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林奇综合征家族中MLH1、MSH2、MSH6和PMS2基因的9种新型致病种系突变。

Nine novel pathogenic germline mutations in MLH1, MSH2, MSH6 and PMS2 in families with Lynch syndrome.

作者信息

Rahner Nils, Friedrichs Nicolaus, Wehner Maria, Steinke Verena, Aretz Stefan, Friedl Waltraut, Buettner Reinhard, Mangold Elisabeth, Propping Peter, Walldorf Constanze

机构信息

Institute of Human Genetics, University of Bonn, Germany.

出版信息

Acta Oncol. 2007;46(6):763-9. doi: 10.1080/02841860701230217.

Abstract

Many germline mutations in the DNA mismatch repair genes have been described so far leading to the clinical phenotype of Lynch syndrome (hereditary nonpolyposis colorectal cancer, HNPCC). Most mutations are private mutations. We report on nine novel pathogenic germline mutations that have been found in families meeting either the Amsterdam or the Bethesda criteria. These findings include the mutations MLH1,c.884+4A>G, MLH1,c.1377_1378insA;p.Glu460ArgfsX19, MLH1,c.1415_1416delGA;p.Arg472ThrfsX5, MSH2,c.301G>T;p.Glu101X, MSH2,c.638_639delTG;p.Leu213GlnfsX18, MSH2,c.842C>A;p.Ser281X, MSH2,c.859G>T;p.Gly287X, MSH6,c.2503C>T;p.Gln835X and a large genomic deletion of exons 1-10 of the PMS2 gene. The mutation MLH1,c.884+4A>G detected in two families results in a complete skipping of exon 10 on mRNA level and thus has been considered as pathogenic. In all cases the tumor tissue of the index patient revealed high microsatellite instability (MSI-H) and showed a complete loss of expression of the affected protein in the tumor cells by immunohistochemistry (IHC). The findings underline the importance of a pre-screening of tumor tissue for an efficient definition of conspicuous cases.

摘要

迄今为止,已发现DNA错配修复基因中的许多种系突变会导致林奇综合征(遗传性非息肉病性结直肠癌,HNPCC)的临床表型。大多数突变是私人突变。我们报告了在符合阿姆斯特丹或贝塞斯达标准的家族中发现的9种新的致病性种系突变。这些发现包括MLH1基因的c.884 + 4A>G突变、MLH1基因的c.1377_1378insA;p.Glu460ArgfsX19突变、MLH1基因的c.1415_1416delGA;p.Arg472ThrfsX5突变、MSH2基因的c.301G>T;p.Glu101X突变、MSH2基因的c.638_639delTG;p.Leu213GlnfsX18突变、MSH2基因的c.842C>A;p.Ser281X突变、MSH2基因的c.859G>T;p.Gly287X突变、MSH6基因的c.2503C>T;p.Gln835X突变以及PMS2基因外显子1 - 10的大片段基因组缺失。在两个家族中检测到的MLH1基因c.884 + 4A>G突变导致mRNA水平上外显子10完全跳跃,因此被认为是致病性的。在所有病例中,索引患者的肿瘤组织显示出高微卫星不稳定性(MSI-H),并且通过免疫组织化学(IHC)在肿瘤细胞中显示出受影响蛋白的表达完全缺失。这些发现强调了对肿瘤组织进行预筛查以有效定义明显病例的重要性。

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