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Kim YN, Kim MK, Lee YJ, Lee Y, Sohn JY, Lee JY, Choi MC, Kim M, Jung SG, Joo WD, Lee C. Identification of Lynch Syndrome in Patients with Endometrial Cancer Based on a Germline Next Generation Sequencing Multigene Panel Test. Cancers (Basel) 2022; 14:cancers14143406. [PMID: 35884469 PMCID: PMC9316192 DOI: 10.3390/cancers14143406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 07/11/2022] [Accepted: 07/12/2022] [Indexed: 12/04/2022] Open
Abstract
We aimed to investigate the prevalence and relative contributions of LS and non-LS mutations in patients with endometrial cancer in Korea. We retrospectively reviewed the medical records of 204 patients diagnosed with endometrial cancer who underwent a germline next generation sequencing multigene panel test covering MLH1, MSH2, MSH6, PMS2, and EPCAM at three tertiary centers. Thirty patients (14.7%) with pathogenic mutations (12 MLH1; 6 MSH2; 10 MSH6; 2 PMS2) and 20 patients (9.8%) with 22 unclassified variants (8 MLH1; 8 MSH2; 2 MSH6; 3 PMS2; 1 EPCAM) were identified. After excluding four close relatives of a proband, the prevalence of LS was 13.0% (26/200). Patients with LS were more likely than those with sporadic cancer to be younger at diagnosis (48 vs. 53 years, p = 0.045) and meet the Amsterdam II criteria (66.7 vs. 3.5%, p < 0.001). Non-endometrioid histology was more prevalent in patients with MSH6 or PMS2 mutations (41.7%) than those with MLH1 or MSH2 mutations (5.6%, p = 0.026). In this pre-selected cohort of endometrial cancer patients who underwent next generation sequencing, the prevalence of LS was 13%, thus supporting the use of gene panel testing for endometrial cancer patients.
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Affiliation(s)
- Yoo-Na Kim
- Department of Obstetrics and Gynecology, Institute of Women’s Life Medical Science, Yonsei University College of Medicine, Seoul 03722, Korea; (Y.-N.K.); (Y.J.L.)
| | - Min Kyu Kim
- Division of Gynecologic Oncology, Department of Obstetrics & Gynecology, Samsung Changwon Hospital, Sungkyunkwan University of Medicine, Changwon 51353, Korea; (M.K.K.); (Y.L.)
| | - Young Joo Lee
- Department of Obstetrics and Gynecology, Institute of Women’s Life Medical Science, Yonsei University College of Medicine, Seoul 03722, Korea; (Y.-N.K.); (Y.J.L.)
| | - Youngeun Lee
- Division of Gynecologic Oncology, Department of Obstetrics & Gynecology, Samsung Changwon Hospital, Sungkyunkwan University of Medicine, Changwon 51353, Korea; (M.K.K.); (Y.L.)
| | - Ji Yeon Sohn
- Department of Laboratory Medicine, Eone Laboratories, Incheon 22014, Korea;
| | - Jung-Yun Lee
- Department of Obstetrics and Gynecology, Institute of Women’s Life Medical Science, Yonsei University College of Medicine, Seoul 03722, Korea; (Y.-N.K.); (Y.J.L.)
- Correspondence: (J.-Y.L.); (M.C.C.); Tel.: +82-2-2228-2237 (J.-Y.L.); +82-31-780-6191 (M.C.C.)
| | - Min Chul Choi
- Comprehensive Gynecologic Cancer Center, CHA Bundang Medical Center, CHA University, Seongnam 13496, Korea; (M.K.); (S.G.J.); (W.D.J.); (C.L.)
- Correspondence: (J.-Y.L.); (M.C.C.); Tel.: +82-2-2228-2237 (J.-Y.L.); +82-31-780-6191 (M.C.C.)
| | - Migang Kim
- Comprehensive Gynecologic Cancer Center, CHA Bundang Medical Center, CHA University, Seongnam 13496, Korea; (M.K.); (S.G.J.); (W.D.J.); (C.L.)
| | - Sang Geun Jung
- Comprehensive Gynecologic Cancer Center, CHA Bundang Medical Center, CHA University, Seongnam 13496, Korea; (M.K.); (S.G.J.); (W.D.J.); (C.L.)
| | - Won Duk Joo
- Comprehensive Gynecologic Cancer Center, CHA Bundang Medical Center, CHA University, Seongnam 13496, Korea; (M.K.); (S.G.J.); (W.D.J.); (C.L.)
| | - Chan Lee
- Comprehensive Gynecologic Cancer Center, CHA Bundang Medical Center, CHA University, Seongnam 13496, Korea; (M.K.); (S.G.J.); (W.D.J.); (C.L.)
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Jung YJ, Kim HR, Kim MK, Lee EJ. A novel germline mutation in hMLH1 in three Korean women with endometrial cancer in a family of Lynch syndrome: case report and literature review. Hered Cancer Clin Pract 2021; 19:28. [PMID: 34082788 PMCID: PMC8176696 DOI: 10.1186/s13053-021-00185-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 05/25/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Endometrial cancer is often the sentinel cancer in women with Lynch syndrome, among which endometrioid endometrial cancer is the most common. We found a Korean case of uterine carcinosarcoma associated with Lynch syndrome. And we reviewed 27 Korean women with endometrial cancer associated with Lynch syndrome already released in case report so far. CASE PRESENTATION The proband, a 45-year-old Korean woman received treatment for endometrioid adenocarcinoma. Her older sister and niece were treated for endometrioid adenocarcinoma and carcinosarcoma, respectively. Family history met the Amsterdam II criteria and immunohistochemical analysis revealed a loss of MLH1 and PMS2. They all harbored a previously unreported germline likely pathogenic variant in c.1367delC in MLH1. They underwent staging operations including total hysterectomy, bilateral salpingo-oophorectomy, pelvic/paraaortic lymph node dissection, and washing cytology. All three women were healthy without evidence of relapse for over 4 years. CONCLUSION This report indicates a novel germline c.1367delC variant in MLH1, and presents a Korean case of uterine carcinosarcoma associated with Lynch syndrome. Furthermore, the c.1757_1758insC variant in MLH1 was suggested as a founder mutation in Lynch syndrome in Korean women.
