1
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Halpern N, Grinshpun A, Boursi B, Golan T, Margalit O, Aderka D, Friedman E, Laitman Y, Hubert A, Kadouri L, Hamburger T, Barnes-Kedar I, Levi Z, Ben-Aharon I, Brenner B, Goldberg Y, Peretz T, Shacham-Shmueli E. Clinical Characteristics and Prognosis of Gastric Cancer Patients with BRCA 1/2 Germline Mutations: Report of Ten Cases and a Literature Review. Onco Targets Ther 2020; 13:11637-11644. [PMID: 33235458 PMCID: PMC7677647 DOI: 10.2147/ott.s276814] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 10/09/2020] [Indexed: 12/11/2022] Open
Abstract
Background The prognosis of gastric cancer (GC) is poor with a median overall survival (OS) of less than 12 months in advanced-stage disease. The search for distinct genetic subgroups of GC patients and predictive biomarkers is ongoing. While BRCA1 or BRCA2 germline mutations (gBRCAm) have potential therapeutic implications in ovarian, breast and pancreatic cancers, their significance in GC patients has not been established. Patients and Methods A retrospective multi-center data analysis of GC patients with gBRCAm was conducted, detailing the clinical characteristics and disease course in this unique subset of patients. Results Ten GC patients with gBRCAm were identified, six of them with metastatic disease. The median OS of all ten GC patients was 47.5 (13–192) months. Median OS for patients diagnosed with operable disease was 55.5 (13–192) months and of the patients with metastatic disease (calculated from metastatic disease diagnosis) 32 (15–52) months with an exceptional 1-, 2- and 3-year survival rate of 100%, 83.3% and 50%, respectively. Conclusion These preliminary data suggest that gBRCAm in GC patients are associated with a favorable prognosis. Furthermore, gBRCAm might be a predictive biomarker to DNA-damaging agents response in GC patients, similarly to its established role in other malignancies. Further research is needed to confirm our findings.
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Affiliation(s)
- Naama Halpern
- Department of Oncology, Sheba Medical Center, Tel-Hashomer, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Albert Grinshpun
- Sharett Institute of Oncology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Ben Boursi
- Department of Oncology, Sheba Medical Center, Tel-Hashomer, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Talia Golan
- Department of Oncology, Sheba Medical Center, Tel-Hashomer, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ofer Margalit
- Department of Oncology, Sheba Medical Center, Tel-Hashomer, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Dan Aderka
- Department of Oncology, Sheba Medical Center, Tel-Hashomer, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Eitan Friedman
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,The Susanne Levy Gertner Oncogenetics Unit, The Danek Gertner Institute of Human Genetics, Chaim Sheba Medical Center, Tel-Hashomer, Israel
| | - Yael Laitman
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Sharett Institute of Oncology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Ayala Hubert
- Sharett Institute of Oncology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Luna Kadouri
- Sharett Institute of Oncology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Tamar Hamburger
- Sharett Institute of Oncology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Inbal Barnes-Kedar
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Recanati Genetics Institute, Rabin Medical Center, Beilinson Hospital, Petach Tikva, Israel
| | - Zohar Levi
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Division of Gastroenterology, Rabin Medical Center, Early Detection and High Risk Unit, Petach Tikva, Israel
| | - Irit Ben-Aharon
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Institute of Oncology, Davidoff Center, Rabin Medical Center, Petach Tikva, Israel
| | - Baruch Brenner
