1
|
Castro-Teles J, Sousa-Pinto B, Rebelo S, Pignatelli D. Pheochromocytomas and paragangliomas in von Hippel-Lindau disease: not a needle in a haystack. Endocr Connect 2021; 10:R293-R304. [PMID: 34596579 PMCID: PMC8630766 DOI: 10.1530/ec-21-0294] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 09/30/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Pheochromocytomas are a hallmark feature of von Hippel-Lindau disease (vHL). To our knowledge, this is the first systematic review with meta-analysis evaluating the frequency of pheochromocytomas and/or paragangliomas (PPGLs) in patients with vHL, as well as among patients with different vHL subtypes. DESIGN Systematic review with meta-analysis. METHODS We searched on MEDLINE, Scopus, and Web of Science. We included primary studies assessing participants with vHL and reporting on the frequency of PPGL. We performed random-effects meta-analysis to quantitatively assess the frequency of PPGL, followed by meta-regression and subgroup analysis. Risk of bias analysis was performed to assess primary studies' methodological quality. RESULTS We included 80 primary studies. In 4263 patients with vHL, the pooled frequency of PPGL was 19.4% (95% CI = 15.9-23.6%, I2 = 86.1%). The frequency increased to 60.0% in patients with vHL type 2 (95% CI = 53.4-66.3%, I2 = 54.6%) and was determined to be of 58.2% in patients with vHL type 2A (95% CI = 49.7-66.3%, I2 = 36.2%), compared to 49.8% in vHL type 2B (95% CI = 39.9-59.7%, I2 = 42.7%), and 84.1% in vHL type 2C (95% CI = 75.1-93.1%, I2 = 0%). In meta-regression analysis, more recent studies were associated with a higher frequency of PPGL. All studies had at least one internal validity item classified as 'high risk of bias,' with 13% studies having low risk of bias in all external validity items. CONCLUSIONS PPGLs are a common manifestation of vHL. Despite methodological limitations and differences across primary studies, our results point to the importance of PPGL screening in patients with vHL.
Collapse
Affiliation(s)
- João Castro-Teles
- Department of Biomedicine, Faculty of Medicine of the University of Porto, Porto, Portugal
| | - Bernardo Sousa-Pinto
- MEDCIDS, Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal
- CINTESIS, Center for Health Technology and Services Research, University of Porto, Porto, Portugal
| | - Sandra Rebelo
- Department of Biomedicine, Faculty of Medicine of the University of Porto, Porto, Portugal
- Instituto de Investigação e Inovação em Saúde (i3S), Universidade do Porto, Porto, Portugal
- Department of Clinical Pathology, Centro Hospitalar Universitário de São João (CHUSJ), Porto, Portugal
| | - Duarte Pignatelli
- Department of Biomedicine, Faculty of Medicine of the University of Porto, Porto, Portugal
- Instituto de Investigação e Inovação em Saúde (i3S), Universidade do Porto, Porto, Portugal
- Institute of Molecular Pathology and Immunology of the University of Porto (IPATIMUP), Porto, Portugal
- Department of Endocrinology, Centro Hospitalar Universitário de São João (CHUSJ), Porto, Portugal
- Correspondence should be addressed to D Pignatelli:
| |
Collapse
|
2
|
Hong B, Ma K, Zhou J, Zhang J, Wang J, Liu S, Zhang Z, Cai L, Zhang N, Gong K. Frequent Mutations of VHL Gene and the Clinical Phenotypes in the Largest Chinese Cohort With Von Hippel-Lindau Disease. Front Genet 2019; 10:867. [PMID: 31620170 PMCID: PMC6759728 DOI: 10.3389/fgene.2019.00867] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Accepted: 08/20/2019] [Indexed: 01/31/2023] Open
Abstract
Von Hippel–Lindau (VHL) disease is a rare autosomal-dominant inherited tumor syndrome. We aimed to analyze the correlations between frequent VHL mutations and phenotypes in Chinese VHL families. We screened 540 patients from 187 unrelated Chinese VHL families for 19 frequent VHL mutations. The penetrance and mean age at onset for VHL-associated susceptible organs were calculated and compared. The overall survival of VHL patients was described with Kaplan–Meier curves. Among the 19 frequent germline mutations, there were four hotspot mutation sites (194, 481, 499, and 500). Missense mutations were the most common types of mutations (70.0%) followed by nonsense mutations (20.0%) and splicing mutations (10.0%). Due to the diversity of these mutations, the penetrance for each organ and the age at onset are distinct. Even in cases of similar mutations, variance in the penetrance and age at onset was observed. The mean age at death for the patients in this cohort was 42.4 ± 13.5 years, and variability was observed in the Kaplan–Meier curves. We present a precise summary of the phenotypes for the frequent VHL mutations in the largest Chinese VHL cohort, which provides valuable strategies for genetic counseling and clinical surveillance of VHL individuals.
