Department of Oncology of Zhangzhou Traditional Chinese Medicine Hospital, Zhangzhou 363000, China.
Shengli Clinical Medical College of Fujian Medical University, Fuzhou 350001, China.
Can J Gastroenterol Hepatol. 2021 Apr 12;2021:6610434. doi: 10.1155/2021/6610434. eCollection 2021.
A large number of colorectal cancers have a genetic background in China. However, due to insufficient awareness, the diagnostic rate remains low and merely 5-6% of colorectal cancer patients are diagnosed with hereditary colorectal cancer. Familial adenomatous polyposis (FAP) is an autosomal dominant genetic disease caused by mutations in the adenomatous polyposis coli (APC) gene. Different mutation sites in APC are associated with the severity of FAP, risks of carcinogenesis, and extraintestinal manifestations. We used next-generation sequencing (NGS) and capture techniques to screen suspected mutation points in the proband in this pedigree. Using modified Sanger sequencing, we identified members of the family who were carriers of this variant and whether this segregated well with disease occurrence. FAP family members had multiple adenomatous polyps in their gastrointestinal tracts, some of which developed into cancer with age. Two subjects presented a rare common bile duct polyp phenotype. No extraintestinal manifestations were observed. A heterozygous frameshift mutation in APC exon 16 (NM_000038.6) was observed in the proband and in other patients: c.3260_3261del (p.Leu1087GlnQfs 31) (rs587782305); the variant call format was CCT/C. Due to the deletion of two bases, a stop codon appeared after 31 amino acids, and the protein was truncated prematurely, which affected the conformation of the protein. Pedigree genetic linkage analysis showed that the clinical phenotype cosegregated with the APC mutation p.L1087fs. This mutation may be the pathogenic in this FAP family and responsible for this rare common bile duct polyp.
中国有大量结直肠癌具有遗传背景。但是,由于认识不足,诊断率仍然较低,仅有 5-6%的结直肠癌患者被诊断为遗传性结直肠癌。家族性腺瘤性息肉病(FAP)是一种常染色体显性遗传疾病,由腺瘤性结肠息肉病基因(APC)基因突变引起。APC 中的不同突变位点与 FAP 的严重程度、致癌风险和肠外表现相关。我们使用下一代测序(NGS)和捕获技术对该家系先证者疑似突变点进行筛查。使用改良的 Sanger 测序,我们鉴定了该变异的携带者家族成员,以及该变异是否与疾病发生良好分离。FAP 家族成员的胃肠道内有多发性腺瘤,其中一些随着年龄的增长发展为癌症。两名受试者表现出罕见的胆总管息肉表型。未观察到肠外表现。先证者和其他患者在 APC 外显子 16 中观察到杂合框移突变(NM_000038.6):c.3260_3261del(p.Leu1087GlnQfs 31)(rs587782305);变异调用格式为 CCT/C。由于两个碱基的缺失,在 31 个氨基酸后出现了一个终止密码子,导致蛋白质过早截短,从而影响了蛋白质的构象。家系遗传连锁分析显示,临床表型与 APC 突变 p.L1087fs 共分离。该突变可能是该 FAP 家系的致病突变,导致了这种罕见的胆总管息肉。