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Gosangi B, Dixe de Oliveira Santo I, Keraliya A, Wang Y, Irugu D, Thomas R, Khandelwal A, Rubinowitz AN, Bader AS. Li-Fraumeni Syndrome: Imaging Features and Guidelines. Radiographics 2024; 44:e230202. [PMID: 39024172 DOI: 10.1148/rg.230202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2024]
Abstract
Li-Fraumeni syndrome (LFS) is a rare autosomal dominant familial cancer syndrome caused by germline mutations of the tumor protein p53 gene (TP53), which encodes the p53 transcription factor, also known as the "guardian of the genome." The most common types of cancer found in families with LFS include sarcomas, leukemia, breast malignancies, brain tumors, and adrenocortical cancers. Osteosarcoma and rhabdomyosarcoma are the most common sarcomas. Patients with LFS are at increased risk of developing early-onset gastric and colon cancers. They are also at increased risk for several other cancers involving the thyroid, lungs, ovaries, and skin. The lifetime risk of cancer in individuals with LFS is greater than 70% in males and greater than 90% in females. Some patients with LFS develop multiple primary cancers during their lifetime, and guidelines have been established for screening these patients. Whole-body MRI is the preferred modality for annual screening of these patients. The management guidelines for patients with LFS vary, as these individuals are more susceptible to developing radiation-induced cancers-for example, women with LFS and breast cancer are treated with total mastectomy instead of lumpectomy with radiation to the breast. The authors review the role of imaging, imaging guidelines, and imaging features of tumors in the setting of LFS. ©RSNA, 2024 Supplemental material is available for this article.
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Affiliation(s)
- Babina Gosangi
- From the Department of Radiology and Biomedical Imaging (B.G., I.D.d.O.S., A.N.R., A.S.B.), Section of Interventional Radiology (Y.W.), Yale School of Medicine, 333 Cedar Street, PO Box 208042, Rm TE-2, New Haven, CT 06520; Department of Radiology, Brigham and Women's Hospital, Boston, Mass (A. Keraliya); Magnus Hospital, Hyderabad, India (D.I.); Department of Radiology, Lahey Hospital and Medical Care Center, Burlington, Mass (R.T.); and Department of Radiology, Mayo University, Rochester, Minn (A. Khandelwal)
| | - Irene Dixe de Oliveira Santo
- From the Department of Radiology and Biomedical Imaging (B.G., I.D.d.O.S., A.N.R., A.S.B.), Section of Interventional Radiology (Y.W.), Yale School of Medicine, 333 Cedar Street, PO Box 208042, Rm TE-2, New Haven, CT 06520; Department of Radiology, Brigham and Women's Hospital, Boston, Mass (A. Keraliya); Magnus Hospital, Hyderabad, India (D.I.); Department of Radiology, Lahey Hospital and Medical Care Center, Burlington, Mass (R.T.); and Department of Radiology, Mayo University, Rochester, Minn (A. Khandelwal)
| | - Abhishek Keraliya
- From the Department of Radiology and Biomedical Imaging (B.G., I.D.d.O.S., A.N.R., A.S.B.), Section of Interventional Radiology (Y.W.), Yale School of Medicine, 333 Cedar Street, PO Box 208042, Rm TE-2, New Haven, CT 06520; Department of Radiology, Brigham and Women's Hospital, Boston, Mass (A. Keraliya); Magnus Hospital, Hyderabad, India (D.I.); Department of Radiology, Lahey Hospital and Medical Care Center, Burlington, Mass (R.T.); and Department of Radiology, Mayo University, Rochester, Minn (A. Khandelwal)
| | - Yifan Wang
- From the Department of Radiology and Biomedical Imaging (B.G., I.D.d.O.S., A.N.R., A.S.B.), Section of Interventional Radiology (Y.W.), Yale School of Medicine, 333 Cedar Street, PO Box 208042, Rm TE-2, New Haven, CT 06520; Department of Radiology, Brigham and Women's Hospital, Boston, Mass (A. Keraliya); Magnus Hospital, Hyderabad, India (D.I.); Department of Radiology, Lahey Hospital and Medical Care Center, Burlington, Mass (R.T.); and Department of Radiology, Mayo University, Rochester, Minn (A. Khandelwal)
| | - David Irugu
