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家族性腺瘤性息肉病的表现与随访:APC 和 MUTYH 突变之间的差异。

Presentation and Follow-up of Familial Adenomatous Polyposis: Differences Between APC and MUTYH Mutations.

机构信息

Servicio de Cirugía General, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, España.

Servicio de Cirugía General, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, España.

出版信息

Cir Esp (Engl Ed). 2020 Oct;98(8):465-471. doi: 10.1016/j.ciresp.2020.04.033. Epub 2020 Jun 3.

Abstract

BACKGROUND

Familial adenomatous polyposis is described as one of the common two types of genetic disorders: APC and MUTYH gene associated polyposis syndrome and the clinical differences between the two can sometimes be unclear.

MATERIALS AND METHODS

A retrospective analysis and comparison was made of clinical, surgical, and histological criteria, mutation types and the long-term results of patients who underwent genetic analysis which resulted in the diagnosis of Familial Adenomatous Polyposis between 1984 and 2018.

RESULTS

Of the total 71 patients included in the study, 14 were identified with the MUTYH gene, and 57 with the APC mutation. In patients with the APC mutation, 63% had duodenal adenoma, 61% gastric polyp and 54% had desmoid tumor. Of the patients with the MUTYH mutation, 21% had duodenal adenoma and 21% were diagnosed with gastric polyps. In 21% of the patients with APC mutation, the polyp count was <100, and 64% of those with the MUTYH mutation had >100 polyps in the colon No statistical difference was determined between the groups in respect of the proportion of patients with >100 polyps.

CONCLUSION

The pre-operative genetic testing of patients with polyposis coli will be useful in determining the future clinical outcome and helpful in guiding an informed decision as to whether to apply surgical treatment. It is useful to determine the colonic and extra-colonic involvement of genetic mutation diseases in patients with Familial adenomatous polyposis.

摘要

背景

家族性腺瘤性息肉病被描述为两种常见的遗传疾病之一:APC 和 MUTYH 基因相关的息肉病综合征,两者的临床差异有时并不明显。

材料和方法

对 1984 年至 2018 年间通过基因分析诊断为家族性腺瘤性息肉病的患者的临床、手术和组织学标准、突变类型和长期结果进行回顾性分析和比较。

结果

在纳入研究的 71 例患者中,有 14 例患者存在 MUTYH 基因突变,57 例患者存在 APC 基因突变。在 APC 基因突变的患者中,63%有十二指肠腺瘤,61%有胃息肉,54%有硬纤维瘤。在 MUTYH 基因突变的患者中,21%有十二指肠腺瘤,21%有胃息肉。在 APC 基因突变的患者中,21%的息肉数量<100 个,而在 MUTYH 基因突变的患者中,有 64%的结肠息肉数量>100 个。APC 基因突变组和 MUTYH 基因突变组中息肉数量>100 个的患者比例无统计学差异。

结论

对结肠息肉病患者进行术前基因检测,有助于确定患者的未来临床结局,并有助于在是否应用手术治疗方面做出知情决策。对于确定家族性腺瘤性息肉病患者遗传突变疾病的结肠和结肠外累及情况是有用的。

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