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A Previously Unrecognized Molecular Landscape of Lynch Syndrome in the Mexican Population. Int J Mol Sci 2022; 23:ijms231911549. [PMID: 36232851 PMCID: PMC9569652 DOI: 10.3390/ijms231911549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 08/26/2022] [Accepted: 09/09/2022] [Indexed: 11/30/2022] Open
Abstract
Lynch syndrome (LS) is the main hereditary colorectal cancer syndrome. There have been few reports regarding the clinical and molecular characteristics of LS patients in Latin America; this is particularly true in the Mexican population, where no information is available. The present study aims to describe the clinical and molecular spectrum of variants in a cohort of patients diagnosed with LS in Mexico. We present a retrospective analysis of 412 patients with suspected LS, whose main site of cancer diagnosis was the colon (58.25%), followed by the endometrium (18.93%). Next-generation sequencing analysis, with an extensive multigene panel, showed that 27.1% (112/414) had a variant in one of the genes of the mismatch repair pathway (MMR); 30.4% (126/414) had a variant in non-MMR genes such as CHEK2, APC, MUTYH, BRCA1, and BRCA2; and 42.5% (176/414) had no genetic variants. Most of the variants were found in MLH1. Pathogenic variants (PVs) in MMR genes were identified in 65.7% (96/146) of the total PVs, and 34.24% (45/146) were in non-MMR genes. Molecular and clinical characterization of patients with LS in specific populations allowed personalized follow-up, with the option for targeted treatment with immune checkpoint inhibitors and the development of public health policies. Moreover, such characterization allows for family cascade testing and consequent prevention strategies.
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Ossa Gomez CA, Achatz MI, Hurtado M, Sanabria-Salas MC, Sullcahuaman Y, Chávarri-Guerra Y, Dutil J, Nielsen SM, Esplin ED, Michalski ST, Bristow SL, Hatchell KE, Nussbaum RL, Pineda-Alvarez DE, Ashton-Prolla P. Germline Pathogenic Variant Prevalence Among Latin American and US Hispanic Individuals Undergoing Testing for Hereditary Breast and Ovarian Cancer: A Cross-Sectional Study. JCO Glob Oncol 2022; 8:e2200104. [PMID: 35867948 PMCID: PMC9812461 DOI: 10.1200/go.22.00104] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 05/13/2022] [Accepted: 06/15/2022] [Indexed: 01/07/2023] Open
Abstract
PURPOSE To report on pathogenic germline variants detected among individuals undergoing genetic testing for hereditary breast and/or ovarian cancer (HBOC) from Latin America and compare them with self-reported Hispanic individuals from the United States. METHODS In this cross-sectional study, unrelated individuals with a personal/family history suggestive of HBOC who received clinician-ordered germline multigene sequencing were grouped according to the location of the ordering physician: group A, Mexico, Central America, and the Caribbean; group B, South America; and group C, United States with individuals who self-reported Hispanic ethnicity. Relatives who underwent cascade testing were analyzed separately. RESULTS Among 24,075 unrelated probands across all regions, most were female (94.9%) and reported a personal history suggestive of HBOC (range, 65.0%-80.6%); the mean age at testing was 49.1 ± 13.1 years. The average number of genes analyzed per patient was highest in group A (A 63 ± 28, B 56 ± 29, and C 40 ± 28). Between 9.1% and 18.7% of patients had pathogenic germline variants in HBOC genes (highest yield in group A), with the majority associated with high HBOC risk. Compared with US Hispanics individuals the overall yield was significantly higher in both Latin American regions (A v C P = 1.64×10-9, B v C P < 2.2×10-16). Rates of variants of uncertain significance were similar across all three regions (33.7%-42.6%). Cascade testing uptake was low in all regions (A 6.6%, B 4.5%, and C 1.9%). CONCLUSION This study highlights the importance of multigene panel testing in Latin American individuals with newly diagnosed or history of HBOC, who can benefit from medical management changes including targeted therapies, eligibility to clinical trials, risk-reducing surgeries, surveillance and prevention of secondary malignancy, and genetic counseling and subsequent cascade testing of at-risk relatives.
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Affiliation(s)
| | - Maria Isabel Achatz
- Department of Oncology, Hospital Sírio-Libanês, Brasília, Distrito Federal, Brazil
| | - Mabel Hurtado
- Instituto Oncológico, Fundación Arturo López Pérez, Santiago, Chile
| | | | - Yasser Sullcahuaman
- Universidad Peruana de Ciencias Aplicadas, Lima, Peru
- Instituto de Investigación Genomica, Lima, Peru
| | - Yanin Chávarri-Guerra
- Department of Hemato-Oncology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Julie Dutil
- Cancer Biology Division, Ponce Research Institute, Ponce Health Sciences University, Pone, Puerto Rico
| | | | | | | | | | | | | | | | - Patricia Ashton-Prolla
- Departamento de Genética, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Serviço de Genética Médica e Laboratório de Medicina Genômica, Centro de Pesquisa Experimental, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
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Leite Rocha D, Ashton-Prolla P, Rosset C. Reviewing the occurrence of large genomic rearrangements in patients with inherited cancer predisposing syndromes: importance of a comprehensive molecular diagnosis. Expert Rev Mol Diagn 2022; 22:319-346. [PMID: 35234551 DOI: 10.1080/14737159.2022.2049247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Hereditary cancer predisposition syndromes are caused by germline pathogenic or likely pathogenic variants in cancer predisposition genes (CPG). The majority of pathogenic variants in CPGs are point mutations, but large gene rearrangements (LGRs) are present in several CPGs. LGRs can be much more difficult to characterize and perhaps they may have been neglected in molecular diagnoses. AREAS COVERED We aimed to evaluate the frequencies of germline LGRs in studies conducted in different populations worldwide through a qualitative systematic review based on an online literature research in PubMed. Two reviewers independently extracted data from published studies between 2009 and 2020. In total, 126 studies from 37 countries and 5 continents were included in the analysis. The number of studies in different continents ranged from 3 to 48 and for several countries there was an absolute lack of information. Asia and Europe represented most of the studies, and LGR frequencies varied from 3.04 to 15.06% in different continents. MLPA was one of the methods of choice in most studies (93%). EXPERT OPINION The LGR frequencies found in this review reinforce the need for comprehensive molecular testing regardless of the population of origin and should be considered by genetic counseling providers.
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Affiliation(s)
- Débora Leite Rocha
- Laboratório de Medicina Genômica, Serviço de Pesquisa Experimental, Hospital de Clínicas de Porto Alegre (HCPA), Rua Ramiro Barcelos, 2350, CEP: 90035-930, Porto Alegre, Rio Grande do Sul, Brazil
| | - Patrícia Ashton-Prolla
- Laboratório de Medicina Genômica, Serviço de Pesquisa Experimental, Hospital de Clínicas de Porto Alegre (HCPA), Rua Ramiro Barcelos, 2350, CEP: 90035-930, Porto Alegre, Rio Grande do Sul, Brazil.,Programa de Pós-Graduação em Genética e Biologia Molecular, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil. Av. Bento Gonçalves, 9500 - Prédio 43312 M, CEP: 91501-970, Caixa Postal 1505, Porto Alegre, Rio Grande do Sul, Brazil.,Serviço de Genética Médica, HCPA, Rio Grande do Sul, Brazil. Rua Ramiro Barcelos, 2350, CEP: 90035-930, Porto Alegre, Rio Grande do Sul, Brazil
| | - Clévia Rosset
- Laboratório de Medicina Genômica, Serviço de Pesquisa Experimental, Hospital de Clínicas de Porto Alegre (HCPA), Rua Ramiro Barcelos, 2350, CEP: 90035-930, Porto Alegre, Rio Grande do Sul, Brazil
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Zhang YJ, Yang Y, Wei Q, Xu T, Zhang XT, Gao J, Tan SY, Liu BR, Zhang JD, Chen XB, Wang ZJ, Qiu M, Wang X, Shen L, Wang XC. A multicenter study assessing the prevalence of germline genetic alterations in Chinese gastric-cancer patients. Gastroenterol Rep (Oxf) 2021; 9:339-349. [PMID: 34567566 PMCID: PMC8460096 DOI: 10.1093/gastro/goab020] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Revised: 03/10/2021] [Accepted: 04/22/2021] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Approximately 10% of patients with gastric cancer (GC) have a genetic predisposition toward the disease. However, there is scant knowledge regarding germline mutations in predisposing genes in the Chinese GC population. This study aimed to determine the spectrum and distribution of predisposing gene mutations among Chinese GC patients known to have hereditary high-risk factors for cancer. METHODS A total of 40 GC patients from 40 families were recruited from seven medical institutions in China. Next-generation sequencing was performed on 171 genes associated with cancer predisposition. For probands carrying pathogenic/likely pathogenic germline variants, Sanger sequencing was applied to validate the variants in the probands as well as their relatives. RESULTS According to sequencing results, 25.0% (10/40) of the patients carried a combined total of 10 pathogenic or likely pathogenic germline variants involving nine different genes: CDH1 (n = 1), MLH1 (n = 1), MSH2 (n = 1), CHEK2 (n = 1), BLM (n = 1), EXT2 (n = 1), PALB2 (n = 1), ERCC2 (n = 1), and SPINK1 (n = 2). In addition, 129 variants of uncertain significance were identified in 27 patients. CONCLUSIONS This study indicates that approximately one in every four Chinese GC patients with hereditary high risk factors may harbor pathogenic/likely pathogenic germline alterations in cancer-susceptibility genes. The results further indicate a unique genetic background for GC among Chinese patients.
