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李-佛美尼综合征:当前策略与未来展望

Li-Fraumeni Syndrome : Current Strategies and Future Perspectives.

作者信息

Lee Ji Won

机构信息

Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

出版信息

J Korean Neurosurg Soc. 2025 May;68(3):305-310. doi: 10.3340/jkns.2025.0050. Epub 2025 Apr 29.

DOI:10.3340/jkns.2025.0050
PMID:40289692
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12062525/
Abstract

Li-Fraumeni syndrome (LFS) is a rare inherited cancer predisposition syndrome caused by germline mutations in the TP53 tumor suppressor gene. It predisposes affected individuals to a wide spectrum of early-onset malignancies, including sarcomas, breast cancer, brain tumors, and adrenocortical carcinoma. Advances in genetic testing and risk management strategies have enhanced the identification and clinical management of LFS patients. Comprehensive surveillance has demonstrated increased survival rates through proactive screening. Beyond surveillance, research is exploring novel approaches such as liquid biopsy for early cancer detection and chemoprevention strategies, including metformin trials, to mitigate cancer risk. This review discusses the molecular basis, clinical spectrum, surveillance strategies, and emerging research in LFS.

摘要

李-佛美尼综合征(LFS)是一种罕见的遗传性癌症易感综合征,由TP53肿瘤抑制基因的种系突变引起。它使受影响的个体易患多种早发性恶性肿瘤,包括肉瘤、乳腺癌、脑肿瘤和肾上腺皮质癌。基因检测和风险管理策略的进展提高了LFS患者的识别和临床管理水平。全面监测通过主动筛查提高了生存率。除了监测,研究正在探索新的方法,如用于早期癌症检测的液体活检和化学预防策略,包括二甲双胍试验,以降低癌症风险。本综述讨论了LFS的分子基础、临床谱、监测策略和新兴研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d915/12062525/6eb3cb216a71/jkns-2025-0050f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d915/12062525/6eb3cb216a71/jkns-2025-0050f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d915/12062525/6eb3cb216a71/jkns-2025-0050f1.jpg

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本文引用的文献

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New Paradigms in the Clinical Management of Li-Fraumeni Syndrome.Li-Fraumeni 综合征临床管理的新模式。
Cold Spring Harb Perspect Med. 2024 Nov 1;14(11):a041584. doi: 10.1101/cshperspect.a041584.
2
Cancer Risks Associated With Pathogenic Variants: Maximum Likelihood Analysis of Extended Pedigrees for Diagnosis of First Cancers Beyond the Li-Fraumeni Syndrome Spectrum.与致病性变异相关的癌症风险:Li-Fraumeni 综合征谱之外的首发癌症的扩展家系的最大似然分析。
JCO Precis Oncol. 2024 Feb;8:e2300453. doi: 10.1200/PO.23.00453.
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Cancer Precision-Prevention trial of Metformin in adults with Li Fraumeni syndrome (MILI) undergoing yearly MRI surveillance: a randomised controlled trial protocol.
Li Fraumeni 综合征成人接受每年 MRI 监测的二甲双胍癌症精准预防试验(MILI):一项随机对照试验方案。
Trials. 2024 Feb 3;25(1):103. doi: 10.1186/s13063-024-07929-w.
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Early Cancer Detection in Li-Fraumeni Syndrome with Cell-Free DNA.使用游离 DNA 进行 Li-Fraumeni 综合征的早期癌症检测。
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NCCN Guidelines® Insights: Genetic/Familial High-Risk Assessment: Breast, Ovarian, and Pancreatic, Version 2.2024.美国国立综合癌症网络(NCCN)指南见解:遗传/家族性高风险评估:乳腺癌、卵巢癌和胰腺癌,2024年第2版
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6
Factors affecting adherence to a high-risk surveillance protocol among patients with Li-Fraumeni syndrome.影响李-弗劳梅尼综合征患者对高危监测方案依从性的因素。
Hered Cancer Clin Pract. 2023 Aug 11;21(1):15. doi: 10.1186/s13053-023-00259-z.
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Avoidance or adaptation of radiotherapy in patients with cancer with Li-Fraumeni and heritable TP53-related cancer syndromes.避免或调整 Li-Fraumeni 和遗传性 TP53 相关癌症综合征患者的放射治疗。
Lancet Oncol. 2021 Dec;22(12):e562-e574. doi: 10.1016/S1470-2045(21)00425-3.
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New surveillance guidelines for Li-Fraumeni and hereditary TP53 related cancer syndrome: implications for germline TP53 testing in breast cancer.李-弗劳梅尼综合征及遗传性TP53相关癌症综合征的新监测指南:对乳腺癌中种系TP53检测的影响
Fam Cancer. 2021 Jan;20(1):1-7. doi: 10.1007/s10689-020-00207-z.
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