Center for Gene Diagnosis, Zhongnan Hospital of Wuhan University, Wuhan 430071, China.
Gene. 2013 Mar 10;516(2):204-8. doi: 10.1016/j.gene.2012.12.077. Epub 2013 Jan 3.
The aim of the study was to identify the causative gene defects associated with familial adenomatous polyposis (FAP) in two Chinese pedigrees.
The diagnosis of FAP patients was confirmed by clinical manifestations, family histories, colonoscopy and pathology examinations. Blood samples were collected and genomic DNA was extracted. The mutation analysis of the adenomatous polyposis coli (APC) and human mutY homolog (MUTYH) genes was conducted by direct polymerase chain reaction (PCR) sequencing and multiplex ligation-dependent probe amplification (MLPA).
In pedigree A, the results of direct PCR sequencing revealed a heterozygous insertion mutation at codon 610 in exon 15 of APC gene (c.1828_1829insG), which resulted in frameshift change (p.Asp610GlyfsX23) in all 4 patients, but was absent in the unaffected familial members and controls. In pedigree B, we didn't identify that causative mutations cosegregated with the clinical phenotype in the APC and MUTYH genes.
We identified a novel insertion mutation as the pathogenic gene of FAP in Chinese population, which could enrich the germline mutation spectrum of APC gene, and the prophylactic proctocolectomy for the mutation carrier in family should be considered.
本研究旨在鉴定两个中国家系中家族性腺瘤性息肉病(FAP)的致病基因突变。
通过临床表现、家族史、结肠镜检查和病理检查,对 FAP 患者进行诊断。采集血样,提取基因组 DNA。采用直接聚合酶链反应(PCR)测序和多重连接依赖性探针扩增(MLPA)方法,对 APC 和人类 mutY 同源物(MUTYH)基因进行突变分析。
在家系 A 中,直接 PCR 测序结果显示 APC 基因第 15 外显子 610 密码子处存在杂合插入突变(c.1828_1829insG),导致所有 4 名患者均出现移码改变(p.Asp610GlyfsX23),而未受累的家族成员和对照者中均未发现该突变。在家系 B 中,我们未在 APC 和 MUTYH 基因中发现与临床表型共分离的致病突变。
我们在中国人群中发现了一种新的插入突变,该突变可作为 FAP 的致病基因,丰富 APC 基因突变谱,对于家系中的突变携带者,应考虑预防性直肠结肠切除术。