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Affiliation(s)
- Yin-Jie Zhang
- Department of Gastrointestinal Oncology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital & Institute, Beijing, P. R. China
- Department of Medical Oncology, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan, P. R. China
| | - Yang Yang
- Comprehensive Cancer Center of Drum Tower Hospital, Medical School of Nanjing University & Clinical Cancer Institute of Nanjing University, Nanjing, Jiangsu, P. R. China
| | - Qing Wei
- Department of Gastrointestinal Oncology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital & Institute, Beijing, P. R. China
- Department of Medical Oncology, Zhejiang Cancer Hospital, Hangzhou, Zhejiang, P. R. China
| | - Ting Xu
- Department of Gastrointestinal Oncology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital & Institute, Beijing, P. R. China
| | - Xiao-Tian Zhang
- Department of Gastrointestinal Oncology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital & Institute, Beijing, P. R. China
| | - Jing Gao
- Department of Gastrointestinal Oncology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital & Institute, Beijing, P. R. China
| | - Si-Yi Tan
- Comprehensive Cancer Center of Drum Tower Hospital, Medical School of Nanjing University & Clinical Cancer Institute of Nanjing University, Nanjing, Jiangsu, P. R. China
| | - Bao-Rui Liu
- Comprehensive Cancer Center of Drum Tower Hospital, Medical School of Nanjing University & Clinical Cancer Institute of Nanjing University, Nanjing, Jiangsu, P. R. China
| | - Jing-Dong Zhang
- Department of Medical Oncology, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, Shenyang, Liaoning, P. R. China
| | - Xiao-Bing Chen
- Department of Gastroenterology and Medical Oncology, Henan Cancer Hospital (Affiliated Cancer Hospital of Zhengzhou University), Zhengzhou, Henan, P. R. China
| | - Zhao-Jie Wang
- Department of Oncology, Henan Provincial People’s Hospital, Zhengzhou, Henan, P. R. China
| | - Meng Qiu
- Department of Medical Oncology, Cancer Center, the State Key Laboratory of Biotherapy, West China Hospital, West China Medical School, Sichuan University, Chengdu, Sichuan, P. R. China
| | - Xin Wang
- State Key Laboratory of Cancer Biology, Xijing Hospital of Digestive Disease, Fourth Military Medical University, Xi’an, Shaanxi, P. R. China
| | - Lin Shen
- Department of Gastrointestinal Oncology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital & Institute, Beijing, P. R. China
| | - Xi-Cheng Wang
- Department of Gastrointestinal Oncology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital & Institute, Beijing, P. R. China
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MLH1 intronic variants mapping to + 5 position of splice donor sites lead to deleterious effects on RNA splicing. Fam Cancer 2021; 19:323-336. [PMID: 32363481 DOI: 10.1007/s10689-020-00182-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Germline pathogenic variants in the DNA mismatch repair genes (MMR): MLH1, MSH2, MSH6, and PMS2, are causative of Lynch syndrome (LS). However, many of the variants mapping outside the invariant splice site positions (IVS ± 1, IVS ± 2) are classified as variants of unknown significance (VUS). Three such variants (MLH1 c.588+5G>C, c.588+5G>T and c.677+5G>A) were identified in 8 unrelated LS families from Argentina, Brazil and Chile. Herein, we collected clinical information on these families and performed segregation analysis and RNA splicing studies to assess the implication of these VUS in LS etiology. Pedigrees showed a clear pattern of variant co-segregation with colorectal cancer and/or other LS-associated malignancies. Tumors presented deficient expression of MLH1-PMS2 proteins in 7/7 of the LS families, and MSI-high status in 3/3 cases. Moreover, RNA analyses revealed that c.588+5G>C and c.588+5G>T induce skipping of exon 7 whereas c.677+5G>A causes skipping of exon 8. In sum, we report that the combined clinical findings in the families and the molecular studies provided the evidences needed to demonstrate that the three MLH1 variants are causative of LS and to classify c.588+5G>C and c.677+5G>A as class 5 (pathogenic), and c.588+5G>T as class 4 (likely-pathogenic). Our findings underline the importance of performing clinical and family analyses, as well as RNA splicing assays in order to determine the clinical significance of intronic variants, and contribute to the genetic counseling and clinical management of patients and their relatives.
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Vidal AF, Ferraz RS, El-Husny A, Silva CS, Vinasco-Sandoval T, Magalhães L, Raiol-Moraes M, Barra WF, Pereira CLBL, de Assumpção PP, de Brito LM, Vialle RA, Santos S, Ribeiro-Dos-Santos Â, Ribeiro-Dos-Santos AM. Comprehensive analysis of germline mutations in northern Brazil: a panel of 16 genes for hereditary cancer-predisposing syndrome investigation. BMC Cancer 2021; 21:363. [PMID: 33827469 PMCID: PMC8028728 DOI: 10.1186/s12885-021-08089-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 03/23/2021] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Next generation sequencing (NGS) has been a handy tool in clinical practice, mainly due to its efficiency and cost-effectiveness. It has been widely used in genetic diagnosis of several inherited diseases, and, in clinical oncology, it may enhance the discovery of new susceptibility genes and enable individualized care of cancer patients. In this context, we explored a pan-cancer panel in the investigation of germline variants in Brazilian patients presenting clinical criteria for hereditary cancer syndromes or familial history. METHODS Seventy-one individuals diagnosed or with familial history of hereditary cancer syndromes were submitted to custom pan-cancer panel including 16 high and moderate penetrance genes previously associated with hereditary cancer syndromes (APC, BRCA1, BRCA2, CDH1, CDKN2A, CHEK2, MSH2, MSH6, MUTYH, PTEN, RB1, RET, TP53, VHL, XPA and XPC). All pathogenic variants were validated by Sanger sequencing. RESULTS We identified a total of eight pathogenic variants among 12 of 71 individuals (16.9%). Among the mutation-positive subjects, 50% were diagnosed with breast cancer and had mutations in BRCA1, CDH1 and MUTYH. Notably, 33.3% were individuals diagnosed with polyposis or who had family cases and harbored pathogenic mutations in APC and MUTYH. The remaining individuals (16.7%) were gastric cancer patients with pathogenic variants in CDH1 and MSH2. Overall, 54 (76.05%) individuals presented at least one variant uncertain significance (VUS), totalizing 81 VUS. Of these, seven were predicted to have disease-causing potential. CONCLUSION Overall, analysis of all these genes in NGS-panel allowed the identification not only of pathogenic variants related to hereditary cancer syndromes but also of some VUS that need further clinical and molecular investigations. The results obtained in this study had a significant impact on patients and their relatives since it allowed genetic counselling and personalized management decisions.
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Affiliation(s)
- Amanda Ferreira Vidal
- Laboratory of Human and Medical Genetics, Graduate Program Genetics and Molecular Biology, Federal University of Pará, Belém, Pará, Brazil
| | - Rafaella Sousa Ferraz
- Laboratory of Human and Medical Genetics, Graduate Program Genetics and Molecular Biology, Federal University of Pará, Belém, Pará, Brazil
| | - Antonette El-Husny
- Bettina Ferro de Souza University Hospital, Federal University of Pará, Belém, Pará, Brazil
| | - Caio Santos Silva
- Laboratory of Human and Medical Genetics, Graduate Program Genetics and Molecular Biology, Federal University of Pará, Belém, Pará, Brazil
| | - Tatiana Vinasco-Sandoval
- Laboratory of Human and Medical Genetics, Graduate Program Genetics and Molecular Biology, Federal University of Pará, Belém, Pará, Brazil
| | - Leandro Magalhães
- Laboratory of Human and Medical Genetics, Graduate Program Genetics and Molecular Biology, Federal University of Pará, Belém, Pará, Brazil
| | - Milene Raiol-Moraes
- Laboratory of Human and Medical Genetics, Graduate Program Genetics and Molecular Biology, Federal University of Pará, Belém, Pará, Brazil
| | - Williams Fernandes Barra
- João de Barros Barreto University Hospital, Federal University of Pará, Belém, Pará, Brazil
- Center of Oncology Research, Federal University of Pará, Belém, Pará, Brazil
| | - Cynthia Lara Brito Lins Pereira
- João de Barros Barreto University Hospital, Federal University of Pará, Belém, Pará, Brazil
- Center of Oncology Research, Federal University of Pará, Belém, Pará, Brazil
| | | | - Leonardo Miranda de Brito
- Laboratory of Human and Medical Genetics, Graduate Program Genetics and Molecular Biology, Federal University of Pará, Belém, Pará, Brazil
| | - Ricardo Assunção Vialle
- Laboratory of Human and Medical Genetics, Graduate Program Genetics and Molecular Biology, Federal University of Pará, Belém, Pará, Brazil
| | - Sidney Santos
- Laboratory of Human and Medical Genetics, Graduate Program Genetics and Molecular Biology, Federal University of Pará, Belém, Pará, Brazil
- Center of Oncology Research, Federal University of Pará, Belém, Pará, Brazil
| | - Ândrea Ribeiro-Dos-Santos
- Laboratory of Human and Medical Genetics, Graduate Program Genetics and Molecular Biology, Federal University of Pará, Belém, Pará, Brazil
- Center of Oncology Research, Federal University of Pará, Belém, Pará, Brazil
| | - André M Ribeiro-Dos-Santos
- Laboratory of Human and Medical Genetics, Graduate Program Genetics and Molecular Biology, Federal University of Pará, Belém, Pará, Brazil.
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Álvarez K, Orellana P, De la Fuente M, Canales T, Pinto E, Heine C, Solar B, Hurtado C, Møller P, Kronberg U, Zarate AJ, Dominguez-Valentin M, López-Köstner F. Spectrum and Frequency of Tumors, Cancer Risk and Survival in Chilean Families with Lynch Syndrome: Experience of the Implementation of a Registry. J Clin Med 2020; 9:jcm9061861. [PMID: 32549215 PMCID: PMC7356331 DOI: 10.3390/jcm9061861] [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] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 06/04/2020] [Accepted: 06/08/2020] [Indexed: 02/07/2023] Open
Abstract
Lynch syndrome (LS) is associated with the highest risk of colorectal (CRC) and several extracolonic cancers. In our effort to characterize LS families from Latin America, this study aimed to describe the spectrum of neoplasms and cancer risk by gender, age and gene, and survival in 34 Chilean LS families. Of them, 59% harbored path_MLH1, 23% path_MSH2, 12% path_PMS2 and 6% path_EPCAM variants. A total of 866 individuals at risk were identified, of which 213 (24.6%) developed 308 neoplasms. In males, CRC was the most common cancer (72.6%), while females showed a greater frequency of extracolonic cancers (58.4%), including uterus and breast (p < 0.0001). The cumulative incidence of extracolonic cancers was higher in females than males (p = 0.001). Path_MLH1 variants are significantly more associated with the development of CRC than extracolonic tumors (59.5% vs. 40.5%) when compared to path_MSH2 (47.5% vs. 52.5%) variants (p = 0.05018). The cumulative incidence of CRC was higher in path_MLH1/path_MSH2 carriers compared to path_PMS2 carriers (p = 0.03). In addition, path_MSH2 carriers showed higher risk of extracolonic tumors (p = 0.002). In conclusion, this study provides a snapshot of the LS profile from Chile and the current LS-associated diagnostic practice and output in Chile. Categorizing cancer risks associated with each population is relevant in the genetic counselling of LS patients.
