Chau Cindy, van Doorn Remco, van Poppelen Natasha M, van der Stoep Nienke, Mensenkamp Arjen R, Sijmons Rolf H, van Paassen Barbara W, van den Ouweland Ans M W, Naus Nicole C, van der Hout Annemieke H, Potjer Thomas P, Bleeker Fonnet E, Wevers Marijke R, van Hest Liselotte P, Jongmans Marjolijn C J, Marinkovic Marina, Bleeker Jaco C, Jager Martine J, Luyten Gregorius P M, Nielsen Maartje
Department of Ophthalmology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands.
Department of Dermatology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands.
Cancers (Basel). 2019 Aug 4;11(8):1114. doi: 10.3390/cancers11081114.
Germline pathogenic variants in the BRCA1-associated protein-1 () gene cause the BAP1-tumor predisposition syndrome (BAP1-TPDS, OMIM 614327). BAP1-TPDS is associated with an increased risk of developing uveal melanoma (UM), cutaneous melanoma (CM), malignant mesothelioma (MMe), renal cell carcinoma (RCC), meningioma, cholangiocarcinoma, multiple non-melanoma skin cancers, and -inactivated nevi. Because of this increased risk, it is important to identify patients with BAP1-TPDS. The associated tumors are treated by different medical disciplines, emphasizing the need for generally applicable guidelines for initiating genetic analysis. In this study, we describe the path to identification of BAP1-TPDS in 21 probands found in the Netherlands and the family history at the time of presentation. We report two cases of de novo germline mutations (2/21, 9.5%). Findings of this study combined with previously published literature, led to a proposal of guidelines for genetic referral. We recommend genetic analysis in patients with ≥2 BAP1-TPDS-associated tumors in their medical history and/or family history. We also propose to test germline in patients diagnosed with UM <40 years, CM <18 years, MMe <50 years, or RCC <46 years. Furthermore, other candidate susceptibility genes for tumor types associated with BAP1-TPDS are discussed, which can be included in gene panels when testing patients.
BRCA1相关蛋白1()基因的种系致病性变异会导致BAP1肿瘤易感性综合征(BAP1-TPDS,OMIM 614327)。BAP1-TPDS与葡萄膜黑色素瘤(UM)、皮肤黑色素瘤(CM)、恶性间皮瘤(MMe)、肾细胞癌(RCC)、脑膜瘤、胆管癌、多种非黑色素皮肤癌以及失活痣的发生风险增加相关。由于这种风险增加,识别患有BAP1-TPDS的患者很重要。相关肿瘤由不同医学学科进行治疗,这凸显了启动基因分析的通用指南的必要性。在本研究中,我们描述了在荷兰发现的21名先证者中识别BAP1-TPDS的过程以及就诊时的家族史。我们报告了2例新发种系突变病例(2/21,9.5%)。本研究结果与先前发表的文献相结合,提出了基因转诊指南。我们建议对病史和/或家族史中有≥2种与BAP1-TPDS相关肿瘤的患者进行基因分析。我们还建议对诊断为40岁以下的UM、18岁以下的CM、50岁以下的MMe或46岁以下的RCC患者进行种系检测。此外,还讨论了与BAP1-TPDS相关的肿瘤类型的其他候选易感基因,在对患者进行检测时可将其纳入基因检测板。