- From the Department of Radiology and Biomedical Imaging (B.G., I.D.d.O.S., A.N.R., A.S.B.), Section of Interventional Radiology (Y.W.), Yale School of Medicine, 333 Cedar Street, PO Box 208042, Rm TE-2, New Haven, CT 06520; Department of Radiology, Brigham and Women's Hospital, Boston, Mass (A. Keraliya); Magnus Hospital, Hyderabad, India (D.I.); Department of Radiology, Lahey Hospital and Medical Care Center, Burlington, Mass (R.T.); and Department of Radiology, Mayo University, Rochester, Minn (A. Khandelwal)
| | - Richard Thomas
- From the Department of Radiology and Biomedical Imaging (B.G., I.D.d.O.S., A.N.R., A.S.B.), Section of Interventional Radiology (Y.W.), Yale School of Medicine, 333 Cedar Street, PO Box 208042, Rm TE-2, New Haven, CT 06520; Department of Radiology, Brigham and Women's Hospital, Boston, Mass (A. Keraliya); Magnus Hospital, Hyderabad, India (D.I.); Department of Radiology, Lahey Hospital and Medical Care Center, Burlington, Mass (R.T.); and Department of Radiology, Mayo University, Rochester, Minn (A. Khandelwal)
| | - Ashish Khandelwal
- From the Department of Radiology and Biomedical Imaging (B.G., I.D.d.O.S., A.N.R., A.S.B.), Section of Interventional Radiology (Y.W.), Yale School of Medicine, 333 Cedar Street, PO Box 208042, Rm TE-2, New Haven, CT 06520; Department of Radiology, Brigham and Women's Hospital, Boston, Mass (A. Keraliya); Magnus Hospital, Hyderabad, India (D.I.); Department of Radiology, Lahey Hospital and Medical Care Center, Burlington, Mass (R.T.); and Department of Radiology, Mayo University, Rochester, Minn (A. Khandelwal)
| | - Ami N Rubinowitz
- From the Department of Radiology and Biomedical Imaging (B.G., I.D.d.O.S., A.N.R., A.S.B.), Section of Interventional Radiology (Y.W.), Yale School of Medicine, 333 Cedar Street, PO Box 208042, Rm TE-2, New Haven, CT 06520; Department of Radiology, Brigham and Women's Hospital, Boston, Mass (A. Keraliya); Magnus Hospital, Hyderabad, India (D.I.); Department of Radiology, Lahey Hospital and Medical Care Center, Burlington, Mass (R.T.); and Department of Radiology, Mayo University, Rochester, Minn (A. Khandelwal)
| | - Anna S Bader
- From the Department of Radiology and Biomedical Imaging (B.G., I.D.d.O.S., A.N.R., A.S.B.), Section of Interventional Radiology (Y.W.), Yale School of Medicine, 333 Cedar Street, PO Box 208042, Rm TE-2, New Haven, CT 06520; Department of Radiology, Brigham and Women's Hospital, Boston, Mass (A. Keraliya); Magnus Hospital, Hyderabad, India (D.I.); Department of Radiology, Lahey Hospital and Medical Care Center, Burlington, Mass (R.T.); and Department of Radiology, Mayo University, Rochester, Minn (A. Khandelwal)
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Yi H, Zhang N, Huang J, Zheng Y, Hong QH, Sundquist J, Sundquist K, Zheng X, Ji J. Association of levonorgestrel-releasing intrauterine device with gynecologic and breast cancers: a national cohort study in Sweden. Am J Obstet Gynecol 2024:S0002-9378(24)00593-3. [PMID: 38759709 DOI: 10.1016/j.ajog.2024.05.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 05/07/2024] [Accepted: 05/08/2024] [Indexed: 05/19/2024]
Abstract
BACKGROUND The levonorgestrel-releasing intrauterine device (LNG-IUD) is widely used for the treatment of menorrhagia, dysmenorrhea, and for contraception. However, the association between the use of LNG-IUD and the risk of site-specific gynecologic and breast cancers remains inconclusive. OBJECTIVE We aim to address this knowledge gap by investigating whether the use of LNG-IUD is associated with a significant risk of site-specific gynecologic and breast cancers. This will be achieved by accessing the nationwide Swedish Registers, with consideration given to the influence and potential interaction of family history of cancer. STUDY DESIGN A total of 514,719 women aged 18 to 50 years who have used LNG-IUD between July 2005 and December 2018 were identified from the Swedish Prescribed Drug Register and randomly matched with 1,544,157 comparisons who did not use LNG-IUD at a ratio of 1:3. The propensity score was calculated and matched among women who used LNG-IUD and the matched comparisons. The follow-up period started from the date of the first prescription of LNG-IUD for users