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Lee SG, Evans G, Stephen M, Goren R, Bondy M, Goodman S. Medulloblastoma and other neoplasms in patients with heterozygous germline SUFU variants: A scoping review. Am J Med Genet A 2024; 194:e63496. [PMID: 38282294 DOI: 10.1002/ajmg.a.63496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 11/17/2023] [Accepted: 11/24/2023] [Indexed: 01/30/2024]
Abstract
In 2002, heterozygous suppressor of fused variants (SUFU+/-) in the germline were described to have a tumor suppressor role in the development of pediatric medulloblastoma (MB). Other neoplasms associated with pathologic germline SUFU+/- variants have also been described among patients with basal cell nevus syndrome (BCNS; BCNS is also known as Gorlin syndrome, nevoid basal cell carcinoma [BCC] syndrome or Gorlin-Goltz syndrome; OMIM 109400), an autosomal-dominant cancer predisposition syndrome. The phenotype of patients with germline SUFU+/- variants is very poorly characterized due to a paucity of large studies with long-term follow-up. As such, there is a clinical need to better characterize the spectrum of neoplasms among patients with germline SUFU+/- variants so that clinicians can provide accurate counseling and optimize tumor surveillance strategies. The objective of this study is to perform a scoping review to map the evidence on the rate of medulloblastoma and to describe the spectrum of other neoplasms among patients with germline SUFU+/- variants. A review of all published literature in PubMed (MEDLINE), EMBASE, Cochrane, and Web of Science were searched from the beginning of each respective database until October 9, 2021. Studies of pediatric and adult patients with a confirmed germline SUFU+/- variant who were evaluated for the presence of any neoplasm (benign or malignant) were included. There were 176 patients (N = 30 studies) identified with a confirmed germline SUFU+/- variant who met inclusion criteria. Data were extracted from two cohort studies, two case-control studies, 18 case series, and eight case reports. The median age at diagnosis of a germline SUFU+/- variant was 4.5 years where 44.4% identified as female and 13.4% of variants were de novo. There were 34 different neoplasms (benign and malignant) documented among patients with confirmed germline SUFU+/- variants, and the most common were medulloblastoma (N = 59 patients), BCC (N = 21 patients), and meningioma (N = 19 patients). The median age at medulloblastoma diagnosis was 1.42 years (range 0.083-3; interquartile range 1.2). When data were available for these three most frequent neoplasms (N = 95 patients), 31 patients (32.6%) had neither MB, BCC nor meningioma; 51 patients (53.7%) had one of medulloblastoma or BCC or meningioma; eight patients (8.4%) had two of medulloblastoma or BCC or meningioma, and five patients (5.3%) had medulloblastoma and BCC and meningioma. This is the first study to synthesize the data on the frequency and spectrum of neoplasms specifically among patients with a confirmed germline SUFU+/- variant. This scoping review is a necessary step forward in optimizing evidence-based tumor surveillance strategies for medulloblastoma and estimating the risk of other neoplasms that could impact patient outcomes.
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Affiliation(s)
- Stephanie G Lee
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Gareth Evans
- Division of Evolution, Infection and Genomic Science, Manchester Centre for Genomic Medicine, Manchester Academic Health Science Centre, University of Manchester, Manchester NHS Foundation Trust, Manchester, UK
| | - Maddie Stephen
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Rachel Goren
- Queen's School of Medicine, Queens University, Kingston, Ontario, Canada
| | - Melissa Bondy
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Palo Alto, California, USA
| | - Steven Goodman
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Palo Alto, California, USA
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2
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Paradise BD, Gainullin VG, Almada LL, Sigafoos AN, Sen S, Vera RE, Raja Arul GL, Toruner M, Pease DR, Gonzalez AL, Mentucci FM, Grasso DH, Fernandez-Zapico ME. SUFU promotes GLI activity in a Hedgehog-independent manner in pancreatic cancer. Biochem J 2023; 480:1199-1216. [PMID: 37477952 DOI: 10.1042/bcj20220439] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Revised: 07/20/2023] [Accepted: 07/21/2023] [Indexed: 07/22/2023]
Abstract
Aberrant activation of the Hedgehog (Hh) signaling pathway, through which the GLI family of transcription factors (TF) is stimulated, is commonly observed in cancer cells. One well-established mechanism of this increased activity is through the inactivation of Suppressor of Fused (SUFU), a negative regulator of the Hh pathway. Relief from negative regulation by SUFU facilitates GLI activity and induction of target gene expression. Here, we demonstrate a novel role for SUFU as a promoter of GLI activity in pancreatic ductal adenocarcinoma (PDAC). In non-ciliated PDAC cells unresponsive to Smoothened agonism, SUFU overexpression increases GLI transcriptional activity. Conversely, knockdown (KD) of SUFU reduces the activity of GLI in PDAC cells. Through array PCR analysis of GLI target genes, we identified B-cell lymphoma 2 (BCL2) among the top candidates down-regulated by SUFU KD. We demonstrate that SUFU KD results in reduced PDAC cell viability, and overexpression of BCL2 partially rescues the effect of reduced cell viability by SUFU KD. Further analysis using as a model GLI1, a major TF activator of the GLI family in PDAC cells, shows the interaction of SUFU and GLI1 in the nucleus through previously characterized domains. Chromatin immunoprecipitation (ChIP) assay shows the binding of both SUFU and GLI1 at the promoter of BCL2 in PDAC cells. Finally, we demonstrate that SUFU promotes GLI1 activity without affecting its protein stability. Through our findings, we propose a novel role of SUFU as a positive regulator of GLI1 in PDAC, adding a new mechanism of Hh/GLI signaling pathway regulation in cancer cells.
