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Yashiro M. Molecular Alterations of Colorectal Cancer with Inflammatory Bowel Disease. Dig Dis Sci 2015; 60:2251-63. [PMID: 25840920 DOI: 10.1007/s10620-015-3646-4] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2014] [Accepted: 03/26/2015] [Indexed: 12/18/2022]
Abstract
Inflammatory bowel disease (IBD) is an important etiologic factor in the development of colorectal cancer (CRC). The risk of CRC begins to increase 8 or 10 years after the diagnosis of IBD. This type of cancer is called colitis-associated CRC (CA-CRC). The molecular pathogenesis of inflammatory epithelium might play a critical role in the development of CA-CRC. Genetic alterations detected in CA-CRC such as genetic mutations, microsatellite instability, and DNA hypermethylation are also recognized in sporadic CRC; however, there are differences in the timing and frequency of molecular events between CA-CRC and sporadic CRC. Interaction between gene-environmental factors, including inflammation, lifestyle, psychological stress, and prior appendectomy, might be associated with the etiopathology of IBD. The mucosal inflammatory mediators, such as oxidant stress, free radicals, and chemokines, may cause the genetic alterations. Understanding the molecular mechanisms of CA-CRC might be important to develop clinical efficacies for patients with IBD. This review discusses the molecular characteristics of CA-CRC, especially ulcerative colitis-associated CRC, including clinical features, signaling pathways, and interactions between genetic alterations and environment involved in inflammatory carcinogenesis.
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Affiliation(s)
- Masakazu Yashiro
- Department of Surgical Oncology, Oncology Institute of Geriatrics and Medical Science, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan,
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Erstad DJ, Tumusiime G, Cusack JC. Prognostic and Predictive Biomarkers in Colorectal Cancer: Implications for the Clinical Surgeon. Ann Surg Oncol 2015. [DOI: 10.1245/s10434-015-4706-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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253
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Papillary thyroid carcinoma (PTC) in Lynch syndrome: Report of two cases and discussion on Lynch syndrome behaviour and genetics. Biomed Pharmacother 2015; 74:9-16. [PMID: 26349957 DOI: 10.1016/j.biopha.2015.06.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Accepted: 06/23/2015] [Indexed: 12/19/2022] Open
Abstract
We present here two cases of papillary thyroid carcinoma (PTC) in patients affected by Lynch syndrome (LS). The first case is a 47-year-old woman with typical hereditary non-polyposis colorectal cancer (HNPCC) syndrome, reported with endometrial and ovarian carcinoma at age 43, and colon cancer at age 45. The patient underwent total thyroidectomy and central node dissection in 2007, at 47years old, with a histological diagnosis of PTC (T1aN1a). Molecular genetics showed a germ-line mutation of the MLH1 gene, 1858 G>T(E620X), with substitution of glycine with a stop codon at position 620. This mutation has pathogenetic significance and was considered responsible for the various tumours of the HNPCC spectrum. In particular, in the same kindred, spanning 5 generations, there were 5 members with colorectal cancer, 4 with endometrial cancer, 3 with gastric and 2 with breast cancer. The second case is a 34-year-old man with typical HNPCC syndrome with colonic resection for colon cancer at age 21. The patient underwent total thyroidectomy with central and lateral node dissection in 2010, at age 34, with a histological diagnosis of PTC with nodal metastases (pT4N1b). Molecular genetic analysis showed a germ-line mutation of the MSH2 gene (thymine insertion at position 907). This mutation had pathogenetic significance and was considered responsible for HNPCC development. Two similar cases have been reported: a 39-year-old woman, and a 44-year-old woman, affected by HNPCC syndrome, with anaplastic thyroid carcinoma and undifferentiated thyroid carcinoma, respectively. We reviewed the Lynch syndrome literature on the history, genetics and expanding tumour spectrum of this condition.
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Ferreira AM, Tuominen I, Sousa S, Gerbens F, van Dijk-Bos K, Osinga J, Kooi KA, Sanjabi B, Esendam C, Oliveira C, Terpstra P, Hardonk M, van der Sluis T, Zazula M, Stachura J, van der Zee AG, Hollema H, Sijmons RH, Aaltonen LA, Seruca R, Hofstra RMW, Westers H. New target genes in endometrial tumors show a role for the estrogen-receptor pathway in microsatellite-unstable cancers. Hum Mutat 2015; 35:1514-23. [PMID: 25231886 DOI: 10.1002/humu.22700] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2014] [Accepted: 09/08/2014] [Indexed: 12/31/2022]
Abstract
Microsatellite instability (MSI) in tumors results in an accumulation of mutations in (target) genes. Previous studies suggest that the profile of target genes differs according to tumor type. This paper describes the first genome-wide search for target genes for mismatch repair-deficient endometrial cancers. Genes expressed in normal endometrium containing coding repeats were analyzed for mutations in tumors. We identified 44 possible genes of which seven are highly mutated (>15%). Some candidates were also found mutated in colorectal and gastric tumors. The most frequently mutated gene, NRIP1 encoding nuclear receptor-interacting protein 1, was silenced in an endometrial tumor cell line and expression microarray experiments were performed. Silencing of NRIP1 was associated with differences in the expression of several genes in the estrogen-receptor network. Furthermore, an enrichment of genes related to cell cycle (regulation) and replication was observed. We present a new profile of target genes, some of them tissue specific, whereas others seem to play a more general role in MSI tumors. The high-mutation frequency combined with the expression data suggest, for the first time, an involvement of NRIP1 in endometrial cancer development.
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Affiliation(s)
- Ana M Ferreira
- Department of Genetics, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands; Department of Pathomorphology, Medical College, Jagiellonian University, Krakow, Poland; Institute of Molecular Pathology and Immunology and Medical Faculty, University of Porto, Porto, Portugal
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Scartozzi M, Giampieri R, Aprile G, Iacono D, Santini D, dell’Aquila E, Silvestris N, Gnoni A, Bonotto M, Puzzoni M, Demurtas L, Cascinu S. The distinctive molecular, pathological and clinical characteristics ofBRAF-mutant colorectal tumors. Expert Rev Mol Diagn 2015; 15:979-87. [DOI: 10.1586/14737159.2015.1047346] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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256
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Amuta AO, Barry AE. Influence of Family History of Cancer on Engagement in Protective Health Behaviors. AMERICAN JOURNAL OF HEALTH EDUCATION 2015. [DOI: 10.1080/19325037.2015.1023478] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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257
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Haukkala A, Konttinen H, Hankonen N, Perola M, Kääriäinen H, Salomaa V. Genetic causal beliefs about morbidity: associations with health behaviors and health outcome beliefs about behavior changes between 1982-2002 in the Finnish population. BMC Public Health 2015; 15:389. [PMID: 25884345 PMCID: PMC4405877 DOI: 10.1186/s12889-015-1657-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2014] [Accepted: 03/18/2015] [Indexed: 11/25/2022] Open
Abstract
Background The role and meaning of genetic information has grown considerably in the recent decades. We examined changes in causal beliefs about morbidity as well as the associations between causal beliefs, health behaviors and obesity, and health outcome beliefs from 1982 to 2002. Methods In five population-based risk-factor surveys (the FINRISK Studies) of individuals aged 25 to 64 years conducted from 1982 to 2002 (n = 37,503), respondents chose the most important cause of morbidity from a list of ten alternatives. Health outcome beliefs were assessed with two items. Physical inactivity and smoking status were based on self-reports and obesity was based on measured height and weight. Results The prevalence of those who endorse genetic factors as the most important cause of morbidity increased from 4% in 1982 to 10% in 1992 and remained at that level until 2002. During the study period, lack of exercise and overweight increased, whereas inappropriate diet and stress diminished as causal beliefs about morbidity. Smokers and physically inactive were more likely to endorse genetic than behavioral causes of morbidity, whereas obese respondents were more likely to choose overweight over genetic causes of morbidity. Those who endorse genetic factors as the most important cause had more pessimistic outcome beliefs about health behavior changes, but these outcome beliefs became more positive in all causal belief groups during the study period. Conclusion Despite increased public discussion of genomics, the relative proportion of those who endorse genetic factors as the most important cause of morbidity has remained low. However, within this group beliefs about benefits of health behavior changes have become more positive. This could indicate that increase in genomic health information does not lead to more negative appraisals of efficacy of lifestyle changes.
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Affiliation(s)
- Ari Haukkala
- Department of Social Research, University of Helsinki, Helsinki, Finland.
| | - Hanna Konttinen
- Department of Social Research, University of Helsinki, Helsinki, Finland.
| | - Nelli Hankonen
- Department of Social Research, University of Helsinki, Helsinki, Finland. .,School of Social Sciences and Humanities, University of Tampere, Tampere, Finland.
| | - Markus Perola
- National Institute for Health and Welfare, Helsinki, Finland.
| | | | - Veikko Salomaa
- National Institute for Health and Welfare, Helsinki, Finland.
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258
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Grech G, Zhan X, Yoo BC, Bubnov R, Hagan S, Danesi R, Vittadini G, Desiderio DM. EPMA position paper in cancer: current overview and future perspectives. EPMA J 2015; 6:9. [PMID: 25908947 PMCID: PMC4407842 DOI: 10.1186/s13167-015-0030-6] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2015] [Accepted: 02/26/2015] [Indexed: 12/31/2022]
Abstract
At present, a radical shift in cancer treatment is occurring in terms of predictive, preventive, and personalized medicine (PPPM). Individual patients will participate in more aspects of their healthcare. During the development of PPPM, many rapid, specific, and sensitive new methods for earlier detection of cancer will result in more efficient management of the patient and hence a better quality of life. Coordination of the various activities among different healthcare professionals in primary, secondary, and tertiary care requires well-defined competencies, implementation of training and educational programs, sharing of data, and harmonized guidelines. In this position paper, the current knowledge to understand cancer predisposition and risk factors, the cellular biology of cancer, predictive markers and treatment outcome, the improvement in technologies in screening and diagnosis, and provision of better drug development solutions are discussed in the context of a better implementation of personalized medicine. Recognition of the major risk factors for cancer initiation is the key for preventive strategies (EPMA J. 4(1):6, 2013). Of interest, cancer predisposing syndromes in particular the monogenic subtypes that lead to cancer progression are well defined and one should focus on implementation strategies to identify individuals at risk to allow preventive measures and early screening/diagnosis. Implementation of such measures is disturbed by improper use of the data, with breach of data protection as one of the risks to be heavily controlled. Population screening requires in depth cost-benefit analysis to justify healthcare costs, and the parameters screened should provide information that allow an actionable and deliverable solution, for better healthcare provision.
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Affiliation(s)
- Godfrey Grech
- />Department of Pathology, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
| | - Xianquan Zhan
- />Key Laboratory of Cancer Proteomics of Chinese Ministry of Health, Xiangya Hospital, Central South University, Changsha, China
| | - Byong Chul Yoo
- />Colorectal Cancer Branch, Division of Translational and Clinical Research I, Research Institute, National Cancer Center, Gyeonggi, 410-769 Republic of Korea
| | - Rostyslav Bubnov
- />Clinical Hospital ‘Pheophania’ of State Management of Affairs Department, Kyiv, Ukraine
- />Zabolotny Institute of Microbiology and Virology, National Academy of Sciences of Ukraine, Kyiv, Ukraine
| | - Suzanne Hagan
- />Dept of Life Sciences, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Romano Danesi
- />Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Giorgio Vittadini
- />Bracco Imaging, Centro Ricerche Bracco, San Donato Milanese, Italy
| | - Dominic M Desiderio
- />Department of Neurology, University of Tennessee Center for Health Science, Memphis, USA
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259
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Sutton PA, Jones RP, Evans JP, Kitteringham N, Goldring C, Palmer DH, Vimalachandran D, Malik HZ. Predicting response to treatment for colorectal cancer: a review of relevant mechanisms and potential biomarkers. COLORECTAL CANCER 2015. [DOI: 10.2217/crc.15.11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Abstract Neoadjuvant therapy for colorectal cancer offers potential oncological benefits but is associated with increased surgical risk. Predictive biomarkers would allow the personalization of this risk/benefit balance, with treatment stratified by likely response. Although current clinical application of predictive biomarkers is limited, a number of potential targets have been proposed. This review summarizes some of the approaches being used to develop predictive biomarkers for the personalization of colorectal cancer management.