as well as for their matched comparisons and ended at the date of diagnosis of gynecologic and breast cancers, date of death from any cause, and the end of the study period, whichever came first. The Cox proportional hazard model with a competing risk analysis was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs). Additive interaction was calculated as the relative excess risk for interaction, while multiplicative interaction was calculated by including a product term in the regression model. RESULTS The use of LNG-IUD was associated with a 13% higher risk of breast cancer (adjusted HR, 1.13; 95% CI, 1.10-1.17), a 33% lower risk of endometrial cancer (adjusted HR, 0.67; 95% CI, 0.56-0.80), a 14% lower risk of ovarian cancer (adjusted HR, 0.86; 95% CI, 0.75-0.99), and a 9% reduced risk of cervical cancer (adjusted HR, 0.91; 95% CI, 0.84-0.99) compared to women who did not use LNG-IUD. A significant additive interaction between LNG-IUD use and family history of cancer was observed in breast cancer, indicating a relative 19% excess risk for interaction (P<.002), and 1.63 additional cases per 10,000 person-years. CONCLUSION The risk of gynecologic and breast cancers exhibits a site-specific effect among LNG-IUD users. It is important to note that the observed effect is small for breast cancer and the results are limited by the observational study design. Clinical recommendations regarding the use of LNG-IUD should carefully weigh its potential benefits and risks. Close monitoring is advisable for the potential development of breast cancer, particularly among women with a family history of breast cancer.
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Affiliation(s)
- Huan Yi
- Department of Gynecologic Oncology, Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, Fujian, China; Department of Clinical Sciences Malmö, Center for Primary Health Care Research, Lund University, Malmo, Sweden; Fujian Province Key Clinical Specialty for Gynecology, Fujian Key Laboratory of Women and Children's Critical Diseases Research, National Key Gynecology Clinical Specialty Construction Institution of China, Fuzhou, Fujian, China.
| | - Naiqi Zhang
- Department of Clinical Sciences Malmö, Center for Primary Health Care Research, Lund University, Malmo, Sweden
| | - Jimiao Huang
- Department of Gynecologic Oncology, Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, Fujian, China
| | - Ying Zheng
- Department of Obstetrics, Fuzhou Second Hospital, Fuzhou, Fujian, China
| | - Qiu Hua Hong
- Department of Gynecologic Oncology, Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, Fujian, China
| | - Jan Sundquist
- Department of Clinical Sciences Malmö, Center for Primary Health Care Research, Lund University, Malmo, Sweden; Department of Family Medicine and Community Health, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY; Department of Functional Pathology, Center for Community-Based Healthcare Research and Education (CoHRE), School of Medicine, Shimane University, Japan; University Clinic Primary Care Skåne, Region Skåne, Malmo, Sweden
| | - Kristina Sundquist
- Department of Clinical Sciences Malmö, Center for Primary Health Care Research, Lund University, Malmo, Sweden; Department of Family Medicine and Community Health, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY; Department of Functional Pathology, Center for Community-Based Healthcare Research and Education (CoHRE), School of Medicine, Shimane University, Japan; University Clinic Primary Care Skåne, Region Skåne, Malmo, Sweden
| | - Xiangqin Zheng
- Department of Gynecologic Oncology, Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, Fujian, China; Fujian Province Key Clinical Specialty for Gynecology, Fujian Key Laboratory of Women and Children's Critical Diseases Research, National Key Gynecology Clinical Specialty Construction Institution of China, Fuzhou, Fujian, China.
| | - Jianguang Ji
- Department of Gynecologic Oncology, Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, Fujian, China; Department of Clinical Sciences Malmö, Center for Primary Health Care Research, Lund University, Malmo, Sweden.
