; University of Minnesota, Minneapolis; Cancer Genetics Program, NYP Columbia Presbyterian Hospital, New York; Cancer Research Laboratories, South West Sydney Clinical School, University of New South Wales, Liverpool Hospital, Liverpool, Australia; and Cancer Research UK Human Cancer Genetics Research Group, University of Cambridge, Cambridge, United Kingdom
| | - Annette Patterson
- Clinical Cancer Genetics and Human Cancer Genetics Programs, Comprehensive Cancer Center, Division of Human Genetics, Department of Internal Medicine, Division of Human Cancer Genetics, Department of Molecular Virology, Immunology and Medical Genetics, The Ohio State University, Columbus; Ferguson Inherited Colon Cancer Registry, Grand Rapids, MI; Division of Genetics, Children’s Mercy Hospital, Kansas City, MO; Molecular Medicine and Genetics and Karmanos Cancer Center Institute, Detroit Medical Center/Wayne State University School of Medicine, Detroit; Cancer Genetics Program, Bennett Cancer Center, Stamford Hospital, Stamford, CT; Pediatric Clinic, Washington University School of Medicine, St. Louis; Department of Genetics, Yale Cancer Center, New Haven, CT; University of Texas Southwestern Medical Center, Dallas; Children’s Hospital, St. Paul; University of Minnesota, Minneapolis; Cancer Genetics Program, NYP Columbia Presbyterian Hospital, New York; Cancer Research Laboratories, South West Sydney Clinical School, University of New South Wales, Liverpool Hospital, Liverpool, Australia; and Cancer Research UK Human Cancer Genetics Research Group, University of Cambridge, Cambridge, United Kingdom
| | - Mary Ella Pierpont
- Clinical Cancer Genetics and Human Cancer Genetics Programs, Comprehensive Cancer Center, Division of Human Genetics, Department of Internal Medicine, Division of Human Cancer Genetics, Department of Molecular Virology, Immunology and Medical Genetics, The Ohio State University, Columbus; Ferguson Inherited Colon Cancer Registry, Grand Rapids, MI; Division of Genetics, Children’s Mercy Hospital, Kansas City, MO; Molecular Medicine and Genetics and Karmanos Cancer Center Institute, Detroit Medical Center/Wayne State University School of Medicine, Detroit; Cancer Genetics Program, Bennett Cancer Center, Stamford Hospital, Stamford, CT; Pediatric Clinic, Washington University School of Medicine, St. Louis; Department of Genetics, Yale Cancer Center, New Haven, CT; University of Texas Southwestern Medical Center, Dallas; Children’s Hospital, St. Paul; University of Minnesota, Minneapolis; Cancer Genetics Program, NYP Columbia Presbyterian Hospital, New York; Cancer Research Laboratories, South West Sydney Clinical School, University of New South Wales, Liverpool Hospital, Liverpool, Australia; and Cancer Research UK Human Cancer Genetics Research Group, University of Cambridge, Cambridge, United Kingdom
| | - Donna Russo
- Clinical Cancer Genetics and Human Cancer Genetics Programs, Comprehensive Cancer Center, Division of Human Genetics, Department of Internal Medicine, Division of Human Cancer Genetics, Department of Molecular Virology, Immunology and Medical Genetics, The Ohio State University, Columbus; Ferguson Inherited Colon Cancer Registry, Grand Rapids, MI; Division of Genetics, Children’s Mercy Hospital, Kansas City, MO; Molecular Medicine and Genetics and Karmanos Cancer Center Institute, Detroit Medical Center/Wayne State University School of Medicine, Detroit; Cancer Genetics Program, Bennett Cancer Center, Stamford Hospital, Stamford, CT; Pediatric Clinic, Washington University School of Medicine, St. Louis; Department of Genetics, Yale Cancer Center, New Haven, CT; University of Texas Southwestern Medical Center, Dallas; Children’s Hospital, St. Paul; University of Minnesota, Minneapolis; Cancer Genetics Program, NYP Columbia Presbyterian Hospital, New York; Cancer Research Laboratories, South West Sydney Clinical School, University of New South Wales, Liverpool Hospital, Liverpool, Australia; and Cancer Research UK Human Cancer Genetics Research Group, University of Cambridge, Cambridge, United Kingdom
| | - Najah T. Nassif
- Clinical Cancer Genetics and Human Cancer Genetics Programs, Comprehensive Cancer Center, Division of Human Genetics, Department of Internal Medicine, Division of Human Cancer Genetics, Department of Molecular Virology, Immunology and Medical Genetics, The Ohio State University, Columbus; Ferguson Inherited Colon Cancer Registry, Grand Rapids, MI; Division of Genetics, Children’s Mercy Hospital, Kansas City, MO; Molecular Medicine and Genetics and Karmanos Cancer Center Institute, Detroit Medical Center/Wayne State University School of Medicine, Detroit; Cancer Genetics Program, Bennett Cancer Center, Stamford Hospital, Stamford, CT; Pediatric Clinic, Washington University School of Medicine, St. Louis; Department of Genetics, Yale Cancer Center, New Haven, CT; University of Texas Southwestern Medical Center, Dallas; Children’s Hospital, St. Paul; University of Minnesota, Minneapolis; Cancer Genetics Program, NYP Columbia Presbyterian Hospital, New York; Cancer Research Laboratories, South West Sydney Clinical School, University of New South Wales, Liverpool Hospital, Liverpool, Australia; and Cancer Research UK Human Cancer Genetics Research Group, University of Cambridge, Cambridge, United Kingdom
| | - Charis Eng
- Clinical Cancer Genetics and Human Cancer Genetics Programs, Comprehensive Cancer Center, Division of Human Genetics, Department of Internal Medicine, Division of Human Cancer Genetics, Department of Molecular Virology, Immunology and Medical Genetics, The Ohio State University, Columbus; Ferguson Inherited Colon Cancer Registry, Grand Rapids, MI; Division of Genetics, Children’s Mercy Hospital, Kansas City, MO; Molecular Medicine and Genetics and Karmanos Cancer Center Institute, Detroit Medical Center/Wayne State University School of Medicine, Detroit; Cancer Genetics Program, Bennett Cancer Center, Stamford Hospital, Stamford, CT; Pediatric Clinic, Washington University School of Medicine, St. Louis; Department of Genetics, Yale Cancer Center, New Haven, CT; University of Texas Southwestern Medical Center, Dallas; Children’s Hospital, St. Paul; University of Minnesota, Minneapolis; Cancer Genetics Program, NYP Columbia Presbyterian Hospital, New York; Cancer Research Laboratories, South West Sydney Clinical School, University of New South Wales, Liverpool Hospital, Liverpool, Australia; and Cancer Research UK Human Cancer Genetics Research Group, University of Cambridge, Cambridge, United Kingdom
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337
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Zhou XP, Woodford-Richens K, Lehtonen R, Kurose K, Aldred M, Hampel H, Launonen V, Virta S, Pilarski R, Salovaara R, Bodmer WF, Conrad BA, Dunlop M, Hodgson SV, Iwama T, Järvinen H, Kellokumpu I, Kim JC, Leggett B, Markie D, Mecklin JP, Neale K, Phillips R, Piris J, Rozen P, Houlston RS, Aaltonen LA, Tomlinson IPM, Eng C. Germline mutations in BMPR1A/ALK3 cause a subset of cases of juvenile polyposis syndrome and of Cowden and Bannayan-Riley-Ruvalcaba syndromes. Am J Hum Genet 2001; 69:704-11. [PMID: 11536076 PMCID: PMC1226057 DOI: 10.1086/323703] [Citation(s) in RCA: 194] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2001] [Accepted: 08/08/2001] [Indexed: 01/08/2023] Open
Abstract
Juvenile polyposis syndrome (JPS) is an inherited hamartomatous-polyposis syndrome with a risk for colon cancer. JPS is a clinical diagnosis by exclusion, and, before susceptibility genes were identified, JPS could easily be confused with other inherited hamartoma syndromes, such as Bannayan-Riley-Ruvalcaba syndrome (BRRS) and Cowden syndrome (CS). Germline mutations of MADH4 (SMAD4) have been described in a variable number of probands with JPS. A series of familial and isolated European probands without MADH4 mutations were analyzed for germline mutations in BMPR1A, a member of the transforming growth-factor beta-receptor superfamily, upstream from the SMAD pathway. Overall, 10 (38%) probands were found to have germline BMPR1A mutations, 8 of which resulted in truncated receptors and 2 of which resulted in missense alterations (C124R and C376Y). Almost all available component tumors from mutation-positive cases showed loss of heterozygosity (LOH) in the BMPR1A region, whereas those from mutation-negative cases did not. One proband with CS/CS-like phenotype was also found to have a germline BMPR1A missense mutation (A338D). Thus, germline BMPR1A mutations cause a significant proportion of cases of JPS and might define a small subset of cases of CS/BRRS with specific colonic phenotype.