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Affiliation(s)
- Paul A Sutton
- Institute of Translational Medicine, University of Liverpool, Ashton Street, Liverpool, L69 3GE, UK
- Department of Colorectal Surgery, Countess of Chester Hospital NHS Foundation Trust, Chester, Cheshire, CH2 1UL, UK
| | - Rob P Jones
- Institute of Translational Medicine, University of Liverpool, Ashton Street, Liverpool, L69 3GE, UK
- Liverpool Hepatobiliary Unit, Aintree University Hospital, Longmoor Lane, Liverpool, Merseyside, L9 7AL, UK
| | - Jonathan P Evans
- Institute of Translational Medicine, University of Liverpool, Ashton Street, Liverpool, L69 3GE, UK
| | - Neil Kitteringham
- Institute of Translational Medicine, University of Liverpool, Ashton Street, Liverpool, L69 3GE, UK
| | - Chris Goldring
- Institute of Translational Medicine, University of Liverpool, Ashton Street, Liverpool, L69 3GE, UK
| | - Dan H Palmer
- Institute of Translational Medicine, University of Liverpool, Ashton Street, Liverpool, L69 3GE, UK
- Clatterbridge Cancer Centre, Bebington, Wirral, Merseyside, CH63 4JY, UK
| | - Dale Vimalachandran
- Department of Colorectal Surgery, Countess of Chester Hospital NHS Foundation Trust, Chester, Cheshire, CH2 1UL, UK
| | - Hassan Z Malik
- Liverpool Hepatobiliary Unit, Aintree University Hospital, Longmoor Lane, Liverpool, Merseyside, L9 7AL, UK
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260
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EMAST is a Form of Microsatellite Instability That is Initiated by Inflammation and Modulates Colorectal Cancer Progression. Genes (Basel) 2015; 6:185-205. [PMID: 25836926 PMCID: PMC4488660 DOI: 10.3390/genes6020185] [Citation(s) in RCA: 76] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2015] [Revised: 03/19/2015] [Accepted: 03/23/2015] [Indexed: 12/12/2022] Open
Abstract
DNA mismatch repair (MMR) function is critical for correcting errors coincident with polymerase-driven DNA replication, and its proteins are frequent targets for inactivation (germline or somatic), generating a hypermutable tumor that drives cancer progression. The biomarker for defective DNA MMR is microsatellite instability-high (MSI-H), observed in ~15% of colorectal cancers, and defined by mono- and dinucleotide microsatellite frameshift mutations. MSI-H is highly correlated with loss of MMR protein expression, is commonly diploid, is often located in the right side of the colon, prognosticates good patient outcome, and predicts poor efficacy with 5-fluorouracil treatment. Elevated microsatellite alterations at selected tetranucleotide repeats (EMAST) is another form of MSI at tetranucleotide repeats that has been observed in multiple cancers, but its etiology and clinical relevance to patient care has only been recently illuminated. Specifically, EMAST is an acquired somatic defect observed in up to 60% of colorectal cancers and caused by unique dysfunction of the DNA MMR protein MSH3 (and its DNA MMR complex MutSβ, a heterodimer of MSH2-MSH3), and in particular a loss-of-function phenotype due to a reversible shift from its normal nuclear location into the cytosol in response to oxidative stress and the pro-inflammatory cytokine interleukin-6. Tumor hypoxia may also be a contributor. Patients with EMAST colorectal cancers show diminished prognosis compared to patients without the presence of EMAST in their cancer. In addition to defective DNA MMR recognized by tetranucleotide (and di- and tri-nucleotide) frameshifts, loss of MSH3 also contributes to homologous recombination-mediated repair of DNA double stranded breaks, indicating the MSH3 dysfunction is a complex defect for cancer cells that generates not only EMAST but also may contribute to chromosomal instability and aneuploidy. Areas for future investigation for this most common DNA MMR defect among colorectal cancers include relationships between EMAST and chemotherapy response, patient outcome with aneuploid changes in colorectal cancers, target gene mutation analysis, and mechanisms related to inflammation-induced compartmentalization and inactivation for MSH3.
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261
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Microsatellite instability use in mismatch repair gene sequence variant classification. Genes (Basel) 2015; 6:150-62. [PMID: 25831438 PMCID: PMC4488658 DOI: 10.3390/genes6020150] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2014] [Revised: 03/04/2015] [Accepted: 03/23/2015] [Indexed: 01/05/2023] Open
Abstract
Inherited mutations in the DNA mismatch repair genes (MMR) can cause MMR deficiency and increased susceptibility to colorectal and endometrial cancer. Microsatellite instability (MSI) is the defining molecular signature of MMR deficiency. The clinical classification of identified MMR gene sequence variants has a direct impact on the management of patients and their families. For a significant proportion of cases sequence variants of uncertain clinical significance (also known as unclassified variants) are identified, constituting a challenge for genetic counselling and clinical management of families. The effect on protein function of these variants is difficult to interpret. The presence or absence of MSI in tumours can aid in determining the pathogenicity of associated unclassified MMR gene variants. However, there are some considerations that need to be taken into account when using MSI for variant interpretation. The use of MSI and other tumour characteristics in MMR gene sequence variant classification will be explored in this review.
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Abstract
Lynch syndrome, which is now recognized as the most common hereditary colorectal cancer condition, is characterized by the predisposition to a spectrum of cancers, primarily colorectal cancer and endometrial cancer. We chronicle over a century of discoveries that revolutionized the diagnosis and clinical management of Lynch syndrome, beginning in 1895 with Warthin's observations of familial cancer clusters, through the clinical era led by Lynch and the genetic era heralded by the discovery of causative mutations in mismatch repair (MMR) genes, to ongoing challenges.
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Affiliation(s)
- Henry T Lynch
- Department of Preventive Medicine and Public Health, Creighton University, 2500 California Plaza, Omaha, Nebraska 68178, USA
| | - Carrie L Snyder
- Department of Preventive Medicine and Public Health, Creighton University, 2500 California Plaza, Omaha, Nebraska 68178, USA
| | - Trudy G Shaw
- Department of Preventive Medicine and Public Health, Creighton University, 2500 California Plaza, Omaha, Nebraska 68178, USA
| | - Christopher D Heinen
- Center for Molecular Medicine, University of Connecticut Health Center, 263 Farmington Avenue, Farmington, Connecticut 06030-3101, USA
| | - Megan P Hitchins
- Department of Medicine (Oncology), Stanford Cancer Institute, Stanford University, Grant Building S169, 1291 Welch Road, Stanford, California 94305, USA
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Kim HO, Kim BG, Cha SJ, Park YG, Lee TJ. Clinicopathologic Significance of BRAF Mutation and Extracellular Signal Regulated Kinase 1/2 Expression in Patients With a Colorectal Adenocarcinoma. Ann Coloproctol 2015; 31:9-15. [PMID: 25745621 PMCID: PMC4349919 DOI: 10.3393/ac.2015.31.1.9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Accepted: 01/03/2015] [Indexed: 02/06/2023] Open
Abstract
Purpose BRAF mutation and expression of extracellular signal regulated kinase (ERK) are linked with colorectal carcinogenesis through the serrated pathway. BRAF and ERK1/2 play important roles in the activation of mitogen-activated protein (MAP) kinase signaling pathways. The present study investigated the clinicopathologic outcomes of BRAF mutation and ERK1/2 expression in patients with colorectal cancer (CRC) and the possibility of using them as prognostic indicators. Methods Dual-priming oligonucleotide-based multiplex polymerase chain reaction for BRAFV600E mutation and immunohistochemical analysis of ERK1/2 were performed using 65 formalin-fixed, paraffin-embedded samples from patients with CRC. We analyzed the dependences of the clinicopathologic features on BRAF mutation and ERK1/2 expression. Results Out of 65 samples from CRC patients, BRAF mutation was detected in 3 (4.6%). The 3 patients with BRAF mutation presented with T3 CRC with lymph node metastasis (stage III) showing moderately or poorly differentiated histology. ERK1 and ERK2 were positively detected in 73.8% and 15.4% of the patients with CRC, respectively. ERK1 expression was significantly correlated with lymph node metastasis (P = 0.049). ERK2 expression was significantly correlated with tumor emboli (P < 0.05), tumor invasion (P = 0.035), lymph node metastasis (P = 0.017), and stage (P = 0.02). Conclusion BRAF mutation and ERK1/2 expression may be associated with advanced or more aggressive CRC. These molecular markers might play prognostic roles in CRC developed through the serrated pathway.
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Affiliation(s)
- Hyung Ook Kim
- Department of Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Beom Gyu Kim
- Department of Surgery, Chung-Ang University College of Medicine, Seoul, Korea
| | - Seong Jae Cha
- Department of Surgery, Chung-Ang University College of Medicine, Seoul, Korea
| | - Yong Gum Park
- Department of Surgery, Chung-Ang University College of Medicine, Seoul, Korea
| | - Tae Jin Lee
- Department of Pathology, Chung-Ang University College of Medicine, Seoul, Korea
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264
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Yamamoto H, Imai K. Microsatellite instability: an update. Arch Toxicol 2015; 89:899-921. [PMID: 25701956 DOI: 10.1007/s00204-015-1474-0] [Citation(s) in RCA: 153] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2015] [Accepted: 02/09/2015] [Indexed: 02/08/2023]
Abstract
Deficient DNA mismatch repair (MMR) results in a strong mutator phenotype known as microsatellite instability (MSI), which is a hallmark of Lynch syndrome-associated cancers. MSI is characterized by length alterations within simple repeated sequences that are called microsatellites. Lynch syndrome is primarily caused by mutations in the MMR genes, mainly MLH1 and MSH2, and less frequently in MSH6, and rarely PMS2, and large genomic rearrangements account for 5-20 % of all mutations. Germ line hemiallelic methylations of MLH1 or MSH2 are termed as epimutations and have been identified as causative of Lynch syndrome. Moreover, germ line 3' deletions of EPCAM gene is involved in MSH2 methylation. MSI is also observed in about 15 % of sporadic colorectal cancer (CRC), gastric cancer (GC), and endometrial cancer (EC), and at lower frequencies in other cancers, often in association with hypermethylation of the MLH1 gene. Trimethylation of histone H3 on Lys36 (H3K36 me3) is an epigenetic histone mark that was required for DNA MMR in vivo. Thus, mutations in the H3K36 trimethyltransferase SETD2 have been reported as a potential cause of MSI. Genetic, epigenetic, and transcriptomic differences have been identified between cancers with and without MSI. Recent comprehensive molecular characterizations of CRC, EC, and GC by The Cancer Genome Atlas indicate that MSI+ cancers are distinct biological entities. The BRAF V600E mutation is specifically associated with sporadic MSI+ CRCs with methylated MLH1, but is not associated with Lynch syndrome-related CRCs. Accumulating evidence indicates a role of interactions between MSI and microRNA (miRNA) in the pathogenesis of MSI-positive (MSI+) cancer. As another new mechanism underlying MSI, overexpression of miR-155 or miR-21 has been shown to downregulate the expression of the MMR genes. Gene targets of frameshift mutations caused by MSI are involved in various cellular functions, including DNA repair (MSH3 and MSH6), cell signaling (TGFBR2 and ACVR2A), apoptosis (BAX), epigenetic regulation (HDAC2 and ARID1A), and miRNA processing (TARBP2 and XPO5), and a subset of MSI+ CRCs reportedly shows the mutated miRNA machinery phenotype. Moreover, microsatellite repeats in miRNA genes, such as hsa-miR-1273c, may be novel MSI targets for CRC, and mutations in noncoding regulatory regions of MRE11, BAX (BaxΔ2), and HSP110 (HSP110ΔE9) may affect the efficiency of chemotherapy. Thus, analyses of MSI and its related molecular alterations in cancers are increasingly relevant in clinical settings, and MSI is a useful screening marker for identifying patients with Lynch syndrome and a prognostic factor for chemotherapeutic interventions. In this review, we summarize recent advances in the pathogenesis of MSI and focus on genome-wide analyses that indicate the potential use of MSI and related alterations as biomarkers and novel therapeutic targets.