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Eksteen C, Riedemann J, Rass AM, du Plessis M, Botha MH, van der Merwe FH, Engelbrecht AM. A Review: Genetic Mutations as a Key to Unlocking Drug Resistance in Cervical Cancer. Cancer Control 2024; 31:10732748241261539. [PMID: 38881031 PMCID: PMC11181891 DOI: 10.1177/10732748241261539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 04/29/2024] [Accepted: 05/27/2024] [Indexed: 06/18/2024] Open
Abstract
Cervical cancer is the fourth most common cancer in women. Advanced stage and metastatic disease are often associated with poor clinical outcomes. This substantiates the absolute necessity for high-throughput diagnostic and treatment platforms that are patient and tumour specific. Cervical cancer treatment constitutes multimodal intervention. Systemic treatments such as chemotherapy and/or focal radiotherapy are typically applied as neoadjuvant and/or adjuvant strategies. Cisplatin constitutes an integral part of standard cervical cancer treatment approaches. However, despite initial patient response, de novo or delayed/acquired treatment resistance is often reported, and toxicity is of concern. Chemotherapy resistance is associated with major alterations in genomic, metabolomic, epigenetic and proteomic landscapes. This results in imbalanced homeostasis associated with pro-oncogenic and proliferative survival, anti-apoptotic benefits, and enhanced DNA damage repair processes. Although significant developments in cancer diagnoses and treatment have been made over the last two decades, drug resistance remains a major obstacle to overcome.
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Affiliation(s)
- Carla Eksteen
- CancerCare, Cape Gate Oncology Centre, Cape Town, South Africa
| | | | - Atarah M Rass
- Department of Physiological Sciences, Faculty of Science, University of Stellenbosch, Stellenbosch, South Africa
| | - Manisha du Plessis
- Department of Physiological Sciences, Faculty of Science, University of Stellenbosch, Stellenbosch, South Africa
| | - Matthys H Botha
- Department of Obstetrics and Gynecology, Stellenbosch University, Stellenbosch, South Africa
| | | | - Anna-Mart Engelbrecht
- Department of Physiological Sciences, Faculty of Science, University of Stellenbosch, Stellenbosch, South Africa
- African Cancer Institute (ACI), Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
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Watanabe T, Soeda S, Okoshi C, Fukuda T, Yasuda S, Fujimori K. Landscape of somatic mutated genes and inherited susceptibility genes in gynecological cancer. J Obstet Gynaecol Res 2023; 49:2629-2643. [PMID: 37632362 DOI: 10.1111/jog.15766] [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: 05/22/2023] [Accepted: 07/26/2023] [Indexed: 08/28/2023]
Abstract
Traditionally, gynecological cancers have been classified based on histology. Since remarkable advancements in next-generation sequencing technology have enabled the exploration of somatic mutations in various cancer types, comprehensive sequencing efforts have revealed the genomic landscapes of some common forms of human cancer. The genomic features of various gynecological malignancies have been reported by several studies of large-scale genomic cohorts, including The Cancer Genome Atlas. Although recent comprehensive genomic profiling tests, which can detect hundreds of genetic mutations at a time from cancer tissues or blood samples, have been increasingly used as diagnostic clinical biomarkers and in therapeutic management decisions, germline pathogenic variants associated with hereditary cancers can also be detected using this test. Gynecological cancers are closely related to genetic factors, with approximately 5% of endometrial cancer cases and 20% of ovarian cancer cases being caused by germline pathogenic variants. Hereditary breast and ovarian cancer syndrome and Lynch syndrome are the two major cancer susceptibility syndromes among gynecological cancers. In addition, several other hereditary syndromes have been reported to be associated with gynecological cancers. In this review, we highlight the genes for somatic mutation and germline pathogenic variants commonly seen in gynecological cancers. We first describe the relationship between clinicopathological attributes and somatic mutated genes. Subsequently, we discuss the characteristics and clinical management of inherited cancer syndromes resulting from pathogenic germline variants in gynecological malignancies.