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Affiliation(s)
- Xiao-Ping Zhou
- Clinical Cancer Genetics and Human Cancer Genetics Programs, Comprehensive Cancer Center, and the Division of Human Genetics, Department of Internal Medicine, The Ohio State University, Columbus; Molecular and Population Genetics Laboratory, Imperial Cancer Research Fund, and Department of Medical Genetics, United Medical and Dental Schools of Guy’s and St. Thomas’ Hospitals, London; Haartman Institute, Department of Medical Genetics, and Department of Pathology, University of Helsinki, and Second Department of Surgery, Helsinki Central Hospital, Helsinki; Imperial Cancer Research Fund Cancer Immunogenetics Laboratory, Institute of Molecular Medicine, University of Oxford, and Department of Pathology, John Radcliffe Hospital, Oxford; United Hospitals, Saint Paul; Medical Research Council Human Genetics Unit, Western General Hospital, Edinburgh; Centre for Polyposis and Intestinal Diseases, Tokyo; Department of Surgery, Jyväskylä Central Hospital, Jyväskylä, Finland; Department of Pediatrics, University of Ulsan College of Medicine and Asan Institute, Seoul; Queensland Institute of Medical Research, Royal Brisbane Hospital, Herston, Brisbane; Molecular Genetics Laboratory, Pathology Department, Dunedin School of Medicine, Dunedin, New Zealand; Polyposis Registry, St. Mark’s Hospital, Harrow, Middlesex, England; Department of Gastroenterology, University of Tel Aviv, Tel Aviv; Section of Cancer Genetics, Institute of Cancer Research, Sutton, Surrey, England; and Cancer Research Campaign Human Cancer Genetics Research Group, University of Cambridge, Cambridge
| | - Kelly Woodford-Richens
- Clinical Cancer Genetics and Human Cancer Genetics Programs, Comprehensive Cancer Center, and the Division of Human Genetics, Department of Internal Medicine, The Ohio State University, Columbus; Molecular and Population Genetics Laboratory, Imperial Cancer Research Fund, and Department of Medical Genetics, United Medical and Dental Schools of Guy’s and St. Thomas’ Hospitals, London; Haartman Institute, Department of Medical Genetics, and Department of Pathology, University of Helsinki, and Second Department of Surgery, Helsinki Central Hospital, Helsinki; Imperial Cancer Research Fund Cancer Immunogenetics Laboratory, Institute of Molecular Medicine, University of Oxford, and Department of Pathology, John Radcliffe Hospital, Oxford; United Hospitals, Saint Paul; Medical Research Council Human Genetics Unit, Western General Hospital, Edinburgh; Centre for Polyposis and Intestinal Diseases, Tokyo; Department of Surgery, Jyväskylä Central Hospital, Jyväskylä, Finland; Department of Pediatrics, University of Ulsan College of Medicine and Asan Institute, Seoul; Queensland Institute of Medical Research, Royal Brisbane Hospital, Herston, Brisbane; Molecular Genetics Laboratory, Pathology Department, Dunedin School of Medicine, Dunedin, New Zealand; Polyposis Registry, St. Mark’s Hospital, Harrow, Middlesex, England; Department of Gastroenterology, University of Tel Aviv, Tel Aviv; Section of Cancer Genetics, Institute of Cancer Research, Sutton, Surrey, England; and Cancer Research Campaign Human Cancer Genetics Research Group, University of Cambridge, Cambridge
| | - Rainer Lehtonen
- Clinical Cancer Genetics and Human Cancer Genetics Programs, Comprehensive Cancer Center, and the Division of Human Genetics, Department of Internal Medicine, The Ohio State University, Columbus; Molecular and Population Genetics Laboratory, Imperial Cancer Research Fund, and Department of Medical Genetics, United Medical and Dental Schools of Guy’s and St. Thomas’ Hospitals, London; Haartman Institute, Department of Medical Genetics, and Department of Pathology, University of Helsinki, and Second Department of Surgery, Helsinki Central Hospital, Helsinki; Imperial Cancer Research Fund Cancer Immunogenetics Laboratory, Institute of Molecular Medicine, University of Oxford, and Department of Pathology, John Radcliffe Hospital, Oxford; United Hospitals, Saint Paul; Medical Research Council Human Genetics Unit, Western General Hospital, Edinburgh; Centre for Polyposis and Intestinal Diseases, Tokyo; Department of Surgery, Jyväskylä Central Hospital, Jyväskylä, Finland; Department of Pediatrics, University of Ulsan College of Medicine and Asan Institute, Seoul; Queensland Institute of Medical Research, Royal Brisbane Hospital, Herston, Brisbane; Molecular Genetics Laboratory, Pathology Department, Dunedin School of Medicine, Dunedin, New Zealand; Polyposis Registry, St. Mark’s Hospital, Harrow, Middlesex, England; Department of Gastroenterology, University of Tel Aviv, Tel Aviv; Section of Cancer Genetics, Institute of Cancer Research, Sutton, Surrey, England; and Cancer Research Campaign Human Cancer Genetics Research Group, University of Cambridge, Cambridge
| | - Keisuke Kurose
- Clinical Cancer Genetics and Human Cancer Genetics Programs, Comprehensive Cancer Center, and the Division of Human Genetics, Department of Internal Medicine, The Ohio State University, Columbus; Molecular and Population Genetics Laboratory, Imperial Cancer Research Fund, and Department of Medical Genetics, United Medical and Dental Schools of Guy’s and St. Thomas’ Hospitals, London; Haartman Institute, Department of Medical Genetics, and Department of Pathology, University of Helsinki, and Second Department of Surgery, Helsinki Central Hospital, Helsinki; Imperial Cancer Research Fund Cancer Immunogenetics Laboratory, Institute of Molecular Medicine, University of Oxford, and Department of Pathology, John Radcliffe Hospital, Oxford; United Hospitals, Saint Paul; Medical Research Council Human Genetics Unit, Western General Hospital, Edinburgh; Centre for Polyposis and Intestinal Diseases, Tokyo; Department of Surgery, Jyväskylä Central Hospital, Jyväskylä, Finland; Department of Pediatrics, University of Ulsan College of Medicine and Asan Institute, Seoul; Queensland Institute of Medical Research, Royal Brisbane Hospital, Herston, Brisbane; Molecular Genetics Laboratory, Pathology Department, Dunedin School of Medicine, Dunedin, New Zealand; Polyposis Registry, St. Mark’s Hospital, Harrow, Middlesex, England; Department of Gastroenterology, University of Tel Aviv, Tel Aviv; Section of Cancer Genetics, Institute of Cancer Research, Sutton, Surrey, England; and Cancer Research Campaign Human Cancer Genetics Research Group, University of Cambridge, Cambridge
| | - Micheala Aldred