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Affiliation(s)
- Hiroyuki Yamamoto
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, 216-8511, Japan,
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Droy-Dupré L, Bossard C, Volteau C, Bezieau S, Laboisse CL, Mosnier JF. Hierarchical clustering identifies a subgroup of colonic adenocarcinomas expressing crypt-like differentiation markers, associated with MSS status and better prognosis. Virchows Arch 2015; 466:383-91. [DOI: 10.1007/s00428-015-1724-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2014] [Revised: 12/21/2014] [Accepted: 01/20/2015] [Indexed: 01/28/2023]
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Zhu L, Li Z, Wang Y, Zhang C, Liu Y, Qu X. Microsatellite instability and survival in gastric cancer: A systematic review and meta-analysis. Mol Clin Oncol 2015; 3:699-705. [PMID: 26137290 DOI: 10.3892/mco.2015.506] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2014] [Accepted: 01/22/2015] [Indexed: 12/20/2022] Open
Abstract
Microsatellite instability (MSI) is associated with the prognosis in several cancers and is used for determination of the chemotherapy regimen in stage II colon cancer in the National Comprehensive Cancer Network guideline. However, the association between MSI and the prognosis of gastric cancer remains unclear. PubMed database was searched until January 2014 using MeSH terms and key words to identify the studies evaluating MSI and prognosis of gastric cancer and the references were manually searched. The main outcome was the overall survival rate and the subordinate outcome was the association between high-frequency MSI (MSI-H) and clinicopathological characteristics. Eight studies met the inclusion criteria and the majority of data were collected retrospectively. There were 1,976 patients, 431 of which were MSI-H patients, with a range of 11.68-33.82%. Four studies used the National Cancer Institute panel to define MSI-H, the other four had microsatellite markers ranging 2-11. Significant associations were found in three studies and the overall summary estimate was hazard ratio, 0.63 (95% confidence interval, 0.52-0.77), with no evidence of inter-study heterogeneity (I2=0.0%). MSI-H patients were identified to have a tendency to have less lymph node (LN) metastasis, superficial tumor invasion and to be intestinal type. In conclusion, MSI-H gastric cancers have an improved prognosis, accompanied with reduced risk of LN metastasis, tumor invasion and mortality.
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Affiliation(s)
- Lin Zhu
- Department of Medical Oncology, The First Hospital of China Medical University, Shenyang, Liaoning 110001, P.R. China
| | - Zhi Li
- Department of Medical Oncology, The First Hospital of China Medical University, Shenyang, Liaoning 110001, P.R. China
| | - Yan Wang
- Department of Medical Oncology, The First Hospital of China Medical University, Shenyang, Liaoning 110001, P.R. China
| | - Chenlu Zhang
- Department of Medical Oncology, The First Hospital of China Medical University, Shenyang, Liaoning 110001, P.R. China
| | - Yunpeng Liu
- Department of Medical Oncology, The First Hospital of China Medical University, Shenyang, Liaoning 110001, P.R. China
| | - Xiujuan Qu
- Department of Medical Oncology, The First Hospital of China Medical University, Shenyang, Liaoning 110001, P.R. China
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Cheah PL, Looi LM, Teoh KH, Rahman NA, Wong LX, Tan SY. Colorectal carcinoma in Malaysians: DNA mismatch repair pattern in a multiethnic population. Asian Pac J Cancer Prev 2015; 15:3287-91. [PMID: 24815484 DOI: 10.7314/apjcp.2014.15.7.3287] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The interesting preponderance of Chinese with colorectal carcinoma (CRC) amongst the three major ethnic groups in Malaysia prompted a study to determine DNA mismatch repair (MMR) status in our CRC and attempt correlation with patient age, gender and ethnicity as well as location, grade, histological type and stage of tumour. Histologically re-confirmed CRC, diagnosed between 1st January 2005 and 31st December 2007 at the Department of Pathology, University of Malaya Medical Centre, were immunohistochemically stained with monoclonal antibodies to MMR proteins, MLH1, MSH2, MSH6 and PMS2 on the Ventana Benchmark XT autostainer. Of the 142 CRC cases entered into the study, there were 82 males and 60 females (M:F=1.4:1). Ethnically, 81 (57.0%) were Chinese, 32 (22.5%) Malays and 29 (20.4%) Indians. The patient ages ranged between 15-87 years (mean=62.4 years) with 21 cases <50-years and 121 ≥50-years of age. 14 (9.9%) CRC showed deficient MMR (dMMR). Concurrent loss of MLH1 and PMS2 occurred in 10, MSH2 and MSH6 in 2 with isolated loss of MSH6 in 1 and PMS2 in 1. dMMR was noted less frequently amongst the Chinese (6.2%) in comparison with their combined Malay and Indian counterparts (14.8%), and was associated with right sided and poorly differentiated tumours (p<0.05). 3 of the 5 (60.0%) dMMR CRC cases amongst the Chinese and 1 of 9 cases (11.1%) amongst the combined Malay and Indian group were <50-years of age. No significant association of dMMR was noted with patient age and gender, tumour stage or mucinous type.
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Affiliation(s)
- Phaik-Leng Cheah
- Department of Pathology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia E-mail :
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269
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Lee SL, Dempsey-Hibbert NC, Vimalachandran D, Wardle TD, Sutton P, Williams JHH. Targeting Heat Shock Proteins in Colorectal Cancer. ACTA ACUST UNITED AC 2015. [DOI: 10.1007/978-3-319-17211-8_17] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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270
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Abstract
A role for somatic mutations in carcinogenesis is well accepted, but the degree to which mutation rates influence cancer initiation and development is under continuous debate. Recently accumulated genomic data have revealed that thousands of tumour samples are riddled by hypermutation, broadening support for the idea that many cancers acquire a mutator phenotype. This major expansion of cancer mutation data sets has provided unprecedented statistical power for the analysis of mutation spectra, which has confirmed several classical sources of mutation in cancer, highlighted new prominent mutation sources (such as apolipoprotein B mRNA editing enzyme catalytic polypeptide-like (APOBEC) enzymes) and empowered the search for cancer drivers. The confluence of cancer mutation genomics and mechanistic insight provides great promise for understanding the basic development of cancer through mutations.
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271
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Haplotype defined by the MLH1-93G/A polymorphism is associated with MLH1 promoter hypermethylation in sporadic colorectal cancers. BMC Res Notes 2014; 7:835. [PMID: 25421847 PMCID: PMC4253604 DOI: 10.1186/1756-0500-7-835] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2013] [Accepted: 11/07/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Methylation of the MLH1 promoter region has been suggested to be a major mechanism of gene inactivation in sporadic microsatellite instability-positive (MSI-H) colorectal cancers (CRCs). Recently, single-nucleotide polymorphism (SNP) in the MLH1 promoter region (MLH1-93G/A; rs1800734) has been proposed to be associated with MLH1 promoter methylation, loss of MLH1 protein expression and MSI-H tumors. We examined the association of MLH1-93G/A and six other SNPs surrounding MLH1-93G/A with the methylation status in 210 consecutive sporadic CRCs in Japanese patients. METHODS Methylation of the MLH1 promoter region was evaluated by Na-bisulfite polymerase chain reaction (PCR)/single-strand conformation polymorphism (SSCP) analysis. The genotype frequencies of SNPs located in the 54-kb region surrounding the MLH1-93G/A SNP were examined by SSCP analysis. RESULTS Methylation of the MLH1 promoter region was observed in 28.6% (60/210) of sporadic CRCs. The proportions of MLH1-93G/A genotypes A/A, A/G and G/G were 26% (n=54), 51% (n=108) and 23% (n=48), respectively, and they were significantly associated with the methylation status (p=0.01). There were no significant associations between genotype frequency of the six other SNPs and methylation status. The A-allele of MLH1-93G/A was more common in cases with methylation than the G-allele (p=0.0094), especially in females (p=0.0067). In logistic regression, the A/A genotype of the MLH1-93G/A SNP was shown to be the most significant risk factor for methylation of the MLH1 promoter region (odds ratio 2.82, p=0.003). Furthermore, a haplotype of the A-allele of rs2276807 located -47 kb upstream from the MLH1-93G/A SNP and the A-allele of MLH1-93G/A SNP was significantly associated with MLH1 promoter methylation. CONCLUSIONS These results indicate that individuals, and particularly females, carrying the A-allele at the MLH1-93G/A SNP, especially in association with the A-allele of rs2276807, may harbor an increased risk of methylation of the MLH1 promoter region.
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272
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Danielsen SA, Eide PW, Nesbakken A, Guren T, Leithe E, Lothe RA. Portrait of the PI3K/AKT pathway in colorectal cancer. Biochim Biophys Acta Rev Cancer 2014; 1855:104-21. [PMID: 25450577 DOI: 10.1016/j.bbcan.2014.09.008] [Citation(s) in RCA: 184] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2014] [Accepted: 09/07/2014] [Indexed: 12/16/2022]
Abstract
PI3K/AKT signaling leads to reduced apoptosis, stimulates cell growth and increases proliferation. Under normal conditions, PI3K/AKT activation is tightly controlled and dependent on both extracellular growth signals and the availability of amino acids and glucose. Genetic aberrations leading to PI3K/AKT hyper-activation are observed at considerable frequency in all major nodes in most tumors. In colorectal cancer the most commonly observed pathway changes are IGF2 overexpression, PIK3CA mutations and PTEN mutations and deletions. Combined, these alterations are found in about 40% of large bowel tumors. In addition, but not mutually exclusive to these, KRAS mutations are observed at a similar frequency. There are however additional, less frequent and more poorly understood events that may also push the PI3K/AKT pathway into overdrive and thus promote malignant growth. Here we discuss aberrations of components at the genetic, epigenetic, transcriptional, post-transcriptional, translational and post-translational level where perturbations may drive excessive PI3K/AKT signaling. Integrating multiple molecular levels will advance our understanding of this cancer critical circuit and more importantly, improve our ability to pharmacologically target the pathway in view of clonal development, tumor heterogeneity and drug resistance mechanisms. In this review, we revisit the PI3K/AKT pathway cancer susceptibility syndromes, summarize the known aberrations at the different regulatory levels and the prognostic and predictive values of these alterations in colorectal cancer.
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Affiliation(s)
- Stine Aske Danielsen
- Department of Cancer Prevention, Institute for Cancer Research, Oslo University Hospital, Oslo, Norway; K.G. Jebsen Colorectal Cancer Research Centre, Oslo University Hospital, Oslo, Norway
| | - Peter Wold Eide
- Department of Cancer Prevention, Institute for Cancer Research, Oslo University Hospital, Oslo, Norway; K.G. Jebsen Colorectal Cancer Research Centre, Oslo University Hospital, Oslo, Norway
| | - Arild Nesbakken
- K.G. Jebsen Colorectal Cancer Research Centre, Oslo University Hospital, Oslo, Norway; Department of Gastrointestinal Surgery, Oslo University Hospital, Oslo, Norway
| | - Tormod Guren
- K.G. Jebsen Colorectal Cancer Research Centre, Oslo University Hospital, Oslo, Norway; Department of Oncology, Oslo University Hospital, Oslo, Norway
| | - Edward Leithe
- Department of Cancer Prevention, Institute for Cancer Research, Oslo University Hospital, Oslo, Norway; K.G. Jebsen Colorectal Cancer Research Centre, Oslo University Hospital, Oslo, Norway
| | - Ragnhild A Lothe
- Department of Cancer Prevention, Institute for Cancer Research, Oslo University Hospital, Oslo, Norway; K.G. Jebsen Colorectal Cancer Research Centre, Oslo University Hospital, Oslo, Norway.
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273
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Hafezi-Bakhtiari S, Wang LM, Colling R, Serra S, Chetty R. Histological overlap between colorectal villous/tubulovillous and traditional serrated adenomas. Histopathology 2014; 66:308-13. [PMID: 25257227 DOI: 10.1111/his.12555] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2014] [Accepted: 09/19/2014] [Indexed: 12/25/2022]
Abstract
AIMS To ascertain the degree of histological overlap between conventional villous/tubulovillous (VA/TVAs) and traditional serrated adenomas (TSA). METHODS AND RESULTS A total of 180 polyps from the left colon/rectum diagnosed as VA/TVAs were retrieved randomly and reviewed by five pathologists looking specifically at luminal serration, cytoplasmic eosinophilia and the presence of ectopic crypt foci (ECF). For comparative purposes, 100 tubular adenomas and 80 TSAs were also examined. Twenty VA/TVAs were reclassified as TSA. Luminal serration as noted in TSA was not seen in any of the remaining 160 polyps, ECFs were noted in 55 of the 160 VA/TVAs (34%), while cytoplasmic eosinophilia (constituting <50% of the adenoma) was noted in only 10 of 160 cases (6.2%). CONCLUSIONS Ectopic crypt foci and cytoplasmic eosinophilia are encountered in sporadic VA/TVAs but not to the same extent and degree as in TSA. ECFs were found in one-third of cases, but cytoplasmic eosinophilia is rare. The pattern of luminal serration in TSA is very characteristic and not recapitulated in VA/TVA. The occurrence of all three histological features together occurs only in TSA. ECFs are not a sine qua non for TSA and are encountered commonly in VA/TVAs. VA/TVAs often contain occasional glands typical of TSA.
