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Natsume S, Yamaguchi T, Eguchi H, Okazaki Y, Horiguchi SI, Ishida H. Germline deletion of chromosome 2p16-21 associated with Lynch syndrome. Hum Genome Var 2021; 8:19. [PMID: 34012011 PMCID: PMC8134480 DOI: 10.1038/s41439-021-00152-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 03/09/2021] [Accepted: 04/01/2021] [Indexed: 11/17/2022] Open
Abstract
We identified a Japanese patient with Lynch syndrome with a novel large germline deletion of chromosome 2p16-21, including the EPCAM, MSH2, and KCNK12 genes. The proband was a 46-year-old man with ascending colon cancer. The clinical significance of germline KCNK12 gene deletion, which encodes one of the subfamilies of two-pore-domain potassium channels, is still unknown.
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Affiliation(s)
- Soichiro Natsume
- Department of Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - Tatsuro Yamaguchi
- Department of Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan. .,Department of Clinical Genetics, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan.
| | - Hidetaka Eguchi
- Diagnosis and Therapeutics of Intractable Diseases and Intractable Disease Research Center, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Yasushi Okazaki
- Diagnosis and Therapeutics of Intractable Diseases and Intractable Disease Research Center, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Shin-Ichiro Horiguchi
- Department of Pathology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - Hideyuki Ishida
- Department of Digestive Tract and General Surgery, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan
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Cini G, Quaia M, Canzonieri V, Fornasarig M, Maestro R, Morabito A, D'Elia AV, Urso ED, Mammi I, Viel A. Toward a better definition of EPCAM deletions in Lynch Syndrome: Report of new variants in Italy and the associated molecular phenotype. Mol Genet Genomic Med 2019; 7:e587. [PMID: 30916491 PMCID: PMC6503020 DOI: 10.1002/mgg3.587] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Revised: 12/21/2018] [Accepted: 01/06/2019] [Indexed: 11/27/2022] Open
Abstract
Background Inherited epimutations of Mismatch Repair (MMR) genes are responsible for Lynch Syndrome (LS) in a small, but well defined, subset of patients. Methylation of the MSH2 promoter consequent to the deletion of the upstream EPCAM gene is found in about 1%–3% of the LS patients and represents a classical secondary, constitutional and tissue‐specific epimutation. Several different EPCAM deletions have been reported worldwide, for the most part representing private variants caused by an Alu‐mediated recombination. Methods 712 patients with suspected LS were tested for MMR mutation in our Institute. EPCAM deletions were detected by multiplex ligation‐dependent probe amplification (MLPA) and then defined by Long‐Range polymerase chain reaction (PCR)/Sanger sequencing. A comprehensive molecular characterization of colorectal cancer (CRC) tissues was carried out by immunohistochemistry of MMR proteins, Microsatellite Instability (MSI) assay, methylation specific MLPA and transcript analyses. In addition, somatic deletions and/or variants were investigated by MLPA and next generation sequencing (NGS). Results An EPCAM deletion was found in five unrelated probands in Italy: variants c.556‐490_*8438del and c.858+1193_*5826del are novel; c.859‐1430_*2033del and c.859‐670_*530del were previously reported. All probands were affected by CRC at young age; tumors showed MSI and abnormal MSH2/MSH6 proteins expression. MSH2 promoter methylation, as well as aberrant in‐frame or out‐of‐frame EPCAM/MSH2 fusion transcripts, were detected in CRCs and normal mucosae. Conclusion An EPCAM deletion was the causative variant in about 2% of our institutional series of 224 LS patients, consistent with previously estimated frequencies. Early age and multiple CRCs was the main clinical feature of this subset of patients.
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Affiliation(s)
- Giulia Cini
- Functional Oncogenomics and Genetics, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, PN, Italy
| | - Michele Quaia
- Functional Oncogenomics and Genetics, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, PN, Italy
| | - Vincenzo Canzonieri
- Pathology, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, PN, Italy
| | - Mara Fornasarig
- Gastroenterology, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, PN, Italy
| | - Roberta Maestro
- Functional Oncogenomics and Genetics, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, PN, Italy
| | | | | | - Emanuele Damiano Urso
- Department of Surgical Oncology and Gastroenterology, University of Padua, Padova, Italy
| | | | - Alessandra Viel
- Functional Oncogenomics and Genetics, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, PN, Italy
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Pathak SJ, Mueller JL, Okamoto K, Das B, Hertecant J, Greenhalgh L, Cole T, Pinsk V, Yerushalmi B, Gurkan OE, Yourshaw M, Hernandez E, Oesterreicher S, Naik S, Sanderson IR, Axelsson I, Agardh D, Boland CR, Martin MG, Putnam CD, Sivagnanam M. EPCAM mutation update: Variants associated with congenital tufting enteropathy and Lynch syndrome. Hum Mutat 2018; 40:142-161. [PMID: 30461124 PMCID: PMC6328345 DOI: 10.1002/humu.23688] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Revised: 10/24/2018] [Accepted: 11/14/2018] [Indexed: 12/30/2022]
Abstract
The epithelial cell adhesion molecule gene (EPCAM, previously known as TACSTD1 or TROP1) encodes a membrane‐bound protein that is localized to the basolateral membrane of epithelial cells and is overexpressed in some tumors. Biallelic mutations in EPCAM cause congenital tufting enteropathy (CTE), which is a rare chronic diarrheal disorder presenting in infancy. Monoallelic deletions of the 3′ end of EPCAM that silence the downstream gene, MSH2, cause a form of Lynch syndrome, which is a cancer predisposition syndrome associated with loss of DNA mismatch repair. Here, we report 13 novel EPCAM mutations from 17 CTE patients from two separate centers, review EPCAM mutations associated with CTE and Lynch syndrome, and structurally model pathogenic missense mutations. Statistical analyses indicate that the c.499dupC (previously reported as c.498insC) frameshift mutation was associated with more severe treatment regimens and greater mortality in CTE, whereas the c.556‐14A>G and c.491+1G>A splice site mutations were not correlated with treatments or outcomes significantly different than random simulation. These findings suggest that genotype–phenotype correlations may be useful in contributing to management decisions of CTE patients. Depending on the type and nature of EPCAM mutation, one of two unrelated diseases may occur, CTE or Lynch syndrome.
