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林奇综合征/遗传性非息肉病性结直肠癌(HNPCC)

Lynch Syndrome/Hereditary Non-polyposis Colorectal Cancer (HNPCC).

作者信息

Stoffel E M

机构信息

Division of Gastroenterology, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA 02115, USA.

出版信息

Minerva Gastroenterol Dietol. 2010 Mar;56(1):45-53.

Abstract

Lynch Syndrome (LS), also known as Hereditary Non-polyposis Colorectal Cancer (HNPCC), is the most common hereditary colorectal cancer syndrome and is estimated to account for 3-5% of CRC cases. LS is caused by mutations in DNA mismatch repair (MMR) genes which are inherited in an autosomal dominant pattern and are associated with accelerated development of cancers. Families affected with Lynch Syndrome typically contain multiple individuals affected with CRC and/or endometrial cancer, with many of the cases diagnosed at younger ages. Lifetime risk for colorectal and endometrial cancers approaches 70-80% and 40-60% respectively, in the absence of medical intervention. Individuals with Lynch Syndrome also have an increased risk for developing other cancers and variations in clinical presentation can make diagnosis difficult. Clinical genetic testing has identified mutations in the MMR genes MLH1, MSH2, MSH6, and PMS2 in many families with Lynch Syndrome. Colonoscopy at frequent intervals has been shown to be effective in reducing morbidity and mortality from Lynch-associated colorectal cancer.

摘要

林奇综合征(LS),也称为遗传性非息肉病性结直肠癌(HNPCC),是最常见的遗传性结直肠癌综合征,估计占结直肠癌病例的3-5%。林奇综合征由DNA错配修复(MMR)基因突变引起,这些基因以常染色体显性模式遗传,并与癌症的加速发展有关。受林奇综合征影响的家族通常有多个个体患有结直肠癌和/或子宫内膜癌,许多病例在较年轻时被诊断出来。在没有医疗干预的情况下,患结直肠癌和子宫内膜癌的终生风险分别接近70-80%和40-60%。林奇综合征患者患其他癌症的风险也会增加,临床表现的差异可能使诊断变得困难。临床基因检测已在许多林奇综合征家族中发现MMR基因MLH1、MSH2、MSH6和PMS2发生突变。定期进行结肠镜检查已被证明可有效降低林奇综合征相关结直肠癌的发病率和死亡率。

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