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Institute of Oncology, Davidoff Center, Rabin Medical Center, Petach Tikva, Israel
| | - Yael Goldberg
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Recanati Genetics Institute, Rabin Medical Center, Beilinson Hospital, Petach Tikva, Israel
| | - Tamar Peretz
- Sharett Institute of Oncology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Einat Shacham-Shmueli
- Department of Oncology, Sheba Medical Center, Tel-Hashomer, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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2
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Barnes-Kedar I, Bernstein-Molho R, Ginzach N, Hartmajer S, Shapira T, Magal N, Kalis ML, Peretz T, Shohat M, Basel-Salmon L, Friedman E, Bazak L, Goldberg Y. The yield of full BRCA1/2 genotyping in Israeli high-risk breast/ovarian cancer patients who do not carry the predominant mutations. Breast Cancer Res Treat 2018; 172:151-157. [PMID: 30014164 DOI: 10.1007/s10549-018-4887-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Accepted: 07/11/2018] [Indexed: 11/30/2022]
Abstract
PURPOSE BRCA1 and BRCA2 genotyping results have clinical implications for cancer risk assessment and targeted therapy. Current practice in Israel is to genotype for the predominant BRCA1/2 mutations first, followed by full gene analysis in eligible mutation-negative individuals. This work assessed the rate of non-predominant mutations in BRCA1/2 in ethnically diverse high-risk cases. METHODS Breast and/or ovarian cancer patients who tested negative for the predominant BRCA1/2 mutations were referred for comprehensive BRCA1/2 genotyping if calculated risk for carrying a BRCA mutation was ≥ 10%. RESULTS Of 1258 eligible patients, 41 (3.3%) carried one of 38 mutations: 3% of Ashkenazi Jews and 3.4% of mixed ethnicities. Detection rate was < 5% among patients diagnosed with cancer younger than 40 or with bilateral breast cancer, and was 5.5% of ovarian cancer patients. Three of the carriers (7.3%) carried gene rearrangements. Three mutations were reported in more than one case. CONCLUSIONS The overall yield of comprehensive BRCA1/2 testing in ethnically diverse high-risk Israeli individuals is 3.3%. This is lower than expected by probability models. A slightly higher rate of BRCA1/2 carriers was seen among ovarian cancer cases. These data should guide BRCA1/2 optimal testing strategy in Israel.
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Affiliation(s)
- Inbal Barnes-Kedar
- Recanati Genetics Institute, Beilinson Hospital, Rabin Medical Center, Petach Tikva, Israel
| | - Rinat Bernstein-Molho
- Breast Cancer Center, Oncology Institute, Chaim Sheba Medical Center, Tel-Hashomer, Israel.,Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Nava Ginzach
- Recanati Genetics Institute, Beilinson Hospital, Rabin Medical Center, Petach Tikva, Israel
| | | | | | - Nurit Magal
- Recanati Genetics Institute, Beilinson Hospital, Rabin Medical Center, Petach Tikva, Israel
| | - Marina Lifshitc Kalis
- Recanati Genetics Institute, Beilinson Hospital, Rabin Medical Center, Petach Tikva, Israel
| | - Tamar Peretz
- Sharett Institute of Oncology, Hebrew University-Hadassah Medical Center, Jerusalem, Israel
| | | | - Lina Basel-Salmon
- Recanati Genetics Institute, Beilinson Hospital, Rabin Medical Center, Petach Tikva, Israel.,Susanne Levy Gertner Oncogenetics Unit, The Danek Gertner Institute of Human Genetics, Chaim Sheba Medical Center, Tel-Hashomer, Israel
| | - Eitan Friedman
- Susanne Levy Gertner Oncogenetics Unit, The Danek Gertner Institute of Human Genetics, Chaim Sheba Medical Center, Tel-Hashomer, Israel.,Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Lily Bazak
- Recanati Genetics Institute, Beilinson Hospital, Rabin Medical Center, Petach Tikva, Israel
| | - Yael Goldberg
- Recanati Genetics Institute, Beilinson Hospital, Rabin Medical Center, Petach Tikva, Israel. .,Maccabi Health Services, Rehovot, Israel.