- Clinical Cancer Genetics and Human Cancer Genetics Programs, Comprehensive Cancer Center, and the Division of Human Genetics, Department of Internal Medicine, The Ohio State University, Columbus; Molecular and Population Genetics Laboratory, Imperial Cancer Research Fund, and Department of Medical Genetics, United Medical and Dental Schools of Guy’s and St. Thomas’ Hospitals, London; Haartman Institute, Department of Medical Genetics, and Department of Pathology, University of Helsinki, and Second Department of Surgery, Helsinki Central Hospital, Helsinki; Imperial Cancer Research Fund Cancer Immunogenetics Laboratory, Institute of Molecular Medicine, University of Oxford, and Department of Pathology, John Radcliffe Hospital, Oxford; United Hospitals, Saint Paul; Medical Research Council Human Genetics Unit, Western General Hospital, Edinburgh; Centre for Polyposis and Intestinal Diseases, Tokyo; Department of Surgery, Jyväskylä Central Hospital, Jyväskylä, Finland; Department of Pediatrics, University of Ulsan College of Medicine and Asan Institute, Seoul; Queensland Institute of Medical Research, Royal Brisbane Hospital, Herston, Brisbane; Molecular Genetics Laboratory, Pathology Department, Dunedin School of Medicine, Dunedin, New Zealand; Polyposis Registry, St. Mark’s Hospital, Harrow, Middlesex, England; Department of Gastroenterology, University of Tel Aviv, Tel Aviv; Section of Cancer Genetics, Institute of Cancer Research, Sutton, Surrey, England; and Cancer Research Campaign Human Cancer Genetics Research Group, University of Cambridge, Cambridge
| | - Heather Hampel
- Clinical Cancer Genetics and Human Cancer Genetics Programs, Comprehensive Cancer Center, and the Division of Human Genetics, Department of Internal Medicine, The Ohio State University, Columbus; Molecular and Population Genetics Laboratory, Imperial Cancer Research Fund, and Department of Medical Genetics, United Medical and Dental Schools of Guy’s and St. Thomas’ Hospitals, London; Haartman Institute, Department of Medical Genetics, and Department of Pathology, University of Helsinki, and Second Department of Surgery, Helsinki Central Hospital, Helsinki; Imperial Cancer Research Fund Cancer Immunogenetics Laboratory, Institute of Molecular Medicine, University of Oxford, and Department of Pathology, John Radcliffe Hospital, Oxford; United Hospitals, Saint Paul; Medical Research Council Human Genetics Unit, Western General Hospital, Edinburgh; Centre for Polyposis and Intestinal Diseases, Tokyo; Department of Surgery, Jyväskylä Central Hospital, Jyväskylä, Finland; Department of Pediatrics, University of Ulsan College of Medicine and Asan Institute, Seoul; Queensland Institute of Medical Research, Royal Brisbane Hospital, Herston, Brisbane; Molecular Genetics Laboratory, Pathology Department, Dunedin School of Medicine, Dunedin, New Zealand; Polyposis Registry, St. Mark’s Hospital, Harrow, Middlesex, England; Department of Gastroenterology, University of Tel Aviv, Tel Aviv; Section of Cancer Genetics, Institute of Cancer Research, Sutton, Surrey, England; and Cancer Research Campaign Human Cancer Genetics Research Group, University of Cambridge, Cambridge
| | - Virpi Launonen
- Clinical Cancer Genetics and Human Cancer Genetics Programs, Comprehensive Cancer Center, and the Division of Human Genetics, Department of Internal Medicine, The Ohio State University, Columbus; Molecular and Population Genetics Laboratory, Imperial Cancer Research Fund, and Department of Medical Genetics, United Medical and Dental Schools of Guy’s and St. Thomas’ Hospitals, London; Haartman Institute, Department of Medical Genetics, and Department of Pathology, University of Helsinki, and Second Department of Surgery, Helsinki Central Hospital, Helsinki; Imperial Cancer Research Fund Cancer Immunogenetics Laboratory, Institute of Molecular Medicine, University of Oxford, and Department of Pathology, John Radcliffe Hospital, Oxford; United Hospitals, Saint Paul; Medical Research Council Human Genetics Unit, Western General Hospital, Edinburgh; Centre for Polyposis and Intestinal Diseases, Tokyo; Department of Surgery, Jyväskylä Central Hospital, Jyväskylä, Finland; Department of Pediatrics, University of Ulsan College of Medicine and Asan Institute, Seoul; Queensland Institute of Medical Research, Royal Brisbane Hospital, Herston, Brisbane; Molecular Genetics Laboratory, Pathology Department, Dunedin School of Medicine, Dunedin, New Zealand; Polyposis Registry, St. Mark’s Hospital, Harrow, Middlesex, England; Department of Gastroenterology, University of Tel Aviv, Tel Aviv; Section of Cancer Genetics, Institute of Cancer Research, Sutton, Surrey, England; and Cancer Research Campaign Human Cancer Genetics Research Group, University of Cambridge, Cambridge
| | - Sanno Virta
- Clinical Cancer Genetics and Human Cancer Genetics Programs, Comprehensive Cancer Center, and the Division of Human Genetics, Department of Internal Medicine, The Ohio State University, Columbus; Molecular and Population Genetics Laboratory, Imperial Cancer Research Fund, and Department of Medical Genetics, United Medical and Dental Schools of Guy’s and St. Thomas’ Hospitals, London; Haartman Institute, Department of Medical Genetics, and Department of Pathology, University of Helsinki, and Second Department of Surgery, Helsinki Central Hospital, Helsinki; Imperial Cancer Research Fund Cancer Immunogenetics Laboratory, Institute of Molecular Medicine, University of Oxford, and Department of Pathology, John Radcliffe Hospital, Oxford; United Hospitals, Saint Paul; Medical Research Council Human Genetics Unit, Western General Hospital, Edinburgh; Centre for Polyposis and Intestinal Diseases, Tokyo; Department of Surgery, Jyväskylä Central Hospital, Jyväskylä, Finland; Department of Pediatrics, University of Ulsan College of Medicine and Asan Institute, Seoul; Queensland Institute of Medical Research, Royal Brisbane Hospital, Herston, Brisbane; Molecular Genetics Laboratory, Pathology Department, Dunedin School of Medicine, Dunedin, New Zealand; Polyposis Registry, St. Mark’s Hospital, Harrow, Middlesex, England; Department of Gastroenterology, University of Tel Aviv, Tel Aviv; Section of Cancer Genetics, Institute of Cancer Research, Sutton, Surrey, England; and Cancer Research Campaign Human Cancer Genetics Research Group, University of Cambridge, Cambridge
| | - Robert Pilarski