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Affiliation(s)
- Brooke D Paradise
- Schulze Center for Novel Therapeutics, Mayo Clinic, Rochester, MN 55905, U.S.A
- Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic, Rochester, MN 55905, U.S.A
| | | | - Luciana L Almada
- Schulze Center for Novel Therapeutics, Mayo Clinic, Rochester, MN 55905, U.S.A
| | - Ashley N Sigafoos
- Schulze Center for Novel Therapeutics, Mayo Clinic, Rochester, MN 55905, U.S.A
| | - Sandhya Sen
- Schulze Center for Novel Therapeutics, Mayo Clinic, Rochester, MN 55905, U.S.A
| | - Renzo E Vera
- Schulze Center for Novel Therapeutics, Mayo Clinic, Rochester, MN 55905, U.S.A
| | - Glancis Luzeena Raja Arul
- Schulze Center for Novel Therapeutics, Mayo Clinic, Rochester, MN 55905, U.S.A
- Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic, Rochester, MN 55905, U.S.A
| | - Murat Toruner
- Schulze Center for Novel Therapeutics, Mayo Clinic, Rochester, MN 55905, U.S.A
| | - David R Pease
- Schulze Center for Novel Therapeutics, Mayo Clinic, Rochester, MN 55905, U.S.A
- Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic, Rochester, MN 55905, U.S.A
| | - Alina L Gonzalez
- Facultad de Ciencias Exactas y Naturales, Instituto de Ciencias de la Tierra y Ambientales de La Pampa (INCITAP), Universidad Nacional de La Pampa - Consejo Nacional de Investigaciones Científicas y Técnicas (UNLPam-CONICET), La Pampa 6300, Argentina
| | | | - Daniel H Grasso
- Instituto de Estudios de la Inmunidad Humoral (IDEHU), Escuela de Farmacia y Bioquimica, Universidad de Buenos Aires, Ciudad Autónoma de Buenos Aires 1113, Argentina
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3
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Álvarez-Salafranca M, García-García M, Montes-Torres A, Rivera-Fuertes I, López-Giménez MT, Ara M. SUFU-associated Gorlin syndrome: Expanding the spectrum between classic nevoid basal cell carcinoma syndrome and multiple hereditary infundibulocystic basal cell carcinoma. Australas J Dermatol 2023; 64:249-254. [PMID: 36825822 DOI: 10.1111/ajd.14014] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 02/11/2023] [Indexed: 02/25/2023]
Abstract
Basal cell nevus syndrome (BCNS), also known as Gorlin syndrome, is characterized by an aberrant activation of the hedgehog (Hh) pathway, most cases being caused by PTCH1 mutations. However, certain features such as multiple hereditary infundibulocystic basal cell carcinomas (MHIBCC), sclerotic fibromas, childhood medulloblastoma or meningioma may be relatively specific to a SUFU mutation. We present two patients with MHIBCC, along with a more complex cutaneous and extracutaneous phenotype. MHIBCC syndrome and BCNS may share clinical features and, indeed, both syndromes probably represent different degrees of upregulation in the Hh pathway.
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Affiliation(s)
| | - Mar García-García
- Department of Pathology, Hospital Clínico Universitario "Lozano Blesa", Zaragoza, Spain
| | - Andrea Montes-Torres
- Department of Dermatology, Hospital Clínico Universitario "Lozano Blesa", Zaragoza, Spain
| | - Ignacio Rivera-Fuertes
- Department of Dermatology, Hospital Clínico Universitario "Lozano Blesa", Zaragoza, Spain
| | | | - Mariano Ara
- Department of Dermatology, Hospital Clínico Universitario "Lozano Blesa", Zaragoza, Spain
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4
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Serpieri V, D’Abrusco F, Dempsey JC, Cheng YHH, Arrigoni F, Baker J, Battini R, Bertini ES, Borgatti R, Christman AK, Curry C, D'Arrigo S, Fluss J, Freilinger M, Gana S, Ishak GE, Leuzzi V, Loucks H, Manti F, Mendelsohn N, Merlini L, Miller CV, Muhammad A, Nuovo S, Romaniello R, Schmidt W, Signorini S, Siliquini S, Szczałuba K, Vasco G, Wilson M, Zanni G, Boltshauser E, Doherty D, Valente EM. SUFU haploinsufficiency causes a recognisable neurodevelopmental phenotype at the mild end of the Joubert syndrome spectrum. J Med Genet 2022; 59:888-894. [PMID: 34675124 PMCID: PMC9411896 DOI: 10.1136/jmedgenet-2021-108114] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 09/29/2021] [Indexed: 01/25/2023]
Abstract
BACKGROUND Joubert syndrome (JS) is a recessively inherited ciliopathy characterised by congenital ocular motor apraxia (COMA), developmental delay (DD), intellectual disability, ataxia, multiorgan involvement, and a unique cerebellar and brainstem malformation. Over 40 JS-associated genes are known with a diagnostic yield of 60%-75%.In 2018, we reported homozygous hypomorphic missense variants of the SUFU gene in two families with mild JS. Recently, heterozygous truncating SUFU variants were identified in families with dominantly inherited COMA, occasionally associated with mild DD and subtle cerebellar anomalies. METHODS We reanalysed next generation sequencing (NGS) data in two cohorts comprising 1097 probands referred for genetic testing of JS genes. RESULTS Heterozygous truncating and splice-site SUFU variants were detected in 22 patients from 17 families (1.5%) with strong male prevalence (86%), and in 8 asymptomatic parents. Patients presented with COMA, hypotonia, ataxia and mild DD, and only a third manifested intellectual disability of variable severity. Brain MRI showed consistent findings characterised by vermis hypoplasia, superior cerebellar dysplasia and subtle-to-mild abnormalities of the superior cerebellar peduncles. The same pattern was observed in two out of three tested asymptomatic parents. CONCLUSION Heterozygous truncating or splice-site SUFU variants cause a novel neurodevelopmental syndrome encompassing COMA and mild JS, which likely represent overlapping entities. Variants can arise de novo or be inherited from a healthy parent, representing the first cause of JS with dominant inheritance and reduced penetrance. Awareness of this condition will increase the diagnostic yield of JS genetic testing, and allow appropriate counselling about prognosis, medical monitoring and recurrence risk.
