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遗传性结直肠癌综合征的流行情况及相关遗传谱,提高对癌症风险的认识以及在越南进行家族级联检测的必要性。

Prevalence and genetic spectrum associated with hereditary colorectal cancer syndromes, the need to improve cancer risk awareness, and family cascade testing in Vietnam.

机构信息

University Medical Center, Ho Chi Minh City, Vietnam.

Medical Genetics Institute, Ho Chi Minh City, Vietnam.

出版信息

Fam Cancer. 2023 Oct;22(4):449-458. doi: 10.1007/s10689-023-00344-1. Epub 2023 Jul 30.

DOI:10.1007/s10689-023-00344-1
PMID:37516717
Abstract

In Vietnam, colorectal cancer is one of the top diagnosed cancers, with 5-10% originating from inherited mutations. This study aims to define the mutation spectrum associated with hereditary colorectal cancer syndromes (HCCS) in Vietnam, evaluate the influence of genetic testing on carriers' awareness, and also investigate the barriers in familial testing. Genetic test reports were collected to identify HCCS cases, then cases underwent a survey investigating self-risk and familial-risk awareness, proactive cancer screening, and familial testing barriers. Participant characteristics, mutation prevalence, and results from the survey were descriptively analyzed and reported. Of all genetic test results, 3% (49/1632) were identified with mutations related to HCCS. Over 77% of them belonged to Lynch syndrome. PMS2 appeared to be the gene with the highest mutation frequency, while MLH1 was the lowest. 44% of cases further undertook cancer screening tests, and 48% of cases' families had uptake genetic testing. The biggest barrier of familial members for not taking genetic test was psychological reasons (fear, not being interested, or not feeling necessary). This study provided new evidence for HCCS mutation spectrum in Vietnamese population and the success in promoting cascade test in high-risk family members through financial and technical support. Also, study has suggested the needs of an innovative genetic testing process focusing on the quality of pre-and post-test consultancy, an increase in follow-ups, and the change in policy for permission of contacting relatives directly to improve the rate of cascade testing and proactive cancer screening.

摘要

在越南,结直肠癌是最常见的癌症之一,其中 5-10%是由遗传突变引起的。本研究旨在确定与遗传性结直肠癌综合征(HCCS)相关的突变谱,评估遗传检测对携带者意识的影响,并调查家族性检测的障碍。收集了基因检测报告,以确定 HCCS 病例,然后对病例进行调查,了解其自身风险和家族风险意识、主动癌症筛查和家族检测障碍。对参与者特征、突变流行率以及调查结果进行描述性分析和报告。在所有基因检测结果中,有 3%(49/1632)与 HCCS 相关的突变。其中超过 77%属于林奇综合征。PMS2 似乎是突变频率最高的基因,而 MLH1 则最低。44%的病例进一步进行了癌症筛查测试,48%的病例家族进行了基因检测。家族成员不进行基因检测的最大障碍是心理原因(恐惧、不感兴趣或认为没有必要)。本研究为越南人群中 HCCS 的突变谱提供了新的证据,并通过财务和技术支持成功地促进了高危家庭成员的级联检测。此外,研究还表明需要一种创新的基因检测流程,重点是检测前和检测后的咨询质量、增加随访,并改变直接联系亲属的政策,以提高级联检测和主动癌症筛查的率。

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