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Figueiredo IN, Leal C, Romanazzi G, Engquist B. Biomathematical model for simulating abnormal orifice patterns in colonic crypts. Math Biosci 2019; 315:108221. [PMID: 31271804 DOI: 10.1016/j.mbs.2019.108221] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Revised: 06/20/2019] [Accepted: 06/26/2019] [Indexed: 02/07/2023]
Abstract
Colonic polyps, which are abnormal growths in the colon, are a major concern in colon cancer diagnosis and prevention. Medical studies evidence that there is a correlation between histopathology and the shapes of the orifices in colonic crypts. We propose a biomathematical model for simulating the appearance of anomalous shapes for the orifices of colonic crypts, associated to an abnormal cell proliferation. It couples a mechanical model that is a mixed elastic/viscoelastic quasi-static model describing the deformation of the crypt orifice, with a convection-diffusion model that simulates the crypt cell dynamics in space and time. The coupling resides in the variation of pressure generated by abnormal proliferative cells that induce a mechanical force and originate the change in shape of the crypt orifice. Furthermore the model is formulated in a two-dimensional setting, for emulating the top view of the colonic mucosa, observed in vivo in colonoscopy images. The primary focus of this study is on the modeling of this complex biological phenomenon, by defining an appropriate reduced biomathematical model. Additionally, a numerical procedure to determine its solution is also addressed. The overall numerical simulations indicate that an excess of cell proliferation, in different crypt locations, creates some of the anomalous patterns of the colonic crypt orifices, observed in vivo in medical images.
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Affiliation(s)
- Isabel N Figueiredo
- CMUC, Department of Mathematics, Faculty of Sciences and Technology, University of Coimbra, Coimbra, Portugal.
| | - Carlos Leal
- CMUC, Department of Mathematics, Faculty of Sciences and Technology, University of Coimbra, Coimbra, Portugal
| | - Giuseppe Romanazzi
- Department of Applied Mathematics, Institute of Mathematics, Statistics and Scientific Computing (IMECC), State University of Campinas (UNICAMP), Brazil
| | - Björn Engquist
- Department of Mathematics and the Institute for Computational Engineering and Sciences, The University of Texas at Austin, Austin, USA
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Pinheiro M, Francisco I, Pinto C, Peixoto A, Veiga I, Filipe B, Santos C, Maia S, Silva J, Pinto P, Santos R, Claro I, Lage P, Lopes P, Ferreira S, Rosa I, Fonseca R, Rodrigues P, Henrique R, Chaves P, Pereira AD, Brandão C, Albuquerque C, Teixeira MR. The nonsense mutation MSH2 c.2152C>T shows a founder effect in Portuguese Lynch syndrome families. Genes Chromosomes Cancer 2019; 58:657-664. [PMID: 30968502 DOI: 10.1002/gcc.22759] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 04/05/2019] [Accepted: 04/08/2019] [Indexed: 12/27/2022] Open
Abstract
The mutational spectrum of the MMR genes is highly heterogeneous, but specific mutations are observed at high frequencies in well-defined populations or ethnic groups, due to founder effects. The MSH2 mutation c.2152C>T, p.(Gln718*), has occasionally been described in Lynch families worldwide, including in Portuguese Lynch syndrome families. During genetic testing for Lynch syndrome at the Portuguese Oncology Institutes of Porto and Lisbon, this mutation was identified in 28 seemingly unrelated families. In order to evaluate if this alteration is a founder mutation, haplotype analysis using microsatellite and SNP markers flanking the MSH2 gene was performed in the 28 probands and 87 family members. Additionally, the geographic origin of these families was evaluated and the age of the mutation estimated. Twelve different haplotypes were phased for 13 out of the 28 families and shared a conserved region of ∼3.6 Mb. Based on the mutation and recombination events observed in the microsatellite haplotypes and assuming a generation time of 25 years, the age estimate for the MSH2 mutation was 273 ± 64 years. The geographic origins of these families were mostly from the Northern region of Portugal. Concluding, these results suggest that the MSH2 c.2152C>T alteration is a founder mutation in Portugal with a relatively recent origin. Furthermore, its high proportion indicates that screening for this mutation as a first step, together with the previously reported Portuguese founder mutations, may be cost-effective in genetic testing of Lynch syndrome suspects of Portuguese ancestry.
