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儿童和青年的遗传性癌症综合征。

Inherited cancer syndromes in children and young adults.

作者信息

D'Orazio John A

机构信息

The Markey Cancer Center and the Department of Pediatrics, Division of Hematology/Oncology, University of Kentucky College of Medicine, Lexington, KY 40536-0096, USA.

出版信息

J Pediatr Hematol Oncol. 2010 Apr;32(3):195-228. doi: 10.1097/MPH.0b013e3181ced34c.

Abstract

Geneticists estimate that 5% to 10% of all cancers diagnosed in the pediatric age range occur in children born with a genetic mutation that directly increases their lifetime risk for neoplasia. However, despite the fact that only a fraction of cancers in children occur as a result of an identified inherited predisposition, characterizing genetic mutations responsible for increased cancer risk in such syndromes has resulted in a profound understanding of relevant molecular pathways involved in carcinogenesis and/or resistance to neoplasia. Importantly, because most cancer predisposition syndromes result in an increased risk of a small number of defined malignancies, personalized prophylactic surveillance and preventive measures can be implemented in affected patients. Lastly, many of the same genetic targets identified from cancer-prone families are mechanistically involved in the majority of sporadic cancers in adults and children, thereby underscoring the clinical relevance of knowledge gained from these defined syndromes and introducing novel therapeutic opportunities to the broader oncologic community. This review highlights the clinical and genetic features of many of the known constitutional genetic syndromes that predispose to malignancy in children and young adults.

摘要

遗传学家估计,在儿科年龄范围内诊断出的所有癌症中,有5%至10%发生在出生时带有基因突变的儿童身上,这种基因突变直接增加了他们患肿瘤的终生风险。然而,尽管儿童癌症中只有一小部分是由已确定的遗传易感性导致的,但对导致此类综合征中癌症风险增加的基因突变进行特征分析,已使人们对致癌和/或肿瘤形成抗性相关的分子途径有了深刻的理解。重要的是,由于大多数癌症易感综合征会导致少数特定恶性肿瘤的风险增加,因此可以对受影响的患者实施个性化的预防性监测和预防措施。最后,从易患癌症的家庭中确定的许多相同基因靶点在大多数成人和儿童散发性癌症中都有机制性参与,从而强调了从这些特定综合征中获得的知识的临床相关性,并为更广泛的肿瘤学界带来了新的治疗机会。本综述重点介绍了许多已知的先天性遗传综合征的临床和遗传特征,这些综合征易使儿童和年轻人患恶性肿瘤。

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