Abstract |
Families at high risk for Lynch syndrome can effectively be recognised by microsatellite instability (MSI) testing. The aim of the present study is to compare the effectiveness of a MSI test for the identification of Lynch syndrome in patients selected by a pathologist mainly based on young age at diagnosis (MSI-testing-indicated-by-a-Pathologist; MIPA), with that of patients selected by a clinical geneticist mainly based on family history (MSI-testing-indicated-by-Family-History; MIFH). Patients with a Lynch syndrome associated tumour were selected using MIPA (n=362) or MIFH (n=887). Germline DNA mutation testing was performed in 171 out of 215 patients (80%) with a MSI positive tumour. MSI was tested positive in 20% of the MIPA-group group compared to 16% in the MIFH-group (P=0.291). In 91 of 171 patients with MSI positive tumours tested for germline mutations were identified as Lynch syndrome patients: 42% in the MIPA-group and 56% in the MIFH-group (P=0.066). Colorectal cancer (CRC) or endometrial cancer (EC) presenting at an age below 50 years would have led to the diagnosis of Lynch syndrome in 89% of these families (CRC below 50 years: 88% and EC below 50 years: 12%). Families detected by MIPA were characterised more often by extracolonic Lynch syndrome associated malignancies, especially EC (P<0.001). Our results indicate that recognition of Lynch syndrome by CRC or EC below 50 years is as effective as a positive family history. Families from patients selected by individual criteria more often harbour extracolonic Lynch syndrome associated malignancies.
|
Authors | P Manders, L Spruijt, C M Kets, H W Willems, D Bodmer, K M Hebeda, I D Nagtegaal, J H J M van Krieken, M J L Ligtenberg, N Hoogerbrugge |
Journal | European journal of cancer (Oxford, England : 1990)
(Eur J Cancer)
Vol. 47
Issue 9
Pg. 1407-13
(Jun 2011)
ISSN: 1879-0852 [Electronic] England |
PMID | 21273057
(Publication Type: Journal Article)
|
Copyright | Copyright © 2010 Elsevier Ltd. All rights reserved. |
Chemical References |
- Adaptor Proteins, Signal Transducing
- MLH1 protein, human
- Nuclear Proteins
- MutL Protein Homolog 1
|
Topics |
- Adaptor Proteins, Signal Transducing
(genetics)
- Adult
- Age Factors
- Aged
- Cohort Studies
- Colorectal Neoplasms
(diagnosis, genetics)
- Colorectal Neoplasms, Hereditary Nonpolyposis
(diagnosis, genetics)
- DNA Methylation
- Family Health
- Female
- Germ-Line Mutation
- Humans
- Male
- Microsatellite Instability
- Middle Aged
- Models, Genetic
- MutL Protein Homolog 1
- Nuclear Proteins
(genetics)
- Risk
|