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Affiliation(s)
- Karin Álvarez
- Oncology and Molecular Genetic Laboratory, Coloproctology Unit, Clínica Las Condes, Santiago 7591047, Chile; (K.Á.); (P.O.); (M.D.l.F.); (E.P.); (C.H.); (C.H.); (U.K.); (A.J.Z.)
| | - Paulina Orellana
- Oncology and Molecular Genetic Laboratory, Coloproctology Unit, Clínica Las Condes, Santiago 7591047, Chile; (K.Á.); (P.O.); (M.D.l.F.); (E.P.); (C.H.); (C.H.); (U.K.); (A.J.Z.)
| | - Marjorie De la Fuente
- Oncology and Molecular Genetic Laboratory, Coloproctology Unit, Clínica Las Condes, Santiago 7591047, Chile; (K.Á.); (P.O.); (M.D.l.F.); (E.P.); (C.H.); (C.H.); (U.K.); (A.J.Z.)
| | - Tamara Canales
- Cancer Institute, Clínica Las Condes, Santiago 7591047, Chile;
| | - Eliana Pinto
- Oncology and Molecular Genetic Laboratory, Coloproctology Unit, Clínica Las Condes, Santiago 7591047, Chile; (K.Á.); (P.O.); (M.D.l.F.); (E.P.); (C.H.); (C.H.); (U.K.); (A.J.Z.)
| | - Claudio Heine
- Oncology and Molecular Genetic Laboratory, Coloproctology Unit, Clínica Las Condes, Santiago 7591047, Chile; (K.Á.); (P.O.); (M.D.l.F.); (E.P.); (C.H.); (C.H.); (U.K.); (A.J.Z.)
- Colorectal Unit, Department of Surgery, Hospital San José, Osorno 5311523, Chile
| | - Benjamín Solar
- Genetic Section, University of Chile Clinic Hospital, Santiago 8380456, Chile;
- Servicio de Neurología Infantil, Hospital de Puerto Montt, Puerto Montt 5507798, Chile
| | - Claudia Hurtado
- Oncology and Molecular Genetic Laboratory, Coloproctology Unit, Clínica Las Condes, Santiago 7591047, Chile; (K.Á.); (P.O.); (M.D.l.F.); (E.P.); (C.H.); (C.H.); (U.K.); (A.J.Z.)
| | - Pål Møller
- Department of Tumor Biology, Institute for Cancer Research, The Norwegian Radium Hospital, 0369 Oslo, Norway; (P.M.); (M.D.-V.)
| | - Udo Kronberg
- Oncology and Molecular Genetic Laboratory, Coloproctology Unit, Clínica Las Condes, Santiago 7591047, Chile; (K.Á.); (P.O.); (M.D.l.F.); (E.P.); (C.H.); (C.H.); (U.K.); (A.J.Z.)
| | - Alejandro José Zarate
- Oncology and Molecular Genetic Laboratory, Coloproctology Unit, Clínica Las Condes, Santiago 7591047, Chile; (K.Á.); (P.O.); (M.D.l.F.); (E.P.); (C.H.); (C.H.); (U.K.); (A.J.Z.)
- Department of Surgery, Finis Terrae University, Santiago 7501015, Chile
| | - Mev Dominguez-Valentin
- Department of Tumor Biology, Institute for Cancer Research, The Norwegian Radium Hospital, 0369 Oslo, Norway; (P.M.); (M.D.-V.)
- Instituto de Investigación, Universidad Católica de Trujillo, Chimbote 02800, Peru
| | - Francisco López-Köstner
- Oncology and Molecular Genetic Laboratory, Coloproctology Unit, Clínica Las Condes, Santiago 7591047, Chile; (K.Á.); (P.O.); (M.D.l.F.); (E.P.); (C.H.); (C.H.); (U.K.); (A.J.Z.)
- Correspondence:
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Della Valle A, Rossi BM, Palmero EI, Antelo M, Vaccaro CA, López-Kostner F, Alvarez K, Cruz-Correa M, Bruno LI, Forones NM, Mindiola JAR, Buleje J, Spirandelli F, Bohorquez M, Cock-Rada AM, Sullcahuaman Y, Nascimento I, Abe-Sandes K, Lino-Silva LS, Petracchi F, Mampel A, Rodriguez Y, Rossi NT, Yañez CB, Rubio C, Petta-Lajus TB, Silveira-Lucas EL, Jiménez G, Peña CMM, Reyes-Silva C, Ayala-Madrigal MDLL, del Monte JS, Quispe R, Recalde A, Neffa F, Sarroca C, de Campos Reis Galvão H, Golubicki M, Piñero TA, Kalfayan PG, Ferro FA, Gonzalez ML, Pérez-Mayoral J, Pimenta CAM, Uyaban SPB, Protzel A, Chávez G, Dueñas M, Gil MLG, Spirandelli E, Chialina S, Echeverry M, Fuenmayor LJP, Torres M, Palma TF, Héritas NC, Martin C, Suárez A, Vallejo M, Rafaela de Souza Timoteo A, Ayala CA, Jaramillo-Koupermann G, Hernández-Sandoval JA, Guerrero AH, Dominguez-Barrera C, Bazo-Alvarez JC, Wernhoff P, Plazzer JP, Balavarca Y, Hovig E, Møller P, Dominguez-Valentin M. A snapshot of current genetic testing practice in Lynch syndrome: The results of a representative survey of 33 Latin American existing centres/registries. Eur J Cancer 2019; 119:112-121. [DOI: 10.1016/j.ejca.2019.07.017] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Revised: 07/10/2019] [Accepted: 07/16/2019] [Indexed: 01/05/2023]
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Sui QQ, Jiang W, Wu XD, Ling YH, Pan ZZ, Ding PR. A frameshift mutation in exon 19 of MLH1 in a Chinese Lynch syndrome family: a pedigree study. J Zhejiang Univ Sci B 2019; 20:105-108. [PMID: 30614234 DOI: 10.1631/jzus.b1800105] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Lynch syndrome (LS), an autosomal dominantly inherited disease previously known as hereditary non-polyposis colorectal cancer (HNPCC), leads to a high risk of colorectal cancer (CRC) as well as malignancy at certain sites including endometrium, ovary, stomach, and small bowel (Hampel et al., 2008; Lynch et al., 2009). Clinically, LS is considered the most common hereditary CRC-predisposing syndrome, accounting for about 3% of all CRC cases (Popat et al., 2005). LS is associated with mutations of DNA mismatch repair (MMR) genes such as MLH1, MSH2, MSH6, PMS2, and EPCAM (Ligtenberg et al., 2009; Lynch et al., 2009), which can trigger a high frequency of replication errors in both microsatellite regions and repetitive sequences in the coding regions of various cancer-related genes. Immunohistochemistry (IHC) tests followed by genetic analysis of these mutations play a significant role in diagnosis, treatment determination, and therapeutic response prediction of LS (Lynch et al., 2009; Alex et al., 2017; Ryan et al., 2017). Here, we report substitution of one base-pair in exon 1 of MLH3 (c.1397C>A) and a frameshift mutation in exon 19 of MLH1 (c.2250_2251ins AA) in a 43-year-old Chinese male with an LS pedigree.
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Affiliation(s)
- Qiao-Qi Sui
- Department of Colorectal Surgery, Sun Yat-sen University Cancer Center, Guangzhou 510060, China.,State Key Laboratory of Oncology in South China, Guangzhou 510060, China
| | - Wu Jiang
- Department of Colorectal Surgery, Sun Yat-sen University Cancer Center, Guangzhou 510060, China.,State Key Laboratory of Oncology in South China, Guangzhou 510060, China
| | - Xiao-Dan Wu
- Department of Colorectal Surgery, Sun Yat-sen University Cancer Center, Guangzhou 510060, China.,State Key Laboratory of Oncology in South China, Guangzhou 510060, China
| | - Yi-Hong Ling
- Department of Pathology, Sun Yat-sen University Cancer Center, Guangzhou 510060, China.,State Key Laboratory of Oncology in South China, Guangzhou 510060, China
| | - Zhi-Zhong Pan
- Department of Colorectal Surgery, Sun Yat-sen University Cancer Center, Guangzhou 510060, China.,State Key Laboratory of Oncology in South China, Guangzhou 510060, China
| | - Pei-Rong Ding
- Department of Colorectal Surgery, Sun Yat-sen University Cancer Center, Guangzhou 510060, China.,State Key Laboratory of Oncology in South China, Guangzhou 510060, China
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10
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Abstract
Lynch syndrome is one of the most common hereditary cancer predisposition syndromes and is associated with increased risks of colorectal and endometrial cancer, as well as multiple other cancer types. While the mechanism of mismatch repair deficiency and microsatellite instability and its role in Lynch-associated carcinogenesis has been known for some time, there have been significant advances recently in diagnostic testing and the understanding of the molecular pathogenesis of Lynch tumors. There is also an increased awareness that the clinical phenotype and cancer risk varies by specific mismatch repair mutation, which in turn has implications on surveillance strategies for patients. Even the treatment of Lynch-associated cancers has changed with the addition of immunotherapy for advanced disease. This progress report aims to review some of the many advances in epidemiology, molecular pathogenesis, diagnosis, clinical phenotype, cancer surveillance, treatment, and chemo- and immune-prevention strategies in the Lynch syndrome field over the past 5 years.
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Affiliation(s)
- Leah H Biller
- Beth Israel Deaconess Medical Center, 450 Brookline Avenue, Boston, MA, 02215, USA
| | - Sapna Syngal
- Dana-Farber Cancer Institute, Boston, MA, USA.
- Harvard Medical School, Boston, MA, USA.