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Affiliation(s)
- Sara Hafezi-Bakhtiari
- Department of Pathology, Laboratory Medicine Program, University Health Network and University of Toronto, Toronto, ON, Canada
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274
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Kim TM, Park PJ. A genome-wide view of microsatellite instability: old stories of cancer mutations revisited with new sequencing technologies. Cancer Res 2014; 74:6377-82. [PMID: 25371413 DOI: 10.1158/0008-5472.can-14-1225] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Microsatellites are simple tandem repeats that are present at millions of loci in the human genome. Microsatellite instability (MSI) refers to DNA slippage events on microsatellites that occur frequently in cancer genomes when there is a defect in the DNA-mismatch repair system. These somatic mutations can result in inactivation of tumor-suppressor genes or disrupt other noncoding regulatory sequences, thereby playing a role in carcinogenesis. Here, we will discuss the ways in which high-throughput sequencing data can facilitate genome- or exome-wide discovery and more detailed investigation of MSI events in microsatellite-unstable cancer genomes. We will address the methodologic aspects of this approach and highlight insights from recent analyses of colorectal and endometrial cancer genomes from The Cancer Genome Atlas project. These include identification of novel MSI targets within and across tumor types and the relationship between the likelihood of MSI events to chromatin structure. Given the increasing popularity of exome and genome sequencing of cancer genomes, a comprehensive characterization of MSI may serve as a valuable marker of cancer evolution and aid in a search for therapeutic targets.
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Affiliation(s)
- Tae-Min Kim
- Department of Medical Informatics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Peter J Park
- Center for Biomedical Informatics, Harvard Medical School, Boston, Massachusetts.
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275
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Lee JH, Kim DK. Microsatellite Instability of Nuclear and Mitochondrial DNAs in Gastric Carcinogenesis. Asian Pac J Cancer Prev 2014. [DOI: 10.7314/apjcp.2014.15.19.8027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
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276
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Vilar E, Mork ME, Cuddy A, Borras E, Bannon SA, Taggart MW, Ying J, Broaddus RR, Luthra R, Rodriguez-Bigas MA, Lynch PM, You YQN. Role of microsatellite instability-low as a diagnostic biomarker of Lynch syndrome in colorectal cancer. Cancer Genet 2014; 207:495-502. [PMID: 25432668 DOI: 10.1016/j.cancergen.2014.10.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2014] [Revised: 08/21/2014] [Accepted: 10/02/2014] [Indexed: 01/13/2023]
Abstract
Lynch syndrome is the most common Mendelian disorder predisposing persons to hereditary colorectal cancer. Carriers of MSH6 mutations constitute less than 10% of the total of cases with Lynch syndrome and present with a weaker clinical phenotype, including low levels of microsatellite instability (MSI-L) in colorectal tumors. The frequency of MSH6 mutation carriers among patients presenting with MSI-L colorectal cancer has yet to be determined, as has the appropriate genetic workup in this context. We have reviewed here the clinicopathologic characteristics, immunohistochemistry, and genetic testing results for 71 patients at a single institution diagnosed with MSI-L colorectal cancers. Of 71 patients with MSI-L tumors, 21 underwent genetic testing for MSH6 mutations, three of whom presented with loss of staining of MSH6 and only one of whom carried a pathogenic germline MSH6 mutation in exon 4 (c.2677_2678delCT; p.Leu893Alafs*6). This latter patient had a significant family history of cancer and had a rectal primary tumor that showed instability only in mononucleotide markers. In this cohort of MSI-L patients, we detected no notable clinicopathologic or molecular characteristic that would help to distinguish a group most likely to harbor germline MSH6 mutations. Therefore, we conclude that the prevalence of MSH6 mutations among patients with MSI-L tumors is very low. Microsatellite instability analysis combined with immunohistochemistry of mismatch repair proteins adequately detects potential MSH6 mutation carriers among MSI-L colorectal cancers.
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Affiliation(s)
- Eduardo Vilar
- Department of Clinical Cancer Prevention, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
| | - Maureen E Mork
- Clinical Cancer Genetics Program, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Amanda Cuddy
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Ester Borras
- Department of Clinical Cancer Prevention, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Sarah A Bannon
- Clinical Cancer Genetics Program, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Melissa W Taggart
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Jun Ying
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Russell R Broaddus
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Rajyalakshmi Luthra
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Miguel A Rodriguez-Bigas
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Patrick M Lynch
- Department of Gastroenterology, Hepatology and Nutrition, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Yi-Qian Nancy You
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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277
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Herzig DO, Tsikitis VL. Molecular markers for colon diagnosis, prognosis and targeted therapy. J Surg Oncol 2014; 111:96-102. [PMID: 25297801 DOI: 10.1002/jso.23806] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2014] [Accepted: 09/09/2014] [Indexed: 12/11/2022]
Abstract
Colorectal adenocarcinoma (CRC), the second leading cancer-related death in the United States, remains a global public health issue. Sporadic CRC is considered the result of sequential mucosal changes from normal colonic mucosa to adenocarcinoma. Efforts in understanding the molecular pathways leading to CRC tumorigenesis may lead to identifying novel, individually tailored therapeutic targets for patients. In this review, we focus on well-published prognostic and predictive markers in CRC and examine their role in clinical practice.
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Affiliation(s)
- Daniel O Herzig
- Department of Surgery, Oregon Health & Science University, Portland, Oregon
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278
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Ciombor KK, Haraldsdottir S, Goldberg RM. How Can Next-Generation Sequencing (Genomics) Help Us in Treating Colorectal Cancer? CURRENT COLORECTAL CANCER REPORTS 2014; 10:372-379. [PMID: 25395895 DOI: 10.1007/s11888-014-0244-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Next generation sequencing methods have exponentially increased the amount of genomic information available to scientists and clinicians. This review will explain the evolution of tumor gene sequencing and identify its potential to accelerate therapeutic progress by using colorectal cancer to illustrate the benefits of this type of analysis. A milestone in sequencing occurred when The Cancer Genome Atlas investigators characterized the genomes of 276 colorectal cancer samples, with the resulting information expected to provide future clinical applications and help to guide the treatment of colorectal cancer. Data regarding colorectal cancer mutational frequencies, prognostic and predictive biomarker usefulness, and signaling pathway alterations are emerging from various next generation sequencing platforms. Next generation sequencing methods are also enhancing our understanding of the causes and consequences of both the chromosomal instability and microsatellite instability pathways, as well as expanding our knowledge of the origins of familial colorectal cancer. Limitations to next generation sequencing methods include the need for storage and analysis of massive quantities of data, as well as assurance that the data is of the highest possible quality. However, this genomic technology carries with it the potential to revolutionize our treatment of colorectal cancer patients through better understanding of the underlying disease biology and subsequent development and application of therapeutic approaches targeting the genetic abnormalities specific to individual malignancies.
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Affiliation(s)
- Kristen K Ciombor
- Division of Medical Oncology, Department of Medicine, The Ohio State University Comprehensive Cancer Center, Columbus, OH
| | - Sigurdis Haraldsdottir
- Division of Medical Oncology, Department of Medicine, The Ohio State University Comprehensive Cancer Center, Columbus, OH
| | - Richard M Goldberg
- Division of Medical Oncology, Department of Medicine, The Ohio State University Comprehensive Cancer Center, Columbus, OH
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279
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Sveen A, Johannessen B, Teixeira MR, Lothe RA, Skotheim RI. Transcriptome instability as a molecular pan-cancer characteristic of carcinomas. BMC Genomics 2014; 15:672. [PMID: 25109687 PMCID: PMC4137096 DOI: 10.1186/1471-2164-15-672] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2014] [Accepted: 08/06/2014] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND We have previously proposed transcriptome instability as a genome-wide, pre-mRNA splicing-related characteristic of colorectal cancer. Here, we explore the hypothesis of transcriptome instability being a general characteristic of cancer. RESULTS Exon-level microarray expression data from ten cancer datasets were analyzed, including breast cancer, cervical cancer, colorectal cancer, gastric cancer, lung cancer, neuroblastoma, and prostate cancer (555 samples), as well as paired normal tissue samples from the colon, lung, prostate, and stomach (93 samples). Based on alternative splicing scores across the genomes, we calculated sample-wise relative amounts of aberrant exon skipping and inclusion. Strong and non-random (P < 0.001) correlations between these estimates and the expression levels of splicing factor genes (n = 280) were found in most cancer types analyzed (breast-, cervical-, colorectal-, lung- and prostate cancer). This suggests a biological explanation for the splicing variation. Surprisingly, these associations prevailed in pan-cancer analyses. This is in contrast to the tissue and cancer specific patterns observed in comparisons across healthy tissue samples from the colon, lung, prostate, and stomach, and between paired cancer-normal samples from the same four tissue types. CONCLUSION Based on exon-level expression profiling and computational analyses of alternative splicing, we propose transcriptome instability as a molecular pan-cancer characteristic. The affected cancers show strong and non-random associations between low expression levels of splicing factor genes, and high amounts of aberrant exon skipping and inclusion, and vice versa, on a genome-wide scale.
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Affiliation(s)
| | | | | | | | - Rolf I Skotheim
- Department of Cancer Prevention, Institute for Cancer Research, The Norwegian Radium Hospital, Oslo University Hospital, P,O, Box 4953 Nydalen, Oslo NO-0424, Norway.
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280
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Valle L. Genetic predisposition to colorectal cancer: Where we stand and future perspectives. World J Gastroenterol 2014; 20:9828-9849. [PMID: 25110415 PMCID: PMC4123366 DOI: 10.3748/wjg.v20.i29.9828] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2013] [Revised: 02/10/2014] [Accepted: 04/03/2014] [Indexed: 02/06/2023] Open
Abstract
The development of colorectal cancer (CRC) can be influenced by genetic factors in both familial cases and sporadic cases. Familial CRC has been associated with genetic changes in high-, moderate- and low-penetrance susceptibility genes. However, despite the availability of current gene-identification techniques, the genetic causes of a considerable proportion of hereditary cases remain unknown. Genome-wide association studies of CRC have identified a number of common low-penetrance alleles associated with a slightly increased or decreased risk of CRC. The accumulation of low-risk variants may partly explain the familial risk of CRC, and some of these variants may modify the risk of cancer in patients with mutations in high-penetrance genes. Understanding the predisposition to develop CRC will require investigators to address the following challenges: the identification of genes that cause uncharacterized hereditary cases of CRC such as familial CRC type X and serrated polyposis; the classification of variants of unknown significance in known CRC-predisposing genes; and the identification of additional cancer risk modifiers that can be used to perform risk assessments for individual mutation carriers. We performed a comprehensive review of the genetically characterized and uncharacterized hereditary CRC syndromes and of low- and moderate-penetrance loci and variants identified through genome-wide association studies and candidate-gene approaches. Current challenges and future perspectives in the field of CRC predisposition are also discussed.
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281
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Giardiello FM, Allen JI, Axilbund JE, Boland CR, Burke CA, Burt RW, Church JM, Dominitz JA, Johnson DA, Kaltenbach T, Levin TR, Lieberman DA, Robertson DJ, Syngal S, Rex DK. Guidelines on genetic evaluation and management of Lynch syndrome: a consensus statement by the US Multi-Society Task Force on colorectal cancer. Gastroenterology 2014; 147:502-26. [PMID: 25043945 DOI: 10.1053/j.gastro.2014.04.001] [Citation(s) in RCA: 359] [Impact Index Per Article: 32.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
The Multi-Society Task Force, in collaboration with invited experts, developed guidelines to assist health care providers with the appropriate provision of genetic testing and management of patients at risk for and affected with Lynch syndrome as follows: Figure 1 provides a colorectal cancer risk assessment tool to screen individuals in the office or endoscopy setting; Figure 2 illustrates a strategy for universal screening for Lynch syndrome by tumor testing of patients diagnosed with colorectal cancer; Figures 3-6 provide algorithms for genetic evaluation of affected and at-risk family members of pedigrees with Lynch syndrome; Table 10 provides guidelines for screening at-risk and affected persons with Lynch syndrome; and Table 12 lists the guidelines for the management of patients with Lynch syndrome. A detailed explanation of Lynch syndrome and the methodology utilized to derive these guidelines, as well as an explanation of, and supporting literature for, these guidelines are provided.