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Affiliation(s)
- Youn-Joon Jung
- Department of Obstetrics and Gynecology, Chung-Ang University College of Medicine, 102 Heukseok-ro, Dongjak-gu, Seoul, 06973, South Korea
| | - Hye Ryoun Kim
- Department of Laboratory Medicine, Chung-Ang University College of Medicine, 102 Heukseok-ro, Dongjak-gu, Seoul, 06973, South Korea
| | - Mi Kyung Kim
- Department of Pathology, Chung-Ang University College of Medicine, 102 Heukseok-ro, Dongjak-gu, Seoul, 06973, South Korea
| | - Eun-Ju Lee
- Department of Obstetrics and Gynecology, Chung-Ang University College of Medicine, 102 Heukseok-ro, Dongjak-gu, Seoul, 06973, South Korea.
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Lim MC, Won YJ, Lim J, Salehi T, Yoo CW, Bristow RE. Second primary cancer after primary peritoneal, epithelial ovarian, and fallopian tubal cancer: a retrospective study. BMC Cancer 2018; 18:800. [PMID: 30089478 PMCID: PMC6083613 DOI: 10.1186/s12885-018-4700-3] [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] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Accepted: 07/27/2018] [Indexed: 02/06/2023] Open
Abstract
Background In this retrospective study, data from patients listed in the Korea Central Cancer Registry during 1993–2014 were analysed, to investigate the incidence and survival of second primary cancers (SPCs) after a diagnosis of primary peritoneal, epithelial ovarian, and fallopian tubal (POFT) cancer. Methods The standardised incidence ratio (SIR) and survival outcomes of patients with SPCs among POFT cancer survivors were analysed. Results Among 20,738 POFT cancer survivors, 798 (3.84%) developed SPCs, at an average interval of 5.50 years. SPC risk in POFT survivors (SIR, 1.29) was higher compared to the general population. The most high-risk type of SPC was leukaemia (3.07) followed by the lung and bronchus (1.80), colon (1.58), rectum and rectosigmoid junction (1.42), thyroid (1.34), and breast (1.26). In women aged < 60 years, cancer of the breast (1.30), ascending colon (2.26), and transverse colon (4.07) as SPCs increased. Up to 10 years after POFT cancer treatment, leukaemia risk increased, especially in those < 60 years, with serous histology, and with distant stage, which required aggressive chemotherapy. The median overall survival time was 12.8 years and 14.3 years in women with POFT cancer and SPCs, respectively. Thyroid and breast cancers were favourable prognostic markers among SPCs. Conclusions The overall SPC risk increases in POFT cancer survivors, especially in those < 60 years. The cancer risk of breast and the proximal colon increase based on hereditary predisposition, while leukaemia likely develops from aggressive treatment. The median overall survival is favourable in POFT cancer survivors with SPCs. Electronic supplementary material The online version of this article (10.1186/s12885-018-4700-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Myong Cheol Lim
- Division of Gynecologic Oncology, Obstetrics and Gynecology, Irvine Medical Center, University of California, California, USA.,Center for Uterine Cancer and Center for Clinical Trials, Hospital, National Cancer Center, Goyang, Republic of Korea.,Cancer Healthcare Research Branch, Research Institute, National Cancer Center, Goyang, Republic of Korea.,Department of Cancer Control & Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Republic of Korea
| | - Young-Joo Won
- Department of Cancer Control & Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Republic of Korea. .,Cancer Registration and Statistics Branch, National Cancer Control Institute, National Cancer Center, Goyang, Republic of Korea.
| | - Jiwon Lim
- Cancer Registration and Statistics Branch, National Cancer Control Institute, National Cancer Center, Goyang, Republic of Korea
| | - Tahereh Salehi
- Division of Gynecologic Oncology, Obstetrics and Gynecology, Irvine Medical Center, University of California, California, USA
| | - Chong Woo Yoo
- Center for Uterine Cancer and Center for Clinical Trials, Hospital, National Cancer Center, Goyang, Republic of Korea
| | - Robert E Bristow
- Division of Gynecologic Oncology, Obstetrics and Gynecology, Irvine Medical Center, University of California, California, USA
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Shaw J, Bulsara C, Cohen PA, Gryta M, Nichols CB, Schofield L, O'Sullivan S, Pachter N, Hardcastle SJ. Investigating barriers to genetic counseling and germline mutation testing in women with suspected hereditary breast and ovarian cancer syndrome and Lynch syndrome. PATIENT EDUCATION AND COUNSELING 2018; 101:938-944. [PMID: 29273311 DOI: 10.1016/j.pec.2017.12.011] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Revised: 12/01/2017] [Accepted: 12/11/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE The aim of the current study was to explore barriers to genetic counseling and testing in women with gynecological cancers deemed at significant risk of carrying a germline mutation. METHODS A qualitative study using semi-structured interviews and inductively analysed thematically. Eight patients with ovarian or endometrial cancer participated in individual semi-structured telephone interviews that assessed motivation for genetic counseling and testing, perceived benefits and barriers, timing of the approach, perceptions of the referral process to genetic services and locus of control in relation to cancer and health. RESULTS Analysis of the interview transcripts revealed five themes relating to perceptions of genetic counseling and testing: Lack of importance; Level of information received; Timing of referral processes; Fear and anxiety; Resistance to and perceptions of counseling. CONCLUSIONS Participants had a limited understanding of hereditary cancer syndromes and did not appreciate the benefits of genetic testing. A consistent approach at the time of referral to genetic services is needed to ensure that the level and format of information is appropriate for patients. PRACTICE IMPLICATIONS The rationale for genetic testing needs to be better explained to patients and the timing of referral should be based both on treatment priorities and patient preferences.