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3
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Toledano H, Barnes-Kedar I, Baris HN. Correspondence on "Neurocutaneous Syndromes and Brain Tumors". J Child Neurol 2016; 31:944. [PMID: 27169900 DOI: 10.1177/0883073815627863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Helen Toledano
- Department of Pediatric Oncology, Schneider Children's Medical Center of Israel, Petach Tikva, Israel Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Inbal Barnes-Kedar
- The Raphael Recanati Genetic Institute, Rabin Medical Center, Beilinson Hospital, Petach Tikva, Israel
| | - Hagit N Baris
- The Genetics Institute, Rambam Health Care Campus, Haifa, Israel Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
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4
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Baris HN, Barnes-Kedar I, Toledano H, Halpern M, Hershkovitz D, Lossos A, Lerer I, Peretz T, Kariv R, Cohen S, Half EE, Magal N, Drasinover V, Wimmer K, Goldberg Y, Bercovich D, Levi Z. Constitutional Mismatch Repair Deficiency in Israel: High Proportion of Founder Mutations in MMR Genes and Consanguinity. Pediatr Blood Cancer 2016; 63:418-27. [PMID: 26544533 DOI: 10.1002/pbc.25818] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Accepted: 09/21/2015] [Indexed: 02/01/2023]
Abstract
BACKGROUND Heterozygous germline mutations in any of the mismatch repair (MMR) genes, MLH1, MSH2, MSH6, and PMS2, cause Lynch syndrome (LS), an autosomal dominant cancer predisposition syndrome conferring a high risk of colorectal, endometrial, and other cancers in adulthood. Offspring of couples where both spouses have LS have a 1:4 risk of inheriting biallelic MMR gene mutations. These cause constitutional MMR deficiency (CMMRD) syndrome, a severe recessively inherited cancer syndrome with a broad tumor spectrum including mainly hematological malignancies, brain tumors, and colon cancer in childhood and adolescence. Many CMMRD children also present with café au lait spots and axillary freckling mimicking neurofibromatosis type 1. PROCEDURE We describe our experience in seven CMMRD families demonstrating the role and importance of founder mutations and consanguinity on its prevalence. Clinical presentations included brain tumors, colon cancer, lymphoma, and small bowel cancer. RESULTS In children from two nonconsanguineous Ashkenazi Jewish (AJ) families, the common Ashkenazi founder mutations were detected; these were homozygous in one family and compound heterozygous in the other. In four consanguineous families of various ancestries, different homozygous mutations were identified. In a nonconsanguineous Caucasus/AJ family, lack of PMS2 was demonstrated in tumor and normal tissues; however, mutations were not identified. CONCLUSIONS CMMRD is rare, but, especially in areas where founder mutations for LS and consanguinity are common, pediatricians should be aware of it since they are the first to encounter these children. Early diagnosis will enable tailored cancer surveillance in the entire family and a discussion regarding prenatal genetic diagnosis.
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Affiliation(s)
- Hagit N Baris
- The Genetics Institute, Rambam Health Care Campus, Haifa, Israel.,Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Inbal Barnes-Kedar
- The Raphael Recanati Genetic Institute, Rabin Medical Center, Beilinson Hospital, Petach Tikva, Israel
| | - Helen Toledano
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Department of Pediatric Oncology, Schneider Children's Medical Center of Israel, Petach Tikva, Israel
| | - Marisa Halpern
- Department of Pathology, Rabin Medical Center, Hasharon Hospital, Petach Tikva, Israel
| | - Dov Hershkovitz
- Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.,Department of Pathology, Rambam Health Care Campus, Haifa, Israel
| | - Alexander Lossos
- Sharett Institute of Oncology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Israela Lerer
- Department of Human Genetics, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Tamar Peretz
- Sharett Institute of Oncology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Revital Kariv
- Department of Gastroenterology & Liver Disease, Sourasky Medical Center, Tel Aviv, Israel
| | - Shlomi Cohen
- The Pediatric Gastroenterology Unit, Sourasky Medical Center, Tel Aviv, Israel
| | - Elizabeth E Half
- Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.,Department of Gastroenterology, Rambam Health Care Campus, Haifa, Israel
| | - Nurit Magal
- The Raphael Recanati Genetic Institute, Rabin Medical Center, Beilinson Hospital, Petach Tikva, Israel
| | - Valerie Drasinover
- The Raphael Recanati Genetic Institute, Rabin Medical Center, Beilinson Hospital, Petach Tikva, Israel
| | - Katharina Wimmer
