Cajal Andrea R, Piñero Tamara A, Verzura Alicia, Santino Juan Pablo, Solano Angela R, Kalfayan Pablo G, Ferro Alejandra, Vaccaro Carlos
Instituto de Ciencias Básicas y Medicina Experimental (ICBME), Instituto Universitario Hospital Italiano, Argentina. E-mail:
Instituto de Ciencias Básicas y Medicina Experimental (ICBME), Instituto Universitario Hospital Italiano, Argentina.
Medicina (B Aires). 2016;76(3):180-2.
Lynch syndrome is the most frequent syndrome in hereditary colorectal cancer, a family-specific deleterious mutations in genes encoding DNA reparation proteins: MLH1 (mutL homolog 1), MSH2, MSH6 (mutS homolog 2 y 6, respectively), PMS2 (PMS1 homolog 2, mismatch repair system component) y MUTYH (mutY DNA glycosylase). The c.2252_2253delAA, p.Lys751Serfs*3 mutation in MLH1 gene segregates with a haplotype reported in the northern region of Italy and whose origin was attributed to a founder effect. This mutation co-segregates with typical characteristics of Lynch syndrome, including early age at onset and multiple primary tumors in the same individual, a high frequency of pancreatic cancer, high microsatellite instability and lack of PMS2 expression. This report describes a mutation in an Argentinian patient with endometrioid adenocarcinoma of uterus. Her first-degree relatives had a history of colon cancer diagnosed before 50 years, fulfilling the Amsterdam Criteria I and Lynch syndrome II. The high pathogenicity associated to this mutation makes necessary the study of all members from families with hereditary cancer, allowing pre-symptomatic genetic diagnosis, early assessment and the instauration of preventive treatments.
林奇综合征是遗传性结直肠癌中最常见的综合征,是一种家族特异性的DNA修复蛋白编码基因有害突变,这些基因包括MLH1(错配修复蛋白1)、MSH2、MSH6(分别为错配修复蛋白2和6)、PMS2(PMS1同源物2,错配修复系统组件)和MUTYH(mutY DNA糖基化酶)。MLH1基因中的c.2252_2253delAA、p.Lys751Serfs*3突变与意大利北部报道的一种单倍型共分离,其起源归因于奠基者效应。该突变与林奇综合征的典型特征共分离,包括发病年龄早、同一个体出现多个原发性肿瘤、胰腺癌高发、微卫星高度不稳定以及缺乏PMS2表达。本报告描述了一名患有子宫内膜样腺癌的阿根廷患者的突变情况。她的一级亲属有在50岁之前被诊断出结肠癌的病史,符合阿姆斯特丹标准I和林奇综合征II。与该突变相关的高致病性使得有必要对遗传性癌症家族的所有成员进行研究,从而实现症状前基因诊断、早期评估以及开展预防性治疗。