- Clinical Cancer Genetics and Human Cancer Genetics Programs, Comprehensive Cancer Center, and the Division of Human Genetics, Department of Internal Medicine, The Ohio State University, Columbus; Molecular and Population Genetics Laboratory, Imperial Cancer Research Fund, and Department of Medical Genetics, United Medical and Dental Schools of Guy’s and St. Thomas’ Hospitals, London; Haartman Institute, Department of Medical Genetics, and Department of Pathology, University of Helsinki, and Second Department of Surgery, Helsinki Central Hospital, Helsinki; Imperial Cancer Research Fund Cancer Immunogenetics Laboratory, Institute of Molecular Medicine, University of Oxford, and Department of Pathology, John Radcliffe Hospital, Oxford; United Hospitals, Saint Paul; Medical Research Council Human Genetics Unit, Western General Hospital, Edinburgh; Centre for Polyposis and Intestinal Diseases, Tokyo; Department of Surgery, Jyväskylä Central Hospital, Jyväskylä, Finland; Department of Pediatrics, University of Ulsan College of Medicine and Asan Institute, Seoul; Queensland Institute of Medical Research, Royal Brisbane Hospital, Herston, Brisbane; Molecular Genetics Laboratory, Pathology Department, Dunedin School of Medicine, Dunedin, New Zealand; Polyposis Registry, St. Mark’s Hospital, Harrow, Middlesex, England; Department of Gastroenterology, University of Tel Aviv, Tel Aviv; Section of Cancer Genetics, Institute of Cancer Research, Sutton, Surrey, England; and Cancer Research Campaign Human Cancer Genetics Research Group, University of Cambridge, Cambridge
| | - Reijo Salovaara
- Clinical Cancer Genetics and Human Cancer Genetics Programs, Comprehensive Cancer Center, and the Division of Human Genetics, Department of Internal Medicine, The Ohio State University, Columbus; Molecular and Population Genetics Laboratory, Imperial Cancer Research Fund, and Department of Medical Genetics, United Medical and Dental Schools of Guy’s and St. Thomas’ Hospitals, London; Haartman Institute, Department of Medical Genetics, and Department of Pathology, University of Helsinki, and Second Department of Surgery, Helsinki Central Hospital, Helsinki; Imperial Cancer Research Fund Cancer Immunogenetics Laboratory, Institute of Molecular Medicine, University of Oxford, and Department of Pathology, John Radcliffe Hospital, Oxford; United Hospitals, Saint Paul; Medical Research Council Human Genetics Unit, Western General Hospital, Edinburgh; Centre for Polyposis and Intestinal Diseases, Tokyo; Department of Surgery, Jyväskylä Central Hospital, Jyväskylä, Finland; Department of Pediatrics, University of Ulsan College of Medicine and Asan Institute, Seoul; Queensland Institute of Medical Research, Royal Brisbane Hospital, Herston, Brisbane; Molecular Genetics Laboratory, Pathology Department, Dunedin School of Medicine, Dunedin, New Zealand; Polyposis Registry, St. Mark’s Hospital, Harrow, Middlesex, England; Department of Gastroenterology, University of Tel Aviv, Tel Aviv; Section of Cancer Genetics, Institute of Cancer Research, Sutton, Surrey, England; and Cancer Research Campaign Human Cancer Genetics Research Group, University of Cambridge, Cambridge
| | - Walter F. Bodmer
- Clinical Cancer Genetics and Human Cancer Genetics Programs, Comprehensive Cancer Center, and the Division of Human Genetics, Department of Internal Medicine, The Ohio State University, Columbus; Molecular and Population Genetics Laboratory, Imperial Cancer Research Fund, and Department of Medical Genetics, United Medical and Dental Schools of Guy’s and St. Thomas’ Hospitals, London; Haartman Institute, Department of Medical Genetics, and Department of Pathology, University of Helsinki, and Second Department of Surgery, Helsinki Central Hospital, Helsinki; Imperial Cancer Research Fund Cancer Immunogenetics Laboratory, Institute of Molecular Medicine, University of Oxford, and Department of Pathology, John Radcliffe Hospital, Oxford; United Hospitals, Saint Paul; Medical Research Council Human Genetics Unit, Western General Hospital, Edinburgh; Centre for Polyposis and Intestinal Diseases, Tokyo; Department of Surgery, Jyväskylä Central Hospital, Jyväskylä, Finland; Department of Pediatrics, University of Ulsan College of Medicine and Asan Institute, Seoul; Queensland Institute of Medical Research, Royal Brisbane Hospital, Herston, Brisbane; Molecular Genetics Laboratory, Pathology Department, Dunedin School of Medicine, Dunedin, New Zealand; Polyposis Registry, St. Mark’s Hospital, Harrow, Middlesex, England; Department of Gastroenterology, University of Tel Aviv, Tel Aviv; Section of Cancer Genetics, Institute of Cancer Research, Sutton, Surrey, England; and Cancer Research Campaign Human Cancer Genetics Research Group, University of Cambridge, Cambridge
| | - Beth A. Conrad
- Clinical Cancer Genetics and Human Cancer Genetics Programs, Comprehensive Cancer Center, and the Division of Human Genetics, Department of Internal Medicine, The Ohio State University, Columbus; Molecular and Population Genetics Laboratory, Imperial Cancer Research Fund, and Department of Medical Genetics, United Medical and Dental Schools of Guy’s and St. Thomas’ Hospitals, London; Haartman Institute, Department of Medical Genetics, and Department of Pathology, University of Helsinki, and Second Department of Surgery, Helsinki Central Hospital, Helsinki; Imperial Cancer Research Fund Cancer Immunogenetics Laboratory, Institute of Molecular Medicine, University of Oxford, and Department of Pathology, John Radcliffe Hospital, Oxford; United Hospitals, Saint Paul; Medical Research Council Human Genetics Unit, Western General Hospital, Edinburgh; Centre for Polyposis and Intestinal Diseases, Tokyo; Department of Surgery, Jyväskylä Central Hospital, Jyväskylä, Finland; Department of Pediatrics, University of Ulsan College of Medicine and Asan Institute, Seoul; Queensland Institute of Medical Research, Royal Brisbane Hospital, Herston, Brisbane; Molecular Genetics Laboratory, Pathology Department, Dunedin School of Medicine, Dunedin, New Zealand; Polyposis Registry, St. Mark’s Hospital, Harrow, Middlesex, England; Department of Gastroenterology, University of Tel Aviv, Tel Aviv; Section of Cancer Genetics, Institute of Cancer Research, Sutton, Surrey, England; and Cancer Research Campaign Human Cancer Genetics Research Group, University of Cambridge, Cambridge
| | - Malcolm Dunlop