- Division of Human Genetics, Medical University Innsbruck, Innsbruck, Austria
| | - Yael Goldberg
- Sharett Institute of Oncology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | | | - Zohar Levi
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Gastroenterology Division, Rabin Medical Center, Beilinson Hospital, Petach Tikva, Israel
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5
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Yablonski-Peretz T, Paluch-Shimon S, Gutman LS, Kaplan Y, Dvir A, Barnes-Kedar I, Kadouri L, Semenisty V, Efrat N, Neiman V, Glasser Y, Michaelson-Cohen R, Katz L, Kaufman B, Golan T, Reish O, Hubert A, Safra T, Yaron Y, Friedman E. Screening for germline mutations in breast/ovarian cancer susceptibility genes in high-risk families in Israel. Breast Cancer Res Treat 2015; 155:133-8. [DOI: 10.1007/s10549-015-3662-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Accepted: 12/12/2015] [Indexed: 10/22/2022]
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6
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Goldberg Y, Barnes-Kedar I, Lerer I, Halpern N, Plesser M, Hubert A, Kadouri L, Goldshmidt H, Solar I, Strul H, Rosner G, Baris H, Peretz T, Levi Z, Kariv R. Genetic features of Lynch syndrome in the Israeli population. Clin Genet 2014; 87:549-53. [DOI: 10.1111/cge.12530] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2014] [Revised: 10/22/2014] [Accepted: 10/23/2014] [Indexed: 10/24/2022]
Affiliation(s)
- Y. Goldberg
- Sharett Institute of Oncology; Hadassah-Hebrew University Medical Center; Jerusalem Israel
| | - I. Barnes-Kedar
- The Raphael Recanati Genetics Institute; Rabin Medical Center, Beilinson Hospital; Petach Tikva Israel
| | - I. Lerer
- Department of Human Genetics; Hadassah-Hebrew University Medical Center; Jerusalem Israel
| | - N. Halpern
- Sharett Institute of Oncology; Hadassah-Hebrew University Medical Center; Jerusalem Israel
| | - M. Plesser
- Sharett Institute of Oncology; Hadassah-Hebrew University Medical Center; Jerusalem Israel
| | - A. Hubert
- Sharett Institute of Oncology; Hadassah-Hebrew University Medical Center; Jerusalem Israel
| | - L. Kadouri
- Sharett Institute of Oncology; Hadassah-Hebrew University Medical Center; Jerusalem Israel
| | - H. Goldshmidt
- Department of Pathology; Hebrew University, Hadassah Medical School; Jerusalem Israel
| | - I. Solar
- Department of Pathology; Tel Aviv Israel
| | - H. Strul
- Department of Gastroenterology; Tel Aviv Sourasky Medical Center; Tel Aviv Israel
| | - G. Rosner
- Department of Gastroenterology; Tel Aviv Sourasky Medical Center; Tel Aviv Israel
| | - H.N. Baris
- Department of Genetics; Rambam Medical Center; Haifa Israel
| | - T. Peretz
- Sharett Institute of Oncology; Hadassah-Hebrew University Medical Center; Jerusalem Israel
| | - Z. Levi
- Gastroenterology Division, Rabin Medical Center; Beilinson Hospital; Petach Tikva Israel
| | - R. Kariv
- Department of Gastroenterology; Tel Aviv Sourasky Medical Center; Tel Aviv Israel
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7
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Levi Z, Kariv R, Barnes-Kedar I, Goldberg Y, Half E, Morgentern S, Eli B, Baris HN, Vilkin A, Belfer RG, Niv Y, Elhasid R, Dvir R, Abu-Freha N, Cohen S. The gastrointestinal manifestation of constitutional mismatch repair deficiency syndrome: from a single adenoma to polyposis-like phenotype and early onset cancer. Clin Genet 2014; 88:474-8. [PMID: 25307252 DOI: 10.1111/cge.12518] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2014] [Revised: 09/12/2014] [Accepted: 10/06/2014] [Indexed: 11/30/2022]
Abstract
Data on the clinical presentation of constitutional mismatch repair deficiency syndrome (CMMRD) is accumulating. However, as the extraintestinal manifestations are often fatal and occur at early age, data on the systematic evaluation of the gastrointestinal tract is scarce. Here we describe 11 subjects with verified biallelic carriage and who underwent colonoscopy, upper endoscopy and small bowel evaluation. Five subjects were symptomatic and in six subjects the findings were screen detected. Two subjects had colorectal cancer and few adenomatous polyps (19, 20 years), three subjects had polyposis-like phenotype (13, 14, 16 years), four subjects had few adenomatous polyps (8, 12-14 years) and two subjects had no polyps (both at age 6). Of the three subjects in the polyposis-like group, two subjects had already developed high-grade dysplasia or cancer and one subject had atypical juvenile polyps suggesting juvenile polyposis. Three out of the five subjects that underwent repeated exams had significant findings during short interval. The gastrointestinal manifestations of CMMRD are highly dependent upon age of examination and highly variable. The polyps may also resemble juvenile polyposis. Intensive surveillance according to current guidelines is mandatory.