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Affiliation(s)
| | - Fulvio D’Abrusco
- Department of Molecular Medicine, University of Pavia, Pavia, Lombardia, Italy
| | - Jennifer C Dempsey
- Department of Pediatrics, University of Washington Center for Mendelian Genomics, WashingtonUSA
| | - Yong-Han Hank Cheng
- Department of Pediatrics, University of Washington Center for Mendelian Genomics, WashingtonUSA
| | - Filippo Arrigoni
- Neuroimaging Lab, Scientific Institute IRCCS Eugenio Medea, Bosisio Parini, Lecco, Italy
| | - Janice Baker
- Genomics and Genetic Medicine Department, Children's Minnesota, Minneapolis, Minnesota, USA
| | - Roberta Battini
- Unit of Child Neuropsychiatry, IRCCS Foundation Stella Maris, Calambrone, Toscana, Italy,Department of Clinical ad Experimental Medicine, University of Pisa, Pisa, Italy
| | - Enrico Silvio Bertini
- Laboratory of Molecular Medicine, Unit of Muscular and Neurodegenerative Diseases, Department of Neuroscience, Bambino Gesu Children's Hospital, IRCCS, Rome, Italy
| | - Renato Borgatti
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy,Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - Angela K Christman
- Department of Pediatrics, University of Washington Center for Mendelian Genomics, WashingtonUSA
| | - Cynthia Curry
- Department of Pediatrics, Stanford University, Stanford, California, USA,Division of Medical Genetics, Department of Pediatrics, University of California San Francisco, Fresno, California, USA,University Pediatric Specialists, Fresno, California, USA
| | - Stefano D'Arrigo
- Department of Developmental Neurology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Joel Fluss
- Department of Women, Children and Adolescents, Geneva University Hospitals, Geneva, Switzerland
| | - Michael Freilinger
- Department of Paediatric and Adolescent Medicine, Medical University of Vienna, Vienna, Austria
| | - Simone Gana
- Neurogenetics Research Centre, IRCCS Mondino Foundation, Pavia, Italy
| | - Gisele E Ishak
- Department of Neuroradiology, University of Washington School of Medicine, Seattle, Washington, USA,Pediatric Radiology, Seattle Children’s Hospital, Seattle, Washington, USA
| | - Vincenzo Leuzzi
- Department of Human Neuroscience, University of Rome La Sapienza, Roma, Lazio, Italy
| | - Hailey Loucks
- Department of Pediatrics, University of Washington Center for Mendelian Genomics, WashingtonUSA
| | - Filippo Manti
- Department of Human Neuroscience, University of Rome La Sapienza, Roma, Lazio, Italy
| | - Nancy Mendelsohn
- Complex Health Solutions, United Healthcare, Minneapolis, Minnesota, USA
| | - Laura Merlini
- Department of Pediatric Radiology, Geneva University Hospitals Children's Hospital, Geneva, Switzerland
| | - Caitlin V Miller
- Department of Pediatrics, University of Washington Center for Mendelian Genomics, WashingtonUSA
| | - Ansar Muhammad
- Institute of Molecular and Clinical Ophthalmology, Basel, Switzerland,Depatment of Ophtalmology, University of Lausanne, Jules Gonin Eye Hospital, Lausanne, Switzerland,Department of Genetic Medicine and Development, University of Geneva, Geneva, Switzerland
| | - Sara Nuovo
- Department of Experimental Medicine, University of Rome La Sapienza, Rome, Lazio, Italy
| | - Romina Romaniello
- Neuropsychiatry and Neurorehabilitation Unit, Scientific Institute, IRCCS Eugenio Medea, Lecco, Italy
| | - Wolfgang Schmidt
- Center for Anatomy and Cell Biology, Neuromuscular Research Department, Medical University of Vienna, Vienna, Austria
| | - Sabrina Signorini
- Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - Sabrina Siliquini
- Child Neuropsychiatry Unit, Paediatric Hospital G Salesi, Ancona, Italy
| | - Krzysztof Szczałuba
- Department of Medical Genetics, Warszawski Uniwersytet Medyczny, Warszawa, Poland
| | - Gessica Vasco
- Unit of Neurorehabilitation, Department of Neurosciences, IRCCS Bambino Gesù Children's Hospital, Roma, Italy
| | - Meredith Wilson
- Department of Clinical Genetics, Children’s Hospital at Westmead, Sydney, New South Wales, Australia,Discipline of Genomic Medicine, University of Sydney, Sydney, New South Wales, Australia
| | - Ginevra Zanni
- Laboratory of Molecular Medicine, Unit of Muscular and Neurodegenerative Diseases, Department of Neuroscience, Bambino Gesu Children's Hospital, IRCCS, Rome, Italy
| | - Eugen Boltshauser
- Department of Pediatric Neurology (Emeritus), University Children's Hospital Zürich, Zurich, Zürich, Switzerland
