Lynch Syndrome without mutation of Mismatch Repair Genes: The other face of the coin?
Autor(a) principal: | |
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Data de Publicação: | 2011 |
Outros Autores: | , , , |
Tipo de documento: | Artigo |
Idioma: | por |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | https://revista.spcir.com/index.php/spcir/article/view/94 |
Resumo: | Background: Lynch Syndrome (LS) is the most frequent form of hereditary colorectal cancer (CRC) and derives from germinative mutations in the mismatch repais genes (MMR). The clinical diagnosis is based on Amsterdam criteria (AC) but definitive diagnostic is based on the identification of a MMR gene mutation. Of these, MLH1 and MSH2 are the most frequent, followed by MSH6 and rarely by other genes (PMS1 and PMS2). In the cases where a germinative mutation is not found, patients appear to have more aggressive CRC and lower incidence of extra-colonic disease. Methods: The patients were selected from a prospectively collected database and the results analysed retrospectively. We selected patients with CRC from families with Amsterdam or Bethesda Criteria for LS. The patients were stratified into 2 groups: patients with known MMR genes mutation (LS) and patients with AC and non-indentified MMR mutation. We reviewed clinical, pathological and survival data. Results: We selected 60 patients, 55 of which had AC for LS and 64% had a defect in MMR genes. Age at diagnosis was not different between groups. XS patients had fewer extra-colonic malignancies (10% vs. 22%; p=0.23) and the CRC were more often left-sided (70% vs. 48%; p=0.09). LS patients were predominantly male (72,5% vs 45%; p=0.049) and Microsatellite Instability was more frequent (79% vs. 22%; p=0.002). The 5-year survival rate was 80% and 62%, respectively for LS and XS (p=0.16). Conclusion: The clinical and pathological differences observed in patients from families with AC without defects of MMR genes, supports the existence of a different clinical entity, which in spite of a similar familiar clustering, presents an unknown carcinogenesis. In the families with X syndrome it is mandatory the clinical screening of all individuals at risk for colorectal cancer and extra-colonic malignancies. Keywords: Colo-rectal cancer; Lynch Syndrome; Mismatch repair genes |
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Lynch Syndrome without mutation of Mismatch Repair Genes: The other face of the coin?Síndrome de Lynch sem mutação germinativa dos genes de reparação do ADN: Uma outra face da mesma moeda?Background: Lynch Syndrome (LS) is the most frequent form of hereditary colorectal cancer (CRC) and derives from germinative mutations in the mismatch repais genes (MMR). The clinical diagnosis is based on Amsterdam criteria (AC) but definitive diagnostic is based on the identification of a MMR gene mutation. Of these, MLH1 and MSH2 are the most frequent, followed by MSH6 and rarely by other genes (PMS1 and PMS2). In the cases where a germinative mutation is not found, patients appear to have more aggressive CRC and lower incidence of extra-colonic disease. Methods: The patients were selected from a prospectively collected database and the results analysed retrospectively. We selected patients with CRC from families with Amsterdam or Bethesda Criteria for LS. The patients were stratified into 2 groups: patients with known MMR genes mutation (LS) and patients with AC and non-indentified MMR mutation. We reviewed clinical, pathological and survival data. Results: We selected 60 patients, 55 of which had AC for LS and 64% had a defect in MMR genes. Age at diagnosis was not different between groups. XS patients had fewer extra-colonic malignancies (10% vs. 22%; p=0.23) and the CRC were more often left-sided (70% vs. 48%; p=0.09). LS patients were predominantly male (72,5% vs 45%; p=0.049) and Microsatellite Instability was more frequent (79% vs. 22%; p=0.002). The 5-year survival rate was 80% and 62%, respectively for LS and XS (p=0.16). Conclusion: The clinical and pathological differences