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李-弗劳梅尼综合征家族中的非小细胞肺癌不同变体:病例报告

Distinct NSCLC Variants in a Family With Li-Fraumeni Syndrome: Case Report.

作者信息

Edmondson Shelby, von Itzstein Mitchell S, Reys Brian, Mayer Melissa, Gagan Jeffrey, Gerber David E

机构信息

UT Southwestern Medical School, Dallas, Texas.

Department of Internal Medicine (Division of Hematology-Oncology), University of Texas Southwestern Medical Center, Dallas, Texas.

出版信息

JTO Clin Res Rep. 2022 Jun 25;3(8):100368. doi: 10.1016/j.jtocrr.2022.100368. eCollection 2022 Aug.

Abstract

INTRODUCTION

Heritable lung cancer may occur in the context of germline mutations (Li-Fraumeni syndrome). Limited cases of intrafamily tumor genomic characteristics have been reported.

MAIN CONCERNS IMPORTANT CLINICAL FINDINGS PRIMARY DIAGNOSES INTERVENTIONS OUTCOMES

A 40-year-old woman with no smoking history or known environmental exposure risk was incidentally found to have stage II (T2N1) NSCLC harboring an exon 19 p.Glu746_Ala750 deletion. Family history was notable for an identical twin sister with colorectal cancer (diagnosed at age 31 y) and a mother with stage I NSCLC harboring an exon 21 c.2573T>G (p.Leu858Arg) mutation (diagnosed at age 69 y). Genetic testing revealed a germline c.542G>A (p.Arg181His) mutation in the patient, her mother, and her sister, consistent with Li-Fraumeni syndrome. No germline mutations were detected.

CONCLUSION

Shared germline mutations may be associated with distinct NSCLC somatic mutations within families with Li-Fraumeni syndrome. Further understanding of the association between genetic cancer syndromes and lung cancer risk may improve early lung cancer detection in populations not otherwise meeting screening eligibility.

摘要

引言

遗传性肺癌可能发生在种系突变(李-弗劳梅尼综合征)的背景下。关于家族内肿瘤基因组特征的病例报道有限。

主要关注点 重要临床发现 主要诊断 干预措施 结果:一名40岁女性,无吸烟史且无已知环境暴露风险,偶然发现患有II期(T2N1)非小细胞肺癌,伴有外显子19 p.Glu⁷⁴⁶_Ala⁷⁵⁰缺失。家族史值得注意的是,她有一个同卵双胞胎姐妹患结直肠癌(31岁时确诊),还有一位母亲患I期非小细胞肺癌,伴有外显子21 c.2573T>G(p.Leu⁸⁵⁸Arg)突变(69岁时确诊)。基因检测显示患者、其母亲和姐妹存在种系c.542G>A(p.Arg¹⁸¹His)突变,符合李-弗劳梅尼综合征。未检测到种系突变。

结论

在李-弗劳梅尼综合征家族中,共享的种系突变可能与不同的非小细胞肺癌体细胞突变相关。进一步了解遗传性癌症综合征与肺癌风险之间的关联,可能会改善在其他不符合筛查条件人群中的早期肺癌检测。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c79f/9304605/a95dd5ee70e6/gr1.jpg

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