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Affiliation(s)
- Manuela Pinheiro
- Department of Genetics, Portuguese Oncology Institute of Porto, Porto, Portugal
| | - Inês Francisco
- Molecular Pathobiology Research Unit, Portuguese Oncology Institute of Lisbon, Lisbon, Portugal
| | - Carla Pinto
- Department of Genetics, Portuguese Oncology Institute of Porto, Porto, Portugal
| | - Ana Peixoto
- Department of Genetics, Portuguese Oncology Institute of Porto, Porto, Portugal
| | - Isabel Veiga
- Department of Genetics, Portuguese Oncology Institute of Porto, Porto, Portugal
| | - Bruno Filipe
- Molecular Pathobiology Research Unit, Portuguese Oncology Institute of Lisbon, Lisbon, Portugal
| | - Catarina Santos
- Department of Genetics, Portuguese Oncology Institute of Porto, Porto, Portugal
| | - Sofia Maia
- Department of Genetics, Portuguese Oncology Institute of Porto, Porto, Portugal
| | - João Silva
- Department of Genetics, Portuguese Oncology Institute of Porto, Porto, Portugal
| | - Pedro Pinto
- Department of Genetics, Portuguese Oncology Institute of Porto, Porto, Portugal
| | - Rui Santos
- Department of Genetics, Portuguese Oncology Institute of Porto, Porto, Portugal
| | - Isabel Claro
- Department of Gastroenterology, Portuguese Oncology Institute of Lisbon, Lisbon, Portugal.,Familial Risk Clinic, Portuguese Oncology Institute of Lisbon, Lisbon, Portugal
| | - Pedro Lage
- Department of Gastroenterology, Portuguese Oncology Institute of Lisbon, Lisbon, Portugal.,Familial Risk Clinic, Portuguese Oncology Institute of Lisbon, Lisbon, Portugal
| | - Paula Lopes
- Department of Pathology, Portuguese Oncology Institute of Porto, Porto, Portugal
| | - Sara Ferreira
- Department of Gastroenterology, Portuguese Oncology Institute of Lisbon, Lisbon, Portugal.,Familial Risk Clinic, Portuguese Oncology Institute of Lisbon, Lisbon, Portugal
| | - Isadora Rosa
- Department of Gastroenterology, Portuguese Oncology Institute of Lisbon, Lisbon, Portugal.,Familial Risk Clinic, Portuguese Oncology Institute of Lisbon, Lisbon, Portugal
| | - Ricardo Fonseca
- Department of Pathology, Portuguese Oncology Institute of Lisbon, Lisbon, Portugal
| | - Paula Rodrigues
- Familial Risk Clinic, Portuguese Oncology Institute of Lisbon, Lisbon, Portugal
| | - Rui Henrique
- Department of Pathology, Portuguese Oncology Institute of Porto, Porto, Portugal.,Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto, Porto, Portugal
| | - Paula Chaves
- Department of Pathology, Portuguese Oncology Institute of Lisbon, Lisbon, Portugal
| | - António Dias Pereira
- Department of Gastroenterology, Portuguese Oncology Institute of Lisbon, Lisbon, Portugal
| | - Catarina Brandão
- Department of Gastroenterology, Portuguese Oncology Institute of Porto, Porto, Portugal
| | - Cristina Albuquerque
- Molecular Pathobiology Research Unit, Portuguese Oncology Institute of Lisbon, Lisbon, Portugal
| | - Manuel R Teixeira
- Department of Genetics, Portuguese Oncology Institute of Porto, Porto, Portugal.,Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto, Porto, Portugal
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Silva S, Lage P, Cabral F, Alves R, Catarino A, Félix A, André S. Bilateral breast fibromatosis after silicone prosthetics in a patient with classic familial adenomatous polyposis: A case report. Oncol Lett 2018; 16:1449-1454. [PMID: 30008823 PMCID: PMC6036415 DOI: 10.3892/ol.2018.8853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2017] [Accepted: 03/16/2018] [Indexed: 11/07/2022] Open