| | - Dan Doherty
- Department of Pediatrics, University of Washington Center for Mendelian Genomics, WashingtonUSA,Center for Integrative Brain Research, Seattle Children’s Research Institute, Seattle, Washington, USA
| | - Enza Maria Valente
- Neurogenetics Research Centre, IRCCS Mondino Foundation, Pavia, Italy,Department of Molecular Medicine, University of Pavia, Pavia, Lombardia, Italy
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5
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Guerrini-Rousseau L, Masliah-Planchon J, Waszak SM, Alhopuro P, Benusiglio PR, Bourdeaut F, Brecht IB, Del Baldo G, Dhanda SK, Garrè ML, Gidding CEM, Hirsch S, Hoarau P, Jorgensen M, Kratz C, Lafay-Cousin L, Mastronuzzi A, Pastorino L, Pfister SM, Schroeder C, Smith MJ, Vahteristo P, Vibert R, Vilain C, Waespe N, Winship IM, Evans DG, Brugieres L. Cancer risk and tumour spectrum in 172 patients with a germline SUFU pathogenic variation: a collaborative study of the SIOPE Host Genome Working Group. J Med Genet 2022; 59:jmedgenet-2021-108385. [PMID: 35768194 PMCID: PMC9613872 DOI: 10.1136/jmedgenet-2021-108385] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 04/23/2022] [Indexed: 11/11/2022]
Abstract
BACKGROUND Little is known about risks associated with germline SUFU pathogenic variants (PVs) known as a cancer predisposition syndrome. METHODS To study tumour risks, we have analysed data of a large cohort of 45 unpublished patients with a germline SUFU PV completed with 127 previously published patients. To reduce the ascertainment bias due to index patient selection, the risk of tumours was evaluated in relatives with SUFU PV (89 patients) using the Nelson-Aalen estimator. RESULTS Overall, 117/172 (68%) SUFU PV carriers developed at least one tumour: medulloblastoma (MB) (86 patients), basal cell carcinoma (BCC) (25 patients), meningioma (20 patients) and gonadal tumours (11 patients). Thirty-three of them (28%) had multiple tumours. Median age at diagnosis of MB, gonadal tumour, first BCC and first meningioma were 1.5, 14, 40 and 44 years, respectively. Follow-up data were available for 160 patients (137 remained alive and 23 died). The cumulative incidence of tumours in relatives was 14.4% (95% CI 6.8 to 21.4), 18.2% (95% CI 9.7 to 25.9) and 44.1% (95% CI 29.7 to 55.5) at the age of 5, 20 and 50 years, respectively. The cumulative risk of an MB, gonadal tumour, BCC and meningioma at age 50 years was: 13.3% (95% CI 6 to 20.1), 4.6% (95% CI 0 to 9.7), 28.5% (95% CI 13.4 to 40.9) and 5.2% (95% CI 0 to 12), respectively. Sixty-four different PVs were reported across the entire SUFU gene and inherited in 73% of cases in which inheritance could be evaluated. CONCLUSION Germline SUFU PV carriers have a life-long increased risk of tumours with a spectrum dominated by MB before the age of 5, gonadal tumours during adolescence and BCC and meningioma in adulthood, justifying fine-tuned surveillance programmes.
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Affiliation(s)
- Léa Guerrini-Rousseau
- Department of Children and Adolescents Oncology, Gustave Roussy, Villejuif, France
- Team "Genomics and Oncogenesis of pediatric Brain Tumors"-Paris Saclay University, INSERM U981, VILLEJUIF, France
| | - Julien Masliah-Planchon
- INSERM U830, Laboratory of Translational Research in Pediatric Oncology, SIREDO Pediatric Oncology Center, Institute Curie, Paris, France
| | - Sebastian M Waszak
- Centre for Molecular Medicine Norway (NCMM), Nordic EMBL Partnership, University of Oslo and Oslo University Hospital, Oslo, Norway
- Department of Pediatric Research, Oslo University Hospital, Oslo, Norway
| | - Pia Alhopuro
- Department of Medical and Clinical Genetics, University of Helsinki, Helsinki, Finland
| | - Patrick R Benusiglio
- Département de Génétique et Institut Universitaire de Cancérologie, Sorbonne University Faculty of Medicine Pitié-Salpêtrière Campus, Paris, France
| | - Franck Bourdeaut
- INSERM U830, Laboratory of Translational Research in Pediatric Oncology, SIREDO Pediatric Oncology Center, Institute Curie, Paris, France
| | - Ines B Brecht
- Department of Pediatric Oncology and Hematology, University Hospitals Tubingen, Tubingen, Germany
| | - Giada Del Baldo
- Department of Hematology/Oncology, Cell Therapy, Gene Therapy and Hemopoietic Transplant, IRCCS, Bambino Gesu Pediatric Hospital, Roma, Italy
| | - Sandeep Kumar Dhanda
- Department of Oncology, St Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Maria Luisa Garrè