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Affiliation(s)
| | - John I Allen
- Yale University School of Medicine, New Haven, Connecticut
| | | | | | | | | | | | - Jason A Dominitz
- VA Puget Sound Health Care System, Seattle, Washington; University of Washington, Seattle, Washington
| | | | | | | | | | - Douglas J Robertson
- White River Junction VA Medical Center, White River Junction, Vermont; Geisel School of Medicine at Dartmouth, White River Junction, Vermont
| | - Sapna Syngal
- Brigham and Women's Hospital, Boston, Massachusetts; Dana Farber Cancer Institute, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts
| | - Douglas K Rex
- Indiana University School of Medicine, Indianapolis, Indiana
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282
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Taieb J, Zaanan A. Should mismatch repair status be determined in all stage II and III colon cancer patients? COLORECTAL CANCER 2014. [DOI: 10.2217/crc.14.25] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
SUMMARY Microsatellite instability constitutes an important oncogenic molecular pathway in colon cancer (12–15%). Microsatellite instability is a molecular marker of deficient DNA mismatch repair (MMR), which occurs from somatic hypermethylation of the MLH1 promoter or less frequently as a result of germline mutations in MMR genes. The excellent prognosis of patients with stage II deficient MMR colon cancer today, makes this information mandatory in order to decide or not on adjuvant chemotherapy. MMR deficiency may also predict tumor chemoresistance to 5-fluorouracil adjuvant treatment. However, when looking at very recent data on 5-fluorouracil plus oxaliplatin-based adjuvant regimens, it seems that the benefit of this adjuvant therapy is similar between deficient and proficient MMR patients.
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Affiliation(s)
- Julien Taieb
- Department of Gastroenterology & Digestive Oncology, Hôpital Européen Georges Pompidou, Paris Descartes University, Paris, France
| | - Aziz Zaanan
- Department of Gastroenterology & Digestive Oncology, Hôpital Européen Georges Pompidou, Paris Descartes University, Paris, France
- UMR-S775, INSERM, Paris, France
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283
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Giardiello FM, Allen JI, Axilbund JE, Boland CR, Burke CA, Burt RW, Church JM, Dominitz JA, Johnson DA, Kaltenbach T, Levin TR, Lieberman DA, Robertson DJ, Syngal S, Rex DK. Guidelines on genetic evaluation and management of Lynch syndrome: a consensus statement by the U.S. Multi-Society Task Force on Colorectal Cancer. Gastrointest Endosc 2014; 80:197-220. [PMID: 25034835 DOI: 10.1016/j.gie.2014.06.006] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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284
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Giardiello FM, Allen JI, Axilbund JE, Boland CR, Burke CA, Burt RW, Church JM, Dominitz JA, Johnson DA, Kaltenbach T, Levin TR, Lieberman DA, Robertson DJ, Syngal S, Rex DK. Guidelines on genetic evaluation and management of Lynch syndrome: a consensus statement by the US Multi-society Task Force on colorectal cancer. Am J Gastroenterol 2014; 109:1159-79. [PMID: 25070057 DOI: 10.1038/ajg.2014.186] [Citation(s) in RCA: 308] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The Multi-Society Task Force, in collaboration with invited experts, developed guidelines to assist health care providers with the appropriate provision of genetic testing and management of patients at risk for and affected with Lynch syndrome as follows: Figure 1 provides a colorectal cancer risk assessment tool to screen individuals in the office or endoscopy setting; Figure 2 illustrates a strategy for universal screening for Lynch syndrome by tumor testing of patients diagnosed with colorectal cancer; Figures 3,4,5,6 provide algorithms for genetic evaluation of affected and at-risk family members of pedigrees with Lynch syndrome; Table 10 provides guidelines for screening at-risk and affected persons with Lynch syndrome; and Table 12 lists the guidelines for the management of patients with Lynch syndrome. A detailed explanation of Lynch syndrome and the methodology utilized to derive these guidelines, as well as an explanation of, and supporting literature for, these guidelines are provided.
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Affiliation(s)
| | - John I Allen
- Yale University School of Medicine, New Haven, Connecticut, USA
| | | | | | | | | | | | - Jason A Dominitz
- 1] VA Puget Sound Health Care System, Seattle, Washington, USA [2] University of Washington, Seattle, Washington, USA
| | | | | | | | | | - Douglas J Robertson
- 1] White River Junction VA Medical Center, White River Junction, Vermont, USA [2] Geisel School of Medicine at Dartmouth, White River Junction, Vermont, USA
| | - Sapna Syngal
- 1] Brigham and Women's Hospital, Boston, Massachusetts, USA [2] Dana Farber Cancer Institute, Boston, Massachusetts, USA [3] Harvard Medical School, Boston, Massachusetts, USA
| | - Douglas K Rex
- Indiana University School of Medicine, Indianapolis, Indiana, USA
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285
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Nguyen HT, Markouli C, Geens M, Barbe L, Sermon K, Spits C. Human embryonic stem cells show low-grade microsatellite instability. Mol Hum Reprod 2014; 20:981-9. [DOI: 10.1093/molehr/gau059] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
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286
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Meier B, Cooke SL, Weiss J, Bailly AP, Alexandrov LB, Marshall J, Raine K, Maddison M, Anderson E, Stratton MR, Gartner A, Campbell PJ. C. elegans whole-genome sequencing reveals mutational signatures related to carcinogens and DNA repair deficiency. Genome Res 2014; 24:1624-36. [PMID: 25030888 PMCID: PMC4199376 DOI: 10.1101/gr.175547.114] [Citation(s) in RCA: 135] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Mutation is associated with developmental and hereditary disorders, aging, and cancer. While we understand some mutational processes operative in human disease, most remain mysterious. We used Caenorhabditis elegans whole-genome sequencing to model mutational signatures, analyzing 183 worm populations across 17 DNA repair-deficient backgrounds propagated for 20 generations or exposed to carcinogens. The baseline mutation rate in C. elegans was approximately one per genome per generation, not overtly altered across several DNA repair deficiencies over 20 generations. Telomere erosion led to complex chromosomal rearrangements initiated by breakage–fusion–bridge cycles and completed by simultaneously acquired, localized clusters of breakpoints. Aflatoxin B1 induced substitutions of guanines in a GpC context, as observed in aflatoxin-induced liver cancers. Mutational burden increased with impaired nucleotide excision repair. Cisplatin and mechlorethamine, DNA crosslinking agents, caused dose- and genotype-dependent signatures among indels, substitutions, and rearrangements. Strikingly, both agents induced clustered rearrangements resembling “chromoanasynthesis,” a replication-based mutational signature seen in constitutional genomic disorders, suggesting that interstrand crosslinks may play a pathogenic role in such events. Cisplatin mutagenicity was most pronounced in xpf-1 mutants, suggesting that this gene critically protects cells against platinum chemotherapy. Thus, experimental model systems combined with genome sequencing can recapture and mechanistically explain mutational signatures associated with human disease.
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Affiliation(s)
- Bettina Meier
- Centre for Gene Regulation and Expression, University of Dundee, Dundee DD1 5EH, Scotland, United Kingdom
| | - Susanna L Cooke
- Cancer Genome Project, Wellcome Trust Sanger Institute, Hinxton, Cambridgeshire CB10 1SA, United Kingdom
| | - Joerg Weiss
- Centre for Gene Regulation and Expression, University of Dundee, Dundee DD1 5EH, Scotland, United Kingdom
| | - Aymeric P Bailly
- Centre for Gene Regulation and Expression, University of Dundee, Dundee DD1 5EH, Scotland, United Kingdom; CRBM/CNRS UMR5237, University of Montpellier, Montpellier 34293, France
| | - Ludmil B Alexandrov
- Cancer Genome Project, Wellcome Trust Sanger Institute, Hinxton, Cambridgeshire CB10 1SA, United Kingdom
| | - John Marshall
- Cancer Genome Project, Wellcome Trust Sanger Institute, Hinxton, Cambridgeshire CB10 1SA, United Kingdom
| | - Keiran Raine
- Cancer Genome Project, Wellcome Trust Sanger Institute, Hinxton, Cambridgeshire CB10 1SA, United Kingdom
| | - Mark Maddison
- Cancer Genome Project, Wellcome Trust Sanger Institute, Hinxton, Cambridgeshire CB10 1SA, United Kingdom
| | - Elizabeth Anderson
- Cancer Genome Project, Wellcome Trust Sanger Institute, Hinxton, Cambridgeshire CB10 1SA, United Kingdom
| | - Michael R Stratton
- Cancer Genome Project, Wellcome Trust Sanger Institute, Hinxton, Cambridgeshire CB10 1SA, United Kingdom
| | - Anton Gartner
- Centre for Gene Regulation and Expression, University of Dundee, Dundee DD1 5EH, Scotland, United Kingdom;
| | - Peter J Campbell
- Cancer Genome Project, Wellcome Trust Sanger Institute, Hinxton, Cambridgeshire CB10 1SA, United Kingdom; Department of Haematology, University of Cambridge, Cambridge CB2 0XY, United Kingdom; Department of Haematology, Addenbrooke's Hospital, Cambridge CB2 0QQ, United Kingdom
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287
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Zaanan A, Bachet JB, André T, Sinicrope FA. Prognostic Impact of Deficient DNA Mismatch Repair and Mutations in KRAS, and BRAFV600E in Patients with Lymph Node-Positive Colon Cancer. CURRENT COLORECTAL CANCER REPORTS 2014; 10:346-353. [PMID: 25386108 DOI: 10.1007/s11888-014-0237-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
While tumor stage remains the key determinant of colorectal cancer (CRC) prognosis and treatment, there is considerable stage-independent variability in clinical outcome. Molecular markers hold promise for explaining variations in clinical behavior, and may identify patient subsets with differential efficacy and survival after adjuvant chemotherapy which is standard of care for patients with lymph node-positive, i.e., stage III, colon cancer. An increased understanding of the molecular evolution and progression of CRC has identified two major pathways of tumorigenesis that are characterized by chromosomal instability or microsatellite instability (MSI). MSI is a consequence of deficient DNA mismatch repair (MMR) that is generally due to epigenetic inactivation of MLH1 in tumors that often carry mutations in oncogenic BRAFV600E . Activating BRAFV600E and KRAS mutations are mutually exclusive and in this article, we review the current status of these mutations and MMR status as prognostic biomarkers in stage III colon cancers.
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Affiliation(s)
- Aziz Zaanan
- Mayo Clinic and Mayo Cancer Center, Rochester, Minnesota, United States of America, 200 First St SW, Rochester, MN 55905. Telephone: 507-255-5713
| | - Jean-Baptiste Bachet
- Departement of Hepato-Gastro-Enterology, Hôpital La Pitié Salpetrière, Université Paris VI, 47-83 boulevard de l'Hôpital, 75651 Paris Cedex 13, France. Telephone: 33 1 42 16 10 45
| | - Thierry André
- Department of Medical Oncology, Hôpital Saint-Antoine, Université Paris VI, 184 rue du Faubourg Saint-Antoine, 75571 Paris Cedex 12, France. Telephone: 33 1 71 97 04 01
| | - Frank A Sinicrope
- Mayo Clinic and Mayo Cancer Center, Rochester, Minnesota, United States of America, 200 First St SW, Rochester, MN 55905. Telephone: 507-255-5713
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288
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Sehgal R, Sheahan K, O'Connell PR, Hanly AM, Martin ST, Winter DC. Lynch syndrome: an updated review. Genes (Basel) 2014; 5:497-507. [PMID: 24978665 PMCID: PMC4198913 DOI: 10.3390/genes5030497] [Citation(s) in RCA: 100] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2013] [Revised: 04/30/2014] [Accepted: 05/09/2014] [Indexed: 01/05/2023] Open
Abstract
Lynch syndrome is one of the most common cancer susceptibility syndromes. Individuals with Lynch syndrome have a 50%-70% lifetime risk of colorectal cancer, 40%-60% risk of endometrial cancer, and increased risks of several other malignancies. It is caused by germline mutations in the DNA mismatch repair genes MLH1, MSH2, MSH6 or PMS2. In a subset of patients, Lynch syndrome is caused by 3' end deletions of the EPCAM gene, which can lead to epigenetic silencing of the closely linked MSH2. Relying solely on age and family history based criteria inaccurately identifies eligibility for Lynch syndrome screening or testing in 25%-70% of cases. There has been a steady increase in Lynch syndrome tumor screening programs since 2000 and institutions are rapidly adopting a universal screening approach to identify the patients that would benefit from genetic counseling and germline testing. These include microsatellite instability testing and/or immunohistochemical testing to identify tumor mismatch repair deficiencies. However, universal screening is not standard across institutions. Furthermore, variation exists regarding the optimum method for tracking and disclosing results. In this review, we summarize traditional screening criteria for Lynch syndrome, and discuss universal screening methods. International guidelines are necessary to standardize Lynch syndrome high-risk clinics.