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Affiliation(s)
- Sagar J Pathak
- Department of Pediatrics, University of California, San Diego, La Jolla, California.,Rady Children's Hospital, San Diego, California
| | - James L Mueller
- Department of Pediatrics, University of California, San Diego, La Jolla, California
| | - Kevin Okamoto
- Department of Pediatrics, University of California, San Diego, La Jolla, California
| | - Barun Das
- Department of Pediatrics, University of California, San Diego, La Jolla, California
| | - Jozef Hertecant
- Genetics/Metabolics Service, Tawam Hospital, Al Ain, United Arab Emirates
| | | | - Trevor Cole
- West Midlands Regional Genetics Service and Birmingham Health Partners, Birmingham Women's Hospital, Birmingham, UK
| | - Vered Pinsk
- Division of Pediatrics, Pediatric Gastroenterology Unit, Soroka University Medical Center and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Baruch Yerushalmi
- Division of Pediatrics, Pediatric Gastroenterology Unit, Soroka University Medical Center and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Odul E Gurkan
- Department of Pediatrics, Gazi University School of Medicine, Ankara, Turkey
| | - Michael Yourshaw
- Department of Human Genetics, University of California, Los Angeles, Los Angeles, California
| | - Erick Hernandez
- Pediatric Gastroenterology, Miami Children's Health System, Miami, Florida
| | | | - Sandhia Naik
- Paediatric Gastroenterology, Barts and the London School of Medicine, London, UK
| | - Ian R Sanderson
- Paediatric Gastroenterology, Barts and the London School of Medicine, London, UK
| | - Irene Axelsson
- Department of Pediatrics, Skane University Hospital, Malmo, Sweden
| | - Daniel Agardh
- Department of Clinical Sciences, Lund University, Skane University Hospital, Malmo, Sweden
| | - C Richard Boland
- Department of Medicine, University of California, San Diego, La Jolla, California
| | - Martin G Martin
- Department of Pediatrics, University of California, Los Angeles, Los Angeles, California
| | - Christopher D Putnam
- Department of Medicine, University of California, San Diego, La Jolla, California.,San Diego Branch, Ludwig Institute for Cancer Research, La Jolla, California
| | - Mamata Sivagnanam
- Department of Pediatrics, University of California, San Diego, La Jolla, California.,Rady Children's Hospital, San Diego, California
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Prevalence and clinicopathologic/molecular characteristics of mismatch repair-deficient colorectal cancer in the under-50-year-old Japanese population. Surg Today 2017; 47:1135-1146. [PMID: 28258479 DOI: 10.1007/s00595-017-1486-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Accepted: 01/12/2017] [Indexed: 02/07/2023]
Abstract
PURPOSE To clarify the prevalence and clinicopathologic/molecular characteristics of mismatch repair (MMR)-deficient colorectal cancer in the young Japanese population. METHODS Immunohistochemical analyses for MMR proteins (MLH1, MSH2, MSH6, and PMS2) were performed in formalin-fixed paraffin-embedded sections prepared from the resected CRC specimens of 119 consecutive patients aged <50 years old, who underwent resection of the primary tumor at our institution between 1996 and 2015. Analyses for somatic BRAF V600E mutation, somatic hypermethylation of the MLH1 promoter, and germline MMR gene mutations were undertaken where indicated. RESULTS MMR protein loss was found in 10 patients (8.4%), 7 (5.9%) of whom were subsequently identified to have Lynch syndrome (LS). The remaining 3 patients were categorized as having sporadic MMR-deficient CRC (n = 2) or "possible LS (n = 1)". In multivariate logistic regression analysis, the presence of tumor-infiltrating lymphocytes (P < 0.01), right-sided location of the tumor (P = 0.01), and a history of LS-associated tumors in the first-degree relatives (P < 0.01) were identified as independent factors predictive of MMR-deficient CRC. CONCLUSION These results are of value in the clinical management of patients with the early onset CRC under circumstances where universal tumor screening approaches for LS are still not available, like in Japan.
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