Department of Pathology, Princess Margaret Hospital, Hong Kong, China.
Chin Med J (Engl). 2011 Jan;124(2):237-41.
Von Hippel-Lindau (VHL) syndrome is an autosomal dominant familial cancer syndrome predisposing the affected individuals to multiple tumours in various organs. The genetic basis of VHL in Southern Chinese is largely unknown. In this study, we characterized the mutation spectrum of VHL in nine unrelated Southern Chinese families.
Nine probands with clinical features of VHL, two symptomatic and eight asymptomatic family members were included in this study. Prenatal diagnosis was performed twice for one proband. Two probands had only isolated bilateral phaeochromocytoma. The VHL gene was screened for mutations by polymerase chain reaction, direct sequencing and multiplex ligation-dependent probe amplification (MLPA).
The nine probands and the two symptomatic family members carried heterozygous germline mutations. Eight different VHL mutations were identified in the nine probands. One splicing mutation, NM_000551.2: c.463+1G > T, was novel. The other seven VHL mutations, c.233A > G [p.Asn78Ser], c.239G > T [p.Ser80Ile], c.319C > G [p.Arg107Gly], c.481C > T [p.Arg161X], c.482G > A [p.Arg161Gln], c.499C > T [p.Arg167Trp] and an exon 2 deletion, had been previously reported. Three asymptomatic family members were positive for the mutation and the other five tested negative. In prenatal diagnosis, the fetuses were positive for the mutation.
Genetic analysis could accurately confirm VHL syndrome in patients with isolated tumours such as sporadic phaeochromocytoma or epididymal papillary cystadenoma. Mutation detection in asymptomatic family members allows regular tumour surveillance and early intervention to improve their prognosis. DNA-based diagnosis can have an important impact on clinical management for VHL families.
希佩尔-林道综合征(VHL)是一种常染色体显性遗传家族性癌症综合征,使受影响的个体易患多种器官的肿瘤。VHL 在华南人群中的遗传基础在很大程度上尚不清楚。在这项研究中,我们对 9 个不相关的华南家族的 VHL 突变谱进行了特征描述。
本研究纳入了 9 名具有 VHL 临床特征的先证者,其中 2 名为有症状,8 名为无症状家族成员。对一名先证者进行了两次产前诊断。两名先证者仅患有孤立的双侧嗜铬细胞瘤。通过聚合酶链反应、直接测序和多重连接依赖性探针扩增(MLPA)筛选 VHL 基因突变。
9 名先证者和 2 名有症状的家族成员携带杂合性种系突变。在 9 名先证者中发现了 8 种不同的 VHL 突变。一种剪接突变,NM_000551.2:c.463+1G > T,是新发现的。其他 7 种 VHL 突变,c.233A > G [p.Asn78Ser]、c.239G > T [p.Ser80Ile]、c.319C > G [p.Arg107Gly]、c.481C > T [p.Arg161X]、c.482G > A [p.Arg161Gln]、c.499C > T [p.Arg167Trp]和外显子 2 缺失,以前曾有报道。3 名无症状家族成员检测出突变阳性,其余 5 名检测结果为阴性。在产前诊断中,胎儿检测出突变阳性。
遗传分析可以准确确认孤立性肿瘤(如散发性嗜铬细胞瘤或附睾乳头状囊腺瘤)患者的 VHL 综合征。对无症状家族成员进行突变检测可进行定期肿瘤监测和早期干预,以改善其预后。基于 DNA 的诊断对 VHL 家族的临床管理具有重要影响。