- Neuro-Oncology Unit, Department of Neurochirurgia, IRCCS Istituto Giannina Gaslini, Genova, Italy
| | - Corrie E M Gidding
- Neuro-Oncology Department, Princess Maxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Steffen Hirsch
- Institute of Human Genetics, University Hospital Heidelberg, Heidelberg, Germany
- Hopp Children's Cancer Center Heidelberg (KiTZ), Heidelberg Health Center, Heidelberg, Germany
| | - Pauline Hoarau
- Department of Children and Adolescents Oncology, Gustave Roussy, Villejuif, France
| | - Mette Jorgensen
- Oncology, Great Ormond Street Hospital For Children NHS Foundation Trust, London, UK
| | - Christian Kratz
- Paediatric Haematology and Oncology, Hannover Medical School, Hannover, Germany
| | - Lucie Lafay-Cousin
- Section of Pediatric Hematology Oncology and Bone Marrow Transplantation, Alberta Children's Hospital and Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Angela Mastronuzzi
- Pediatric Hematology/Oncology and Stem Cells Transplatation, Bambino Gesu Pediatric Hospital, Roma, Italy
| | - Lorenza Pastorino
- Department of Oncology, Biology and Genetics, University of Genoa, Genoa, Italy
- Genetics of Rare Cancers, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Stefan M Pfister
- Hopp Children's Cancer Center Heidelberg (KiTZ), Heidelberg Health Center, Heidelberg, Germany
- Division of Pediatric Neurooncology, DKFZ, Heidelberg, Germany
- Department of Pediatric Oncology, Hematology and Immunology, University Hospital Heidelberg, Heidelberg, Germany
| | - Christopher Schroeder
- Institute of Medical Genetics and Applied Genomics, University of Tubingen Institute of Human Genetics, Tubingen, Germany
| | - Miriam Jane Smith
- Division of Evolution, Infection and Genomics, The University of Manchester, Manchester, UK
| | - Pia Vahteristo
- Department of Medical and Clinical Genetics, University of Helsinki, Helsinki, Finland
- Department of Medical and Clinical Genetics, Applied Tumor Genomics Research Program, University of Helsinki, Helsinki, Finland
| | - Roseline Vibert
- Department of Genetics, PSL Research University, Institute Curie, Paris, France
| | - Catheline Vilain
- Department of Genetics, Hôpital Universitaire des Enfants Reine Fabiola, ULB Center of Human Genetics, Universite Libre de Bruxelles, Bruxelles, Belgium
- Department of Genetics, Hôpital Erasme, ULB Center of Human Genetics, Universite Libre de Bruxelles, Bruxelles, Belgium
| | - Nicolas Waespe
- CANSEARCH Research Platform, Depatment of pediatric oncology and hematology, University of Geneva, Geneva, Switzerland
- Childhood Cancer Research Group, Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Ingrid M Winship
- Department of Medicine, The Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - D Gareth Evans
- Manchester Centre for Genomic Medicine, St Mary's Hospital, Manchester Academic Health Science Centre, School of Biological Sciences,Division of Evolution, Infection and Genomics, The University of Manchester, Manchester, UK
| | - Laurence Brugieres
- Team "Genomics and Oncogenesis of pediatric Brain Tumors"-Paris Saclay University, INSERM U981, VILLEJUIF, France
- Department of Children and Adolescents Oncology, Gustave Roussy Institute, Villejuif, France
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Verkouteren BJA, Cosgun B, Reinders MGHC, Kessler PAWK, Vermeulen RJ, Klaassens M, Lambrechts S, van Rheenen JR, van Geel M, Vreeburg M, Mosterd K. A guideline for the clinical management of basal cell nevus syndrome (Gorlin-Goltz syndrome). Br J Dermatol 2021; 186:215-226. [PMID: 34375441 PMCID: PMC9298899 DOI: 10.1111/bjd.20700] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/06/2021] [Indexed: 11/28/2022]
Abstract
The overall objective of this guideline is to provide up-to-date, evidence-based recommendations for the diagnosis and surveillance of all symptoms of children and adults with either basal cell nevus syndrome (BCNS), a clinical suspicion of BCNS, or a parent with BCNS. In the last two groups the guidelines should be followed until the diagnosis of BCNS can be rejected with certainty. The guideline aims to: - Update and expand on the previous guidelines by an appraisal of all relevant literature from January 2011 up to January 2021 - Address important, practical, clinical questions relating to the primary guideline objective - Provide guideline recommendations - Discuss potential developments and future directions.
