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两个家族中存在纯合子PMS2种系突变,这些家族患有早发性血液系统恶性肿瘤、脑肿瘤、HNPCC相关肿瘤以及1型神经纤维瘤病体征。

Homozygous PMS2 germline mutations in two families with early-onset haematological malignancy, brain tumours, HNPCC-associated tumours, and signs of neurofibromatosis type 1.

作者信息

Krüger Stefan, Kinzel Miriam, Walldorf Constanze, Gottschling Sven, Bier Andrea, Tinschert Sigrid, von Stackelberg Arend, Henn Wolfram, Görgens Heike, Boue Stephanie, Kölble Konrad, Büttner Reinhard, Schackert Hans K

机构信息

Department of Surgical Research, Dresden University of Technology, Dresden, Germany.

出版信息

Eur J Hum Genet. 2008 Jan;16(1):62-72. doi: 10.1038/sj.ejhg.5201923. Epub 2007 Sep 12.

Abstract

Heterozygous germline mutations in mismatch repair (MMR) genes MLH1, PMS2, MSH2, and MSH6 cause Lynch syndrome. New studies have indicated that biallelic mutations lead to a distinctive syndrome, childhood cancer syndrome (CCS), with haematological malignancies and tumours of brain and bowel early in childhood, often associated with signs of neurofibromatosis type 1. We provide further evidence for CCS reporting on six children from two consanguineous families carrying homozygous PMS2 germline mutations. In family 1, all four children had the homozygous p.I590Xfs mutation. Two had a glioblastoma at the age of 6 years and one of them had three additional Lynch-syndrome associated tumours at 15. Another sibling suffered from a glioblastoma at age 9, and the fourth sibling had infantile myofibromatosis at 1. In family 2, two of four siblings were homozygous for the p.G271V mutation. One had two colorectal cancers diagnosed at ages 13 and 14, the other had a Non-Hodgkin's lymphoma and a colorectal cancer at ages 10 and 11, respectively. All children with malignancies had multiple café-au-lait spots. After reviewing published cases of biallelic MMR gene mutations, we provide a concise description of CCS, revealing similarities in age distribution with carriers of heterozygous MMR gene mutations.

摘要

错配修复(MMR)基因MLH1、PMS2、MSH2和MSH6中的杂合种系突变会导致林奇综合征。新的研究表明,双等位基因突变会导致一种独特的综合征,即儿童癌症综合征(CCS),在儿童早期会出现血液系统恶性肿瘤以及脑和肠道肿瘤,常伴有1型神经纤维瘤病的体征。我们报告了来自两个近亲家庭的6名携带纯合PMS2种系突变的儿童,为儿童癌症综合征提供了进一步的证据。在家庭1中,所有4名儿童都有纯合的p.I590Xfs突变。两名儿童在6岁时患胶质母细胞瘤,其中一名在15岁时还患有另外3种与林奇综合征相关的肿瘤。另一名兄弟姐妹在9岁时患胶质母细胞瘤,第四名兄弟姐妹在1岁时患婴儿肌纤维瘤病。在家庭2中,4名兄弟姐妹中有两名是p.G271V突变的纯合子。一名分别在13岁和14岁时被诊断出患有两种结直肠癌,另一名分别在10岁和11岁时患非霍奇金淋巴瘤和结直肠癌。所有患恶性肿瘤的儿童都有多个咖啡牛奶斑。在回顾了已发表的双等位基因MMR基因突变病例后,我们对儿童癌症综合征进行了简要描述,揭示了其与杂合MMR基因突变携带者在年龄分布上的相似性。

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