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病例报告:一名患有胃肠道间质瘤和肺腺癌患者的胚系突变。

Case report: Germline mutation in a patient with GIST and lung adenocarcinoma.

作者信息

Martino Stefania, De Summa Simona, Pilato Brunella, Digennaro Maria, Laera Letizia, Tommasi Stefania, Patruno Margherita

机构信息

Center for Study of Heredo-Familial Tumors, IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy.

Molecular Diagnostics and Pharmacogenetics Unit, IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy.

出版信息

Front Oncol. 2024 Aug 2;14:1419739. doi: 10.3389/fonc.2024.1419739. eCollection 2024.

DOI:10.3389/fonc.2024.1419739
PMID:39156708
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11327130/
Abstract

The gene () is involved in telomere maintenance and stability and plays a crucial role in the preservation of genomic stability. is considered a high-penetrance melanoma susceptibility gene; however, the number of cancer types associated with the pathogenic germline variants of is gradually increasing, including chronic lymphocytic leukemia (CLL), angiosarcomas, and gliomas, even though many associations are still elusive. Here, we reported a case of a 60-year-old man who showed early-onset multiple neoplasms, including multiple melanomas, gastrointestinal stromal tumor (GIST), and lung adenocarcinoma. Next-generation sequencing (NGS) analyses revealed a germline heterozygous pathogenic variant in the gene. Notably, GIST and lung adenocarcinoma were not previously reported in association with the germline variant. Lung cancer susceptibility syndrome is very rare and the actual knowledge is limited to a few genes although major genetic factors are unidentified. Recently, genome-wide association studies (GWAS) have pointed out an association between variants and lung cancer. This case report highlights the clinical relevance of alterations, particularly their potential involvement in lung cancer. It also suggests that testing may be warranted in patients with familial cancer syndrome, particularly those with a history of melanoma and other solid tumors.

摘要

基因()参与端粒的维持和稳定,并在基因组稳定性的维持中发挥关键作用。被认为是一种高外显率的黑色素瘤易感基因;然而,与致病种系变异相关的癌症类型数量正在逐渐增加,包括慢性淋巴细胞白血病(CLL)、血管肉瘤和神经胶质瘤,尽管许多关联仍不明确。在此,我们报告了一例60岁男性病例,该患者出现早发性多种肿瘤,包括多发性黑色素瘤、胃肠道间质瘤(GIST)和肺腺癌。二代测序(NGS)分析揭示了基因中的种系杂合致病变异。值得注意的是,此前尚未报道GIST和肺腺癌与种系变异有关。肺癌易感综合征非常罕见,尽管主要遗传因素尚未明确,但实际已知的仅限于少数几个基因。最近,全基因组关联研究(GWAS)指出了变异与肺癌之间的关联。本病例报告强调了改变的临床相关性,特别是它们在肺癌中的潜在作用。这也表明,对于患有家族性癌症综合征的患者,特别是那些有黑色素瘤和其他实体瘤病史的患者,可能有必要进行检测。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7b1d/11327130/e01c8d9a79bf/fonc-14-1419739-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7b1d/11327130/ab04b0a5ec0d/fonc-14-1419739-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7b1d/11327130/1b91e0985ed7/fonc-14-1419739-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7b1d/11327130/e01c8d9a79bf/fonc-14-1419739-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7b1d/11327130/ab04b0a5ec0d/fonc-14-1419739-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7b1d/11327130/1b91e0985ed7/fonc-14-1419739-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7b1d/11327130/e01c8d9a79bf/fonc-14-1419739-g003.jpg

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本文引用的文献

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Associations between telomere attrition, genetic variants in telomere maintenance genes, and non-small cell lung cancer risk in the Jammu and Kashmir population of North India.印度北部查谟和克什米尔地区人群中端粒损耗、端粒维持基因遗传变异与非小细胞肺癌风险的相关性。
BMC Cancer. 2023 Sep 18;23(1):874. doi: 10.1186/s12885-023-11387-z.
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Size matters in telomere biology disorders ‒ expanding phenotypic spectrum in patients with long or short telomeres.端粒生物学障碍中的长度因素——长短端粒患者的表型谱扩展
Hered Cancer Clin Pract. 2023 May 15;21(1):7. doi: 10.1186/s13053-023-00251-7.
3
POT1 mutations cause differential effects on telomere length leading to opposing disease phenotypes.
POT1 突变导致端粒长度产生不同的影响,从而导致相反的疾病表型。
J Cell Physiol. 2023 Jun;238(6):1237-1255. doi: 10.1002/jcp.31034. Epub 2023 May 14.
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Familial Clonal Hematopoiesis in a Long Telomere Syndrome.长端粒综合征中的家族性克隆性造血
N Engl J Med. 2023 Jun 29;388(26):2422-2433. doi: 10.1056/NEJMoa2300503. Epub 2023 May 4.
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A germline exome analysis reveals harmful variants in multiple myeloma patients and families.种系外显子组分析揭示了多发性骨髓瘤患者及其家族中的有害变异。
EJHaem. 2022 Sep 2;3(4):1352-1357. doi: 10.1002/jha2.557. eCollection 2022 Nov.
6
Whole exome sequencing identified a novel variant as a candidate pathogenic allele underlying a Li-Fraumeni-like family.全外显子组测序鉴定出一个新的变异,作为一个李-弗劳梅尼综合征样家族潜在的致病等位基因。
Front Oncol. 2022 Nov 1;12:963364. doi: 10.3389/fonc.2022.963364. eCollection 2022.
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Analyses of rare predisposing variants of lung cancer in 6,004 whole genomes in Chinese.中国 6004 例全基因组中肺癌罕见易感变异体的分析。
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