Collapse
Affiliation(s)
- Baoan Hong
- Department of Urology, Peking University First Hospital, Beijing, China.,Hereditary Kidney Cancer Research Center, Peking University First Hospital, Beijing, China.,Institute of Urology, Peking University, Beijing, China.,National Urological Cancer Center, Beijing, China.,Department of Urology, Beijing Cancer Hospital, Beijing, China.,Beijing Institute for Cancer Research, Beijing, China
| | - Kaifang Ma
- Department of Urology, Peking University First Hospital, Beijing, China.,Hereditary Kidney Cancer Research Center, Peking University First Hospital, Beijing, China.,Institute of Urology, Peking University, Beijing, China.,National Urological Cancer Center, Beijing, China
| | - Jingcheng Zhou
- Department of Urology, Peking University First Hospital, Beijing, China.,Hereditary Kidney Cancer Research Center, Peking University First Hospital, Beijing, China.,Institute of Urology, Peking University, Beijing, China.,National Urological Cancer Center, Beijing, China
| | - Jiufeng Zhang
- Department of Urology, Peking University First Hospital, Beijing, China.,Hereditary Kidney Cancer Research Center, Peking University First Hospital, Beijing, China.,Institute of Urology, Peking University, Beijing, China.,National Urological Cancer Center, Beijing, China
| | - Jiangyi Wang
- Department of Urology, Peking University First Hospital, Beijing, China.,Hereditary Kidney Cancer Research Center, Peking University First Hospital, Beijing, China.,Institute of Urology, Peking University, Beijing, China.,National Urological Cancer Center, Beijing, China
| | - Shengjie Liu
- Department of Urology, Peking University First Hospital, Beijing, China.,Hereditary Kidney Cancer Research Center, Peking University First Hospital, Beijing, China.,Institute of Urology, Peking University, Beijing, China.,National Urological Cancer Center, Beijing, China
| | - Zhongyuan Zhang
- Department of Urology, Peking University First Hospital, Beijing, China.,Hereditary Kidney Cancer Research Center, Peking University First Hospital, Beijing, China.,Institute of Urology, Peking University, Beijing, China.,National Urological Cancer Center, Beijing, China
| | - Lin Cai
- Department of Urology, Peking University First Hospital, Beijing, China.,Hereditary Kidney Cancer Research Center, Peking University First Hospital, Beijing, China.,Institute of Urology, Peking University, Beijing, China.,National Urological Cancer Center, Beijing, China
| | - Ning Zhang
- Department of Urology, Beijing Cancer Hospital, Beijing, China.,Beijing Institute for Cancer Research, Beijing, China
| | - Kan Gong
- Department of Urology, Peking University First Hospital, Beijing, China.,Hereditary Kidney Cancer Research Center, Peking University First Hospital, Beijing, China.,Institute of Urology, Peking University, Beijing, China.,National Urological Cancer Center, Beijing, China
| |
Collapse
|
3
|
Liu Q, Yuan G, Tong D, Liu G, Yi Y, Zhang J, Zhang Y, Wang LA, Wang L, Zhang D, Chen R, Guan Y, Yi X, Lan W, Jiang J. Novel genotype-phenotype correlations in five Chinese families with Von Hippel-Lindau disease. Endocr Connect 2018; 7:870-878. [PMID: 29871882 PMCID: PMC6026882 DOI: 10.1530/ec-18-0167] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Accepted: 06/04/2018] [Indexed: 11/25/2022]
Abstract
CONTEXT Von Hippel-Lindau (VHL) disease manifests as a variety of benign and malignant neoplasms. Previous studies of VHL disease have documented several genotype-phenotype correlations; however, many such correlations are still unknown. Increased identification of new mutations and patients with previously described mutations will allow us to better understand how VHL mutations influence disease phenotypes. PATIENTS AND DESIGN A total of 45 individuals from five unrelated families were evaluated, of which 21 patients were either diagnosed with VHL disease or showed strong evidence related to this disease. We compared the patients' gene sequencing results with their medical records including CT or MRI scans, eye examinations and laboratory/pathological examinations. Patients were also interviewed to obtain information regarding their family history. RESULTS We identified four missense mutations: c.239G>T (p.Ser80Ile), linked with VHL Type 2B, was associated with renal cell carcinoma, pheochromocytoma and hemangioma in the cerebellum; c.232A>T (p.Asn78Tyr) manifested as RCC alone and likely caused VHL Type 1; c.500G>A (p.Arg167Gln) mutation was more likely to cause VHL Type 2 than Type 1 as it preferentially induced Pheo and HB in the retina, cerebellum and spinal cord; c.293A>G (p.Try98Cys) was associated with Pheo and thus likely induced VHL Type 2. CONCLUSIONS Characterizing VHL disease genotype-phenotype correlations can enhance the ability to predict the risk of individual patients developing different VHL-related phenotypes. Ultimately, such insight will improve the diagnostics, surveillance and treatment of VHL patients. PRECIS Four missense mutations in VHL have been identified in 21 individuals when five unrelated Chinese families with VHL disease were analyzed; VHL mutations are highly associated with unique disease phenotypes.