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Affiliation(s)
- Rishabh Sehgal
- Centre for Colorectal Disease, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland.
| | - Kieran Sheahan
- Centre for Colorectal Disease, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland.
| | - Patrick R O'Connell
- Centre for Colorectal Disease, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland.
| | - Ann M Hanly
- Centre for Colorectal Disease, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland.
| | - Sean T Martin
- Centre for Colorectal Disease, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland.
| | - Desmond C Winter
- Centre for Colorectal Disease, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland.
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289
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Gonsalves WI, Mahoney MR, Sargent DJ, Nelson GD, Alberts SR, Sinicrope FA, Goldberg RM, Limburg PJ, Thibodeau SN, Grothey A, Hubbard JM, Chan E, Nair S, Berenberg JL, McWilliams RR. Patient and tumor characteristics and BRAF and KRAS mutations in colon cancer, NCCTG/Alliance N0147. J Natl Cancer Inst 2014; 106:dju106. [PMID: 24925349 DOI: 10.1093/jnci/dju106] [Citation(s) in RCA: 126] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND KRAS and BRAF (V600E) mutations are important predictive and prognostic markers, respectively, in colon cancer, but little is known about patient and clinical factors associated with them. METHODS Two thousand three hundred twenty-six of 3397 patients in the N0147 phase III adjuvant trial for stage III colon cancer completed a patient questionnaire. Primary tumors were assessed for KRAS and BRAF (V600E) mutations and defective mismatch repair (dMMR) status. Logistic regression models and categorical data analysis were used to identify associations of patient and tumor characteristics with mutation status. All statistical tests were two-sided. RESULTS KRAS (35%) and BRAF (V600E) (14%) mutations were nearly mutually exclusive. KRAS mutations were more likely to be present in patients without a family history of colon cancer and never smokers. Tumors with KRAS mutations were less likely to have dMMR (odds ratio [OR] = 0.21; 95% confidence interval [CI] = 0.15 to 0.31; P < .001) and high-grade histology (OR = 0.73; 95% CI = 0.59 to 0.92; P < .001) but were more often right-sided. Among KRAS-mutated tumors, those with a Gly13Asp mutation tended to have dMMR and high-grade histology. Tumors with BRAF (V600E) mutations were more likely to be seen in patients who were aged 70 years or older (OR = 3.33; 95% CI = 2.50 to 4.42; P < .001) and current or former smokers (OR = 1.64; 95% CI = 1.26 to 2.14; P < .001) but less likely in non-whites and men. Tumors with BRAF (V600E) mutations were more likely to be right-sided and to have four or more positive lymph nodes, high-grade histology, and dMMR. CONCLUSIONS Specific patient and tumor characteristics are associated with KRAS and BRAF (V600E) mutations.
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Affiliation(s)
- Wilson I Gonsalves
- Affiliations of authors: Division of Hematology/Division of Medical Oncology (WIG), Division of Biomedical Statistics & Informatics (MRM, GDN), Cancer Center Statistics (DJS), Division of Medical Oncology (SRA, AG, JMH, RRM), Division of Gastroenterology & Hepatology/Division of Medical Oncology (FAS), Division of Gastroenterology & Hepatology (PJL), Molecular Genetics (SNT), Mayo Clinic, Rochester, MN; Department of Internal Medicine, Division of Medical Oncology, Ohio State University, Columbus, OH (RMG); Division of Hematology/Oncology, Vanderbilt University, Nashville, TN (EC); Section of Hematology/Medical Oncology, Lehigh Valley Health Network, Allentown, PA (SN); Cancer Prevention & Control Program, University of Hawaii Cancer Center, Honolulu, HI (JLB)
| | - Michelle R Mahoney
- Affiliations of authors: Division of Hematology/Division of Medical Oncology (WIG), Division of Biomedical Statistics & Informatics (MRM, GDN), Cancer Center Statistics (DJS), Division of Medical Oncology (SRA, AG, JMH, RRM), Division of Gastroenterology & Hepatology/Division of Medical Oncology (FAS), Division of Gastroenterology & Hepatology (PJL), Molecular Genetics (SNT), Mayo Clinic, Rochester, MN; Department of Internal Medicine, Division of Medical Oncology, Ohio State University, Columbus, OH (RMG); Division of Hematology/Oncology, Vanderbilt University, Nashville, TN (EC); Section of Hematology/Medical Oncology, Lehigh Valley Health Network, Allentown, PA (SN); Cancer Prevention & Control Program, University of Hawaii Cancer Center, Honolulu, HI (JLB)
| | - Daniel J Sargent
- Affiliations of authors: Division of Hematology/Division of Medical Oncology (WIG), Division of Biomedical Statistics & Informatics (MRM, GDN), Cancer Center Statistics (DJS), Division of Medical Oncology (SRA, AG, JMH, RRM), Division of Gastroenterology & Hepatology/Division of Medical Oncology (FAS), Division of Gastroenterology & Hepatology (PJL), Molecular Genetics (SNT), Mayo Clinic, Rochester, MN; Department of Internal Medicine, Division of Medical Oncology, Ohio State University, Columbus, OH (RMG); Division of Hematology/Oncology, Vanderbilt University, Nashville, TN (EC); Section of Hematology/Medical Oncology, Lehigh Valley Health Network, Allentown, PA (SN); Cancer Prevention & Control Program, University of Hawaii Cancer Center, Honolulu, HI (JLB)
| | - Garth D Nelson
- Affiliations of authors: Division of Hematology/Division of Medical Oncology (WIG), Division of Biomedical Statistics & Informatics (MRM, GDN), Cancer Center Statistics (DJS), Division of Medical Oncology (SRA, AG, JMH, RRM), Division of Gastroenterology & Hepatology/Division of Medical Oncology (FAS), Division of Gastroenterology & Hepatology (PJL), Molecular Genetics (SNT), Mayo Clinic, Rochester, MN; Department of Internal Medicine, Division of Medical Oncology, Ohio State University, Columbus, OH (RMG); Division of Hematology/Oncology, Vanderbilt University, Nashville, TN (EC); Section of Hematology/Medical Oncology, Lehigh Valley Health Network, Allentown, PA (SN); Cancer Prevention & Control Program, University of Hawaii Cancer Center, Honolulu, HI (JLB)
| | - Steven R Alberts
- Affiliations of authors: Division of Hematology/Division of Medical Oncology (WIG), Division of Biomedical Statistics & Informatics (MRM, GDN), Cancer Center Statistics (DJS), Division of Medical Oncology (SRA, AG, JMH, RRM), Division of Gastroenterology & Hepatology/Division of Medical Oncology (FAS), Division of Gastroenterology & Hepatology (PJL), Molecular Genetics (SNT), Mayo Clinic, Rochester, MN; Department of Internal Medicine, Division of Medical Oncology, Ohio State University, Columbus, OH (RMG); Division of Hematology/Oncology, Vanderbilt University, Nashville, TN (EC); Section of Hematology/Medical Oncology, Lehigh Valley Health Network, Allentown, PA (SN); Cancer Prevention & Control Program, University of Hawaii Cancer Center, Honolulu, HI (JLB)
| | - Frank A Sinicrope
- Affiliations of authors: Division of Hematology/Division of Medical Oncology (WIG), Division of Biomedical Statistics & Informatics (MRM, GDN), Cancer Center Statistics (DJS), Division of Medical Oncology (SRA, AG, JMH, RRM), Division of Gastroenterology & Hepatology/Division of Medical Oncology (FAS), Division of Gastroenterology & Hepatology (PJL), Molecular Genetics (SNT), Mayo Clinic, Rochester, MN; Department of Internal Medicine, Division of Medical Oncology, Ohio State University, Columbus, OH (RMG); Division of Hematology/Oncology, Vanderbilt University, Nashville, TN (EC); Section of Hematology/Medical Oncology, Lehigh Valley Health Network, Allentown, PA (SN); Cancer Prevention & Control Program, University of Hawaii Cancer Center, Honolulu, HI (JLB)
| | - Richard M Goldberg
- Affiliations of authors: Division of Hematology/Division of Medical Oncology (WIG), Division of Biomedical Statistics & Informatics (MRM, GDN), Cancer Center Statistics (DJS), Division of Medical Oncology (SRA, AG, JMH, RRM), Division of Gastroenterology & Hepatology/Division of Medical Oncology (FAS), Division of Gastroenterology & Hepatology (PJL), Molecular Genetics (SNT), Mayo Clinic, Rochester, MN; Department of Internal Medicine, Division of Medical Oncology, Ohio State University, Columbus, OH (RMG); Division of Hematology/Oncology, Vanderbilt University, Nashville, TN (EC); Section of Hematology/Medical Oncology, Lehigh Valley Health Network, Allentown, PA (SN); Cancer Prevention & Control Program, University of Hawaii Cancer Center, Honolulu, HI (JLB)
| | - Paul J Limburg
- Affiliations of authors: Division of Hematology/Division of Medical Oncology (WIG), Division of Biomedical Statistics & Informatics (MRM, GDN), Cancer Center Statistics (DJS), Division of Medical Oncology (SRA, AG, JMH, RRM), Division of Gastroenterology & Hepatology/Division of Medical Oncology (FAS), Division of Gastroenterology & Hepatology (PJL), Molecular Genetics (SNT), Mayo Clinic, Rochester, MN; Department of Internal Medicine, Division of Medical Oncology, Ohio State University, Columbus, OH (RMG); Division of Hematology/Oncology, Vanderbilt University, Nashville, TN (EC); Section of Hematology/Medical Oncology, Lehigh Valley Health Network, Allentown, PA (SN); Cancer Prevention & Control Program, University of Hawaii Cancer Center, Honolulu, HI (JLB)
| | - Stephen N Thibodeau
- Affiliations of authors: Division of Hematology/Division of Medical Oncology (WIG), Division of Biomedical Statistics & Informatics (MRM, GDN), Cancer Center Statistics (DJS), Division of Medical Oncology (SRA, AG, JMH, RRM), Division of Gastroenterology & Hepatology/Division of Medical Oncology (FAS), Division of Gastroenterology & Hepatology (PJL), Molecular Genetics (SNT), Mayo Clinic, Rochester, MN; Department of Internal Medicine, Division of Medical Oncology, Ohio State University, Columbus, OH (RMG); Division of Hematology/Oncology, Vanderbilt University, Nashville, TN (EC); Section of Hematology/Medical Oncology, Lehigh Valley Health Network, Allentown, PA (SN); Cancer Prevention & Control Program, University of Hawaii Cancer Center, Honolulu, HI (JLB)
| | - Axel Grothey
- Affiliations of authors: Division of Hematology/Division of Medical Oncology (WIG), Division of Biomedical Statistics & Informatics (MRM, GDN), Cancer Center Statistics (DJS), Division of Medical Oncology (SRA, AG, JMH, RRM), Division of Gastroenterology & Hepatology/Division of Medical Oncology (FAS), Division of Gastroenterology & Hepatology (PJL), Molecular Genetics (SNT), Mayo Clinic, Rochester, MN; Department of Internal Medicine, Division of Medical Oncology, Ohio State University, Columbus, OH (RMG); Division of Hematology/Oncology, Vanderbilt University, Nashville, TN (EC); Section of Hematology/Medical Oncology, Lehigh Valley Health Network, Allentown, PA (SN); Cancer Prevention & Control Program, University of Hawaii Cancer Center, Honolulu, HI (JLB)
| | - Joleen M Hubbard
- Affiliations of authors: Division of Hematology/Division of Medical Oncology (WIG), Division of Biomedical Statistics & Informatics (MRM, GDN), Cancer Center Statistics (DJS), Division of Medical Oncology (SRA, AG, JMH, RRM), Division of Gastroenterology & Hepatology/Division of Medical Oncology (FAS), Division of Gastroenterology & Hepatology (PJL), Molecular Genetics (SNT), Mayo Clinic, Rochester, MN; Department of Internal Medicine, Division of Medical Oncology, Ohio State University, Columbus, OH (RMG); Division of Hematology/Oncology, Vanderbilt University, Nashville, TN (EC); Section of Hematology/Medical Oncology, Lehigh Valley Health Network, Allentown, PA (SN); Cancer Prevention & Control Program, University of Hawaii Cancer Center, Honolulu, HI (JLB)
| | - Emily Chan