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Affiliation(s)
- Takafumi Watanabe
- Department of Obstetrics and Gynecology, Fukushima Medical University, Fukushima, Japan
| | - Shu Soeda
- Department of Obstetrics and Gynecology, Fukushima Medical University, Fukushima, Japan
| | - Chihiro Okoshi
- Department of Obstetrics and Gynecology, Fukushima Medical University, Fukushima, Japan
| | - Toma Fukuda
- Department of Obstetrics and Gynecology, Fukushima Medical University, Fukushima, Japan
| | - Shun Yasuda
- Department of Obstetrics and Gynecology, Fukushima Medical University, Fukushima, Japan
| | - Keiya Fujimori
- Department of Obstetrics and Gynecology, Fukushima Medical University, Fukushima, Japan
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dos Santos JTT, Rosa RCA, Pereira ALE, Assunção-Luiz AV, Bacalá BT, Ferraz VEDF, Flória M. Risk for Hereditary Neoplastic Syndromes in Women with Mismatch Repair-Proficient Endometrial Cancer. Genes (Basel) 2023; 14:1999. [PMID: 38002942 PMCID: PMC10671603 DOI: 10.3390/genes14111999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 10/17/2023] [Accepted: 10/21/2023] [Indexed: 11/26/2023] Open
Abstract
Endometrial cancer (EC) is a prevalent malignancy in women, and those who are proficient in the DNA mismatch repair (pMMR) pathway may have a family history (FH) that meets the criteria for a hereditary neoplastic condition (HNS). This study aimed to estimate the risk of HNS in women with pMMR endometrial tumors by analyzing their FH. To achieve this, we collaborated with a primary study and collected FH information by telephone. The final sample comprised 42 women who responded to the Primary Screening Questionnaire. Their family pedigrees were drawn and categorized according to internationally standardized criteria for the risk of HNS. Results showed that 26 women (61%) were found to be at risk for HNS, with Bethesda criteria being met by 23%, Amsterdam criteria by 15%, and 4% met the attenuated familial adenomatous polyposis criteria. Our results emphasize the importance of FH and the need to encourage healthcare professionals to collect and document FH more frequently, even if it is self-reported. By identifying individuals with HNS, we can improve their outcomes and reduce the burden of cancer in families with a predisposition to cancer.
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Affiliation(s)
| | - Reginaldo Cruz Alves Rosa
- Department of Genetics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto 14040-901, SP, Brazil; (R.C.A.R.); (A.L.E.P.); (V.E.d.F.F.)
| | - Alison Luis Eburneo Pereira
- Department of Genetics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto 14040-901, SP, Brazil; (R.C.A.R.); (A.L.E.P.); (V.E.d.F.F.)
| | - Alan Vinicius Assunção-Luiz
- Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto 14040-901, SP, Brazil; (J.T.T.d.S.); (A.V.A.-L.); (B.T.B.)
| | - Bruna Tavares Bacalá
- Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto 14040-901, SP, Brazil; (J.T.T.d.S.); (A.V.A.-L.); (B.T.B.)
| | - Victor Evangelista de Faria Ferraz
- Department of Genetics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto 14040-901, SP, Brazil; (R.C.A.R.); (A.L.E.P.); (V.E.d.F.F.)
| | - Milena Flória
- Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto 14040-901, SP, Brazil; (J.T.T.d.S.); (A.V.A.-L.); (B.T.B.)
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Kotnik U, Maver A, Peterlin B, Lovrecic L. Assessment of pathogenic variation in gynecologic cancer genes in a national cohort. Sci Rep 2023; 13:5307. [PMID: 37002323 PMCID: PMC10066348 DOI: 10.1038/s41598-023-32397-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 03/27/2023] [Indexed: 04/03/2023] Open
Abstract
Population-based estimates of pathogenic variation burden in gynecologic cancer predisposition genes are a prerequisite for the development of effective precision public health strategies. This study aims to reveal the burden of pathogenic variants in a comprehensive set of clinically relevant breast, ovarian, and endometrial cancer genes in a large population-based study. We performed a rigorous manual classification procedure to identify pathogenic variants in a panel of 17 gynecologic cancer predisposition genes in a cohort of 7091 individuals, representing 0.35% of the general population. The population burden of pathogenic variants in hereditary gynecologic cancer-related genes in our study was 2.14%. Pathogenic variants in genes ATM, BRCA1, and CDH1 are significantly enriched and the burden of pathogenic variants in CHEK2 is decreased in our population compared to the control population. We have identified a high burden of pathogenic variants in several gynecologic cancer-related genes in the Slovenian population, most importantly in the BRCA1 gene.
