Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, The Hospital for Sick Children, Zane Cohen Center, Mount Sinai Hospital, University of Toronto, Ontario, Canada.
Department of Medicine (Gastroenterology), University of California San Diego, San Diego, California.
Gastroenterology. 2017 May;152(6):1605-1614. doi: 10.1053/j.gastro.2017.02.011. Epub 2017 Mar 28.
The US Multi-Society Task Force on Colorectal Cancer, with invited experts, developed a consensus statement and recommendations to assist health care providers with appropriate management of patients with biallelic mismatch repair deficiency (BMMRD) syndrome, also called constitutional mismatch repair deficiency syndrome. This position paper outlines what is known about BMMRD, the unique genetic and clinical aspects of the disease, and reviews the current management approaches to this disorder. This article represents a starting point from which diagnostic and management decisions can undergo rigorous testing for efficacy. There is a lack of strong evidence and a requirement for further research. Nevertheless, providers need direction on how to recognize and care for BMMRD patients today. In addition to identifying areas of research, this article provides guidance for surveillance and management. The major challenge is that BMMRD is rare, limiting the ability to accumulate unbiased data and develop controlled prospective trials. The formation of effective international consortia that collaborate and share data is proposed to accelerate our understanding of this disease.
美国多学会大肠癌工作组,特邀专家,制定了共识声明和建议,以协助医疗保健提供者对双等位基因错配修复缺陷(BMMRD)综合征(也称为遗传性错配修复缺陷综合征)患者进行适当的管理。本立场文件概述了关于 BMMRD 的已知内容、疾病的独特遗传和临床方面,并回顾了目前对这种疾病的管理方法。本文代表了一个起点,可对诊断和管理决策进行严格的疗效测试。目前缺乏强有力的证据,需要进一步研究。尽管如此,提供者需要了解如何识别和照顾 BMMRD 患者。除了确定研究领域外,本文还为监测和管理提供了指导。主要的挑战是 BMMRD 很罕见,这限制了收集无偏见数据和开展对照前瞻性试验的能力。建议组建有效的国际合作组织,进行合作和数据共享,以加速我们对这种疾病的理解。