- Clinical Cancer Genetics and Human Cancer Genetics Programs, Comprehensive Cancer Center, and the Division of Human Genetics, Department of Internal Medicine, The Ohio State University, Columbus; Molecular and Population Genetics Laboratory, Imperial Cancer Research Fund, and Department of Medical Genetics, United Medical and Dental Schools of Guy’s and St. Thomas’ Hospitals, London; Haartman Institute, Department of Medical Genetics, and Department of Pathology, University of Helsinki, and Second Department of Surgery, Helsinki Central Hospital, Helsinki; Imperial Cancer Research Fund Cancer Immunogenetics Laboratory, Institute of Molecular Medicine, University of Oxford, and Department of Pathology, John Radcliffe Hospital, Oxford; United Hospitals, Saint Paul; Medical Research Council Human Genetics Unit, Western General Hospital, Edinburgh; Centre for Polyposis and Intestinal Diseases, Tokyo; Department of Surgery, Jyväskylä Central Hospital, Jyväskylä, Finland; Department of Pediatrics, University of Ulsan College of Medicine and Asan Institute, Seoul; Queensland Institute of Medical Research, Royal Brisbane Hospital, Herston, Brisbane; Molecular Genetics Laboratory, Pathology Department, Dunedin School of Medicine, Dunedin, New Zealand; Polyposis Registry, St. Mark’s Hospital, Harrow, Middlesex, England; Department of Gastroenterology, University of Tel Aviv, Tel Aviv; Section of Cancer Genetics, Institute of Cancer Research, Sutton, Surrey, England; and Cancer Research Campaign Human Cancer Genetics Research Group, University of Cambridge, Cambridge
| | - Shirley V. Hodgson
- Clinical Cancer Genetics and Human Cancer Genetics Programs, Comprehensive Cancer Center, and the Division of Human Genetics, Department of Internal Medicine, The Ohio State University, Columbus; Molecular and Population Genetics Laboratory, Imperial Cancer Research Fund, and Department of Medical Genetics, United Medical and Dental Schools of Guy’s and St. Thomas’ Hospitals, London; Haartman Institute, Department of Medical Genetics, and Department of Pathology, University of Helsinki, and Second Department of Surgery, Helsinki Central Hospital, Helsinki; Imperial Cancer Research Fund Cancer Immunogenetics Laboratory, Institute of Molecular Medicine, University of Oxford, and Department of Pathology, John Radcliffe Hospital, Oxford; United Hospitals, Saint Paul; Medical Research Council Human Genetics Unit, Western General Hospital, Edinburgh; Centre for Polyposis and Intestinal Diseases, Tokyo; Department of Surgery, Jyväskylä Central Hospital, Jyväskylä, Finland; Department of Pediatrics, University of Ulsan College of Medicine and Asan Institute, Seoul; Queensland Institute of Medical Research, Royal Brisbane Hospital, Herston, Brisbane; Molecular Genetics Laboratory, Pathology Department, Dunedin School of Medicine, Dunedin, New Zealand; Polyposis Registry, St. Mark’s Hospital, Harrow, Middlesex, England; Department of Gastroenterology, University of Tel Aviv, Tel Aviv; Section of Cancer Genetics, Institute of Cancer Research, Sutton, Surrey, England; and Cancer Research Campaign Human Cancer Genetics Research Group, University of Cambridge, Cambridge
| | - Takeo Iwama
- Clinical Cancer Genetics and Human Cancer Genetics Programs, Comprehensive Cancer Center, and the Division of Human Genetics, Department of Internal Medicine, The Ohio State University, Columbus; Molecular and Population Genetics Laboratory, Imperial Cancer Research Fund, and Department of Medical Genetics, United Medical and Dental Schools of Guy’s and St. Thomas’ Hospitals, London; Haartman Institute, Department of Medical Genetics, and Department of Pathology, University of Helsinki, and Second Department of Surgery, Helsinki Central Hospital, Helsinki; Imperial Cancer Research Fund Cancer Immunogenetics Laboratory, Institute of Molecular Medicine, University of Oxford, and Department of Pathology, John Radcliffe Hospital, Oxford; United Hospitals, Saint Paul; Medical Research Council Human Genetics Unit, Western General Hospital, Edinburgh; Centre for Polyposis and Intestinal Diseases, Tokyo; Department of Surgery, Jyväskylä Central Hospital, Jyväskylä, Finland; Department of Pediatrics, University of Ulsan College of Medicine and Asan Institute, Seoul; Queensland Institute of Medical Research, Royal Brisbane Hospital, Herston, Brisbane; Molecular Genetics Laboratory, Pathology Department, Dunedin School of Medicine, Dunedin, New Zealand; Polyposis Registry, St. Mark’s Hospital, Harrow, Middlesex, England; Department of Gastroenterology, University of Tel Aviv, Tel Aviv; Section of Cancer Genetics, Institute of Cancer Research, Sutton, Surrey, England; and Cancer Research Campaign Human Cancer Genetics Research Group, University of Cambridge, Cambridge
| | - Heikki Järvinen
- Clinical Cancer Genetics and Human Cancer Genetics Programs, Comprehensive Cancer Center, and the Division of Human Genetics, Department of Internal Medicine, The Ohio State University, Columbus; Molecular and Population Genetics Laboratory, Imperial Cancer Research Fund, and Department of Medical Genetics, United Medical and Dental Schools of Guy’s and St. Thomas’ Hospitals, London; Haartman Institute, Department of Medical Genetics, and Department of Pathology, University of Helsinki, and Second Department of Surgery, Helsinki Central Hospital, Helsinki; Imperial Cancer Research Fund Cancer Immunogenetics Laboratory, Institute of Molecular Medicine, University of Oxford, and Department of Pathology, John Radcliffe Hospital, Oxford; United Hospitals, Saint Paul; Medical Research Council Human Genetics Unit, Western General Hospital, Edinburgh; Centre for Polyposis and Intestinal Diseases, Tokyo; Department of Surgery, Jyväskylä Central Hospital, Jyväskylä, Finland; Department of Pediatrics, University of Ulsan College of Medicine and Asan Institute, Seoul; Queensland Institute of Medical Research, Royal Brisbane Hospital, Herston, Brisbane; Molecular Genetics Laboratory, Pathology Department, Dunedin School of Medicine, Dunedin, New Zealand; Polyposis Registry, St. Mark’s Hospital, Harrow, Middlesex, England; Department of Gastroenterology, University of Tel Aviv, Tel Aviv; Section of Cancer Genetics, Institute of Cancer Research, Sutton, Surrey, England; and Cancer Research Campaign Human Cancer Genetics Research Group, University of Cambridge, Cambridge
| | - Ilmo Kellokumpu
- Clinical Cancer Genetics and Human Cancer Genetics Programs, Comprehensive Cancer Center, and the Division of Human Genetics, Department of Internal Medicine, The Ohio State University, Columbus; Molecular and Population Genetics Laboratory, Imperial Cancer Research Fund, and Department of Medical Genetics, United Medical and Dental Schools of Guy’s and St. Thomas’ Hospitals, London; Haartman Institute, Department of Medical Genetics, and Department of Pathology, University of Helsinki, and Second Department of Surgery, Helsinki Central Hospital, Helsinki; Imperial Cancer Research Fund Cancer Immunogenetics Laboratory, Institute of Molecular Medicine, University of Oxford, and Department of Pathology, John Radcliffe Hospital, Oxford; United Hospitals, Saint Paul; Medical Research Council Human Genetics Unit, Western General Hospital, Edinburgh; Centre for Polyposis and Intestinal Diseases, Tokyo; Department of Surgery, Jyväskylä Central Hospital, Jyväskylä, Finland; Department of Pediatrics, University of Ulsan College of Medicine and Asan Institute, Seoul; Queensland Institute of Medical Research, Royal Brisbane Hospital, Herston, Brisbane; Molecular Genetics Laboratory, Pathology Department, Dunedin School of Medicine, Dunedin, New Zealand; Polyposis Registry, St. Mark’s Hospital, Harrow, Middlesex, England; Department of Gastroenterology, University of Tel Aviv, Tel Aviv; Section of Cancer Genetics, Institute of Cancer Research, Sutton, Surrey, England; and Cancer Research Campaign Human Cancer Genetics Research Group, University of Cambridge, Cambridge