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Affiliation(s)
- Josephine Shaw
- St. John of God Subiaco Hospital, Subiaco, Western Australia, Australia
| | - Caroline Bulsara
- Institute for Health Research, University of Notre Dame Australia, Fremantle, Western Australia, Australia
| | - Paul A Cohen
- St. John of God Subiaco Hospital, Subiaco, Western Australia, Australia; Institute for Health Research, University of Notre Dame Australia, Fremantle, Western Australia, Australia; Division of Women's and Infants' Health, School of Medicine, University of Western Australia, Crawley, Western Australia, Australia.
| | - Madeleine Gryta
- School of Medicine, University of Notre Dame Australia, Fremantle, Western Australia, Australia
| | - Cassandra B Nichols
- Genetic Services of Western Australia, Subiaco, Western Australia, Australia; Inherited Cancer Connect Partnership (ICCon)
| | - Lyn Schofield
- Genetic Services of Western Australia, Subiaco, Western Australia, Australia
| | - Sarah O'Sullivan
- Genetic Services of Western Australia, Subiaco, Western Australia, Australia; WOMEN Centre, West Leederville, Western Australia, Australia
| | - Nicholas Pachter
- Genetic Services of Western Australia, Subiaco, Western Australia, Australia; School of Paediatrics and Child Health, University of Western Australia, Australia; School of Medicine and Pharmacology, University of Western Australia, Australia
| | - Sarah J Hardcastle
- Health Psychology and Behavioural Medicine Research Group, School of Psychology and Speech Pathology, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
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Assessment of DNA repair susceptibility genes identified by whole exome sequencing in head and neck cancer. DNA Repair (Amst) 2018; 66-67:50-63. [PMID: 29747023 DOI: 10.1016/j.dnarep.2018.04.005] [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: 02/20/2018] [Revised: 04/24/2018] [Accepted: 04/24/2018] [Indexed: 12/31/2022]
Abstract
Head and neck cancer (HNC), the sixth most common cancer globally, stands second in India. In Northeast (NE) India, it is the sixth most common cause of death in males and seventh in females. Prolonged tobacco and alcohol consumption constitute the major etiological factors for HNC development, which induce DNA damage. Therefore, DNA repair pathway is a crucial system in maintaining genomic integrity and preventing carcinogenesis. The present work was aimed to predict the consequence of significant germline variants of the DNA repair genes in disease predisposition. Whole exome sequencing was performed in Ion Proton™ platform on 15 case-control samples from the HNC-prevalent states of Manipur, Mizoram, and Nagaland. Variant annotation was done in Ion Reporter™ as well as wANNOVAR. Subsequent statistical and bioinformatics analysis identified significant exonic and intronic variants associated with HNC. Amongst our observed variants, 78.6% occurred in ExAC, 94% reported in dbSNP and 5.8% & 9.3% variants were present in ClinVar and HGMD, respectively. The total variants were dispersed among 199 genes with DSBR and FA pathway being the most mutated pathways. The allelic association test suggested that the intronic variants in HLTF and RAD52 gene significantly associated (P < 0.05) with the risk (OR > 5), while intronic variants in PARP4, RECQL5, EXO1 and PER1 genes and exonic variant in TDP2 gene showed protection (OR < 1) for HNC. MDR analysis proposed the exonic variants in MSH6, BRCA2, PALB2 and TP53 genes and intronic variant in RECQL5 genetic region working together during certain phase of DNA repair mechanism for HNC causation. In addition, other intronic and 3'UTR variations caused modifications in the transcription factor binding sites and miRNA target sites associated with HNC. Large-scale validation in NE Indian population, in-depth structure prediction and subsequent simulation of our recognized polymorphisms is necessary to identify true causal variants related to HNC.
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Lee HJ, Choi MC, Jang JH, Jung SG, Park H, Joo WD, Kim TH, Lee C, Lee JH. Clinicopathologic characteristics of double primary endometrial and colorectal cancers in a single institution. J Obstet Gynaecol Res 2018; 44:944-950. [PMID: 29442399 DOI: 10.1111/jog.13603] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Accepted: 12/31/2017] [Indexed: 01/13/2023]
Abstract
AIM To investigate the clinicopathologic and genetic correlations between double primary endometrial and colorectal cancer related to Lynch syndrome and to analyze germline mutations in mismatch repair genes in endometrial cancer patients in Korea. METHODS Thirteen patients diagnosed with pathologically endometrial and colorectal cancer between January 2005 and November 2016 in a single institution were enrolled in the study. The medical records were retrospectively analyzed. The genetic mutational information of endometrial cancer in Korea was retrieved from the literature review. RESULTS Endometrial cancer was diagnosed first in eight (62%) patients, and one patient was diagnosed with colorectal cancer first. Endometrioid adenocarcinoma was reported in 10 of 13 (77%) endometrial cancer patients. Endometrial cancer was found at the low uterine segment in three patients. Three of four patients had high microsatellite instability. The loss of mismatch repair proteins was confirmed in 7 of 11 cases using immunohistochemistry. Four patients fulfilled clinical criteria based on a family history of cancer. Overall, the incidence of suspected Lynch syndrome was 77% (10/13). Four of them underwent genetic testing and three were found to have a pathogenic germline mutation. A possible founder mutation, c.1757_1758insC in MLH1, was observed in 21 germline mutation information from literature review. CONCLUSION The present study describes the clinicopathologic data of double primary endometrial and colorectal cancer patients and supports that these patients should undergo closed approach for Lynch syndrome. Moreover, a possible founder mutation in Korean endometrial cancer patients was identified.