- Brigham & Women's Hospital, Boston, MA, USA.
| | - Matthew B Yurgelun
- Dana-Farber Cancer Institute, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
- Brigham & Women's Hospital, Boston, MA, USA
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11
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Vaccaro CA, López-Kostner F, Adriana DV, Palmero EI, Rossi BM, Antelo M, Solano A, Carraro DM, Forones NM, Bohorquez M, Lino-Silva LS, Buleje J, Spirandelli F, Abe-Sandes K, Nascimento I, Sullcahuaman Y, Sarroca C, Gonzalez ML, Herrando AI, Alvarez K, Neffa F, Galvão HC, Esperon P, Golubicki M, Cisterna D, Cardoso FC, Torrezan GT, Junior SA, Pimenta CAM, da Cruz Formiga MN, Santos E, Sá CU, Oliveira EP, Fujita R, Spirandelli E, Jimenez G, Guindalini RSC, de Azevedo RGMV, Bueno LSM, Dos Santos Nogueira ST, Loarte MT, Padron J, Del Carmen Castro-Mujica M, Del Monte JS, Caballero C, Peña CMM, Pinto J, Barletta-Carrillo C, Melva GA, Piñero T, Beltran PM, Ashton-Prolla P, Rodriguez Y, Quispe R, Rossi NT, Martin C, Chialina S, Kalfayan PG, Bazo-Alvarez JC, Cañete AR, Dominguez-Barrera C, Nuñez L, Da Silva SD, Balavarca Y, Wernhoff P, Plazzer JP, Møller P, Hovig E, Dominguez-Valentin M. From colorectal cancer pattern to the characterization of individuals at risk: Picture for genetic research in Latin America. Int J Cancer 2018; 145:318-326. [PMID: 30303536 PMCID: PMC6587543 DOI: 10.1002/ijc.31920] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 09/14/2018] [Accepted: 09/19/2018] [Indexed: 12/14/2022]
Abstract
Colorectal cancer (CRC) is one of the most common cancers in Latin America and the Caribbean, with the highest rates reported for Uruguay, Brazil and Argentina. We provide a global snapshot of the CRC patterns, how screening is performed, and compared/contrasted to the genetic profile of Lynch syndrome (LS) in the region. From the literature, we find that only nine (20%) of the Latin America and the Caribbean countries have developed guidelines for early detection of CRC, and also with a low adherence. We describe a genetic profile of LS, including a total of 2,685 suspected families, where confirmed LS ranged from 8% in Uruguay and Argentina to 60% in Peru. Among confirmed LS, path_MLH1 variants were most commonly identified in Peru (82%), Mexico (80%), Chile (60%), and path_MSH2/EPCAM variants were most frequently identified in Colombia (80%) and Argentina (47%). Path_MSH6 and path_PMS2 variants were less common, but they showed important presence in Brazil (15%) and Chile (10%), respectively. Important differences exist at identifying LS families in Latin American countries, where the spectrum of path_MLH1 and path_MSH2 variants are those most frequently identified. Our findings have an impact on the evaluation of the patients and their relatives at risk for LS, derived from the gene affected. Although the awareness of hereditary cancer and genetic testing has improved in the last decade, it is remains deficient, with 39%–80% of the families not being identified for LS among those who actually met both the clinical criteria for LS and showed MMR deficiency.
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Affiliation(s)
- Carlos Alberto Vaccaro
- PROCANHE- Instituto de Medicina Traslacional e Ingeniería Biomédica (IMTIB)-CONICET, Instituto Universitario del Hospital Italiano (IUHI), Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | | | - Della Valle Adriana
- Hospital Fuerzas Armadas, Grupo Colaborativo Uruguayo, Investigación de Afecciones Oncológicas Hereditarias (GCU), Montevideo, Uruguay
| | - Edenir Inez Palmero
- Molecular Oncology Research Center, Barretos Cancer Hospital, Brazil & Barretos School of Health Sciences - FACISB, Barretos, SP, Brazil
| | | | - Marina Antelo
- Oncology Section of the Public Hospital of Gastroenterology "Dr. C. B. Udaondo", Buenos Aires, Argentina.,Instituto de Salud Colectiva, Universidad Nacional de Lanús, Buenos Aires, Argentina
| | - Angela Solano
- Sección de Genotipificación, Departamento de Análisis Clínicos, Centro de Educación Médica e Investigaciones Clínicas (CEMIC), Buenos Aires, Argentina
| | | | - Nora Manoukian Forones
- Gastroenterology Division, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Mabel Bohorquez
- Grupo de Investigación Citogenética, Filogenia y Evolución de Poblaciones, Facultades de Ciencias y de Ciencias de Salud, Universidad del Tolima, Ibagué, Colombia
| | | | - Jose Buleje
- Centro de Genética y Biología Molecular, Instituto de Investigación, Facultad de Medicina Humana, Universidad de San Martín de Porres, Lima, Perú
| | - Florencia Spirandelli
- Servicio de Coloproctologia y Asesoria Genetica en Cancer, Hospital Español de Rosario, Rosario, Argentina
| | - Kiyoko Abe-Sandes
- Instituto de Ciências da Saúde, Universidade Federal da Bahia, Salvador, Brazil
| | - Ivana Nascimento
- Instituto de Ciência da Saúde e Núcleo de Oncologia da Bahia, Salvador, Brazil
| | - Yasser Sullcahuaman
- Universidad Peruana de Ciencias Aplicadas, Lima, Peru.,Instituto de Investigación Genomica, Lima, Peru
| | - Carlos Sarroca
- Hospital Fuerzas Armadas, Grupo Colaborativo Uruguayo, Investigación de Afecciones Oncológicas Hereditarias (GCU), Montevideo, Uruguay
| | - Maria Laura Gonzalez
- PROCANHE- Instituto de Medicina Traslacional e Ingeniería Biomédica (IMTIB)-CONICET, Instituto Universitario del Hospital Italiano (IUHI), Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Alberto Ignacio Herrando
- PROCANHE- Instituto de Medicina Traslacional e Ingeniería Biomédica (IMTIB)-CONICET, Instituto Universitario del Hospital Italiano (IUHI), Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Karin Alvarez
- Laboratorio de Oncología y Genética Molecular, Clínica Los Condes, Santiago, Chile
| | - Florencia Neffa
- Hospital Fuerzas Armadas, Grupo Colaborativo Uruguayo, Investigación de Afecciones Oncológicas Hereditarias (GCU), Montevideo, Uruguay
| | - Henrique Camposreis Galvão
- Molecular Oncology Research Center, Barretos Cancer Hospital, Brazil & Barretos School of Health Sciences - FACISB, Barretos, SP, Brazil
| | - Patricia Esperon
- Hospital Fuerzas Armadas, Grupo Colaborativo Uruguayo, Investigación de Afecciones Oncológicas Hereditarias (GCU), Montevideo, Uruguay
| | - Mariano Golubicki
- Molecular Laboratory, Hospital of Gastroenterology "Dr. C. B. Udaondo", Buenos Aires, Argentina
| | - Daniel Cisterna
- Molecular Laboratory, Hospital of Gastroenterology "Dr. C. B. Udaondo", Buenos Aires, Argentina
| | - Florencia C Cardoso
- Sección de Genotipificación, Departamento de Análisis Clínicos, Centro de Educación Médica e Investigaciones Clínicas (CEMIC), Buenos Aires, Argentina
| | | | | | | | | | | | | | | | - Ricardo Fujita
- Centro de Genética y Biología Molecular, Instituto de Investigación, Facultad de Medicina Humana, Universidad de San Martín de Porres, Lima, Perú
| | - Enrique Spirandelli
- Servicio de Coloproctologia y Asesoria Genetica en Cancer, Hospital Español de Rosario, Rosario, Argentina
| | - Geiner Jimenez
- Hospital Dr. Rafael Angel Calderón Guardia, Caja Costarricense de Seguro Social, San Jose, Costa Rica
| | - Rodrigo Santa Cruz Guindalini
- Faculdade de Medicina-Universidade de São Paulo and Clínica de Oncologia/grupo (CLION), Clínica de Assistência à Mulher (CAM), Bahia, Brazil
| | | | - Larissa Souza Mario Bueno
- Complexo Hospital Universitário Professor Edgar Santos, Universidade Federal da Bahia, Bahia, Brazil
| | | | - Mariela Torres Loarte
- Universidad Peruana de Ciencias Aplicadas, Lima, Peru.,Instituto de Investigación Genomica, Lima, Peru
| | | | | | | | | | - Carlos Mario Muñeton Peña
- Unidad de Genética Médica, Departamento de Pediatría, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
| | - Joseph Pinto
- Unidad de Investigación Básica y Traslacional, Oncosalud-AUNA, Lima, Peru
| | | | | | - Tamara Piñero
- PROCANHE- Instituto de Medicina Traslacional e Ingeniería Biomédica (IMTIB)-CONICET, Instituto Universitario del Hospital Italiano (IUHI), Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.,IMTIB-Instituto Universitario Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | | | - Patricia Ashton-Prolla
- Departamento de Genética da Universidade Federal do Rio Grande do Sul (UFRGS) e Serviço de Genética Médica do Hospital de Clinicas de Porto Alegre (HCPA) & Rede Brasileira de Câncer Hereditário, Porto Alegre, Brazil
| | | | - Richard Quispe