Collapse
Affiliation(s)
- Qiuli Liu
- Department of UrologyInstitute of Surgery Research, Daping Hospital, Third Military Medical University, Chongqing, People's Republic of China
| | - Gang Yuan
- Department of UrologyInstitute of Surgery Research, Daping Hospital, Third Military Medical University, Chongqing, People's Republic of China
| | - Dali Tong
- Department of UrologyInstitute of Surgery Research, Daping Hospital, Third Military Medical University, Chongqing, People's Republic of China
| | - Gaolei Liu
- Department of UrologyInstitute of Surgery Research, Daping Hospital, Third Military Medical University, Chongqing, People's Republic of China
| | - Yuting Yi
- Geneplus-Beijing InstituteBeijing, People's Republic of China
| | - Jun Zhang
- Department of UrologyInstitute of Surgery Research, Daping Hospital, Third Military Medical University, Chongqing, People's Republic of China
| | - Yao Zhang
- Department of UrologyInstitute of Surgery Research, Daping Hospital, Third Military Medical University, Chongqing, People's Republic of China
| | - Lin-Ang Wang
- Department of UrologyInstitute of Surgery Research, Daping Hospital, Third Military Medical University, Chongqing, People's Republic of China
| | - Luofu Wang
- Department of UrologyInstitute of Surgery Research, Daping Hospital, Third Military Medical University, Chongqing, People's Republic of China
| | - Dianzheng Zhang
- Department of Bio-Medical SciencesPhiladelphia College of Osteopathic Medicine, Philadelphia, Pennsylvania, USA
| | - Rongrong Chen
- Geneplus-Beijing InstituteBeijing, People's Republic of China
| | - Yanfang Guan
- Geneplus-Beijing InstituteBeijing, People's Republic of China
| | - Xin Yi
- Geneplus-Beijing InstituteBeijing, People's Republic of China
| | - Weihua Lan
- Department of UrologyInstitute of Surgery Research, Daping Hospital, Third Military Medical University, Chongqing, People's Republic of China
| | - Jun Jiang
- Department of UrologyInstitute of Surgery Research, Daping Hospital, Third Military Medical University, Chongqing, People's Republic of China
| |
Collapse
|
4
|
Wang Y, Liang G, Tian J, Wang X, Chen A, Liang T, Du Y, Li H, Du J, Yu L, Chen Z. Pedigree analysis, diagnosis and treatment in Von Hippel-Lindau syndrome: A report of three cases. Oncol Lett 2018; 15:4882-4890. [PMID: 29616089 PMCID: PMC5876499 DOI: 10.3892/ol.2018.7957] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Accepted: 02/17/2017] [Indexed: 11/08/2022] Open
Abstract
The objective of the present study was to systematically investigate the clinical features, diagnosis and therapeutic treatment of Von Hippel-Lindau (VHL) syndrome in order to improve understanding of this disease. A total of 3 cases of VHL syndrome treated at the Affiliated Hospital of Zunyi Medical College (Zunyi, China) between September 2014 and October 2015 were retrospectively analyzed. The associated literature was reviewed, and the diagnostic and therapeutic features were discussed. Case 1 was diagnosed as VHL syndrome accompanied by a renal tumor on the right side, and radical tumor resection in the right kidney was performed. Postoperative pathological examination indicated clear cell carcinoma. Case 2 was diagnosed as VHL syndrome accompanied by bilateral adrenal pheochromocytoma. The left-side adrenal tumor was removed, and postoperative pathological analysis was suggestive of adrenal pheochromocytoma. Case 3 visited the hospital due to the presence of masses on the left and right sides of the kidney, but did not undergo surgery for personal reasons. Follow-ups were scheduled subsequent to surgery at another hospital. The diagnosis in all 3 cases was confirmed by genetic testing, where VHL mutations were detected in all patients. Following surgery, pedigree and genetic analysis was performed in all 3 pedigrees and VHL mutations were identified in 7 family members. The diagnosis of VHL syndrome should be based on the clinical manifestation of the patients and the results of genetic tests. DNA analysis of mutations is the main method for diagnosis. An appropriate surgical plan should be formulated based on the site, size and number of tumors, and the condition of the patient. Since VHL syndrome is an inheritable genetic disorder and relapse following surgery is common, pedigree analysis of the patient and lifelong follow-ups are essential. Additionally, physicians should pay attention to VHL syndrome in order to avoid missing diagnosis or misdiagnosis.