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Affiliation(s)
- Hyun J Lee
- Comprehensive Gynecologic Cancer Center, Department of Obstetrics and Gynecology, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Min C Choi
- Comprehensive Gynecologic Cancer Center, Department of Obstetrics and Gynecology, CHA Bundang Medical Center, CHA University, Seongnam, Korea.,Hereditary Gynecologic Cancer Clinic, Precision Medicine Center, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | | | - Sang G Jung
- Comprehensive Gynecologic Cancer Center, Department of Obstetrics and Gynecology, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Hyun Park
- Comprehensive Gynecologic Cancer Center, Department of Obstetrics and Gynecology, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Won D Joo
- Comprehensive Gynecologic Cancer Center, Department of Obstetrics and Gynecology, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Tae H Kim
- Hereditary Gynecologic Cancer Clinic, Precision Medicine Center, CHA Bundang Medical Center, CHA University, Seongnam, Korea.,Department of Pathology, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Chan Lee
- Comprehensive Gynecologic Cancer Center, Department of Obstetrics and Gynecology, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Je H Lee
- Comprehensive Gynecologic Cancer Center, Department of Obstetrics and Gynecology, CHA Bundang Medical Center, CHA University, Seongnam, Korea.,Hereditary Gynecologic Cancer Clinic, Precision Medicine Center, CHA Bundang Medical Center, CHA University, Seongnam, Korea
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Lim MC, Won YJ, Lim J, Seo SS, Kang S, Yoo CW, Kim JY, Oh JH, Bristow RE, Park SY. Second primary colorectal cancer among endometrial cancer survivor: shared etiology and treatment sequelae. J Cancer Res Clin Oncol 2018; 144:845-854. [PMID: 29445866 PMCID: PMC5916981 DOI: 10.1007/s00432-018-2599-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2018] [Accepted: 01/29/2018] [Indexed: 11/26/2022]
Abstract
Purpose To evaluate the incidence of colon cancer as a second primary cancer (CCSPC) and the survival outcomes of women with and without CCSPC after the diagnosis of endometrial cancer (EC). Methods The standardized incidence ratio (SIR) of CCSPC and survival outcomes of EC survivors with and without CCSPC were analyzed using data from January 1 1993 to December 31 2011, obtained from the Korea Central Cancer Registry. Results Of 14,797 EC survivors, 147 (0.99%) developed CCSPC after an average interval of 5.5 years. The SIR of CCSPC among EC survivors was 2.56, higher than that of colon cancer in the general population. The SIR of CCSPC was highest for the ascending (3.77), followed by the transverse (3.45), descending colon (2.06), and rectum (1.99). The risk of a proximal site of CCSPC was high, especially within 5 years after the diagnosis of EC in the ascending (SIR, 4.37) and transverse (4.91) colon, and in young survivors (< 60 years) in the ascending (5.19) and transverse (3.82) colon. The 5- and 10-year overall survival rates were 84.8 and 80.4% among survivors with EC only and 89.2 and 76.3% for survivors with CCSPC, respectively. Conclusions The risk of CCSPC among EC survivors increases especially in the proximal colon in young survivors. These results could be used for surveillance and counseling of EC survivors.
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Affiliation(s)
- Myong Cheol Lim
- Cancer Healthcare Research Branch, Research Institute, National Cancer Center, Goyang, Republic of Korea
- Center for Uterine Cancer, Hospital, National Cancer Center, Goyang, Republic of Korea
- Center for Clinical Trials, Hospital, National Cancer Center, Goyang, Republic of Korea
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Republic of Korea
- Division of Gynecologic Oncology, Obstetrics and Gynecology, Irvine Medical Center, University of California, California, USA
| | - Young-Joo Won
- Cancer Registration and Statistics Branch, National Cancer Control Institute, National Cancer Center, Goyang, Republic of Korea.
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Republic of Korea.
| | - Jiwon Lim
- Cancer Registration and Statistics Branch, National Cancer Control Institute, National Cancer Center, Goyang, Republic of Korea
| | - Sang-Soo Seo
- Center for Uterine Cancer, Hospital, National Cancer Center, Goyang, Republic of Korea
| | - Sokbom Kang
- Precision Medicine Branch, Research Institute, National Cancer Center, Goyang, Republic of Korea
- Center for Uterine Cancer, Hospital, National Cancer Center, Goyang, Republic of Korea
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Republic of Korea
| | - Chong Woo Yoo
- Center for Uterine Cancer, Hospital, National Cancer Center, Goyang, Republic of Korea
| | - Joo-Young Kim
- Center for Uterine Cancer, Hospital, National Cancer Center, Goyang, Republic of Korea
- Department of Cancer Biomedical Science, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Republic of Korea
| | - Jae Hwan Oh
- Common Cancer Branch, Research Institute, National Cancer Center, Goyang, Republic of Korea
- Center for Colorectal Cancer, Hospital, National Cancer Center, Goyang, Republic of Korea
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Republic of Korea
| | - Robert E Bristow
- Division of Gynecologic Oncology, Obstetrics and Gynecology, Irvine Medical Center, University of California, California, USA
| | - Sang-Yoon Park
- Common Cancer Branch, Research Institute, National Cancer Center, Goyang, Republic of Korea
- Center for Uterine Cancer, Hospital, National Cancer Center, Goyang, Republic of Korea
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Lee HJ, Lee MH, Choi MC, Jung SG, Joo WD, Kim TH, Lee C, Jang JH. Case Report of Menopausal Woman Diagnosed with Endometrial Cancer after Colon Cancer with Germline Mutation in MSH6 in Korea. J Menopausal Med 2017; 23:69-73. [PMID: 28523262 PMCID: PMC5432470 DOI: 10.6118/jmm.2017.23.1.69] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Revised: 02/02/2017] [Accepted: 02/20/2017] [Indexed: 01/13/2023] Open
Abstract
We present a case of an endometrial cancer patient with germline mutation in MutS homolog 6 (MSH6), associated with Lynch syndrome. A 60-year-old Korean woman had a personal history of colon cancer 23 years ago. She also had a family history of endometrial cancer and colon cancer of her sisters and brothers. Immunohistochemistry was negative for MutL homolog 1 (MLH1) and positive for MutS homolog 2 (MSH2). Based on these findings, she underwent genetic counseling and testing that revealed a frameshift germline mutation at MSH6 (c. 3261dupC).