- Laboratorio de Genética Molecular del Instituto de Servicios de Laboratorio de Diagnóstico e Investigación en Salud (SELADIS), La Paz, Bolivia
| | | | - Claudia Martin
- Hospital Privado Universitario de Cordoba, Cordoba, Argentina
| | - Sergio Chialina
- Servicio de Coloproctologia y Asesoria Genetica en Cancer, Hospital Español de Rosario, Rosario, Argentina
| | - Pablo German Kalfayan
- PROCANHE- Instituto de Medicina Traslacional e Ingeniería Biomédica (IMTIB)-CONICET, Instituto Universitario del Hospital Italiano (IUHI), Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Juan Carlos Bazo-Alvarez
- Research Department of Primary Care and Population Health, University College London, London, United Kingdom.,Centro de Estudios de Población, Universidad Católica los Ángeles de Chimbote (ULADECH-Católica), Chimbote, Perú
| | - Alcides Recalde Cañete
- Facultad de Ciencias Medicas Médicas, Universidad Nacional de Asunción, Asuncion, Paraguay
| | | | - Lina Nuñez
- National Institute of Cancer, Buenos Aires, Argentina
| | - Sabrina Daniela Da Silva
- Lady Davis Institute for Medical Research and Segal Cancer Center, Jewish General Hospital, Montreal, QC, Canada.,Department of Otolaryngology-Head and Neck Surgery, McGill University, Montreal, QC, Canada
| | - Yesilda Balavarca
- Division of Preventive Oncology, German Cancer Research Center and National Center for Tumor Diseases, Heidelberg, Germany
| | - Patrik Wernhoff
- Department of Tumor Biology, Institute for Cancer Research, Oslo University Hospital, Oslo, Norway
| | - John-Paul Plazzer
- Colorectal Medicine and Genetics, The Royal Melbourne Hospital, Melbourne, Australia.,Department of Medicine, Melbourne University, Melbourne, Australia
| | - Pål Møller
- Department of Tumor Biology, Institute for Cancer Research, Oslo University Hospital, Oslo, Norway.,Department of Medical Genetics, Oslo University Hospital, Oslo, Norway.,Department of Human Medicine, Universität Witten/Herdecke, Witten, Germany
| | - Eivind Hovig
- Department of Tumor Biology, Institute for Cancer Research, Oslo University Hospital, Oslo, Norway.,Institute of Cancer Genetics and Informatics, Oslo University Hospital, Oslo, Norway.,Department of Informatics, University of Oslo, Oslo, Norway
| | - Mev Dominguez-Valentin
- Department of Tumor Biology, Institute for Cancer Research, Oslo University Hospital, Oslo, Norway
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12
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Köger N, Paulsen L, López-Kostner F, Della Valle A, Vaccaro CA, Palmero EI, Alvarez K, Sarroca C, Neffa F, Kalfayan PG, Gonzalez ML, Rossi BM, Reis RM, Brieger A, Zeuzem S, Hinrichsen I, Dominguez-Valentin M, Plotz G. Evaluation of MLH1 variants of unclear significance. Genes Chromosomes Cancer 2018. [PMID: 29520894 DOI: 10.1002/gcc.22536] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Inactivating mutations in the MLH1 gene cause the cancer predisposition Lynch syndrome, but for small coding genetic variants it is mostly unclear if they are inactivating or not. Nine such MLH1 variants have been identified in South American colorectal cancer (CRC) patients (p.Tyr97Asp, p.His112Gln, p.Pro141Ala, p.Arg265Pro, p.Asn338Ser, p.Ile501del, p.Arg575Lys, p.Lys618del, p.Leu676Pro), and evidence of pathogenicity or neutrality was not available for the majority of these variants. We therefore performed biochemical laboratory testing of the variant proteins and compared the results to protein in silico predictions on structure and conservation. Additionally, we collected all available clinical information of the families to come to a conclusion concerning their pathogenic potential and facilitate clinical diagnosis in the affected families. We provide evidence that four of the alterations are causative for Lynch syndrome, four are likely neutral and one shows compromised activity which can currently not be classified with respect to its pathogenic potential. The work demonstrates that biochemical testing, corroborated by congruent evolutionary and structural information, can serve to reliably classify uncertain variants when other data are insufficient.
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Affiliation(s)
- Nicole Köger
- Biomedizinisches Forschungslabor, Medizinische Klinik 1, Universitätsklinik Frankfurt, Frankfurt, Germany
| | - Lea Paulsen
- Biomedizinisches Forschungslabor, Medizinische Klinik 1, Universitätsklinik Frankfurt, Frankfurt, Germany
| | | | - Adriana Della Valle
- Hospital Fuerzas Armadas, Grupo Colaborativo Uruguayo, Investigación de Afecciones Oncológicas Hereditarias (GCU), Montevideo, Uruguay
| | | | - Edenir Inêz Palmero
- Barretos Cancer Hospital, Molecular Oncology Research Center, Barretos, São Paulo, Brazil.,Barretos School of Health Sciences-FACISB, Barretos, São Paulo, Brazil
| | - Karin Alvarez
- Laboratorio de Oncología y Genética Molecular, Clínica Los Condes, Santiago, Chile
| | - Carlos Sarroca
- Hospital Fuerzas Armadas, Grupo Colaborativo Uruguayo, Investigación de Afecciones Oncológicas Hereditarias (GCU), Montevideo, Uruguay
| | - Florencia Neffa
- Hospital Fuerzas Armadas, Grupo Colaborativo Uruguayo, Investigación de Afecciones Oncológicas Hereditarias (GCU), Montevideo, Uruguay
| | | | - Maria Laura Gonzalez
- Hereditary Cancer Program (PROCANHE), Hospital Italiano, Buenos Aires, Argentina
| | | | - Rui Manuel Reis
- Biomedizinisches Forschungslabor, Medizinische Klinik 1, Universitätsklinik Frankfurt, Frankfurt, Germany.,Life and Health Sciences Q5 753 Research Institute (ICVS), Health Sciences School, University of Minho, Braga, 754, Portugal.,ICVS/3B's-PT Government Associate Laboratory, Braga, Guimarães, 755, Portugal
| | - Angela Brieger
- Biomedizinisches Forschungslabor, Medizinische Klinik 1, Universitätsklinik Frankfurt, Frankfurt, Germany
| | - Stefan Zeuzem
- Biomedizinisches Forschungslabor, Medizinische Klinik 1, Universitätsklinik Frankfurt, Frankfurt, Germany
| | - Inga Hinrichsen
- Biomedizinisches Forschungslabor, Medizinische Klinik 1, Universitätsklinik Frankfurt, Frankfurt, Germany
| | - Mev Dominguez-Valentin
- Department of Tumor Biology, Institute for Cancer Research, Oslo University Hospital, Oslo, Norway
| | - Guido Plotz
- Biomedizinisches Forschungslabor, Medizinische Klinik 1, Universitätsklinik Frankfurt, Frankfurt, Germany
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13
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Schneider NB, Pastor T, de Paula AE, Achatz MI, dos Santos ÂR, Vianna FSL, Rosset C, Pinheiro M, Ashton‐Prolla P, Moreira MÂM, Palmero EI. Germline MLH1, MSH2 and MSH6 variants in Brazilian patients with colorectal cancer and clinical features suggestive of Lynch Syndrome. Cancer Med 2018; 7:2078-2088. [PMID: 29575718 PMCID: PMC5943474 DOI: 10.1002/cam4.1316] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Revised: 11/20/2017] [Accepted: 11/27/2017] [Indexed: 12/13/2022] Open
Abstract
Lynch syndrome (LS) is the most common hereditary colorectal cancer syndrome, caused by germline mutations in one of the major genes involved in mismatch repair (MMR): MLH1,MSH2,MSH6 and more rarely, PMS2. Recently, germline deletions in EPCAM have been also associated to the syndrome. Most of the pathogenic MMR mutations found in LS families occur in MLH1 or MSH2. Gene variants include missense, nonsense, frameshift mutations, large genomic rearrangements and splice‐site variants and most of the studies reporting the molecular characterization of LS families have been conducted outside South America. In this study, we analyzed 60 unrelated probands diagnosed with colorectal cancer and LS criteria. Testing for germline mutations and/or rearrangements in the most commonly affected MMR genes (MLH1, MSH2, EPCAM and MSH6) was done by Sanger sequencing and MLPA. Pathogenic or likely pathogenic variants were identified in MLH1 or MSH2 in 21 probands (35.0%). Of these, approximately one‐third were gene rearrangements. In addition, nine variants of uncertain significance (VUS) were identified in 10 (16.6%) of the sixty probands analyzed. Other four novel variants were identified, only in MLH1. Our results suggest that MSH6 pathogenic variants are not common among Brazilian LS probands diagnosed with CRC and that MMR gene rearrangements account for a significant proportion of the germline variants in this population underscoring the need to include rearrangement analysis in the molecular testing of Brazilian individuals with suspected Lynch syndrome.