| | - J. C. Kim
- Clinical Cancer Genetics and Human Cancer Genetics Programs, Comprehensive Cancer Center, and the Division of Human Genetics, Department of Internal Medicine, The Ohio State University, Columbus; Molecular and Population Genetics Laboratory, Imperial Cancer Research Fund, and Department of Medical Genetics, United Medical and Dental Schools of Guy’s and St. Thomas’ Hospitals, London; Haartman Institute, Department of Medical Genetics, and Department of Pathology, University of Helsinki, and Second Department of Surgery, Helsinki Central Hospital, Helsinki; Imperial Cancer Research Fund Cancer Immunogenetics Laboratory, Institute of Molecular Medicine, University of Oxford, and Department of Pathology, John Radcliffe Hospital, Oxford; United Hospitals, Saint Paul; Medical Research Council Human Genetics Unit, Western General Hospital, Edinburgh; Centre for Polyposis and Intestinal Diseases, Tokyo; Department of Surgery, Jyväskylä Central Hospital, Jyväskylä, Finland; Department of Pediatrics, University of Ulsan College of Medicine and Asan Institute, Seoul; Queensland Institute of Medical Research, Royal Brisbane Hospital, Herston, Brisbane; Molecular Genetics Laboratory, Pathology Department, Dunedin School of Medicine, Dunedin, New Zealand; Polyposis Registry, St. Mark’s Hospital, Harrow, Middlesex, England; Department of Gastroenterology, University of Tel Aviv, Tel Aviv; Section of Cancer Genetics, Institute of Cancer Research, Sutton, Surrey, England; and Cancer Research Campaign Human Cancer Genetics Research Group, University of Cambridge, Cambridge
| | - Barbara Leggett
- Clinical Cancer Genetics and Human Cancer Genetics Programs, Comprehensive Cancer Center, and the Division of Human Genetics, Department of Internal Medicine, The Ohio State University, Columbus; Molecular and Population Genetics Laboratory, Imperial Cancer Research Fund, and Department of Medical Genetics, United Medical and Dental Schools of Guy’s and St. Thomas’ Hospitals, London; Haartman Institute, Department of Medical Genetics, and Department of Pathology, University of Helsinki, and Second Department of Surgery, Helsinki Central Hospital, Helsinki; Imperial Cancer Research Fund Cancer Immunogenetics Laboratory, Institute of Molecular Medicine, University of Oxford, and Department of Pathology, John Radcliffe Hospital, Oxford; United Hospitals, Saint Paul; Medical Research Council Human Genetics Unit, Western General Hospital, Edinburgh; Centre for Polyposis and Intestinal Diseases, Tokyo; Department of Surgery, Jyväskylä Central Hospital, Jyväskylä, Finland; Department of Pediatrics, University of Ulsan College of Medicine and Asan Institute, Seoul; Queensland Institute of Medical Research, Royal Brisbane Hospital, Herston, Brisbane; Molecular Genetics Laboratory, Pathology Department, Dunedin School of Medicine, Dunedin, New Zealand; Polyposis Registry, St. Mark’s Hospital, Harrow, Middlesex, England; Department of Gastroenterology, University of Tel Aviv, Tel Aviv; Section of Cancer Genetics, Institute of Cancer Research, Sutton, Surrey, England; and Cancer Research Campaign Human Cancer Genetics Research Group, University of Cambridge, Cambridge
| | - David Markie
- Clinical Cancer Genetics and Human Cancer Genetics Programs, Comprehensive Cancer Center, and the Division of Human Genetics, Department of Internal Medicine, The Ohio State University, Columbus; Molecular and Population Genetics Laboratory, Imperial Cancer Research Fund, and Department of Medical Genetics, United Medical and Dental Schools of Guy’s and St. Thomas’ Hospitals, London; Haartman Institute, Department of Medical Genetics, and Department of Pathology, University of Helsinki, and Second Department of Surgery, Helsinki Central Hospital, Helsinki; Imperial Cancer Research Fund Cancer Immunogenetics Laboratory, Institute of Molecular Medicine, University of Oxford, and Department of Pathology, John Radcliffe Hospital, Oxford; United Hospitals, Saint Paul; Medical Research Council Human Genetics Unit, Western General Hospital, Edinburgh; Centre for Polyposis and Intestinal Diseases, Tokyo; Department of Surgery, Jyväskylä Central Hospital, Jyväskylä, Finland; Department of Pediatrics, University of Ulsan College of Medicine and Asan Institute, Seoul; Queensland Institute of Medical Research, Royal Brisbane Hospital, Herston, Brisbane; Molecular Genetics Laboratory, Pathology Department, Dunedin School of Medicine, Dunedin, New Zealand; Polyposis Registry, St. Mark’s Hospital, Harrow, Middlesex, England; Department of Gastroenterology, University of Tel Aviv, Tel Aviv; Section of Cancer Genetics, Institute of Cancer Research, Sutton, Surrey, England; and Cancer Research Campaign Human Cancer Genetics Research Group, University of Cambridge, Cambridge
| | - Jukka-Pekka Mecklin
- Clinical Cancer Genetics and Human Cancer Genetics Programs, Comprehensive Cancer Center, and the Division of Human Genetics, Department of Internal Medicine, The Ohio State University, Columbus; Molecular and Population Genetics Laboratory, Imperial Cancer Research Fund, and Department of Medical Genetics, United Medical and Dental Schools of Guy’s and St. Thomas’ Hospitals, London; Haartman Institute, Department of Medical Genetics, and Department of Pathology, University of Helsinki, and Second Department of Surgery, Helsinki Central Hospital, Helsinki; Imperial Cancer Research Fund Cancer Immunogenetics Laboratory, Institute of Molecular Medicine, University of Oxford, and Department of Pathology, John Radcliffe Hospital, Oxford; United Hospitals, Saint Paul; Medical Research Council Human Genetics Unit, Western General Hospital, Edinburgh; Centre for Polyposis and Intestinal Diseases, Tokyo; Department of Surgery, Jyväskylä Central Hospital, Jyväskylä, Finland; Department of Pediatrics, University of Ulsan College of Medicine and Asan Institute, Seoul; Queensland Institute of Medical Research, Royal Brisbane Hospital, Herston, Brisbane; Molecular Genetics Laboratory, Pathology Department, Dunedin School of Medicine, Dunedin, New Zealand; Polyposis Registry, St. Mark’s Hospital, Harrow, Middlesex, England; Department of Gastroenterology, University of Tel Aviv, Tel Aviv; Section of Cancer Genetics, Institute of Cancer Research, Sutton, Surrey, England; and Cancer Research Campaign Human Cancer Genetics Research Group, University of Cambridge, Cambridge