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Affiliation(s)
- Hyun Jung Lee
- Comprehensive Gynecologic Cancer Center, Department of Obstetrics and Gynecology, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Min Hee Lee
- Comprehensive Gynecologic Cancer Center, Department of Obstetrics and Gynecology, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Min Chul Choi
- Comprehensive Gynecologic Cancer Center, Department of Obstetrics and Gynecology, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Sang Geun Jung
- Comprehensive Gynecologic Cancer Center, Department of Obstetrics and Gynecology, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Won Duk Joo
- Comprehensive Gynecologic Cancer Center, Department of Obstetrics and Gynecology, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Tae Hoen Kim
- Department of Pathology, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Chan Lee
- Comprehensive Gynecologic Cancer Center, Department of Obstetrics and Gynecology, CHA Bundang Medical Center, CHA University, Seongnam, Korea
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Endometrial adenocarcinoma in a 13-year-old girl. Obstet Gynecol Sci 2016; 59:152-6. [PMID: 27004208 PMCID: PMC4796087 DOI: 10.5468/ogs.2016.59.2.152] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Revised: 09/02/2015] [Accepted: 09/05/2015] [Indexed: 12/11/2022] Open
Abstract
Endometrial cancer is the third most common gynecologic cancer in the Korea and occurs mainly in menopausal women. Although it can develop in young premenopausal women cancer as well, an attack in the adolescent girl is very rare. A 13-year-old girl visited gynecology department with the complaint of abnormal uterine bleeding. An endometrial biopsy revealed FIGO (International Federation of Gynecology and Obstetrics) grade II endometrial adenocarcinoma. In the treatment of endometrial cancer, conservative management should be considered if the patient is nulliparous or wants the fertility preservation. Therefore, we decided to perform a hormonal therapy and a follow-up endometrial biopsy after progestin administration for eight months revealed no residual tumor. We report a case of endometrial cancer occurred in a 13-year-old girl with a brief review of the literature.
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Survival outcome in endometrial cancer patients according to hereditary predisposition. Taiwan J Obstet Gynecol 2015; 54:24-8. [PMID: 25675915 DOI: 10.1016/j.tjog.2014.11.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/30/2014] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE A familial history of ovarian cancer/breast cancer is considered a significant prognostic factor for ovarian cancer. We investigated hereditary factors by examining the incidence of synchronous malignancy in patients with endometrial cancer, and assessed the prognostic role of heredity in endometrial cancer. METHODS We retrospectively evaluated patients with endometrial cancer who underwent surgery from January 2001 to April 2011. A hereditary background in this study was defined as double primary cancer, that is, endometrial cancer accompanied by colon, ovarian, or breast cancer suggestive of Lynch syndrome, hereditary breast ovarian cancer syndrome, or Cowden syndrome, respectively. RESULTS Among 282 patients with endometrial cancer in the study population, 20 patients (7.1%) had a hereditary predisposition: 10 patients (3.5%) had ovarian cancer, six patients (2.1%) had breast cancer, and four patients (1.4%) had colon cancer. Age and lower uterine segment involvement were not statistically different between the hereditary and nonhereditary groups. The majority of the women in the hereditary group presented with Stage I cancer; however, there were no significant differences in Stage I cancer between the hereditary group and the sporadic endometrial cancer group (85% and 77%, respectively, p = 0.561). The median follow-up period was 60 months. A 5-year overall survival rate was not different between the two groups (95% and 95%, respectively, p = 0.659). Among a subgroup of patients with Stage I endometrial cancer, the 5-year overall survival rate was lower in the endometrial cancer with a hereditary predisposition group compared with the sporadic endometrial cancer group (94% and 98%, respectively, p = 0.027). CONCLUSION Seven percent of the women with endometrial cancer in our study had other malignancies such as ovarian, colon, or breast cancer synchronously. Among a subgroup of patients with Stage I cancer in the endometrial cancer with a hereditary predisposition group, the 5-year overall survival rate was significantly lower (94%). This finding should be confirmed in a larger population.
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The gynecological surveillance of women with Lynch syndrome in Sweden. Gynecol Oncol 2015; 138:717-22. [DOI: 10.1016/j.ygyno.2015.07.016] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2015] [Revised: 07/09/2015] [Accepted: 07/10/2015] [Indexed: 12/11/2022]
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Tangjitgamol S, Khunnarong J, Srijaipracharoen S. Synchronous and metachronous malignancy in endometrial cancer patients treated in a tertiary care center of Thailand. J Gynecol Oncol 2015. [PMID: 26197770 PMCID: PMC4620366 DOI: 10.3802/jgo.2015.26.4.293] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Objective To evaluate the prevalence and features of non-endometrial cancers in Thai endometrial cancer (EC) patients. Methods EC patients treated in our institution were identified and the following data were collected: age, EC stage, histopathology, adjuvant therapy, other cancers, living status, and cause of death. Results The mean age of the 344 patients was 56.8±10.8 years. Fifty (14.5%) had other synchronous and metachronous cancers. Mean ages of the patients with or without other cancers were not significantly different, 55.7±10.04 years versus 57.1±11.0 years, respectively (p=0.358). History of any cancer in the family and tumor in the lower uterine segment were more frequent among the patients with other cancers (6.0% vs. 1.7%, p=0.095; 12.0% vs. 1.0%, p<0.001; respectively). Six patients had ≥2 other cancers. Ovarian, breast, and colon were the three most common other cancers. After a median follow-up of 57.1 months, 18.3% of patients had died: 30.0% of patients with other cancers and 16.3% of those without other cancers. The corresponding EC deaths were 14.0% and 11.2%. The 5-year overall survival was significantly lower in patients who had other cancers: 79.3% (95% confidence interval [CI], 68.3 to 90.3) vs. 86.0% (95% CI, 81.7 to 90.3) than in those without (p=0.023). However, the corresponding disease-specific survival was not significantly different: 85.1% (95% CI, 75.5 to 94.7) compared with 89.0% (95% CI, 85.1 to 92.9), respectively (p=0.514). Conclusion Thai EC patients had a high incidence of other cancers. Overall survival of EC patients who had other cancers was worse than those without, while disease-specific survival was not significantly different.