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Affiliation(s)
- Nayê Balzan Schneider
- Laboratório de Medicina GenômicaCentro de Pesquisa ExperimentalHospital de Clínicas de Porto Alegre (HCPA) and Programa de Pós Graduação em Genética e Biologia MolecularUniversidade Federal do Rio Grande do Sul (UFRGS)Porto AlegreBrazil
| | - Tatiane Pastor
- Genetics ProgramInstituto Nacional de CâncerRio de JaneiroBrazil
| | | | - Maria Isabel Achatz
- AC Camargo Cancer CenterSão PauloBrazil
- Clinical Genetics BranchDivision of Cancer Epidemiology and GeneticsDepartment of Health and Human ServicesNational Cancer InstituteNational Institutes of HealthBethesdaMaryland
| | - Ândrea Ribeiro dos Santos
- Núcleo de Pesquisas Oncológicas and Laboratório de Genética Humana e MédicaUniversidade Federal do Pará Universidade Federal do Pará (UFPA)BelémBrazil
| | - Fernanda Sales Luiz Vianna
- Laboratório de Pesquisa em Bioética e Ética na Ciência‐ LAPEBEC ‐ Centro de Pesquisa ExperimentalHospital de Clínicas de Porto AlegrePorto AlegreBrazil
| | - Clévia Rosset
- Laboratório de Medicina GenômicaCentro de Pesquisa ExperimentalHospital de Clínicas de Porto Alegre (HCPA) and Programa de Pós Graduação em Genética e Biologia MolecularUniversidade Federal do Rio Grande do Sul (UFRGS)Porto AlegreBrazil
| | - Manuela Pinheiro
- Serviço de GenéticaInstituto Português de Oncologia do Porto (IPO Porto)PortoPortugal
| | - Patricia Ashton‐Prolla
- Laboratório de Medicina GenômicaCentro de Pesquisa ExperimentalHospital de Clínicas de Porto Alegre (HCPA) and Programa de Pós Graduação em Genética e Biologia MolecularUniversidade Federal do Rio Grande do Sul (UFRGS)Porto AlegreBrazil
| | | | - Edenir Inêz Palmero
- Molecular Oncology Research CenterBarretos Cancer HospitalBarretosBrazil
- Barretos School of Health SciencesDr. Paulo Prata – FACISBBarretosBrazil
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14
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Rossi BM, Palmero EI, López-Kostner F, Sarroca C, Vaccaro CA, Spirandelli F, Ashton-Prolla P, Rodriguez Y, de Campos Reis Galvão H, Reis RM, Escremim de Paula A, Capochin Romagnolo LG, Alvarez K, Della Valle A, Neffa F, Kalfayan PG, Spirandelli E, Chialina S, Gutiérrez Angulo M, Castro-Mujica MDC, Sanchez de Monte J, Quispe R, da Silva SD, Rossi NT, Barletta-Carrillo C, Revollo S, Taborga X, Morillas LL, Tubeuf H, Monteiro-Santos EM, Piñero TA, Dominguez-Barrera C, Wernhoff P, Martins A, Hovig E, Møller P, Dominguez-Valentin M. A survey of the clinicopathological and molecular characteristics of patients with suspected Lynch syndrome in Latin America. BMC Cancer 2017; 17:623. [PMID: 28874130 PMCID: PMC5586063 DOI: 10.1186/s12885-017-3599-4] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Accepted: 08/23/2017] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Genetic counselling and testing for Lynch syndrome (LS) have recently been introduced in several Latin America countries. We aimed to characterize the clinical, molecular and mismatch repair (MMR) variants spectrum of patients with suspected LS in Latin America. METHODS Eleven LS hereditary cancer registries and 34 published LS databases were used to identify unrelated families that fulfilled the Amsterdam II (AMSII) criteria and/or the Bethesda guidelines or suggestive of a dominant colorectal (CRC) inheritance syndrome. RESULTS We performed a thorough investigation of 15 countries and identified 6 countries where germline genetic testing for LS is available and 3 countries where tumor testing is used in the LS diagnosis. The spectrum of pathogenic MMR variants included MLH1 up to 54%, MSH2 up to 43%, MSH6 up to 10%, PMS2 up to 3% and EPCAM up to 0.8%. The Latin America MMR spectrum is broad with a total of 220 different variants which 80% were private and 20% were recurrent. Frequent regions included exons 11 of MLH1 (15%), exon 3 and 7 of MSH2 (17 and 15%, respectively), exon 4 of MSH6 (65%), exons 11 and 13 of PMS2 (31% and 23%, respectively). Sixteen international founder variants in MLH1, MSH2 and MSH6 were identified and 41 (19%) variants have not previously been reported, thus representing novel genetic variants in the MMR genes. The AMSII criteria was the most used clinical criteria to identify pathogenic MMR carriers although microsatellite instability, immunohistochemistry and family history are still the primary methods in several countries where no genetic testing for LS is available yet. CONCLUSION The Latin America LS pathogenic MMR variants spectrum included new variants, frequently altered genetic regions and potential founder effects, emphasizing the relevance implementing Lynch syndrome genetic testing and counseling in all of Latin America countries.
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Affiliation(s)
| | - Edenir Inêz Palmero
- Molecular Oncology Research Center, Barretos Cancer Hospital, Barretos, SP Brazil
| | | | - Carlos Sarroca
- Hospital Fuerzas Armadas, Grupo Colaborativo Uruguayo, Investigación de Afecciones Oncológicas Hereditarias (GCU), Montevideo, Uruguay
| | | | - Florencia Spirandelli
- Servicio de Coloproctologia y Asesoria Genetica en Cancer, Hospital Español de Rosario, Rosario, Argentina
| | - Patricia Ashton-Prolla
- Departamento de Genética da Universidade Federal do Rio Grande do Sul (UFRGS) e Serviço de Genética Médica do Hospital de Clinicas de Porto Alegre (HCPA) & Rede Brasileira de Câncer Hereditário, Porto Alegre, Rio Grande Do Sul Brazil
| | | | | | - Rui Manuel Reis
- Molecular Oncology Research Center, Barretos Cancer Hospital & Life and Health Sciences Research Institute (ICVS), Health Sciences School, University of Minho, Braga, Portugal
- ICVS/3B’s-PT Government Associate Laboratory, Braga, Guimarães Portugal
| | | | | | - Karin Alvarez
- Laboratorio de Oncología y Genética Molecular, Clínica Los Condes, Santiago, Chile
| | - Adriana Della Valle
- Hospital Fuerzas Armadas, Grupo Colaborativo Uruguayo, Investigación de Afecciones Oncológicas Hereditarias (GCU), Montevideo, Uruguay
| | - Florencia Neffa
- Hospital Fuerzas Armadas, Grupo Colaborativo Uruguayo, Investigación de Afecciones Oncológicas Hereditarias (GCU), Montevideo, Uruguay
| | | | - Enrique Spirandelli
- Servicio de Coloproctologia y Asesoria Genetica en Cancer, Hospital Español de Rosario, Rosario, Argentina
| | - Sergio Chialina
- Servicio de Coloproctologia y Asesoria Genetica en Cancer, Hospital Español de Rosario, Rosario, Argentina
| | | | | | | | - Richard Quispe
- Laboratorio de Genética Molecular del Instituto de Servicios de Laboratorio de Diagnóstico e Investigación en Salud (SELADIS), La Paz, Bolivia
| | - Sabrina Daniela da Silva
- Lady Davis Institute for Medical Research and Segal Cancer Center, Jewish General Hospital, Montreal, Quebec, Canada
- Department of Otolaryngology-Head and Neck Surgery, McGill University, Montreal, Quebec, Canada
| | | | - Claudia Barletta-Carrillo
- Equipo Funcional de Genética y Biologia Molecular, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru
| | - Susana Revollo
- Laboratorio de Genética Molecular del Instituto de Servicios de Laboratorio de Diagnóstico e Investigación en Salud (SELADIS), La Paz, Bolivia
| | - Ximena Taborga
- Laboratorio de Genética Molecular del Instituto de Servicios de Laboratorio de Diagnóstico e Investigación en Salud (SELADIS), La Paz, Bolivia
| | | | - Hélène Tubeuf
- Inserm-U1079-IRIB, UNIROUEN, Normandie Univ, Normandy Centre for Genomic and Personalized Medicine, Rouen, France
- Interactive Biosoftware, Rouen, France
| | | | - Tamara Alejandra Piñero
- Instituto de Ciencias Basicas y Medicina Experimental (ICBME), Hospital Italiano, Buenos Aires, Argentina
| | - Constantino Dominguez-Barrera
- Department of Preventive Medicine, Faculty of Medicine, Universidad Nacional Mayor de San Marcos (UNMSM), Lima, Peru
| | - Patrik Wernhoff
- Department of Clinical Molecular Biology (EpiGen), Akershus University Hospital, Lørenskog, Norway
| | - Alexandra Martins
- Inserm-U1079-IRIB, UNIROUEN, Normandie Univ, Normandy Centre for Genomic and Personalized Medicine, Rouen, France
| | - Eivind Hovig
- Department of Tumor Biology, Institute for Cancer Research, Oslo University Hospital, Oslo, Norway
- Institute of Cancer Genetics and Informatics, Oslo University Hospital, Oslo, Norway
| | - Pål Møller
- Department of Tumor Biology, Institute for Cancer Research, Oslo University Hospital, Oslo, Norway
- Department of Medical Genetics, Oslo University Hospital, Oslo, Norway
- Department of Human Medicine, Universität Witten/Herdecke, Witten, Germany
| | - Mev Dominguez-Valentin
- Department of Tumor Biology, Institute for Cancer Research, Oslo University Hospital, Oslo, Norway
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15
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Abstract
After decades of unawareness about Lynch syndrome, the medical community in South America is increasingly interested and informed. The visits and support of mentors like H. T. Lynch had been crucial to this awakening. Several countries have at least one registry with skilled personnel in genetic counseling and research. However, this only represents a very restricted resource for the region. According to the GETH, there are 27 hereditary cancer care centers in South America (21 in Brazil, 3 in Argentina, 1 in Uruguay, 1 in Chile and 1 in Peru). These registries differ in fundamental aspects of function, capabilities and funding, but are able to conduct high quality clinical, research and educational activities due to the dedication and personal effort of their members, and organizational support. More support from the governments as well as the participation of the community would boost the initiatives of people leading these groups. Meantime, the collaboration among the South American registries and the involvement of registries and leaders from developed countries will allow to maximize the efficiency in caring for affected patients and their families. The aim of this article is to describe how the knowledge of LS began to be spread in South America, how the first registries were organized and to summarize the current state of progress. In addition, we will provide an update of the clinical and molecular findings in the region.