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Affiliation(s)
- Urška Kotnik
- Clinical Institute of Genomic Medicine, University Medical Centre Ljubljana, Ljubljana, Slovenia.
- Biotechnical Faculty, University of Ljubljana, Ljubljana, Slovenia.
| | - Aleš Maver
- Clinical Institute of Genomic Medicine, University Medical Centre Ljubljana, Ljubljana, Slovenia
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Borut Peterlin
- Clinical Institute of Genomic Medicine, University Medical Centre Ljubljana, Ljubljana, Slovenia
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Luca Lovrecic
- Clinical Institute of Genomic Medicine, University Medical Centre Ljubljana, Ljubljana, Slovenia
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
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Kicman A, Niczyporuk M, Kulesza M, Motyka J, Ławicki S. Utility of Matrix Metalloproteinases in the Diagnosis, Monitoring and Prognosis of Ovarian Cancer Patients. Cancer Manag Res 2022; 14:3359-3382. [PMID: 36474934 PMCID: PMC9719685 DOI: 10.2147/cmar.s385658] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 11/08/2022] [Indexed: 01/14/2024] Open
Abstract
Ovarian cancer is one of the most common gynecologic malignancies. It is characterized by a high mortality rate, which is mainly due to the asymptomatic course of the disease. In light of the high mortality rate and increasing morbidity, new diagnostic methods are being explored to enable earlier detection, better monitoring, and improved prognosis. Such diagnostic methods include the assessment of tumor markers in various biological samples. Among the markers currently being investigated, extracellular matrix metalloproteinases (MMPs) are of particular interest. The objective of this article was to compile the existing knowledge of MMPs in ovarian cancer patients and to describe their potential diagnostic utility. Additionally, this article provides an overview of the symptoms, complications, and risk factors associated with ovarian cancer and the role of MMPs in physiology and pathology. Preliminary results indicate that tissue expression and blood and body fluid levels of MMPs may be different in ovarian cancer patients than in healthy women. The expression and concentration of individual MMPs have been shown to be correlated with cancer stage and disease severity. In addition, the preliminary value of some of these enzymes in predicting prognosis is discussed. However, as the amount of data is limited, more studies are needed to fully evaluate the potential function of individual MMPs in ovarian cancer patients. Based on the knowledge gathered for this article, it seems that MMP-2, MMP-3, MMP-7, MMP-8, MMP-9, MMP-13, are tentatively the most useful. A thorough evaluation of their utility as modern biomarkers in ovarian cancer requires further investigation.
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Affiliation(s)
- Aleksandra Kicman
- Department of Aesthetic Medicine, Medical University of Bialystok, Bialystok, Poland
| | - Marek Niczyporuk
- Department of Aesthetic Medicine, Medical University of Bialystok, Bialystok, Poland
| | - Monika Kulesza
- Department of Population Medicine and Lifestyle Diseases Prevention, Medical University of Bialystok, Bialystok, Poland
| | - Joanna Motyka
- Department of Population Medicine and Lifestyle Diseases Prevention, Medical University of Bialystok, Bialystok, Poland
| | - Sławomir Ławicki
- Department of Population Medicine and Lifestyle Diseases Prevention, Medical University of Bialystok, Bialystok, Poland
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8
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Kostov S, Watrowski R, Kornovski Y, Dzhenkov D, Slavchev S, Ivanova Y, Yordanov A. Hereditary Gynecologic Cancer Syndromes - A Narrative Review. Onco Targets Ther 2022; 15:381-405. [PMID: 35422633 PMCID: PMC9005127 DOI: 10.2147/ott.s353054] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 03/18/2022] [Indexed: 12/11/2022] Open
Abstract
Hereditary cancer syndromes are defined as syndromes, where the genetics of cancer are the result of low penetrant polymorphisms or of a single gene disorder inherited in a mendelian fashion. During the last decade, compelling evidence has accumulated that approximately 5-10% of all cancers could be attributed to hereditary cancer syndromes. A tremendous progress has been made over the last decade in the evaluation and management of these syndromes. However, hereditary syndromes associated with gynecologic malignancies still present significant challenge for oncogynecologists. Oncogynecologists tend to pay more attention to staging, histological type and treatment options of gynecological cancers than thinking of inherited cancers and taking a detailed family history. Moreover, physicians should also be familiar with screening strategies in patients with inherited gynecological cancers. Lynch syndrome and hereditary breast-ovarian cancer syndrome are the most common and widely discussed syndromes in medical literature. The aim of the present review article is to delineate and emphasize the majority of hereditary gynecological cancer syndromes, even these, which are rarely reported in oncogynecology. The following inherited cancers are briefly discussed: Lynch syndrome; "site-specific" ovarian cancer and hereditary breast-ovarian cancer syndrome; Cowden syndrome; Li-Fraumeni syndrome; Peutz-Jeghers syndrome; ataxia-telangiectasia; DICER1- syndrome; gonadal dysgenesis; tuberous sclerosis; multiple endocrine neoplasia type I, II; hereditary small cell carcinoma of the ovary, hypercalcemic type and hereditary undifferentiated uterine sarcoma; hereditary diffuse gastric cancer and MUTYH-associated polyposis. Epidemiology, pathogenesis, diagnosis, pathology and screening of these syndromes are discussed. General treatment recommendations are beyond the scope of this review.
