Institut für Humangenetik, Uniniversitätsklinikum Bonn.
Dtsch Arztebl Int. 2008 Oct;105(41):706-14. doi: 10.3238/arztebl.2008.0706. Epub 2008 Oct 10.
Persons carrying mutations for hereditary cancer syndromes are at high risk for the development of tumors at an early age, as well as the synchronous or metachronous development of multiple tumors of the corresponding tumor spectrum. The genetic causes of many hereditary cancer syndromes have already been identified. About 5% of all cancers are part of a hereditary cancer syndrome.
Selective literature review, including evidence-based guidelines and recommendations.
Clinical criteria are currently available according to which many hereditary cancer syndromes can be diagnosed or suspected and which point the way to further molecular genetic analysis. A physician can easily determine whether these criteria are met by directed questioning about the patient's personal and family medical history. The identification of the causative germ line mutation in the family allows confirmation of the diagnosis in the affected individual and opens up the option of predictive testing in healthy relatives.
Mutation carriers for hereditary cancer syndromes need long-term medical surveillance in a specialized center. It is important that these persons should be identified in the primary care setting and then referred for genetic counseling if molecular genetic testing is to be performed in a targeted, rational manner.
遗传性癌症综合征患者携带基因突变,因此存在肿瘤在早年发生的高风险,以及相应肿瘤谱中多个肿瘤的同步或异时发生。许多遗传性癌症综合征的遗传原因已经确定。大约 5%的癌症是遗传性癌症综合征的一部分。
选择性文献回顾,包括循证指南和建议。
目前可根据临床标准诊断或怀疑许多遗传性癌症综合征,并为进一步的分子遗传学分析指明方向。通过询问患者的个人和家族病史,可以很容易地确定医生是否符合这些标准。在家族中确定致病的种系突变可以在受影响的个体中确认诊断,并为健康亲属提供预测性测试的选择。
遗传性癌症综合征的突变携带者需要在专门中心进行长期的医学监测。重要的是,这些人应该在初级保健环境中得到识别,如果要以有针对性和合理的方式进行分子遗传学检测,则应将其转介进行遗传咨询。