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16
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López F, Hurtado BQC, Álvarez BQK, Kronberg U, Pinto EE, Peralta O, Adaniel C, Salinas EF, Letelier C. ¿CÓMO ORGANIZAR Y ESTRUCTURAR UN PROGRAMA DE SÍNDROMES HEREDITARIOS QUE PREDISPONEN AL DESARROLLO DEL CÁNCER? REVISTA MÉDICA CLÍNICA LAS CONDES 2017. [DOI: 10.1016/j.rmclc.2017.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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17
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Ricker CN, Hanna DL, Peng C, Nguyen NT, Stern MC, Schmit SL, Idos GE, Patel R, Tsai S, Ramirez V, Lin S, Shamasunadara V, Barzi A, Lenz HJ, Figueiredo JC. DNA mismatch repair deficiency and hereditary syndromes in Latino patients with colorectal cancer. Cancer 2017. [PMID: 28640387 PMCID: PMC5610604 DOI: 10.1002/cncr.30790] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND The landscape of hereditary syndromes and clinicopathologic characteristics among US Latino/Hispanic individuals with colorectal cancer (CRC) remains poorly understood. METHODS A total of 265 patients with CRC who were enrolled in the Hispanic Colorectal Cancer Study were included in the current study. Information regarding CRC risk factors was elicited through interviews, and treatment and survival data were abstracted from clinical charts. Tumor studies and germline genetic testing results were collected from medical records or performed using standard molecular methods. RESULTS The mean age of the patients at the time of diagnosis was 53.7 years (standard deviation, 10.3 years), and 48.3% were female. Overall, 21.2% of patients reported a first‐degree or second‐degree relative with CRC; 3.4% met Amsterdam I/II criteria. With respect to Bethesda guidelines, 38.5% of patients met at least 1 criterion. Of the 161 individuals who had immunohistochemistry and/or microsatellite instability testing performed, 21 (13.0%) had mismatch repair (MMR)‐deficient (dMMR) tumors. dMMR tumors were associated with female sex (61.9%), earlier age at the time of diagnosis (50.4 ± 12.4 years), proximal location (61.9%), and first‐degree (23.8%) or second‐degree (9.5%) family history of CRC. Among individuals with dMMR tumors, 13 (61.9%) had a germline MMR mutation (MutL homolog 1 [MLH1] in 6 patients; MutS homolog 2 [MSH2] in 4 patients; MutS homolog 6 [MHS6] in 2 patients; and PMS1 homolog 2, mismatch repair system component [PMS2] in 1 patient). The authors identified 2 additional MLH1 mutation carriers by genetic testing who had not received immunohistochemistry/microsatellite instability testing. In total, 5.7% of the entire cohort were confirmed to have Lynch syndrome. In addition, 6 individuals (2.3%) had a polyposis phenotype. CONCLUSIONS The percentage of dMMR tumors noted among Latino individuals (13%) is similar to estimates in non‐Hispanic white individuals. In the current study, the majority of individuals with dMMR tumors were confirmed to have Lynch syndrome. Cancer 2017. © 2017 The Authors. Cancer published by Wiley Periodicals, Inc. on behalf of American Cancer Society. Cancer 2017;123:3732–3743. © 2017 American Cancer Society The landscape of hereditary syndromes and clinicopathologic characteristics among Latino/Hispanic individuals in the United States with colorectal cancer remains poorly understood. Using data from the Hispanic Colorectal Cancer Study, approximately 13% of cases in the current study appear to have mismatch repair‐deficient tumors, 61.9% of which will be confirmed to have Lynch syndrome.
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Affiliation(s)
- Charité N Ricker
- Department of Medicine, Division of Medical Oncology, Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, California
| | - Diana L Hanna
- Department of Medicine, Division of Medical Oncology, Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, California
| | - Cheng Peng
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Nathalie T Nguyen
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Mariana C Stern
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Stephanie L Schmit
- Department of Medicine, Division of Medical Oncology, Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, California.,Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California.,Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida.,Department of Gastrointestinal Oncology, Moffitt Cancer Center, Tampa, Florida
| | - Greg E Idos
- Department of Medicine, Division of Gastrointestinal and Liver Disease, Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, California
| | - Ravi Patel
- Department of Medicine, Division of Medical Oncology, Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, California
| | - Steven Tsai
- Department of Medicine, Division of Medical Oncology, Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, California
| | - Veronica Ramirez
- Department of Medicine, Division of Medical Oncology, Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, California
| | - Sonia Lin
- Department of Medicine, Division of Medical Oncology, Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, California
| | - Vinay Shamasunadara
- Department of Medicine, Division of Medical Oncology, Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, California
| | - Afsaneh Barzi
- Department of Medicine, Division of Medical Oncology, Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, California
| | - Heinz-Josef Lenz
- Department of Medicine, Division of Medical Oncology, Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, California
| | - Jane C Figueiredo
- Department of Medicine, Division of Medical Oncology, Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, California.,Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California.,Department of Medicine, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, California
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18
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Sunga AY, Ricker C, Espenschied CR, Castillo D, Melas M, Herzog J, Bannon S, Cruz-Correa M, Lynch P, Solomon I, Gruber SB, Weitzel JN. Spectrum of mismatch repair gene mutations and clinical presentation of Hispanic individuals with Lynch syndrome. Cancer Genet 2017; 212-213:1-7. [PMID: 28449805 PMCID: PMC8800930 DOI: 10.1016/j.cancergen.2017.01.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Revised: 01/13/2017] [Accepted: 01/15/2017] [Indexed: 12/21/2022]
Abstract
Lynch syndrome (LS), the most common hereditary colorectal cancer syndrome, is caused by mismatch repair (MMR) gene mutations. However, data about MMR mutations in Hispanics are limited. This study aims to describe the spectrum of MMR mutations in Hispanics with LS and explore ancestral origins. This case series involved an IRB-approved retrospective chart review of self-identified Hispanic patients (n = 397) seen for genetic cancer risk assessment at four collaborating academic institutions in California, Texas, and Puerto Rico who were evaluated by MMR genotyping and/or tumor analysis. A literature review was conducted for all mutations identified. Of those who underwent clinical genetic testing (n = 176), 71 had MMR gene mutations. Nine mutations were observed more than once. One third (3/9) of recurrent mutations and two additional mutations (seen only once) were previously reported in Spain, confirming the influence of Spanish ancestry on MMR mutations in Hispanic populations. The recurrent mutations identified (n = 9) included both previously reported mutations as well as unique mutations not in the literature. This is the largest report of Hispanic MMR mutations in North America; however, a larger sample and haplotype analyses are needed to better understand recurrent MMR mutations in Hispanic populations.
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Affiliation(s)
- Annette Y Sunga
- Clinical Cancer Genetics, City of Hope National Medical Center, Duarte, CA 91010, USA
| | - Charité Ricker
- USC Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA 90089, USA
| | - Carin R Espenschied
- Clinical Cancer Genetics, City of Hope National Medical Center, Duarte, CA 91010, USA
| | - Danielle Castillo
- Clinical Cancer Genetics, City of Hope National Medical Center, Duarte, CA 91010, USA
| | - Marilena Melas
- USC Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA 90089, USA
| | - Josef Herzog
- Clinical Cancer Genetics, City of Hope National Medical Center, Duarte, CA 91010, USA
| | - Sarah Bannon
- Clinical Cancer Genetics, MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Marcia Cruz-Correa
- Clinical Cancer Genetics, University of Puerto Rico Comprehensive Cancer Center, Rio Piedras 00935, Puerto Rico
| | - Patrick Lynch
- Clinical Cancer Genetics, MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Ilana Solomon
- Clinical Cancer Genetics, City of Hope National Medical Center, Duarte, CA 91010, USA
| | - Stephen B Gruber
- USC Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA 90089, USA
| | - Jeffrey N Weitzel
- Clinical Cancer Genetics, City of Hope National Medical Center, Duarte, CA 91010, USA.
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19
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Cruz-Correa M, Pérez-Mayoral J, Dutil J, Echenique M, Mosquera R, Rivera-Román K, Umpierre S, Rodriguez-Quilichini S, Gonzalez-Pons M, Olivera MI, Pardo S. Hereditary cancer syndromes in Latino populations: genetic characterization and surveillance guidelines. Hered Cancer Clin Pract 2017; 15:3. [PMID: 28127413 PMCID: PMC5251307 DOI: 10.1186/s13053-017-0063-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2016] [Accepted: 01/05/2017] [Indexed: 12/17/2022] Open
Abstract
Hereditary cancer predisposition syndromes comprise approximately 10% of diagnosed cancers; however, familial forms are believed to account for up to 30% of some cancers. In Hispanics, the most commonly diagnosed hereditary cancers include colorectal cancer syndromes such as, Lynch Syndrome, Familial Adenomatous Polyposis, and hereditary breast and ovarian cancer syndromes. Although the incidence of hereditary cancers is low, patients diagnosed with hereditary cancer syndromes are at high-risk for developing secondary cancers. Furthermore, the productivity loss that occurs after cancer diagnosis in these high-risk patients has a negative socio-economic impact. This review summarizes the genetic basis, phenotype characteristics, and the National Comprehensive Cancer Network's screening, testing, and surveillance guidelines for the leading hereditary cancer syndromes. The aim of this review is to promote a better understanding of cancer genetics and genetic testing in Hispanic patients.