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Affiliation(s)
- B J A Verkouteren
- Department of Dermatology, Maastricht University Medical Centre, Maastricht, the Netherlands.,GROW research institute for oncology and developmental biology, Maastricht University, Maastricht, the Netherlands
| | - B Cosgun
- Department of Dermatology, Maastricht University Medical Centre, Maastricht, the Netherlands.,GROW research institute for oncology and developmental biology, Maastricht University, Maastricht, the Netherlands
| | - M G H C Reinders
- Department of Dermatology, Maastricht University Medical Centre, Maastricht, the Netherlands.,GROW research institute for oncology and developmental biology, Maastricht University, Maastricht, the Netherlands
| | - P A W K Kessler
- Department of Cranio-Maxillofacial surgery, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - R J Vermeulen
- Department of Neurology, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - M Klaassens
- Department of Paediatrics, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - S Lambrechts
- Department of Gynaecology, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - J R van Rheenen
- Department of Ophthalmology, St. Anna Hospital, Geldrop, the Netherlands
| | - M van Geel
- Department of Dermatology, Maastricht University Medical Centre, Maastricht, the Netherlands.,GROW research institute for oncology and developmental biology, Maastricht University, Maastricht, the Netherlands.,Department of Clinical Genetics, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - M Vreeburg
- Department of Clinical Genetics, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - K Mosterd
- Department of Dermatology, Maastricht University Medical Centre, Maastricht, the Netherlands.,GROW research institute for oncology and developmental biology, Maastricht University, Maastricht, the Netherlands
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7
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Hedgehog/GLI Signaling Pathway: Transduction, Regulation, and Implications for Disease. Cancers (Basel) 2021; 13:cancers13143410. [PMID: 34298625 PMCID: PMC8304605 DOI: 10.3390/cancers13143410] [Citation(s) in RCA: 84] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 07/04/2021] [Accepted: 07/05/2021] [Indexed: 12/12/2022] Open
Abstract
Simple Summary The Hedgehog/GLI (Hh/GLI) pathway plays a major role during development and it is commonly dysregulated in many diseases, including cancer. This highly concerted series of ligands, receptors, cytoplasmic signaling molecules, transcription factors, and co-regulators is involved in regulating the biological functions controlled by this pathway. Activation of Hh/GLI in cancer is most often through a non-canonical method of activation, independent of ligand binding. This review is intended to summarize our current understanding of the Hh/GLI signaling, non-canonical mechanisms of pathway activation, its implication in disease, and the current therapeutic strategies targeting this cascade. Abstract The Hh/GLI signaling pathway was originally discovered in Drosophila as a major regulator of segment patterning in development. This pathway consists of a series of ligands (Shh, Ihh, and Dhh), transmembrane receptors (Ptch1 and Ptch2), transcription factors (GLI1–3), and signaling regulators (SMO, HHIP, SUFU, PKA, CK1, GSK3β, etc.) that work in concert to repress (Ptch1, Ptch2, SUFU, PKA, CK1, GSK3β) or activate (Shh, Ihh, Dhh, SMO, GLI1–3) the signaling cascade. Not long after the initial discovery, dysregulation of the Hh/GLI signaling pathway was implicated in human disease. Activation of this signaling pathway is observed in many types of cancer, including basal cell carcinoma, medulloblastoma, colorectal, prostate, pancreatic, and many more. Most often, the activation of the Hh/GLI pathway in cancer occurs through a ligand-independent mechanism. However, in benign disease, this activation is mostly ligand-dependent. The upstream signaling component of the receptor complex, SMO, is bypassed, and the GLI family of transcription factors can be activated regardless of ligand binding. Additional mechanisms of pathway activation exist whereby the entirety of the downstream signaling pathway is bypassed, and PTCH1 promotes cell cycle progression and prevents caspase-mediated apoptosis. Throughout this review, we summarize each component of the signaling cascade, non-canonical modes of pathway activation, and the implications in human disease, including cancer.
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Current recommendations for cancer surveillance in Gorlin syndrome: a report from the SIOPE host genome working group (SIOPE HGWG). Fam Cancer 2021; 20:317-325. [PMID: 33860896 PMCID: PMC8484213 DOI: 10.1007/s10689-021-00247-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 03/17/2021] [Indexed: 01/22/2023]
Abstract
Gorlin syndrome (MIM 109,400), a cancer predisposition syndrome related to a constitutional pathogenic variation (PV) of a gene in the Sonic Hedgehog pathway (PTCH1 or SUFU), is associated with a broad spectrum of benign and malignant tumors. Basal cell carcinomas (BCC), odontogenic keratocysts and medulloblastomas are the main tumor types encountered, but meningiomas, ovarian or cardiac fibromas and sarcomas have also been described. The clinical features and tumor risks are different depending on the causative gene. Due to the rarity of this condition, there is little data on phenotype-genotype correlations. This report summarizes genotype-based recommendations for screening patients with PTCH1 and SUFU-related Gorlin syndrome, discussed during a workshop of the Host Genome Working Group of the European branch of the International Society of Pediatric Oncology (SIOPE HGWG) held in January 2020. In order to allow early detection of BCC, dermatologic examination should start at age 10 in PTCH1, and at age 20 in SUFU PV carriers. Odontogenic keratocyst screening, based on odontologic examination, should begin at age 2 with annual orthopantogram beginning around age 8 for PTCH1 PV carriers only. For medulloblastomas, repeated brain MRI from birth to 5 years should be proposed for SUFU PV carriers only. Brain MRI for meningiomas and pelvic ultrasound for ovarian fibromas should be offered to both PTCH1 and SUFU PV carriers. Follow-up of patients treated with radiotherapy should be prolonged and thorough because of the risk of secondary malignancies. Prospective evaluation of evidence of the effectiveness of these surveillance recommendations is required.
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Hedgehog Pathway Alterations Downstream of Patched-1 Are Common in Infundibulocystic Basal Cell Carcinoma. Am J Dermatopathol 2020; 43:266-272. [PMID: 32796174 DOI: 10.1097/dad.0000000000001746] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT The infundibulocystic variant of basal cell carcinoma (BCC) is characterized histologically by anastamosing strands of basaloid epithelium with associated small infundibular-type cysts. Since its first description in 1987, this rare entity has generated considerable controversy with some authors classifying it as a benign follicular neoplasm rather than a BCC subtype. Prior studies aiming to settle this issue using immunohistochemical analysis reached opposite conclusions. The defining feature of BCC is activation of the Hedgehog signaling pathway, and mutations in Patched-1 (PTCH1) are the most common molecular finding in both sporadic and inherited forms of BCC. Mutations in other downstream components including Smoothened (SMO) and Suppressor of Fused (SUFU) also occur, but are much less common. Here, we report a molecular genetic analysis of a small series of infundibulocystic BCC using a next-generation DNA sequencing platform. All 4 cases harbored mutations or other genetic alterations in components of the Hedgehog pathway, supporting the classification of this entity as a BCC variant. Interestingly, these tumors were enriched for genetic alterations downstream of PTCH1, involving SUFU, SMO, GLI1, and GLI2. This observation was of particular interest given that rare kindreds of the Multiple Hereditary Infundibulocystic BCC syndrome (MHIBCC), which is related, but possibly distinct from the nevoid BCC syndrome, harbored mutations in SUFU. Our results support the classification of the infundibulocystic variant as a subtype of BCC, and suggest that the level at which genetic alterations occur within the Hedgehog pathway may be an important determinant of the morphologic features in BCC.
