Pocard M, Soravia C
Service de Chirurgie Générale et Digestive, Hôpital Lariboisière, Paris.
Ann Chir. 1999;53(10):975-8.
Hereditary non-polyposis colorectal cancer (HNPCC) is an autosomal dominant condition in which affected individuals develop colorectal cancer or extracolonic cancer, most commonly endometrial, at an early age. Recent advances in molecular genetics have led to the identification of a germline mutation of DNA mismatch-repair genes to be responsible for the majority of HNPPC cases. Since clinical screening of gene carriers can help to prevent cancer, it is important to devise strategies applicable to this syndrome. Recommendations for current management, especially screening and surgical treatment are under study, as they have not yet been clearly established. This paper reviews the clinical presentation, the molecular genetic diagnosis and therapeutic approaches of this syndrome including the controversies concerning prophylactic colectomy for cancer or gene carriers.
遗传性非息肉病性结直肠癌(HNPCC)是一种常染色体显性遗传病,患者在年轻时易患结直肠癌或结肠外癌症,最常见的是子宫内膜癌。分子遗传学的最新进展已导致发现DNA错配修复基因的种系突变是大多数HNPPC病例的病因。由于对基因携带者进行临床筛查有助于预防癌症,因此制定适用于该综合征的策略很重要。目前关于治疗管理的建议,尤其是筛查和手术治疗,仍在研究中,尚未明确确立。本文综述了该综合征的临床表现、分子遗传学诊断和治疗方法,包括有关癌症或基因携带者预防性结肠切除术的争议。