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Affiliation(s)
- Stoyan Kostov
- Department of Gynecology, University Hospital "Saint Anna", Medical University "Prof. Dr. Paraskev Stoyanov", Varna, Bulgaria.,Faculty of Health Care, Medical University Pleven, Pleven, Bulgaria
| | - Rafał Watrowski
- Faculty of Medicine, University of Freiburg, Freiburg, 79106, Germany
| | - Yavor Kornovski
- Department of Gynecology, University Hospital "Saint Anna", Medical University "Prof. Dr. Paraskev Stoyanov", Varna, Bulgaria
| | - Deyan Dzhenkov
- Department of General and Clinical Pathology, Forensic Medicine and Deontology, Division of General and Clinical Pathology, Faculty of Medicine, Medical University "Prof. Dr. Paraskev Stoyanov", Varna, Bulgaria
| | - Stanislav Slavchev
- Department of Gynecology, University Hospital "Saint Anna", Medical University "Prof. Dr. Paraskev Stoyanov", Varna, Bulgaria
| | - Yonka Ivanova
- Department of Gynecology, University Hospital "Saint Anna", Medical University "Prof. Dr. Paraskev Stoyanov", Varna, Bulgaria
| | - Angel Yordanov
- Department of Gynecologic Oncology, Medical University Pleven, Pleven, Bulgaria
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Adejumo PO, Aniagwu TIG, Awolude OA, Oni AO, Ajayi OO, Fagbenle O, Ogungbade D, Kochheiser M, Ogundiran T, Olopade OI. Feasibility of genetic testing for cancer risk assessment programme in Nigeria. Ecancermedicalscience 2021; 15:1283. [PMID: 34824606 PMCID: PMC8580592 DOI: 10.3332/ecancer.2021.1283] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Indexed: 12/24/2022] Open
Abstract
Background A high frequency of BRCA mutations has been established in Nigerian breast cancer (BC) patients. Recently, patients’ and first-degree relatives’ interest have been raised on cancer genetic risk assessment through our awareness activities in Nigeria. This led to the emergence of nurse-led cancer genetic counselling (CGC) and testing aimed at providing standard-of-care for individuals at increased risk of hereditary breast and ovarian cancers. Methods In June 2018, CGC and testing of patients with BC and ovarian cancer (OC) commenced in collaboration with Color Genomics Inc. for a 30-panel gene testing. Previously trained nurses in CGC at the University College Hospital, Ibadan offered genetic counselling (GC) to willing patients with BC and gynaecological cancer in four out-patient oncology clinics and departments for the pilot study. Consultation consisted of CGC, patient’s history, pedigree and sample collection for genetic testing (GT). Results Forty-seven patients – 40 with BC, five with OC and two with endometrial cancer received GC, and all chose to undergo GT. The average age at testing was 48.2 ± 12.1 years. Eight women reported a known family cancer history and there were more perceived benefits than barriers to GT with the patients experiencing the desire for none of their relative to have cancer. Results revealed no mutations in 27 (57.4%), 16 (4.0%) variants of unknown significance and 4 (8.5%) pathogenic mutations. Conclusion Personalised cancer care utilises GC and testing for cancer risk assessment towards prevention and early detection in high risk women. The study indicates the necessity of expanded cancer genetic services for integration into patient care and cancer prevention.