| | - Kay Neale
- Clinical Cancer Genetics and Human Cancer Genetics Programs, Comprehensive Cancer Center, and the Division of Human Genetics, Department of Internal Medicine, The Ohio State University, Columbus; Molecular and Population Genetics Laboratory, Imperial Cancer Research Fund, and Department of Medical Genetics, United Medical and Dental Schools of Guy’s and St. Thomas’ Hospitals, London; Haartman Institute, Department of Medical Genetics, and Department of Pathology, University of Helsinki, and Second Department of Surgery, Helsinki Central Hospital, Helsinki; Imperial Cancer Research Fund Cancer Immunogenetics Laboratory, Institute of Molecular Medicine, University of Oxford, and Department of Pathology, John Radcliffe Hospital, Oxford; United Hospitals, Saint Paul; Medical Research Council Human Genetics Unit, Western General Hospital, Edinburgh; Centre for Polyposis and Intestinal Diseases, Tokyo; Department of Surgery, Jyväskylä Central Hospital, Jyväskylä, Finland; Department of Pediatrics, University of Ulsan College of Medicine and Asan Institute, Seoul; Queensland Institute of Medical Research, Royal Brisbane Hospital, Herston, Brisbane; Molecular Genetics Laboratory, Pathology Department, Dunedin School of Medicine, Dunedin, New Zealand; Polyposis Registry, St. Mark’s Hospital, Harrow, Middlesex, England; Department of Gastroenterology, University of Tel Aviv, Tel Aviv; Section of Cancer Genetics, Institute of Cancer Research, Sutton, Surrey, England; and Cancer Research Campaign Human Cancer Genetics Research Group, University of Cambridge, Cambridge
| | - Robin Phillips
- Clinical Cancer Genetics and Human Cancer Genetics Programs, Comprehensive Cancer Center, and the Division of Human Genetics, Department of Internal Medicine, The Ohio State University, Columbus; Molecular and Population Genetics Laboratory, Imperial Cancer Research Fund, and Department of Medical Genetics, United Medical and Dental Schools of Guy’s and St. Thomas’ Hospitals, London; Haartman Institute, Department of Medical Genetics, and Department of Pathology, University of Helsinki, and Second Department of Surgery, Helsinki Central Hospital, Helsinki; Imperial Cancer Research Fund Cancer Immunogenetics Laboratory, Institute of Molecular Medicine, University of Oxford, and Department of Pathology, John Radcliffe Hospital, Oxford; United Hospitals, Saint Paul; Medical Research Council Human Genetics Unit, Western General Hospital, Edinburgh; Centre for Polyposis and Intestinal Diseases, Tokyo; Department of Surgery, Jyväskylä Central Hospital, Jyväskylä, Finland; Department of Pediatrics, University of Ulsan College of Medicine and Asan Institute, Seoul; Queensland Institute of Medical Research, Royal Brisbane Hospital, Herston, Brisbane; Molecular Genetics Laboratory, Pathology Department, Dunedin School of Medicine, Dunedin, New Zealand; Polyposis Registry, St. Mark’s Hospital, Harrow, Middlesex, England; Department of Gastroenterology, University of Tel Aviv, Tel Aviv; Section of Cancer Genetics, Institute of Cancer Research, Sutton, Surrey, England; and Cancer Research Campaign Human Cancer Genetics Research Group, University of Cambridge, Cambridge
| | - Juan Piris
- Clinical Cancer Genetics and Human Cancer Genetics Programs, Comprehensive Cancer Center, and the Division of Human Genetics, Department of Internal Medicine, The Ohio State University, Columbus; Molecular and Population Genetics Laboratory, Imperial Cancer Research Fund, and Department of Medical Genetics, United Medical and Dental Schools of Guy’s and St. Thomas’ Hospitals, London; Haartman Institute, Department of Medical Genetics, and Department of Pathology, University of Helsinki, and Second Department of Surgery, Helsinki Central Hospital, Helsinki; Imperial Cancer Research Fund Cancer Immunogenetics Laboratory, Institute of Molecular Medicine, University of Oxford, and Department of Pathology, John Radcliffe Hospital, Oxford; United Hospitals, Saint Paul; Medical Research Council Human Genetics Unit, Western General Hospital, Edinburgh; Centre for Polyposis and Intestinal Diseases, Tokyo; Department of Surgery, Jyväskylä Central Hospital, Jyväskylä, Finland; Department of Pediatrics, University of Ulsan College of Medicine and Asan Institute, Seoul; Queensland Institute of Medical Research, Royal Brisbane Hospital, Herston, Brisbane; Molecular Genetics Laboratory, Pathology Department, Dunedin School of Medicine, Dunedin, New Zealand; Polyposis Registry, St. Mark’s Hospital, Harrow, Middlesex, England; Department of Gastroenterology, University of Tel Aviv, Tel Aviv; Section of Cancer Genetics, Institute of Cancer Research, Sutton, Surrey, England; and Cancer Research Campaign Human Cancer Genetics Research Group, University of Cambridge, Cambridge
| | - Paul Rozen
- Clinical Cancer Genetics and Human Cancer Genetics Programs, Comprehensive Cancer Center, and the Division of Human Genetics, Department of Internal Medicine, The Ohio State University, Columbus; Molecular and Population Genetics Laboratory, Imperial Cancer Research Fund, and Department of Medical Genetics, United Medical and Dental Schools of Guy’s and St. Thomas’ Hospitals, London; Haartman Institute, Department of Medical Genetics, and Department of Pathology, University of Helsinki, and Second Department of Surgery, Helsinki Central Hospital, Helsinki; Imperial Cancer Research Fund Cancer Immunogenetics Laboratory, Institute of Molecular Medicine, University of Oxford, and Department of Pathology, John Radcliffe Hospital, Oxford; United Hospitals, Saint Paul; Medical Research Council Human Genetics Unit, Western General Hospital, Edinburgh; Centre for Polyposis and Intestinal Diseases, Tokyo; Department of Surgery, Jyväskylä Central Hospital, Jyväskylä, Finland; Department of Pediatrics, University of Ulsan College of Medicine and Asan Institute, Seoul; Queensland Institute of Medical Research, Royal Brisbane Hospital, Herston, Brisbane; Molecular Genetics Laboratory, Pathology Department, Dunedin School of Medicine, Dunedin, New Zealand; Polyposis Registry, St. Mark’s Hospital, Harrow, Middlesex, England; Department of Gastroenterology, University of Tel Aviv, Tel Aviv; Section of Cancer Genetics, Institute of Cancer Research, Sutton, Surrey, England; and Cancer Research Campaign Human Cancer Genetics Research Group, University of Cambridge, Cambridge