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Mutations in SUFU and PTCH1 genes may cause different cutaneous cancer predisposition syndromes: similar, but not the same. Fam Cancer 2019; 17:601-606. [PMID: 29356994 DOI: 10.1007/s10689-018-0073-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Many cancer predisposition syndromes are preceded or accompanied by a range of typical skin signs. Gorlin syndrome is a rare multisystem inherited disorder which can predispose to basal cell carcinomas (BCCs), childhood medulloblastomas in addition to various developmental abnormalities; the majority of cases are due to mutations in the PTCH1 gene. Approximately 5% of cases have been attributed to a mutation in the SUFU gene. Certain phenotypic features have been identified as being more prevalent in individuals with a SUFU mutation such as childhood medulloblastoma, infundibulocystic BCCs and trichoepitheliomas. Recently hamartomatous skin lesions have also been noted in families with childhood medulloblastoma, a "Gorlin like" phenotype and a SUFU mutation. Here we describe a family previously diagnosed with Gorlin syndrome with a novel SUFU splice site deleterious genetic variant, who have several dermatological features including palmar sclerotic fibromas which has not been described in relation to a SUFU mutation before. We highlight the features more prominent in individuals with a SUFU mutation. It is important to note that emerging therapies for treatment of BCCs in patients with a PTCH1 mutation may not be effective in those with a SUFU mutation.
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Guerrini-Rousseau L, Dufour C, Varlet P, Masliah-Planchon J, Bourdeaut F, Guillaud-Bataille M, Abbas R, Bertozzi AI, Fouyssac F, Huybrechts S, Puget S, Bressac-De Paillerets B, Caron O, Sevenet N, Dimaria M, Villebasse S, Delattre O, Valteau-Couanet D, Grill J, Brugières L. Germline SUFU mutation carriers and medulloblastoma: clinical characteristics, cancer risk, and prognosis. Neuro Oncol 2018; 20:1122-1132. [PMID: 29186568 PMCID: PMC6280147 DOI: 10.1093/neuonc/nox228] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Background Germline mutations of suppressor of fused homolog (SUFU) predispose to sonic hedgehog (SHH) medulloblastoma. Germline SUFU mutations have been reported in nevoid basal cell carcinoma syndrome (NBCCS), but little is known about the cancer risk and clinical spectrum. Methods We performed a retrospective review of all patients with medulloblastoma and a germline SUFU mutation in France. Results Twenty-two patients from 17 families were identified with medulloblastoma and a germline SUFU mutation (median age at diagnosis: 16.5 mo). Macrocrania was present in 20 patients, but only 5 met the diagnostic criteria for NBCCS. Despite treatment with surgery and chemotherapy, to avoid radiotherapy in all patients except one, the outcome was worse than expected for SHH medulloblastoma, due to the high incidence of local relapses (8/22 patients) and second malignancies (n = 6 in 4/22 patients). The 5-year progression-free survival and overall survival rates were 42% and 66%. Mutations were inherited in 79% of patients, and 34 additional SUFU mutation carriers were identified within 14 families. Medulloblastoma penetrance was incomplete, but higher than in Patched 1 (PTCH1) mutation carriers. Besides medulloblastoma, 19 other tumors were recorded among the 56 SUFU mutation carriers, including basal cell carcinoma (BCC) in 2 patients and meningioma in 3 patients. Conclusion Germline SUFU mutations strongly predispose to medulloblastoma in the first years of life, with worse prognosis than usually observed for SHH medulloblastoma. The clinical spectrum differs between SUFU and PTCH1 mutation carriers, and BCC incidence is much lower in SUFU mutation carriers. The optimal treatment of SUFU mutation-associated medulloblastoma has not been defined.