- Affiliations of authors: Division of Hematology/Division of Medical Oncology (WIG), Division of Biomedical Statistics & Informatics (MRM, GDN), Cancer Center Statistics (DJS), Division of Medical Oncology (SRA, AG, JMH, RRM), Division of Gastroenterology & Hepatology/Division of Medical Oncology (FAS), Division of Gastroenterology & Hepatology (PJL), Molecular Genetics (SNT), Mayo Clinic, Rochester, MN; Department of Internal Medicine, Division of Medical Oncology, Ohio State University, Columbus, OH (RMG); Division of Hematology/Oncology, Vanderbilt University, Nashville, TN (EC); Section of Hematology/Medical Oncology, Lehigh Valley Health Network, Allentown, PA (SN); Cancer Prevention & Control Program, University of Hawaii Cancer Center, Honolulu, HI (JLB)
| | - Suresh Nair
- Affiliations of authors: Division of Hematology/Division of Medical Oncology (WIG), Division of Biomedical Statistics & Informatics (MRM, GDN), Cancer Center Statistics (DJS), Division of Medical Oncology (SRA, AG, JMH, RRM), Division of Gastroenterology & Hepatology/Division of Medical Oncology (FAS), Division of Gastroenterology & Hepatology (PJL), Molecular Genetics (SNT), Mayo Clinic, Rochester, MN; Department of Internal Medicine, Division of Medical Oncology, Ohio State University, Columbus, OH (RMG); Division of Hematology/Oncology, Vanderbilt University, Nashville, TN (EC); Section of Hematology/Medical Oncology, Lehigh Valley Health Network, Allentown, PA (SN); Cancer Prevention & Control Program, University of Hawaii Cancer Center, Honolulu, HI (JLB)
| | - Jeffrey L Berenberg
- Affiliations of authors: Division of Hematology/Division of Medical Oncology (WIG), Division of Biomedical Statistics & Informatics (MRM, GDN), Cancer Center Statistics (DJS), Division of Medical Oncology (SRA, AG, JMH, RRM), Division of Gastroenterology & Hepatology/Division of Medical Oncology (FAS), Division of Gastroenterology & Hepatology (PJL), Molecular Genetics (SNT), Mayo Clinic, Rochester, MN; Department of Internal Medicine, Division of Medical Oncology, Ohio State University, Columbus, OH (RMG); Division of Hematology/Oncology, Vanderbilt University, Nashville, TN (EC); Section of Hematology/Medical Oncology, Lehigh Valley Health Network, Allentown, PA (SN); Cancer Prevention & Control Program, University of Hawaii Cancer Center, Honolulu, HI (JLB)
| | - Robert R McWilliams
- Affiliations of authors: Division of Hematology/Division of Medical Oncology (WIG), Division of Biomedical Statistics & Informatics (MRM, GDN), Cancer Center Statistics (DJS), Division of Medical Oncology (SRA, AG, JMH, RRM), Division of Gastroenterology & Hepatology/Division of Medical Oncology (FAS), Division of Gastroenterology & Hepatology (PJL), Molecular Genetics (SNT), Mayo Clinic, Rochester, MN; Department of Internal Medicine, Division of Medical Oncology, Ohio State University, Columbus, OH (RMG); Division of Hematology/Oncology, Vanderbilt University, Nashville, TN (EC); Section of Hematology/Medical Oncology, Lehigh Valley Health Network, Allentown, PA (SN); Cancer Prevention & Control Program, University of Hawaii Cancer Center, Honolulu, HI (JLB).
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290
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Sun Y, Wang L, Guo SC, Wu XB, Xu XH. High-throughput sequencing to identify miRNA biomarkers in colorectal cancer patients. Oncol Lett 2014; 8:711-713. [PMID: 25013489 PMCID: PMC4081398 DOI: 10.3892/ol.2014.2215] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2013] [Accepted: 01/30/2014] [Indexed: 11/25/2022] Open
Abstract
The altered expression of microRNAs (miRNAs) is associated with a number of cancer types. The study of the association between the miRNA profile and cancer may be useful to identify potential biomarkers of certain types of cancer. In the present study, 19 miRNAs were identified by high-throughput sequencing in the serum of colorectal cancer (CRC) patients. A network analysis was performed based on a computational approach to identify associations between CRC and miRNAs. The present study may be useful to identify cancer-specific signatures and potentially useful biomarkers for the diagnosis of CRC. The network analysis of miRNA-target genes may aid in identifying altered miRNA regulatory networks that are involved in tumor pathogenesis.
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Affiliation(s)
- Yan Sun
- Department of Gastroenterology, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510150, P.R. China
| | - Lin Wang
- Department of Oncology, Guangzhou Red Cross Hospital, Guangzhou, Guangdong 510150, P.R. China
| | - Sheng-Chao Guo
- Department of Gastroenterology, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510150, P.R. China
| | - Xiao-Bing Wu
- Department of General Surgery, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510150, P.R. China
| | - Xue-Hu Xu
- Department of General Surgery, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510150, P.R. China
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291
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ALVARADO-BACHMANN RAUL, SMITH ADRIAN, GUNDARA JUSTINS, KUO SAMUELC, GILL ANTHONYJ, SAMRA JASWINDERS, HUGH THOMASJ. The incidence of mismatch repair gene defects in colorectal liver metastases. Mol Med Rep 2014; 10:1003-6. [DOI: 10.3892/mmr.2014.2257] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2014] [Accepted: 03/29/2014] [Indexed: 11/06/2022] Open
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292
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Wimmer K, Kratz CP, Vasen HFA, Caron O, Colas C, Entz-Werle N, Gerdes AM, Goldberg Y, Ilencikova D, Muleris M, Duval A, Lavoine N, Ruiz-Ponte C, Slavc I, Burkhardt B, Brugieres L. Diagnostic criteria for constitutional mismatch repair deficiency syndrome: suggestions of the European consortium 'care for CMMRD' (C4CMMRD). J Med Genet 2014; 51:355-65. [PMID: 24737826 DOI: 10.1136/jmedgenet-2014-102284] [Citation(s) in RCA: 332] [Impact Index Per Article: 30.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Constitutional mismatch repair deficiency (CMMRD) syndrome is a distinct childhood cancer predisposition syndrome that results from biallelic germline mutations in one of the four MMR genes, MLH1, MSH2, MSH6 or PMS2. The tumour spectrum is very broad, including mainly haematological, brain and intestinal tract tumours. Patients show a variety of non-malignant features that are indicative of CMMRD. However, currently no criteria that should entail diagnostic evaluation of CMMRD exist. We present a three-point scoring system for the suspected diagnosis CMMRD in a paediatric/young adult cancer patient. Tumours highly specific for CMMRD syndrome are assigned three points, malignancies overrepresented in CMMRD two points and all other malignancies one point. According to their specificity for CMMRD and their frequency in the general population, additional features are weighted with 1-2 points. They include multiple hyperpigmented and hypopigmented skin areas, brain malformations, pilomatricomas, a second childhood malignancy, a Lynch syndrome (LS)-associated tumour in a relative and parental consanguinity. According to the scoring system, CMMRD should be suspected in any cancer patient who reaches a minimum of three points by adding the points of the malignancy and the additional features. The diagnostic steps to confirm or refute the suspected diagnosis are outlined. We expect that application of the suggested strategy for CMMRD diagnosis will increase the number of patients being identified at the time when they develop their first tumour. This will allow adjustment of the treatment modalities, offering surveillance strategies for second malignancies and appropriate counselling of the entire family.
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Affiliation(s)
- Katharina Wimmer
- Division of Human Genetics, Medical University Innsbruck, Innsbruck, Austria
| | - Christian P Kratz
- Department of Pediatric Hematology & Oncology, Hannover Medical School, Hannover, Germany
| | - Hans F A Vasen
- Department of Gastroenterology & Hepatology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Olivier Caron
- Department of Medical Oncology, Gustave Roussy Cancer Institute, Villejuif, France
| | - Chrystelle Colas
- Department of Genetics, Pitié Salpêtrière Hospital, AP-HP, Paris, France INSERM, UMR_S 938, CDR Saint-Antoine, Paris, France Sorbonne Universités, UPMC Univ Paris 06, UMR_S 938, CDR Saint-Antoine, Paris, France
| | - Natacha Entz-Werle
- Pédiatrie Onco-Hématologie-Pédiatrie III-CHRU Hautepierre UdS-EA 3430, Strasbourg, France
| | - Anne-Marie Gerdes
- Department of Clinical Genetics, Copenhagen University Hospital Rigshospital, Copenhagen, Denmark
| | - Yael Goldberg
- Department of Oncology, Sharret Institute, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Denisa Ilencikova
- 2nd Pediatric Department of Children University Hospital, Comenius University, Bratislava, Slovakia
| | - Martine Muleris
- INSERM, UMR_S 938, CDR Saint-Antoine, Paris, France Sorbonne Universités, UPMC Univ Paris 06, UMR_S 938, CDR Saint-Antoine, Paris, France
| | - Alex Duval
- INSERM, UMR_S 938, CDR Saint-Antoine, Paris, France Sorbonne Universités, UPMC Univ Paris 06, UMR_S 938, CDR Saint-Antoine, Paris, France
| | - Noémie Lavoine
- Department of Children and Adolescents Oncology, Gustave Roussy Cancer Institute, Villejuif, France
| | - Clara Ruiz-Ponte
- Fundación Pública Galega de Medicina Xenómica (FPGMX) SERGAS, Grupo de Medicina Xenómica, IDIS, Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERer), Santiago de Compostela, Spain
| | - Irene Slavc
- Department of Pediatrics, Medical University of Vienna, Vienna, Austria
| | - Brigit Burkhardt
- Department of Pediatric Hematology and Oncology, University Children's Hospital, Münster, Germany
| | - Laurence Brugieres
- Department of Children and Adolescents Oncology, Gustave Roussy Cancer Institute, Villejuif, France
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293
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Whiffin N, Houlston RS. Architecture of inherited susceptibility to colorectal cancer: a voyage of discovery. Genes (Basel) 2014; 5:270-84. [PMID: 24705330 PMCID: PMC4094933 DOI: 10.3390/genes5020270] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2013] [Revised: 03/07/2014] [Accepted: 03/10/2014] [Indexed: 01/29/2023] Open
Abstract
This review looks back at five decades of research into genetic susceptibility to colorectal cancer (CRC) and the insights these studies have provided. Initial evidence of a genetic basis of CRC stems from epidemiological studies in the 1950s and is further provided by the existence of multiple dominant predisposition syndromes. Genetic linkage and positional cloning studies identified the first high-penetrance genes for CRC in the 1980s and 1990s. More recent genome-wide association studies have identified common low-penetrance susceptibility loci and provide support for a polygenic model of disease susceptibility. These observations suggest a high proportion of CRC may arise in a group of susceptible individuals as a consequence of the combined effects of common low-penetrance risk alleles and rare variants conferring moderate CRC risks. Despite these advances, however, currently identified loci explain only a small fraction of the estimated heritability to CRC. It is hoped that a new generation of sequencing projects will help explain this missing heritability.
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Affiliation(s)
- Nicola Whiffin
- Molecular and Population Genetics Team, Genetics and Epidemiology, The Institute of Cancer Research, Sutton, SM2 5NG, UK.
| | - Richard S Houlston
- Molecular and Population Genetics Team, Genetics and Epidemiology, The Institute of Cancer Research, Sutton, SM2 5NG, UK.