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Affiliation(s)
- Siriwan Tangjitgamol
- Department of Obstetrics and Gynecology, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand.
| | - Jakkapan Khunnarong
- Department of Obstetrics and Gynecology, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand
| | - Sunamchok Srijaipracharoen
- Department of Obstetrics and Gynecology, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand
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Characteristics of hereditary nonpolyposis colorectal cancer patients with double primary cancers in endometrium and colorectum. Obstet Gynecol Sci 2015; 58:112-6. [PMID: 25798424 PMCID: PMC4366863 DOI: 10.5468/ogs.2015.58.2.112] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2014] [Revised: 08/22/2014] [Accepted: 10/03/2014] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVE The hereditary nonpolyposis colorectal cancer is inherited syndrome characterized by the development of cancers in various organ system; these includes colorectum, endometrium, and less frequently, small bowel, stomach, urinary tract, ovaries, and brain. We aimed to investigate the clinicopathologic characteristics of hereditary nonpolyposis colorectal cancer patients who had both endometrial and colorectal cancers. METHODS Between January 2004 and December 2013, 12 women diagnosed with endometrial and colorectal cancers in a single institution were included in this analysis. For these patients, clinical and molecular findings were analyzed retrospectively. RESULTS All 12 women undertook microsatellite instability analysis, and 9 (75%) were confirmed of having microsatellite instability-high. Among 9 cases with immunohistochemical staining for MLH1 and MSH2, 6 were positive for the loss of mismatch repair protein. Mutational analyses for MLH1 and MSH2 were performed in 3 out of 12 patients; all of them showed germline mutation. CONCLUSION This study suggests that there is a genetic background in patients with double primary malignancies in their endometrium and colorectum when analyzed with microsatellite instability studies, immunohistochemistry staining, and mutation studies. This finding supports the necessity of re-defining the high-risk groups in endometrial cancers clinically. This will also help diagnose malignancies in such patients in early stages, as well as counsel other family members.
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Son Y, Lim MC, Seo SS, Kang S, Park SY. Completeness of pedigree and family cancer history for ovarian cancer patients. J Gynecol Oncol 2014; 25:342-8. [PMID: 25142628 PMCID: PMC4195306 DOI: 10.3802/jgo.2014.25.4.342] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2014] [Revised: 08/03/2014] [Accepted: 08/03/2014] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE To investigate the completeness of pedigree and of number of pedigree analysis to know the acceptable familial history in Korean women with ovarian cancer. METHODS Interview was conducted in 50 ovarian cancer patients for obtaining familial history three times over the 6 weeks. The completeness of pedigree is estimated in terms of familial history of disease (cancer), health status (health living, disease and death), and onset age of disease and death. RESULTS The completion of pedigree was 79.3, 85.1, and 85.6% at the 1st, 2nd, and 3rd time of interview and the time for pedigree analysis was 34.3, 10.8, and 3.1 minutes, respectively. The factors limiting pedigree analysis were as follows: out of contact with their relatives (38%), no living ancestors who know the family history (34%), dispersed family member because of the Korean War (16%), unknown cause of death (12%), reluctance to ask medical history of relatives (10%), and concealing their ovarian cancer (10%). The percentage of cancers revealed in 1st (2%) and 2nd degree (8%) relatives were increasing through surveys, especially colorectal cancer related with Lynch syndrome (4%). CONCLUSION Analysis of pedigree at least two times is acceptable in Korean woman with ovarian cancer from the first study. The completion of pedigree is increasing, while time to take family history is decreasing during three time survey.
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Affiliation(s)
- Yedong Son
- Center for Uterine Cancer, National Cancer Center, Goyang, Korea
| | - Myong Cheol Lim
- Center for Uterine Cancer, National Cancer Center, Goyang, Korea.
| | - Sang Soo Seo
- Center for Uterine Cancer, National Cancer Center, Goyang, Korea
| | - Sokbom Kang
- Center for Uterine Cancer, National Cancer Center, Goyang, Korea
| | - Sang Yoon Park
- Center for Uterine Cancer, National Cancer Center, Goyang, Korea.
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Challenges in assessing pathogenicity based on frequency of variants in mismatch repair genes: an extreme case of a MSH2 variant and a meta-analysis. Gene 2014; 546:421-4. [PMID: 24933000 DOI: 10.1016/j.gene.2014.06.027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2013] [Revised: 04/30/2014] [Accepted: 06/13/2014] [Indexed: 11/21/2022]
Abstract
The clinical interpretation of variants in mismatch repair (MMR) genes associated with Lynch syndrome can be confusing when the functional nature of the variant is not clearly defined. We report an extreme case where a polymorphism in the MSH2 gene which had a low minor allele frequency, was misclassified as a mutation based on low evidential methods in the database and previous publications. We expanded this experience to perform a systematic meta-analysis in order to investigate other variants that have potentially been misclassified. Our results suggested that the interpretation of pathogenicity should be more cautious and emphasized the need for solid validation through multiple analyses including functional analysis for variants in MMR genes.
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Tzortzatos G, Wersäll O, Danielsson KG, Lindblom A, Tham E, Mints M. Familial cancer among consecutive uterine cancer patients in Sweden. Hered Cancer Clin Pract 2014; 12:14. [PMID: 24851142 PMCID: PMC4029977 DOI: 10.1186/1897-4287-12-14] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2014] [Accepted: 04/25/2014] [Indexed: 01/25/2023] Open
Abstract
Background Uterine cancer (UC) represents 5.1% of all female malignancies in Sweden. Accumulation of UC in families occurs in around 5% of cases. We wanted to identify any familial association between UC and other selected cancers and to study the frequency of Lynch,Cowden and cancer syndromes among consecutive UC patients in Sweden. Methods 481 UC patients were included. Information on the cancer diagnoses of their relatives (first- (FDRs) and second-degree (SDRs) relatives and first cousins) was obtained. The relative frequencies of different cancers among relatives were compared to those in the Swedish general cancer population in 1970 and 2010. Families that fulfilled the criteria for hereditary cancer syndromes were tested for mutations in the causative genes. Families with at least one case of UC in addition to the index patient were compared to families with no additional cases to investigate possible characteristics of putative hereditary cancer syndromes. Results There was an increased prevalence of UC in our study population compared to the Swedish general cancer population in 1970 and 2010 (6% vs. 4% and 3%, respectively). Seven families had Lynch Syndrome according to the Amsterdam II criteria. No families fulfilled the criteria for Cowden syndrome. In total 13% of index patients had at least one relative with UC and these families tended to have more cases of early onset cancer among family members. In addition, 16% of index patients were diagnosed with at least one other cancer. No families fulfilled the criteria for Cowden syndrome. Conclusion We showed a familial clustering of UC among relatives of our index patients. Of the seven families with mutation-verified Lynch Syndrome, only one had been previously diagnosed, highlighting the need to increase gynecologists’ awareness of the importance of taking family history. Our data on multiple cancers and young age of onset in families with uterine cancer is compatible with the existence of additional hereditary uterine cancer syndromes.