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Affiliation(s)
- Prisca O Adejumo
- Department of Nursing, College of Medicine, University of Ibadan, Ibadan, 200284, Nigeria
| | - Toyin I G Aniagwu
- School of Occupational Health Nursing, University College Hospital, Ibadan, 200212, Nigeria
| | - Olutosin A Awolude
- Department of Obstetrics and Gynaecology, College of Medicine, University of Ibadan/University College Hospital, Ibadan, 200284, Nigeria
| | - Abiodun O Oni
- Department of Surgery, University College Hospital, Ibadan, 200212, Nigeria
| | - Olubunmi O Ajayi
- Department of Obstetrics and Gynaecology, College of Medicine, University of Ibadan/University College Hospital, Ibadan, 200284, Nigeria
| | - Omolara Fagbenle
- Department of Radiation Oncology, University College Hospital, Ibadan, 200212, Nigeria
| | - Dasola Ogungbade
- Department of Radiology, University College Hospital, Ibadan, 200212, Nigeria
| | - Makayla Kochheiser
- Center for Clinical Cancer Genetics, University of Chicago, Chicago, IL, 60637, USA.,Center for Global Health, University of Chicago, Chicago IL, 60637, USA
| | - Temidayo Ogundiran
- Department of Surgery, University College Hospital, Ibadan, 200212, Nigeria
| | - Olufunmilayo I Olopade
- Center for Clinical Cancer Genetics, University of Chicago, Chicago, IL, 60637, USA.,Center for Global Health, University of Chicago, Chicago IL, 60637, USA
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Pesce F, Devouassoux-Shisheboran M. [The pathology of hereditary ovarian tumors]. Ann Pathol 2020; 40:85-94. [PMID: 32178889 DOI: 10.1016/j.annpat.2020.02.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 01/21/2020] [Accepted: 02/10/2020] [Indexed: 11/24/2022]
Abstract
About 23% of adnexal tumors are related to a hereditary syndrome, most often hereditary breast and ovarian cancer syndrome or Lynch syndrome, responsible of epithelial tumors. However, the pathologist should be aware of rare hereditary syndromes responsible of non-epithelial ovarian tumors. Ovarian tumors associated with germline mutation of BRCA genes are essentially high-grade serous carcinomas of tubal origin, while those seen in Lynch syndrome are most often endometrioid or clear cell carcinomas. Sex-cord tumors associated with a familial predisposition are Sertoli-Leydig cell tumors in DICER syndrome and sex-cord tumors with annular tubules in Peutz-Jeghers syndrome. Small cell carcinoma of hypercalcemic type may be associated with a rhabdoid tumor predisposition syndrome 2. Finally, rare germ cell tumors have been reported related to ataxia telangiectasia. The recognition of these entities by pathologists is crucial. Even though the morphologic features pointing toward an inherited mutation may vary depending on the syndrome, the diagnosis may contribute to refer the patient for genetic counselling, modifying the management and follow-up of the patient and her family.
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Affiliation(s)
- Florian Pesce
- Institut multisite des hospices civils de Lyon, centre hospitalier Lyon Sud, 165, chemin du Grand-Revoyet, 69495 Pierre Bénite cedex, France
| | - Mojgan Devouassoux-Shisheboran
- Institut multisite des hospices civils de Lyon, centre hospitalier Lyon Sud, 165, chemin du Grand-Revoyet, 69495 Pierre Bénite cedex, France.
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Katabathina VS, Menias CO, Khanna L, Murphy L, Dasyam AK, Lubner MG, Prasad SR. Hereditary Gastrointestinal Cancer Syndromes: Role of Imaging in Screening, Diagnosis, and Management. Radiographics 2019; 39:1280-1301. [DOI: 10.1148/rg.2019180185] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Elsherif SB, Faria SC, Lall C, Iyer R, Bhosale PR. Ovarian Cancer Genetics and Implications for Imaging and Therapy. J Comput Assist Tomogr 2019; 43:835-845. [DOI: 10.1097/rct.0000000000000932] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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