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294
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Martín-López JV, Fishel R. The mechanism of mismatch repair and the functional analysis of mismatch repair defects in Lynch syndrome. Fam Cancer 2014; 12:159-68. [PMID: 23572416 DOI: 10.1007/s10689-013-9635-x] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
The majority of Lynch syndrome (LS), also known as hereditary non-polyposis colorectal cancer (HNPCC), has been linked to heterozygous defects in DNA mismatch repair (MMR). MMR is a highly conserved pathway that recognizes and repairs polymerase misincorporation errors and nucleotide damage as well as functioning as a damage sensor that signals apoptosis. Loss-of-heterozygosity (LOH) that retains the mutant MMR allele and epigenetic silencing of MMR genes are associated with an increased mutation rate that drives carcinogenesis as well as microsatellite instability that is a hallmark of LS/HNPCC. Understanding the biophysical functions of the MMR components is crucial to elucidating the role of MMR in human tumorigenesis and determining the pathogenetic consequences of patients that present in the clinic with an uncharacterized variant of the MMR genes. We summarize the historical association between LS/HNPCC and MMR, discuss the mechanism of the MMR and finally examine the functional analysis of MMR defects found in LS/HNPCC patients and their relationship with the severity of the disease.
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Affiliation(s)
- Juana V Martín-López
- Department of Molecular Virology, Immunology and Medical Genetics, Human Cancer Genetics, The Ohio State University Wexner Medical Center, Columbus, OH 43210, USA
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295
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Shia J, Holck S, Depetris G, Greenson JK, Klimstra DS. Lynch syndrome-associated neoplasms: a discussion on histopathology and immunohistochemistry. Fam Cancer 2014; 12:241-60. [PMID: 23435936 DOI: 10.1007/s10689-013-9612-4] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
It was a century ago that Warthin, a pathologist, first described the clinical condition now known as Lynch syndrome. One hundred years later, our understanding of this syndrome has advanced significantly. Much of the progress took place over the last 25 years and was marked by a series of interacting developments from the disciplines of clinical oncology, pathology, and molecular genetics, with each development serving to guide or enhance the next. The advancement of our understanding about the pathology of Lynch syndrome associated tumors exemplifies such intimate interplay among disciplines. Today, accumulative knowledge has enabled surgical pathologists to detect tumors that are likely to be associated with Lynch syndrome, and the pathologist is playing an increasingly more important role in the care of these patients. The pathologist's ability is afforded primarily by information gained from tumor histopathology and by DNA mismatch repair protein immunohistochemistry. It is therefore pertinent both for the pathologists to accurately ascertain this morphologic information, and for all that are involved in the care of these patients to thoroughly understand the implications of such information. This article provides an overview of the development of histopathology and immunohistochemistry in Lynch syndrome-associated tumors, particularly in colorectal and endometrial cancers, and outlines the issues and current status of these specific pathologic aspects in not only the major tumors but also those less commonly seen or only newly reported in Lynch syndrome patients.
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Affiliation(s)
- Jinru Shia
- Department of Pathology, Memorial Sloan-Kettering Cancer Center, 1275 York Ave, New York, NY 10021, USA.
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296
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297
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Shin US, Cho SS, Moon SM, Park SH, Jee SH, Jung EJ, Hwang DY. Is microsatellite instability really a good prognostic factor of colorectal cancer? Ann Coloproctol 2014; 30:28-34. [PMID: 24639968 PMCID: PMC3953166 DOI: 10.3393/ac.2014.30.1.28] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2013] [Accepted: 10/24/2013] [Indexed: 12/28/2022] Open
Abstract
PURPOSE The aim of this study was to investigate the clinicopathologic features of and the prognosis for colorectal cancers (CRCs) with microsatellite instabilities (MSIs). METHODS Between 2006 and 2009, genotyping was performed on 245 patients with stage II/III CRCs to establish the MSI status. The clinicopathologic differences and the prognostic value of MSI were analyzed. The median follow-up period was 38 months (range, 7-68 months). RESULTS Of the total 245 patients, 20 (8.2%) had MSI-high (H) and 225 (91.8%) had MSI-low (L) or stable (S) CRCs. Adjuvant chemotherapies were performed on 101 stage II (87.8%) and 107 stage III patients (82.3%). Patients with MSI-H CRCs more frequently had a family history of colon cancer (10% vs. 2.7%, P = 0.003), more frequently had a cancer located at the proximal colon (90.0% vs. 19.1%, P < 0.0001), and more often showed a mucinous phenotype or poor differentiation (35.0% vs. 7.1%, P = 0.001). Despite less frequent lymph node metastasis (25% vs. 55.6%, P = 0.01), the number of retrieved lymph nodes was higher (26.3 ± 13.1 vs. 20.7 ± 1.2, P = 0.04) in the MSI-H group. The overall survival and the disease-free survival (DFS) did not differ with respect to MSI status. However, in the stage II subgroup, the DFS for patients with MSI-H CRCs was significantly worse (72.2% vs. 90.7%, P = 0.03). The multivariate analysis performed on this subgroup revealed that MSI-H was an independent poor prognostic factor (adjusted hazard ratio, 4.0; 95% confidence interval, 1.0-15.6, P = 0.046). CONCLUSION MSI-H CRCs had distinct clinicopathologic features, and MSI-H was an independent poor prognostic factor in stage II CRCs. Considering the majority of stage II patients were administrated adjuvant chemotherapy, the efficacy of adjuvant chemotherapy for treating MSI CRCs might be different from that for treating MSI-L/S tumors.
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Affiliation(s)
- Ui Sup Shin
- Department of Surgery, Korea Cancer Center Hospital, Korea Institute of Radiological & Medical Sciences, Seoul, Korea
| | - Sang Sik Cho
- Department of Surgery, Korea Cancer Center Hospital, Korea Institute of Radiological & Medical Sciences, Seoul, Korea
| | - Sun Mi Moon
- Department of Surgery, Korea Cancer Center Hospital, Korea Institute of Radiological & Medical Sciences, Seoul, Korea
| | - Sun Hoo Park
- Department of Pathology, Korea Cancer Center Hospital, Korea Institute of Radiological & Medical Sciences, Seoul, Korea
| | - Sun Hee Jee
- Department of Surgery, Korea Cancer Center Hospital, Korea Institute of Radiological & Medical Sciences, Seoul, Korea
| | - Eun-Joo Jung
- Department of Surgery, Colorectal Cancer Center, Kunkuk University Medical Center, Seoul, Korea
| | - Dae-Yong Hwang
- Department of Surgery, Colorectal Cancer Center, Kunkuk University Medical Center, Seoul, Korea
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298
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Bertorelle R, Rampazzo E, Pucciarelli S, Nitti D, Rossi AD. Telomeres, telomerase and colorectal cancer. World J Gastroenterol 2014; 20:1940-1950. [PMID: 24616570 PMCID: PMC3934464 DOI: 10.3748/wjg.v20.i8.1940] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2013] [Revised: 12/03/2013] [Accepted: 01/15/2014] [Indexed: 02/06/2023] Open
Abstract
Colorectal cancer (CRC) is the third most common cancer worldwide and, despite improved treatments, is still an important cause of cancer-related deaths. CRC encompasses a complex of diseases arising from a multi-step process of genetic and epigenetic events. Besides heterogeneity in the molecular and biological features of CRC, chromosomal instability is a hallmark of cancer and cancer cells may also circumvent replicative senescence and acquire the ability to sustain unlimited proliferation. Telomere/telomerase interplay is an important mechanism involved in both genomic stability and cellular replicative potential, and its dysfunction plays a key role in the oncogenetic process. The erosion of telomeres, mainly because of cell proliferation, may be accelerated by specific alterations in the genes involved in CRC, such as APC and MSH2. Although there is general agreement that the shortening of telomeres plays a role in the early steps of CRC carcinogenesis by promoting chromosomal instability, the prognostic role of telomere length in CRC is still under debate. The activation of telomerase reverse transcriptase (TERT), the catalytic component of the telomerase complex, allows cancer cells to grow indefinitely by maintaining the length of the telomeres, thus favouring tumour formation/progression. Several studies indicate that TERT increases with disease progression, and most studies suggest that telomerase is a useful prognostic factor. Plasma TERT mRNA may also be a promising marker for the minimally invasive monitoring of disease progression and response to therapy.
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299
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Rasool S, Rasool V, Naqvi T, Ganai BA, Shah BA. Genetic unraveling of colorectal cancer. Tumour Biol 2014; 35:5067-82. [PMID: 24573608 DOI: 10.1007/s13277-014-1713-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2013] [Accepted: 01/29/2014] [Indexed: 02/06/2023] Open
Abstract
Colorectal cancer is a common disease in both men and women (being the third most common cancer in men and the second most common among women) and thus represents an important and serious public health issue, especially in the western world. Although it is a well-established fact that cancers of the large intestine produce symptoms relatively earlier at a stage that can be easily cured by resection, a large number of people lose their lives to this deadly disease each year. Recent times have seen an important change in the incidence of colorectal cancer in different parts of the world. The etiology of colorectal cancer is multifactorial and is likely to involve the actions of genes at multiple levels along the multistage carcinogenesis process. Exhaustive efforts have been made out in the direction of unraveling the role of various environmental factors, gene mutations, and polymorphisms worldwide (as well as in Kashmir-"a valley of gastrointestinal cancers") that have got a role to play in the development of this disease so that antitumor drugs could be developed against this cancer, first, and, finally, the responsiveness or resistance to these agents could be understood for combating this global issue.
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Affiliation(s)
- Sabha Rasool
- Department of Biochemistry, University of Kashmir, Hazratbal, Srinagar, 190006, Kashmir, India
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300
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Grupp K, Boumesli R, Tsourlakis MC, Koop C, Wilczak W, Adam M, Sauter G, Simon R, Izbicki JR, Graefen M, Huland H, Steurer S, Schlomm T, Minner S, Quaas A. The prognostic impact of high Nijmegen breakage syndrome (NBS1) gene expression in ERG-negative prostate cancers lacking PTEN deletion is driven by KPNA2 expression. Int J Cancer 2014; 135:1399-407. [DOI: 10.1002/ijc.28778] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2013] [Accepted: 01/16/2014] [Indexed: 01/13/2023]
Affiliation(s)
- Katharina Grupp
- General, Visceral and Thoracic Surgery Department and Clinic; University Medical Center Hamburg-Eppendorf; Germany
- Institute of Pathology, University Medical Center Hamburg-Eppendorf; Germany
| | - Rebecca Boumesli
- Institute of Pathology, University Medical Center Hamburg-Eppendorf; Germany
| | | | - Christina Koop
- Institute of Pathology, University Medical Center Hamburg-Eppendorf; Germany
| | - Waldemar Wilczak
- Institute of Pathology, University Medical Center Hamburg-Eppendorf; Germany
| | - Meike Adam
- Martini-Clinic, Prostate Cancer Center; University Medical Center Hamburg-Eppendorf; Germany
- Department of Urology, Section for translational Prostate Cancer Research; University Medical Center Hamburg-Eppendorf; Germany
| | - Guido Sauter
- Institute of Pathology, University Medical Center Hamburg-Eppendorf; Germany
| | - Ronald Simon
- Institute of Pathology, University Medical Center Hamburg-Eppendorf; Germany
| | - Jakob Robert Izbicki
- General, Visceral and Thoracic Surgery Department and Clinic; University Medical Center Hamburg-Eppendorf; Germany
| | - Markus Graefen
- Martini-Clinic, Prostate Cancer Center; University Medical Center Hamburg-Eppendorf; Germany
| | - Hartwig Huland
- Martini-Clinic, Prostate Cancer Center; University Medical Center Hamburg-Eppendorf; Germany
| | - Stefan Steurer
- Institute of Pathology, University Medical Center Hamburg-Eppendorf; Germany
| | - Thorsten Schlomm
- Martini-Clinic, Prostate Cancer Center; University Medical Center Hamburg-Eppendorf; Germany
- Department of Urology, Section for translational Prostate Cancer Research; University Medical Center Hamburg-Eppendorf; Germany
| | - Sarah Minner
- Institute of Pathology, University Medical Center Hamburg-Eppendorf; Germany
| | - Alexander Quaas
- Institute of Pathology, University Medical Center Hamburg-Eppendorf; Germany
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