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Affiliation(s)
- Léa Guerrini-Rousseau
- Département de Cancérologie de l’Enfant et de l’Adolescent, Gustave Roussy, Université Paris-Saclay, Villejuif, France,Corresponding author: Léa Guerrini-Rousseau, Gustave Roussy, Département de Cancérologie de l’Enfant et de l’Adolescent, 114 rue Edouard Vaillant, 94805 Villejuif, France ()
| | - Christelle Dufour
- Département de Cancérologie de l’Enfant et de l’Adolescent, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Pascale Varlet
- Service de neuropathologie, Hôpital Sainte-Anne, Université Paris Descartes, Paris, France
| | - Julien Masliah-Planchon
- PSL Research University, INSERM U830 Génétique et Biologie des Cancers Institut Curie, Paris, France,Unité de génétique somatique, SIREDO pediatric oncology center, Institut Curie, Paris, France
| | - Franck Bourdeaut
- PSL Research University, INSERM U830 Génétique et Biologie des Cancers Institut Curie, Paris, France,Département d’oncologie Pédiatrique adolescents Jeunes Adultes, Institut Curie, Paris, France, SIREDO pediatric oncology center, Institut Curie, Paris, France,Institut Curie SIRIC - Laboratoire de Recherche Translationnelle en Oncologie Pédiatrique, Institut Curie, Paris, France
| | - Marine Guillaud-Bataille
- Département de Biologie et Pathologie Médicales, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Rachid Abbas
- INSERM U1018, CESP, Université Paris-Sud, Université Paris-Saclay, Villejuif, France,Service de Biostatistique et d’Epidémiologie, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | | | - Fanny Fouyssac
- Onco-hématologie pédiatrique, Hôpital d’Enfants, CHU Nancy, Nancy, France
| | - Sophie Huybrechts
- Hematology-Oncology Unit, Hôpital Universitaire des Enfants Reine Fabiola, ULB Université libre de Bruxelles, Brussels, Belgium
| | - Stéphanie Puget
- Service de neurochirurgie pédiatrique, Hôpital Necker-Enfants malades, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | | | - Olivier Caron
- PSL Research University, INSERM U830 Génétique et Biologie des Cancers Institut Curie, Paris, France,Unité de génétique somatique, SIREDO pediatric oncology center, Institut Curie, Paris, France,Département de Médecine Oncologique, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Nicolas Sevenet
- Laboratoire de génétique moléculaire, Département de bio-pathologie, Institut Bergonié, Bordeaux, France,INSERM U1218, Université de Bordeaux, Bordeaux, France,UFR des Sciences Pharmaceutiques, Université de Bordeaux, Bordeaux, France
| | - Marina Dimaria
- Département de Médecine Oncologique, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Sophie Villebasse
- Département de Médecine Oncologique, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Olivier Delattre
- Département de Cancérologie de l’Enfant et de l’Adolescent, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Dominique Valteau-Couanet
- Département de Cancérologie de l’Enfant et de l’Adolescent, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Jacques Grill
- Unité Mixte de Recherche 8203 du Centre National de la Recherche Scientifique, Université Paris-Saclay, Villejuif, France
| | - Laurence Brugières
- Département de Cancérologie de l’Enfant et de l’Adolescent, Gustave Roussy, Université Paris-Saclay, Villejuif, France
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Huang D, Wang Y, Tang J, Luo S. Molecular mechanisms of suppressor of fused in regulating the hedgehog signalling pathway. Oncol Lett 2018; 15:6077-6086. [PMID: 29725392 DOI: 10.3892/ol.2018.8142] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2017] [Accepted: 10/17/2017] [Indexed: 02/07/2023] Open
Abstract
Highly conserved throughout evolution, the hedgehog (Hh) signalling pathway has been demonstrated to be involved in embryonic development, stem cell maintenance and tissue homeostasis in animals ranging from invertebrates to vertebrates. In the human body, a variety of cancer types are associated with the aberrantly activated Hh signalling pathway. Multiple studies have revealed suppressor of fused (Sufu) as a key negative regulator of this signalling pathway. In vertebrates, Sufu primarily functions as a tumor suppressor factor by interacting with and inhibiting glioma-associated oncogene homologues (GLIs), which are the terminal transcription factors of the Hh signalling pathway and belong to the Kruppel family of zinc finger proteins; by contrast, the regulation of Sufu itself remains relatively unclear. In the present review article, we focus on the effects of Sufu on the Hh signalling pathway in tumourigenesis and the molecular mechanisms underlying the regulation of GLI by Sufu. In addition, the factors modulating the activity of Sufu at post-transcriptional levels are also discussed.
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Affiliation(s)
- Dengliang Huang
- Center for Experimental Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, P.R. China.,Jiangxi Key Laboratory of Molecular Diagnostics and Precision Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, P.R. China
| | - Yiting Wang
- Center for Experimental Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, P.R. China.,Jiangxi Key Laboratory of Molecular Diagnostics and Precision Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, P.R. China
| | - Jiabin Tang
- Center for Experimental Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, P.R. China
| | - Shiwen Luo
- Center for Experimental Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, P.R. China.,Jiangxi Key Laboratory of Molecular Diagnostics and Precision Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, P.R. China
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Huq AJ, Bogwitz M, Gorelik A, Winship IM, White SM, Trainer AH. Cohort study of Gorlin syndrome with emphasis on standardised phenotyping and quality of life assessment. Intern Med J 2017; 47:664-673. [DOI: 10.1111/imj.13429] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2016] [Revised: 02/18/2017] [Accepted: 03/15/2017] [Indexed: 11/27/2022]
Affiliation(s)
- Aamira J. Huq
- Department of Genetic Medicine; Royal Melbourne Hospital; Melbourne Victoria Australia
| | - Michael Bogwitz
- Department of Genetic Medicine; Royal Melbourne Hospital; Melbourne Victoria Australia
| | - Alexandra Gorelik
- Melbourne EpiCentre; Royal Melbourne Hospital; Melbourne Victoria Australia
| | - Ingrid M. Winship
- Department of Genetic Medicine; Royal Melbourne Hospital; Melbourne Victoria Australia
- Department of Medicine; University of Melbourne; Melbourne Victoria Australia
| | - Susan M. White
- Victorian Clinical Genetics Services; Murdoch Childrens Research Institute; Melbourne Victoria Australia
- Department of Paediatrics; University of Melbourne; Melbourne Victoria Australia
| | - Alison H. Trainer
- Department of Genetic Medicine; Royal Melbourne Hospital; Melbourne Victoria Australia
- Department of Medicine; University of Melbourne; Melbourne Victoria Australia
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