observed in patients from families with AC without defects of MMR genes, supports the existence of a different clinical entity, which in spite of a similar familiar clustering, presents an unknown carcinogenesis. In the families with X syndrome it is mandatory the clinical screening of all individuals at risk for colorectal cancer and extra-colonic malignancies. Keywords: Colo-rectal cancer; Lynch Syndrome; Mismatch repair genes Introdução: O Síndrome de Lynch (SL) é a forma mais frequente de cancro colorectal (CCR) hereditário e tem origem em mutações germinativas nos genes de reparação do ADN (MMR). O diagnóstico clínico é baseado nos critérios de Amesterdão (CA), mas o diag- nóstico definitivo baseia-se na identificação de uma mutação germinativa num dos MMR. Destes, o MLH1 e o MSH2 são os mais frequentemente envolvidos, seguindo-se o MSH6 e, muito raramente outros genes (PMS2 e PMS1). Nos casos em que uma mutação germinativa não é identificada, os doentes, parecem desenvolver formas mais agressivas de CCR e menor incidência de tumores extra- -cólicos. Métodos: Os doentes foram seleccionados de uma base de dados prospectiva e os resultados analisados de forma retrospectiva. Seleccionamos doentes com CCR pertencentes a famílias com CA ou critérios de Bethesda. Os doentes foram estratificados em 2 grupos: doentes com identificação de mutações patogénicas dos MMR (SL) e doentes com CCR pertencentes a famílias com CA, mas sem identificação de mutação genética (Síndrome X). Foram analisadas as características clínicas e patológicas destes doentes. Resultados: Foram seleccionados 60 doentes, 55 dos quais pertencentes a famílias com CA. Destes, 64% apresentavam mutações patogénicas dos genes MMR. A idade à data de diagnóstico não foi diferente entre os grupos. Nos doentes com Síndrome X, a presença de doença extra-cólica foi inferior (10% vs. 22%; p=0,23) e os tumores do cólon eram mais frequentemente distais ao ângulo esplénico (70% vs 48%; p=0,09). Nos doentes com SL verificou-se predominio do sexo masculino (72,5% vs 45%; p=0,049) e a Instabilidade de Microsatélites (IMS) foi mais frequente (79% vs. 22%; p=0,002). A taxa de sobrevida aos 5 anos foi de 80% e 62%, respectivamente para o SL e o SX (p=0,16). Conclusões: As diferenças clínicas e patológicas observadas nos doentes pertencentes a famílias com CA sem mutação dos genes MMR, suportam a existência de uma entidade clínica diferente que, apesar de um agrupamento familiar semelhante apresenta uma carcinogénese globalmente desconhecida. Nas famílias com SX é mandatória a vigilância clínica de todos os indivíduos em risco de desenvolverem CCR e tumores extra-cólicos do espectro do SL. Palavras-Chave: Cancro colo-rectal; Síndrome de Lynch; Genes de Reparação do ADN Sociedade Portuguesa de Cirurgia2011-06-29info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttps://revista.spcir.com/index.php/spcir/article/view/94Revista Portuguesa de Cirurgia; No 17 (2011): Junho 2011 - II Série; 7-14Revista Portuguesa de Cirurgia; No 17 (2011): Junho 2011 - II Série; 7-142183-11651646-6918reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPporhttps://revista.spcir.com/index.php/spcir/article/view/94https://revista.spcir.com/index.php/spcir/article/view/94/91Copyright (c) 2016 Revista Portuguesa de Cirurgiainfo:eu-repo/semantics/openAccessFaria, GilBaptista, M.Magalhães, A.Machado, T.Pimenta, A.2024-03-14T22:05:34Zoai:revista.spcir.com:article/94Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-20T04:00:55.395862Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Lynch Syndrome without mutation of Mismatch Repair Genes: The other face of the coin? Síndrome de Lynch sem mutação germinativa dos genes de reparação do ADN: Uma outra face da mesma moeda? |
title |
Lynch Syndrome without mutation of Mismatch Repair Genes: The other face of the coin? |
spellingShingle |
Lynch Syndrome without mutation of Mismatch Repair Genes: The other face of the coin? Faria, Gil |
title_short |
Lynch Syndrome without mutation of Mismatch Repair Genes: The other face of the coin? |
