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癌症易感综合征:儿科多学科遗传性癌症咨询科室的一项回顾性队列分析

Cancer predisposing syndrome: a retrospective cohort analysis in a pediatric and multidisciplinary genetic cancer counseling unit.

作者信息

Escudero Adela, Ferreras Cristina, Rodriguez-Salas Nuria, Corral Dolores, Rodriguez Laura, Pérez-Martínez Antonio

机构信息

Institute of Medical and Molecular Genetics, La Paz University Hospital, Paseo de la Castellana 261, 28046, Madrid, Spain.

La Paz Hospital Institute for Health Research (IdiPAZ), Madrid, Spain.

出版信息

Int J Clin Oncol. 2022 May;27(5):992-1000. doi: 10.1007/s10147-022-02133-9. Epub 2022 Feb 21.

Abstract

INTRODUCTION

Approximately 10% of pediatric patients with cancer have an inherited, sometimes masked, cancer predisposition syndrome (CPS). Identifying patients with genetic susceptibility to malignant disease is essential for their correct diagnosis and clinical management.

MATERIALS AND METHODS

Here, we present the workflow and experience of a multidisciplinary cancer predisposition unit focused on pediatric patients with cancer.

RESULTS

Between July 2018 and July 2020, 214 patients were diagnosed with pediatric cancer in our Hospital. Of all, 49 patients were treated at the CPS unit, 48 of whom were recommended a genetic study. Mutational analysis was performed on DNA from peripheral blood samples, with approximately 45% of the patients (n = 22) receiving a confirmed CPS diagnosis, all of whom underwent genetic counseling. These cases represent 20% of all pediatric cancers diagnosed in the same center during this period. Most of the patients were diagnosed with hereditary retinoblastoma; however, we also identified families with Li-Fraumeni syndrome, multiple endocrine neoplasia type 2, hereditary melanoma, hereditary leiomyomatosis, and Gardner syndrome.

CONCLUSION

Despite its limitations regarding the type of tumors and number of patients included, this study revealed that implementing a specialized unit focused on children with cancer results in a higher diagnostic rate and better genetic counseling for patients with pediatric cancer predisposition syndromes.

摘要

引言

约10%的儿童癌症患者患有遗传性癌症易感性综合征(CPS),有时这种综合征会被掩盖。识别对恶性疾病具有遗传易感性的患者对于其正确诊断和临床管理至关重要。

材料与方法

在此,我们介绍一个专注于儿童癌症患者的多学科癌症易感性诊断小组的工作流程和经验。

结果

在2018年7月至2020年7月期间,我院有214例患者被诊断为儿童癌症。其中,49例患者在癌症易感性诊断小组接受治疗,其中48例被建议进行基因研究。对外周血样本的DNA进行了突变分析,约45%的患者(n = 22)被确诊为CPS,所有这些患者都接受了遗传咨询。这些病例占同期该中心诊断的所有儿童癌症的20%。大多数患者被诊断为遗传性视网膜母细胞瘤;然而,我们也发现了患有李-佛美尼综合征、2型多发性内分泌肿瘤、遗传性黑色素瘤、遗传性平滑肌瘤病和加德纳综合征的家庭。

结论

尽管本研究在肿瘤类型和纳入患者数量方面存在局限性,但研究表明,设立一个专注于儿童癌症患者的专门小组,可提高儿童癌症易感性综合征患者的诊断率,并为其提供更好的遗传咨询。

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