| | - Richard S. Houlston
- Clinical Cancer Genetics and Human Cancer Genetics Programs, Comprehensive Cancer Center, and the Division of Human Genetics, Department of Internal Medicine, The Ohio State University, Columbus; Molecular and Population Genetics Laboratory, Imperial Cancer Research Fund, and Department of Medical Genetics, United Medical and Dental Schools of Guy’s and St. Thomas’ Hospitals, London; Haartman Institute, Department of Medical Genetics, and Department of Pathology, University of Helsinki, and Second Department of Surgery, Helsinki Central Hospital, Helsinki; Imperial Cancer Research Fund Cancer Immunogenetics Laboratory, Institute of Molecular Medicine, University of Oxford, and Department of Pathology, John Radcliffe Hospital, Oxford; United Hospitals, Saint Paul; Medical Research Council Human Genetics Unit, Western General Hospital, Edinburgh; Centre for Polyposis and Intestinal Diseases, Tokyo; Department of Surgery, Jyväskylä Central Hospital, Jyväskylä, Finland; Department of Pediatrics, University of Ulsan College of Medicine and Asan Institute, Seoul; Queensland Institute of Medical Research, Royal Brisbane Hospital, Herston, Brisbane; Molecular Genetics Laboratory, Pathology Department, Dunedin School of Medicine, Dunedin, New Zealand; Polyposis Registry, St. Mark’s Hospital, Harrow, Middlesex, England; Department of Gastroenterology, University of Tel Aviv, Tel Aviv; Section of Cancer Genetics, Institute of Cancer Research, Sutton, Surrey, England; and Cancer Research Campaign Human Cancer Genetics Research Group, University of Cambridge, Cambridge
| | - Lauri A. Aaltonen
- Clinical Cancer Genetics and Human Cancer Genetics Programs, Comprehensive Cancer Center, and the Division of Human Genetics, Department of Internal Medicine, The Ohio State University, Columbus; Molecular and Population Genetics Laboratory, Imperial Cancer Research Fund, and Department of Medical Genetics, United Medical and Dental Schools of Guy’s and St. Thomas’ Hospitals, London; Haartman Institute, Department of Medical Genetics, and Department of Pathology, University of Helsinki, and Second Department of Surgery, Helsinki Central Hospital, Helsinki; Imperial Cancer Research Fund Cancer Immunogenetics Laboratory, Institute of Molecular Medicine, University of Oxford, and Department of Pathology, John Radcliffe Hospital, Oxford; United Hospitals, Saint Paul; Medical Research Council Human Genetics Unit, Western General Hospital, Edinburgh; Centre for Polyposis and Intestinal Diseases, Tokyo; Department of Surgery, Jyväskylä Central Hospital, Jyväskylä, Finland; Department of Pediatrics, University of Ulsan College of Medicine and Asan Institute, Seoul; Queensland Institute of Medical Research, Royal Brisbane Hospital, Herston, Brisbane; Molecular Genetics Laboratory, Pathology Department, Dunedin School of Medicine, Dunedin, New Zealand; Polyposis Registry, St. Mark’s Hospital, Harrow, Middlesex, England; Department of Gastroenterology, University of Tel Aviv, Tel Aviv; Section of Cancer Genetics, Institute of Cancer Research, Sutton, Surrey, England; and Cancer Research Campaign Human Cancer Genetics Research Group, University of Cambridge, Cambridge
| | - Ian P. M. Tomlinson
- Clinical Cancer Genetics and Human Cancer Genetics Programs, Comprehensive Cancer Center, and the Division of Human Genetics, Department of Internal Medicine, The Ohio State University, Columbus; Molecular and Population Genetics Laboratory, Imperial Cancer Research Fund, and Department of Medical Genetics, United Medical and Dental Schools of Guy’s and St. Thomas’ Hospitals, London; Haartman Institute, Department of Medical Genetics, and Department of Pathology, University of Helsinki, and Second Department of Surgery, Helsinki Central Hospital, Helsinki; Imperial Cancer Research Fund Cancer Immunogenetics Laboratory, Institute of Molecular Medicine, University of Oxford, and Department of Pathology, John Radcliffe Hospital, Oxford; United Hospitals, Saint Paul; Medical Research Council Human Genetics Unit, Western General Hospital, Edinburgh; Centre for Polyposis and Intestinal Diseases, Tokyo; Department of Surgery, Jyväskylä Central Hospital, Jyväskylä, Finland; Department of Pediatrics, University of Ulsan College of Medicine and Asan Institute, Seoul; Queensland Institute of Medical Research, Royal Brisbane Hospital, Herston, Brisbane; Molecular Genetics Laboratory, Pathology Department, Dunedin School of Medicine, Dunedin, New Zealand; Polyposis Registry, St. Mark’s Hospital, Harrow, Middlesex, England; Department of Gastroenterology, University of Tel Aviv, Tel Aviv; Section of Cancer Genetics, Institute of Cancer Research, Sutton, Surrey, England; and Cancer Research Campaign Human Cancer Genetics Research Group, University of Cambridge, Cambridge
| | - Charis Eng
- Clinical Cancer Genetics and Human Cancer Genetics Programs, Comprehensive Cancer Center, and the Division of Human Genetics, Department of Internal Medicine, The Ohio State University, Columbus; Molecular and Population Genetics Laboratory, Imperial Cancer Research Fund, and Department of Medical Genetics, United Medical and Dental Schools of Guy’s and St. Thomas’ Hospitals, London; Haartman Institute, Department of Medical Genetics, and Department of Pathology, University of Helsinki, and Second Department of Surgery, Helsinki Central Hospital, Helsinki; Imperial Cancer Research Fund Cancer Immunogenetics Laboratory, Institute of Molecular Medicine, University of Oxford, and Department of Pathology, John Radcliffe Hospital, Oxford; United Hospitals, Saint Paul; Medical Research Council Human Genetics Unit, Western General Hospital, Edinburgh; Centre for Polyposis and Intestinal Diseases, Tokyo; Department of Surgery, Jyväskylä Central Hospital, Jyväskylä, Finland; Department of Pediatrics, University of Ulsan College of Medicine and Asan Institute, Seoul; Queensland Institute of Medical Research, Royal Brisbane Hospital, Herston, Brisbane; Molecular Genetics Laboratory, Pathology Department, Dunedin School of Medicine, Dunedin, New Zealand; Polyposis Registry, St. Mark’s Hospital, Harrow, Middlesex, England; Department of Gastroenterology, University of Tel Aviv, Tel Aviv; Section of Cancer Genetics, Institute of Cancer Research, Sutton, Surrey, England; and Cancer Research Campaign Human Cancer Genetics Research Group, University of Cambridge, Cambridge
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