title_full |
Lynch Syndrome without mutation of Mismatch Repair Genes: The other face of the coin? |
title_fullStr |
Lynch Syndrome without mutation of Mismatch Repair Genes: The other face of the coin? |
title_full_unstemmed |
Lynch Syndrome without mutation of Mismatch Repair Genes: The other face of the coin? |
title_sort |
Lynch Syndrome without mutation of Mismatch Repair Genes: The other face of the coin? |
author |
Faria, Gil |
author_facet |
Faria, Gil Baptista, M. Magalhães, A. Machado, T. Pimenta, A. |
author_role |
author |
author2 |
Baptista, M. Magalhães, A. Machado, T. Pimenta, A. |
author2_role |
author author author author |
dc.contributor.author.fl_str_mv |
Faria, Gil Baptista, M. Magalhães, A. Machado, T. Pimenta, A. |
description |
Background: Lynch Syndrome (LS) is the most frequent form of hereditary colorectal cancer (CRC) and derives from germinative mutations in the mismatch repais genes (MMR). The clinical diagnosis is based on Amsterdam criteria (AC) but definitive diagnostic is based on the identification of a MMR gene mutation. Of these, MLH1 and MSH2 are the most frequent, followed by MSH6 and rarely by other genes (PMS1 and PMS2). In the cases where a germinative mutation is not found, patients appear to have more aggressive CRC and lower incidence of extra-colonic disease. Methods: The patients were selected from a prospectively collected database and the results analysed retrospectively. We selected patients with CRC from families with Amsterdam or Bethesda Criteria for LS. The patients were stratified into 2 groups: patients with known MMR genes mutation (LS) and patients with AC and non-indentified MMR mutation. We reviewed clinical, pathological and survival data. Results: We selected 60 patients, 55 of which had AC for LS and 64% had a defect in MMR genes. Age at diagnosis was not different between groups. XS patients had fewer extra-colonic malignancies (10% vs. 22%; p=0.23) and the CRC were more often left-sided (70% vs. 48%; p=0.09). LS patients were predominantly male (72,5% vs 45%; p=0.049) and Microsatellite Instability was more frequent (79% vs. 22%; p=0.002). The 5-year survival rate was 80% and 62%, respectively for LS and XS (p=0.16). Conclusion: The clinical and pathological differences observed in patients from families with AC without defects of MMR genes, supports the existence of a different clinical entity, which in spite of a similar familiar clustering, presents an unknown carcinogenesis. In the families with X syndrome it is mandatory the clinical screening of all individuals at risk for colorectal cancer and extra-colonic malignancies. Keywords: Colo-rectal cancer; Lynch Syndrome; Mismatch repair genes |
publishDate |
2011 |
dc.date.none.fl_str_mv |
2011-06-29 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://revista.spcir.com/index.php/spcir/article/view/94 |
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https://revista.spcir.com/index.php/spcir/article/view/94 |
dc.language.iso.fl_str_mv |
por |
language |
por |
dc.relation.none.fl_str_mv |
https://revista.spcir.com/index.php/spcir/article/view/94 https://revista.spcir.com/index.php/spcir/article/view/94/91 |
dc.rights.driver.fl_str_mv |
Copyright (c) 2016 Revista Portuguesa de Cirurgia info:eu-repo/semantics/openAccess |
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Copyright (c) 2016 Revista Portuguesa de Cirurgia |
eu_rights_str_mv |
openAccess |
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application/pdf |
dc.publisher.none.fl_str_mv |
Sociedade Portuguesa de Cirurgia |
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Sociedade Portuguesa de Cirurgia |
dc.source.none.fl_str_mv |
Revista Portuguesa de Cirurgia; No 17 (2011): Junho 2011 - II Série; 7-14 Revista Portuguesa de Cirurgia; No 17 (2011): Junho 2011 - II Série; 7-14 2183-1165 1646-6918 reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
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RCAAP |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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