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Affiliation(s)
- Gerasimos Tzortzatos
- Department of Women's and Children's Health, Division of Obstetrics and Gynecology, Karolinska Institutet, Karolinska University Hospital, Solna/Huddinge, Stockholm, Sweden ; Division of Obstetrics and Gynecology, Karolinska University Hospital Huddinge, Stockholm S-14186, Sweden
| | - Ofra Wersäll
- Department of Women's and Children's Health, Division of Obstetrics and Gynecology, Karolinska Institutet, Karolinska University Hospital, Solna/Huddinge, Stockholm, Sweden
| | - Kristina Gemzell Danielsson
- Department of Women's and Children's Health, Division of Obstetrics and Gynecology, Karolinska Institutet, Karolinska University Hospital, Solna/Huddinge, Stockholm, Sweden
| | - Annika Lindblom
- Department of Clinical Genetics, Karolinska Institutet, Karolinska University Hospital, Solna, Stockholm, Sweden ; Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Emma Tham
- Department of Clinical Genetics, Karolinska Institutet, Karolinska University Hospital, Solna, Stockholm, Sweden ; Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Miriam Mints
- Department of Women's and Children's Health, Division of Obstetrics and Gynecology, Karolinska Institutet, Karolinska University Hospital, Solna/Huddinge, Stockholm, Sweden
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Lim MC, Moon EK, Shin A, Jung KW, Won YJ, Seo SS, Kang S, Kim JW, Kim JY, Park SY. Incidence of cervical, endometrial, and ovarian cancer in Korea, 1999-2010. J Gynecol Oncol 2013; 24:298-302. [PMID: 24167664 PMCID: PMC3805909 DOI: 10.3802/jgo.2013.24.4.298] [Citation(s) in RCA: 101] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2013] [Accepted: 07/03/2013] [Indexed: 11/30/2022] Open
Abstract
Objective To investigate the recent incidence of and trends in cervical, endometrial, and ovarian cancer in Korean females. Methods Data from the Korea Central Cancer Registry between 1999 and 2010 were analyzed. Age-standardized rates (ASRs) and annual percent changes (APCs) were calculated. Results The absolute incidence rates of the three major gynecologic cancers increased: 6,394 in 1999 to 7,454 in 2010. The ASR for gynecologic cancer was 23.7 per 100,000 in 1999 and decreased to 21.0 in 2010 (APC, -1.1%; 95% confidence interval [CI], -1.53 to -0.70) due to a definitive decrease in the incidence of cervical cancer (APC, -4.3%). Endometrial cancer has been definitively increasing (APC, 6.9% during 1999-2010), especially in females <30 years old (APC, 11.2%) and in females ≥80 years old (APC, 9.5%). The incidence of ovarian cancer is increasing gradually (APC, 1.5%). Conclusion ASRs and APC for gynecologic cancers overall are decreasing due to the decrease in the incidence of cervical cancer. However, the incidence of endometrial and ovarian cancer has been increasing.
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Affiliation(s)
- Myong Cheol Lim
- Center for Uterine Cancer, National Cancer Center, Goyang, Korea
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Dekker N, van Dorst EBL, van der Luijt RB, van Gijn ME, van Tuil M, Offerhaus JA, Ausems MGEM. Acceptance of genetic counseling and testing in a hospital-based series of patients with gynecological cancer. J Genet Couns 2012. [PMID: 23192360 DOI: 10.1007/s10897-012-9553-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Referral of patients with endometrial (EC) and/or ovarian cancer (OC) for genetic counseling is based on age at diagnosis and family history. Many patients with hereditary cancers are missed by following this strategy. We determined acceptance and mutation detection rate of offering genetic counseling and testing to unselected EC and OC patients. Therefore, in 2007, EC and OC patients were invited for genetic counseling and testing. Patients were asked for their reasons to accept or decline. Nineteen out of fifty-two EC patients (36 %) and twenty-two out of thirty-five OC patients (63 %) accepted genetic counseling, mainly to receive risk assessment for themselves and relatives. Counseling was declined mainly because patients did not want more tests or had no relatives for whom it was relevant. Eighteen out of nineteen EC patients (95 %) and twenty out of twenty-two OC patients (91 %) underwent genetic testing. One EC patient carried an MSH6 mutation (mutation detection rate: 6 %). BRCA1/2 mutations were found in two out of twenty OC patients (10 %). Eleven patients (29 %) received surveillance recommendations for themselves and their relatives. Finally, family history recorded by the gynecologist was compared to that taken by the clinical geneticist. Gynecologists reported family history in ten out of forty-one participants (24 %). In conclusion, genetic counseling and testing are acceptable to patients with OC and/or EC. The 10 % BRCA1/2 mutation detection rate and underreporting of family history by gynecologists warrant referral for genetic counseling for all OC patients, followed by BRCA1/2 testing if indicated. We recommend that microsatellite instability and immunohistochemical analysis be performed in all EC patients, followed by genetic counseling if appropriate. These strategies will lead to better cancer prevention in gynecological cancer patients and their relatives.