Collapse
Affiliation(s)
- Yuanliang Wang
- Department of Urology, Affiliated Hospital of Zunyi Medical College, Zunyi, Guizhou 563000, P.R. China
| | - Guobiao Liang
- Department of Urology, Affiliated Hospital of Zunyi Medical College, Zunyi, Guizhou 563000, P.R. China
| | - Jing Tian
- Department of Anesthesiology, Affiliated Hospital of Zunyi Medical College, Zunyi, Guizhou 563000, P.R. China
| | - Xin Wang
- Department of Urology, Affiliated Hospital of Zunyi Medical College, Zunyi, Guizhou 563000, P.R. China
| | - Anjian Chen
- Department of Urology, Affiliated Hospital of Zunyi Medical College, Zunyi, Guizhou 563000, P.R. China
| | - Tiancai Liang
- Department of Urology, Affiliated Hospital of Zunyi Medical College, Zunyi, Guizhou 563000, P.R. China
| | - Yang Du
- Department of Urology, Affiliated Hospital of Zunyi Medical College, Zunyi, Guizhou 563000, P.R. China
| | - Hao Li
- Department of Urology, Affiliated Hospital of Zunyi Medical College, Zunyi, Guizhou 563000, P.R. China
| | - Jiang Du
- Department of Urology, Affiliated Hospital of Zunyi Medical College, Zunyi, Guizhou 563000, P.R. China
| | - Lang Yu
- Department of Urology, Affiliated Hospital of Zunyi Medical College, Zunyi, Guizhou 563000, P.R. China
| | - Zongping Chen
- Department of Urology, Affiliated Hospital of Zunyi Medical College, Zunyi, Guizhou 563000, P.R. China
| |
Collapse
|
5
|
VHL mosaicism can be detected by clinical next-generation sequencing and is not restricted to patients with a mild phenotype. Eur J Hum Genet 2013; 22:1149-52. [PMID: 24301059 DOI: 10.1038/ejhg.2013.279] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2013] [Revised: 10/24/2013] [Accepted: 10/30/2013] [Indexed: 11/08/2022] Open
Abstract
The identification of Von Hippel-Lindau (VHL) mosaic mutations by conventional Sanger sequencing requires a labour-intensive enrichment step, thus explaining that mosaicism occurrence is underestimated in patients. Nowadays, it is possible to detect mutation in cell sub-populations by next-generation sequencing (NGS). Here, we described a diagnosis strategy using NGS with high coverage in a series of eight patients who were negative for a VHL abnormality by Sanger sequencing and deletion search. In two patients, a mosaic mutation in VHL was detected by NGS. One patient with a 5.7% mutated allele frequency had a severe phenotype and an early disease onset. In conclusion, clinical NGS in an hospital molecular oncogenetics laboratory is an efficient tool to identify VHL mosaic mutation. Its use may improve patient monitoring and genetic counseling.
Collapse
|
6
|
Ebenazer A, Rajaratnam S, Pai R. Detection of large deletions in the VHL gene using a Real-Time PCR with SYBR Green. Fam Cancer 2013; 12:519-24. [DOI: 10.1007/s10689-013-9606-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|