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Affiliation(s)
- Z Levi
- The Early Detection and High Risk GI Cancer Service, the Gastroenterology Division, Rabin Medical Center, Petach Tikva, Israel.,Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - R Kariv
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.,Department of Gastroenterology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - I Barnes-Kedar
- The Raphael Recanati Genetics Institute, Rabin Medical Center, Beilinson Hospital, Petach Tikva, Israel
| | - Y Goldberg
- The Sharett Institute for Oncology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - E Half
- Gastroenterology Department, Rambam Health Care Campus, Haifa, Israel
| | - S Morgentern
- Pathology Department, Rabin Medical Center, Petach Tikva, Israel
| | - B Eli
- Pathology Department, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - H N Baris
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.,The Raphael Recanati Genetics Institute, Rabin Medical Center, Beilinson Hospital, Petach Tikva, Israel
| | - A Vilkin
- The Early Detection and High Risk GI Cancer Service, the Gastroenterology Division, Rabin Medical Center, Petach Tikva, Israel
| | - R G Belfer
- The Early Detection and High Risk GI Cancer Service, the Gastroenterology Division, Rabin Medical Center, Petach Tikva, Israel
| | - Y Niv
- The Early Detection and High Risk GI Cancer Service, the Gastroenterology Division, Rabin Medical Center, Petach Tikva, Israel.,Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - R Elhasid
- Pediatric Hemato-Oncology Department, Tel Aviv, Israel
| | - R Dvir
- The Pediatric Gastroenterology Unit, 'Dana-Dwek' Children's Hospital, Tel Aviv Medical Center, Tel Aviv, Israel
| | - N Abu-Freha
- Gastroenterology Department, Soroka Medical Center, Beersheba, Israel
| | - S Cohen
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.,The Pediatric Gastroenterology Unit, 'Dana-Dwek' Children's Hospital, Tel Aviv Medical Center, Tel Aviv, Israel
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8
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Rozen P, Levi Z, Hazazi R, Barnes-Kedar I, Samuel Z, Vilkin A, Niv Y. A familial gastrointestinal cancer clinic: organization, aims and activities, 2004-2007. Isr Med Assoc J 2008; 10:695-698. [PMID: 19009948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
BACKGROUND Dedicated, organ-specific screening clinics have been shown to significantly reduce cancer morbidity and mortality. OBJECTIVES To establish a dedicated clinic for Clalit Health Service patients at high risk for hereditary gastrointestinal cancer and to provide them with clinical and genetic counseling, diagnostic screening and follow-up. RESULTS During the 3 years of the clinic's activity, 634 high risk families, including 3804 at-risk relatives, were evaluated. The most common conditions were hereditary colorectal syndromes, Lynch syndrome (n=259), undefined young-onset or familial colorectal cancer (n=214), familial adenomatous polyposis (n=55), and others (n=106). They entered follow-up protocols and 52 underwent surgical procedures. CONCLUSIONS Consistent public and professional education is needed to increase awareness of hereditary colorectal cancer and the possibility of family screening, early diagnosis and therapy. The public health services--i.e., the four health management organizations--should provide genetic testing for these patients who, at present, are required to pay for almost all of these available but costly tests. Dedicated colorectal surgical units are needed to provide the specialized therapeutic procedures needed by patients with familial colorectal cancer. Our future plans include adding psychosocial support for these at-risk patients and their families as well as preventive lifestyle and dietary intervention.
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Affiliation(s)
- Paul Rozen
- Department of Gastroenterology, Rabin Medical Center, Beilinson Campus, Petah Tikva, Israel.
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9
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Barnes-Kedar I, Amiel A, Maor O, Fejgin M. Elevated human chorionic gonadotropin levels in pregnancies with sex chromosome abnormalities. Am J Med Genet 1993; 45:356-7. [PMID: 8434623 DOI: 10.1002/ajmg.1320450314] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Numerous reports have dealt with the usefulness of the maternal serum alpha-fetoprotein marker (MsAFP) and human chorionic gonadotropin (MshCG) levels in the detection of Down syndrome (DS) and other autosomal trisomies. Only few reports have discussed the possible association of elevated levels of MshCG and sex chromosome aneuploidy. We wish to report on 3 cases in which this association was found.
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Affiliation(s)
- I Barnes-Kedar
- Genetics Unit, Sapir Medical Center, Meir General Hospital, Kfar-Saba, Israel
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