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Affiliation(s)
- Nicky Dekker
- Department of Reproductive Medicine and Gynaecology, University Medical Center Utrecht, Utrecht, the Netherlands
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Correlation between body mass index and prevalence of hereditary nonpolyposis colorectal cancer in Korean patients with endometrial cancer. Int J Gynecol Cancer 2012; 22:267-72. [PMID: 22274318 DOI: 10.1097/igc.0b013e31823b3650] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE The purpose of the study was to investigate the relationship between body mass index (BMI) and hereditary nonpolyposis colorectal cancer (HNPCC) in Korean women with endometrial cancer. METHODS Among 227 patients with endometrial cancer in the study population, 20 patients (8.8%) had HNPCC. The patients were divided into 2 groups based on the BMI: nonobese (BMI ≤25 kg/m) and obese (BMI >25 kg/m); then the nonobese group was subdivided into 2 groups: normal weight (BMI <23 kg/m) and overweight (BMI, 23-25 kg/m). The distributions of BMI categories were compared between patients with sporadic endometrial cancer and with HNPCC-related endometrial cancer. RESULTS Among 207 patients with sporadic endometrial cancer, 119 (57.5%) were nonobese and 88 patients (42.5%) were obese. Of 20 patients with endometrial cancer related to HNPCC, 10 (50.0%) were nonobese and 10 (50.0%) were obese. In a subgroup analysis of only nonobese patients, 68 patients with sporadic endometrial cancer had normal weight and 51 were overweight. On the other hand, all 10 patients with HNPCC related to endometrial cancer had normal weight. There was no significant difference between the group with HNPCC-related endometrial cancer and the group with sporadic endometrial cancer according to BMI (P = 0.221). However, BMI proportions in HNPCC related to endometrial cancer were significantly different from those in sporadic endometrial cancer (P = 0.016). Among a subgroup of nonobese patients, the proportion of normal weight was significant higher in patients with HNPCC-related endometrial cancer compared to those in sporadic endometrial cancer (P = 0.006). CONCLUSION Body mass index was not different between sporadic endometrial cancer and HNPCC-related endometrial cancer in Koreans. However, BMI proportions in the patients with HNPCC related to endometrial cancer was significantly different from those in sporadic endometrial cancer. Specifically, among nonobese patients, the proportion of normal weight was significantly high in Korean women with HNPCC.
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Yoo HJ, Park SY, Lim MC. Hereditary portion as an initial genetic approach in gynecologic cancer: synchronous tumor of ovary and endometrium. J Gynecol Oncol 2012; 23:72-3. [PMID: 22355471 PMCID: PMC3280071 DOI: 10.3802/jgo.2012.23.1.72] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- Heon Jong Yoo
- Center of Uterine Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Korea
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Dreyer G. Screening for gynaecologic cancers in genetically predisposed women. Best Pract Res Clin Obstet Gynaecol 2012; 26:267-82. [PMID: 22361688 DOI: 10.1016/j.bpobgyn.2011.11.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2011] [Accepted: 11/09/2011] [Indexed: 12/24/2022]
Abstract
Hereditary breast and ovarian cancer syndrome and hereditary non-polyposis colon cancer syndrome are the two most important syndromes responsible for inherited cancers in gynaecology. Genetic testing is available for both these syndromes. Breast cancer gene testing is affordable and easy in women with ancestry where the mutation patterns are known, whereas other population groups need full gene screening. Hereditary non-polyposis colon cancer syndrome can now be diagnosed more frequently with the use of immunohistochemistry. Ovarian cancer risk is high in hereditary breast and ovarian cancer syndromes, and advanced screening techniques should be used when preventive surgery is not an option. Early detection techniques offer less protection than prophylactic removal, but enable women to retain their reproductive organs. Oophorectomy has the advantage of reducing breast cancer risk. In colorectal cancer syndromes, the risk for endometrial and ovarian cancer is much elevated. These risks should be recognised and addressed as these diseases are easy to prevent.
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Affiliation(s)
- Greta Dreyer
- Gynaecologic Oncology Unit, Department of Obstetrics and Gynaecology, University of Pretoria, 183 Charles Street, Brooklyn 0181, South Africa.
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Kim MK, Song SY, Do IG, Kim SH, Choi CH, Kim TJ, Lee JW, Bae DS, Kim BG. Synchronous gynecologic malignancy and preliminary results of Lynch syndrome. J Gynecol Oncol 2011; 22:233-8. [PMID: 22247799 PMCID: PMC3254841 DOI: 10.3802/jgo.2011.22.4.233] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2011] [Revised: 07/06/2011] [Accepted: 07/14/2011] [Indexed: 11/30/2022] Open
Abstract
Objective Lynch syndrome is a hereditary cancer syndrome that increases the risks of colorectal and gynecologic malignancies such as endometrial and ovarian cancer. Studies have shown that mutations in mismatch repair genes (MSH2, MSH6, and MLH1) are associated with Lynch syndrome. The aim of our study was to estimate the value of MSH2, MSH6, and MLH1 immunohistochemistry based on family history in a Korean sample. Methods Thirty six women with synchronous gynecologic tumors of endometrial and ovarian cancer were identified among patients being treated at our institution. Among them, 32 patients had tumor blocks (total 62 slides) available for analysis. According to a diagnostic algorithm, we performed immunohistochemistry analyses. Staining was scored based on intensity and proportion (negative or 0: intensity undetectable or minimal, proportion <5%; weak or 1+: intensity mild, proportion 5-30%; strong or 2+: intensity moderate to marked, proportion 30-99%). Results Among 32 eligible patients, 9 (28%) had a family history of cancer. Six patients (19%) were negative for MLH1; among them, four (4/6) were negative at both sites. Nine patients (28%) were negative for MSH2 or MSH6 at both sites or negative for both MSH2 and MSH6. Among these three patients showed negative staining for both sites. The three patients showing negative staining for MLH1, MSH2, and MSH6 at both sites with family history were considered to be the screening positive groups of Lynch syndrome. Conclusion In this study, the frequency of Lynch syndrome associated immunohistochemical staining (MLH1, MSH2, and MSH6) group was estimated as 9% (3/32) among Korean women with synchronous gynecologic tumors.
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Affiliation(s)
- Min Kyu Kim
- Division of Gynecologic Oncology, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
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