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Affiliation(s)
- Marcia Cruz-Correa
- Department of Cancer Biology, University of Puerto Rico Comprehensive Cancer Center, San Juan, PR USA
- University of Puerto Rico Medical Sciences Campus, School of Medicine, San Juan, PR USA
- University of Puerto Rico Comprehensive Cancer Center, PMB711 Ave. De Diego 89 Ste. 105, San Juan, PR 00927-6346 USA
| | - Julyann Pérez-Mayoral
- Department of Cancer Biology, University of Puerto Rico Comprehensive Cancer Center, San Juan, PR USA
- University of Puerto Rico Medical Sciences Campus, School of Medicine, San Juan, PR USA
| | - Julie Dutil
- Ponce Health Sciences University, Ponce Research Institute, Ponce, PR USA
| | | | | | - Keila Rivera-Román
- Department of Pediatrics, University of Puerto Rico School of Medicine, San Juan, PR USA
| | - Sharee Umpierre
- Department of Cancer Biology, University of Puerto Rico Comprehensive Cancer Center, San Juan, PR USA
| | | | - Maria Gonzalez-Pons
- Department of Cancer Biology, University of Puerto Rico Comprehensive Cancer Center, San Juan, PR USA
- University of Puerto Rico Medical Sciences Campus, School of Medicine, San Juan, PR USA
| | - Myrta I. Olivera
- Department of Cancer Biology, University of Puerto Rico Comprehensive Cancer Center, San Juan, PR USA
- University of Puerto Rico Medical Sciences Campus, School of Medicine, San Juan, PR USA
| | - Sherly Pardo
- Department of Pathology, University of Puerto Rico School of Medicine, San Juan, PR USA
| | - on behalf of the Puerto Rico Clinical Cancer Genetics Consortia
- Department of Cancer Biology, University of Puerto Rico Comprehensive Cancer Center, San Juan, PR USA
- University of Puerto Rico Medical Sciences Campus, School of Medicine, San Juan, PR USA
- Ponce Health Sciences University, Ponce Research Institute, Ponce, PR USA
- Cancer Center, Auxilio Mutuo Hospital, San Juan, PR USA
- Puerto Rico Gastroenterology Association, San Juan, PR USA
- Department of Pediatrics, University of Puerto Rico School of Medicine, San Juan, PR USA
- Department of Pathology, University of Puerto Rico School of Medicine, San Juan, PR USA
- University of Puerto Rico Comprehensive Cancer Center, PMB711 Ave. De Diego 89 Ste. 105, San Juan, PR 00927-6346 USA
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20
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Dominguez-Valentin M, Wernhoff P, Cajal AR, Kalfayan PG, Piñero TA, Gonzalez ML, Ferro A, Sammartino I, Causada Calo NS, Vaccaro CA. MLH1 Ile219Val Polymorphism in Argentinean Families with Suspected Lynch Syndrome. Front Oncol 2016; 6:189. [PMID: 27606285 PMCID: PMC4996012 DOI: 10.3389/fonc.2016.00189] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Accepted: 08/08/2016] [Indexed: 12/20/2022] Open
Affiliation(s)
- Mev Dominguez-Valentin
- Department of Tumor Biology, Institute for Cancer Research, Oslo University Hospital , Oslo , Norway
| | - Patrik Wernhoff
- Unit of Muscle Biology, Lund Transgenic Core Facility/Reproductive Immunology, Department of Experimental Medical Science, Lund University , Lund , Sweden
| | - Andrea R Cajal
- Institute of Basic Sciences and Experimental Medicine (ICBME), Instituto Universitario Hospital Italiano , Buenos Aires , Argentina
| | - Pablo G Kalfayan
- Programa de Cancer Hereditario (ProCanHe), Hospital Italiano de Buenos Aires , Buenos Aires , Argentina
| | - Tamara A Piñero
- Programa de Cancer Hereditario (ProCanHe), Hospital Italiano de Buenos Aires , Buenos Aires , Argentina
| | - Maria L Gonzalez
- Programa de Cancer Hereditario (ProCanHe), Hospital Italiano de Buenos Aires , Buenos Aires , Argentina
| | - Alejandra Ferro
- Programa de Cancer Hereditario (ProCanHe), Hospital Italiano de Buenos Aires , Buenos Aires , Argentina
| | - Ines Sammartino
- Programa de Cancer Hereditario (ProCanHe), Hospital Italiano de Buenos Aires , Buenos Aires , Argentina
| | - Natalia S Causada Calo
- Programa de Cancer Hereditario (ProCanHe), Hospital Italiano de Buenos Aires , Buenos Aires , Argentina
| | - Carlos A Vaccaro
- Programa de Cancer Hereditario (ProCanHe), Hospital Italiano de Buenos Aires , Buenos Aires , Argentina
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21
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Cruz-Correa M, Diaz-Algorri Y, Pérez-Mayoral J, Suleiman-Suleiman W, Gonzalez-Pons MDM, Bertrán C, Casellas N, Rodríguez N, Pardo S, Rivera K, Mosquera R, Rodriguez-Quilichini S. Clinical characterization and mutation spectrum in Caribbean Hispanic families with Lynch syndrome. Fam Cancer 2016; 14:415-25. [PMID: 25782445 DOI: 10.1007/s10689-015-9795-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Lynch syndrome (LS) is an inherited form of colorectal cancer (CRC) caused by germline mutations in the mismatch repair (MMR) genes. It accounts for approximately 5% of all CRCs. The prevalence of LS among US Hispanics is unknown. The objective of this study was to describe the germline mutations of LS in Caribbean Hispanics from Puerto Rico and Dominican Republic. A total of 89 subjects were recruited through the Puerto Rico Familial Colorectal Cancer Registry and were classified according to Amsterdam and Bethesda clinical guidelines. For those tumors with lack of expression of MMR protein, gene sequencing was ordered. A total of 35 individuals with deficient MMR system were identified: 22 had MMR mutations and 13 had tumors with absent MMR protein expression. Our results show that the mutation spectrum of Caribbean Hispanic LS patients was composed mostly of MSH2 (66.7%) mutations, followed by MLH1 (25.0%). One mutation was identified in MSH6 (8.3%). A previously unidentified mutation in MLH1 gene c.2044_2045del was found in one Caribbean Hispanic family. MMR mutation-positive individuals were found to be more likely to have a prominent family history of CRC and tumors located at the proximal colon. Compared to MSH2 mutation carriers, MLH1 mutation-positive individuals were more likely to have a strong family history of CRC and LS associated cancers. Furthermore, insurance coverage for genetic testing was found to be limited in the study population with 65.1% of the individuals recruited were denied coverage. This report presents the first description of the mutation spectrum and clinicopathologic characteristics of LS Caribbean Hispanics patients.
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Affiliation(s)
- Marcia Cruz-Correa
- Department of Gastrointestinal Oncology and Genetics, University of Puerto Rico Comprehensive Cancer Center, PMB711 Ave. De Diego 89 Ste. 105, San Juan, PR, 00927-6346, USA,
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22
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Paskulin DD, Giacomazzi J, Achatz MI, Costa S, Reis RM, Hainaut P, dos Santos SEB, Ashton-Prolla P. Ancestry of the Brazilian TP53 c.1010G>A (p.Arg337His, R337H) Founder Mutation: Clues from Haplotyping of Short Tandem Repeats on Chromosome 17p. PLoS One 2015; 10:e0143262. [PMID: 26618902 PMCID: PMC4664269 DOI: 10.1371/journal.pone.0143262] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Accepted: 11/01/2015] [Indexed: 11/22/2022] Open
Abstract
Rare germline mutations in TP53 (17p13.1) cause a highly penetrant predisposition to a specific spectrum of early cancers, defining the Li-Fraumeni Syndrome (LFS). A germline mutation at codon 337 (p.Arg337His, c1010G>A) is found in about 0.3% of the population of Southern Brazil. This mutation is associated with partially penetrant LFS traits and is found in the germline of patients with early cancers of the LFS spectrum unselected for familial history. To characterize the extended haplotypes carrying the mutation, we have genotyped 9 short tandem repeats on chromosome 17p in 12 trios of Brazilian p.Arg337His carriers. Results confirm that all share a common ancestor haplotype of Caucasian/Portuguese-Iberic origin, distant in about 72–84 generations (2000 years assuming a 25 years intergenerational distance) and thus pre-dating European migration to Brazil. So far, the founder p.Arg337His haplotype has not been detected outside Brazil, with the exception of two residents of Portugal, one of them of Brazilian origin. On the other hand, increased meiotic recombination in p.Arg337His carriers may account for higher than expected haplotype diversity. Further studies comparing haplotypes in populations of Brazil and of other areas of Portuguese migration are needed to understand the historical context of this mutation in Brazil.
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Affiliation(s)
- Diego Davila Paskulin
- Post-Graduate Program, Genetics and Molecular Biology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
- Genomic Medicine Laboratory, Experimental Research Center, Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil
- * E-mail:
| | - Juliana Giacomazzi
- Post-Graduate Program, Genetics and Molecular Biology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
- Genomic Medicine Laboratory, Experimental Research Center, Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil
| | | | - Sandra Costa
- Life and Health Sciences Research Institute, University of Minho, Braga, Portugal; ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Rui Manoel Reis
- Life and Health Sciences Research Institute, University of Minho, Braga, Portugal; ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal
- Molecular Oncology Research Center, Barretos Cancer Hospital, Barretos, São Paulo, Brazil
| | - Pierre Hainaut
- International Prevention Research Institute, Lyon and Institut Albert Bonniot/INSERM 823, Grenoble, France
| | | | - Patricia Ashton-Prolla
- Post-Graduate Program, Genetics and Molecular Biology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
- Genomic Medicine Laboratory, Experimental Research Center, Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil
- Medical Genetics Service), Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil
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23
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Ponti G, Castellsagué E, Ruini C, Percesepe A, Tomasi A. Mismatch repair genes founder mutations and cancer susceptibility in Lynch syndrome. Clin Genet 2014; 87:507-16. [PMID: 25345868 DOI: 10.1111/cge.12529] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2014] [Revised: 10/03/2014] [Accepted: 10/17/2014] [Indexed: 12/18/2022]
Abstract
Founder mutations in specific populations are common in several Mendelian disorders. They are shared by apparently unrelated families that inherited them from a common ancestor that existed hundreds to thousands of years ago. They have been proven to impact in molecular diagnostics strategies in specific populations, where they can be assessed as the first screening step and, if positive, avoid further expensive gene scanning. In Lynch syndrome (LS), a dominantly inherited colorectal cancer disease, more than 50 founder pathogenic mutations have been described so far in the mismatch repair (MMR) genes (MLH1, MSH2, MSH6 and PMS2). We here provide a comprehensive summary of the founder mutations found in the MMR genes and an overview of their main characteristics. At a time when high-throughput strategies are being introduced in the molecular diagnostics of cancer, genetic testing for founder mutations can complement next generation sequencing (NGS) technologies to most efficiently identify MMR gene mutations in any given population. Additionally, special attention is paid to MMR founder mutations with interesting anthropological significance.
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Affiliation(s)
- G Ponti
- Department of Diagnostic and Clinical Medicine and Public Health, University of Modena and Reggio Emilia, Modena, Italy
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24
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Report of a Novel Mutation in MLH1 Gene in a Hispanic Family from Puerto Rico Fulfilling Classic Amsterdam Criteria for Lynch Syndrome. Gastroenterol Res Pract 2014; 2014:527946. [PMID: 25389437 PMCID: PMC4217335 DOI: 10.1155/2014/527946] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2014] [Revised: 09/30/2014] [Accepted: 09/30/2014] [Indexed: 02/06/2023] Open
Abstract
In Puerto Rico, colorectal cancer (CRC) represents the second leading cause of cancer in men and women. Familial CRC accounts for 10–15% of the total CRC cases, while Lynch syndrome accounts for approximately 2–4% of cases. Limited information is available about the prevalence, clinical manifestations, and genetic mutations of hereditary CRC in US Hispanic individuals. In this paper we report a novel mutation in the hMLH1 gene in a Puerto Rican Hispanic family with Lynch syndrome recruited through the Puerto Rico Familial Colorectal Cancer Registry (PURIFICAR). Our proband was identified by applying Amsterdam and Bethesda criteria for Lynch syndrome, analysis of protein expression by immunohistochemistry, and genetic sequencing of the mismatch repair genes. A novel mutation at c.2044_2045 in hMLH1 consisting of the deletion of two consecutive nucleotides (AT) at exon 18 was identified. This deletion causes a frameshift in the protein coding sequence at p.682 resulting in premature termination and a truncated MLH1 protein. To our knowledge, this mutation has not been previously reported in the literature. The detection of this novel mutation in MLH1 further emphasizes the need for genetic testing in at-risk patients for hereditary CRC from various ethnic and racial backgrounds.
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