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[遗传性非息肉病性结直肠癌的登记]

[Registration of hereditary non-polyposis colorectal cancer].

作者信息

Bernstein I T, Bisgaard M L, Myrhøj T

机构信息

H:S Hvidovre Hospital, gastroenheden, HNPCC-registret.

出版信息

Ugeskr Laeger. 1999 Nov 8;161(45):6174-8.

Abstract

Hereditary non-polyposis colorectal cancer is a dominant inherited disease, with development of colorectal cancer (CRC) and other cancers too. About 3% of all CRC-cases belong to an HNPCC-family. Mutations responsible for the disease has been identified in five genes, all of them involved in DNA mismatch repair. Since the establishment of the Danish HNPCC Register 345 families have been referred, and 101 of these families had HNPCC. Median age of onset for CRC was 50 years: Approximately 60% of the tumors were situated on the right side, 9% had synchronous tumors and the risk of metachronous tumours was 40% in 20 years. Tumours were localised in 64% of the cases, and the 5-year crude survival rate was better in HNPCC compared to sporadic CRC. The number of CRC diagnosed as Dukes A in HNPCC has risen since 1990, and the survival after CRC in HNPCC has increased. The disease specific mutation is identified in 21 families, from which 152 persons at risk have had a molecular genetic diagnose, and 83 could afterwards evade screening protocols. Few years after the establishment of the HNPCC-registry, it is indicated that information, registration and screening lead to an earlier diagnosis and a better prognosis after CRC.

摘要

遗传性非息肉病性结直肠癌是一种显性遗传病,也会引发结直肠癌(CRC)和其他癌症。所有结直肠癌病例中约3%属于遗传性非息肉病性结直肠癌家族。已在五个基因中鉴定出导致该疾病的突变,所有这些基因都参与DNA错配修复。自丹麦遗传性非息肉病性结直肠癌登记处成立以来,已转诊345个家庭,其中101个家庭患有遗传性非息肉病性结直肠癌。结直肠癌的中位发病年龄为50岁:约60%的肿瘤位于右侧,9%有同步肿瘤,20年内异时性肿瘤的风险为40%。64%的病例肿瘤局限,与散发性结直肠癌相比,遗传性非息肉病性结直肠癌的5年粗生存率更好。自1990年以来,遗传性非息肉病性结直肠癌中诊断为杜克A期的结直肠癌数量有所增加,遗传性非息肉病性结直肠癌患者结直肠癌后的生存率也有所提高。在21个家庭中鉴定出疾病特异性突变,其中152名有风险的人进行了分子遗传学诊断,之后83人可以避免筛查方案。遗传性非息肉病性结直肠癌登记处成立几年后,有迹象表明,信息、登记和筛查可导致结直肠癌的早期诊断和更好的预后。

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