Abstract
Breast fibromatosis is a benign fibroblastic proliferation accounting for less than 0.2% of breast tumors. It presents sporadically or as a manifestation of familial adenomatous polyposis (FAP). Fibromatosis in FAP may develop in patients with adenomatous polyposis coli (APC) gene mutations at any location through the gene. Notably, there is an increased risk if mutation is downstream codon 1400. The present case report described a 33-year-old woman with recurrent bilateral breast fibromatosis after breast implants in a context of classic FAP. APC mutation (codon-935) was detected at the age of 16. In the same year, a thyroidectomy for a cribriform-morular papillary thyroid carcinoma (pT1) was performed. Seven years later, a prophylactic total colectomy with >100 adenomas without invasive carcinoma was performed and the patient was kept under surveillance. At the age of 30 years old, she underwent breast silicone implantation for cosmetic reasons. One year later, bilateral breast tumors were diagnosed in core biopsy as fibromatosis (nuclear β-catenin+, estrogen receptors-). After no success with medical treatment with tamoxifen, bilateral mastectomy was performed. The patient relapsed one year later and a fibromatosis lesion in the right thoracic wall was excised again. The patient demonstrated no signs of relapse 24 months after the surgery. This rare case illustrates that the increased risk of developing fibromatosis in patients with FAP, even in the classic form, should be considered before deciding to place breast implants.
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Affiliation(s)
- Sara Silva
- NOVA Medical School/Faculdade de Ciências Médicas, Universidade Nova de Lisboa, 1169-056 Lisbon, Portugal
| | - Pedro Lage
- Department of Gastroenterology, Instituto Português de Oncologia de Lisboa Francisco Gentil (IPOLFG), 1099-023 Lisbon, Portugal
| | - Francisco Cabral
- Department of Surgery, Instituto Português de Oncologia de Lisboa Francisco Gentil (IPOLFG), 1099-023 Lisbon, Portugal
| | - Rui Alves
- Department of Surgery, Instituto Português de Oncologia de Lisboa Francisco Gentil (IPOLFG), 1099-023 Lisbon, Portugal
| | - Ana Catarino
- NOVA Medical School/Faculdade de Ciências Médicas, Universidade Nova de Lisboa, 1169-056 Lisbon, Portugal.,Department of Pathology, Serviço de Anatomia Patológica do Hospital da Luz, 1500-650 Lisbon, Portugal
| | - Ana Félix
- NOVA Medical School/Faculdade de Ciências Médicas, Universidade Nova de Lisboa, 1169-056 Lisbon, Portugal.,Department of Pathology, Instituto Português de Oncologia de Lisboa Francisco Gentil (IPOLFG), 1099-023 Lisbon, Portugal
| | - Saudade André
- NOVA Medical School/Faculdade de Ciências Médicas, Universidade Nova de Lisboa, 1169-056 Lisbon, Portugal.,Department of Pathology, Instituto Português de Oncologia de Lisboa Francisco Gentil (IPOLFG), 1099-023 Lisbon, Portugal
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Flisikowska T, Stachowiak M, Xu H, Wagner A, Hernandez-Caceres A, Wurmser C, Perleberg C, Pausch H, Perkowska A, Fischer K, Frishman D, Fries R, Switonski M, Kind A, Saur D, Schnieke A, Flisikowski K. Porcine familial adenomatous polyposis model enables systematic analysis of early events in adenoma progression. Sci Rep 2017; 7:6613. [PMID: 28747659 DOI: 10.1038/s41598-017-06741-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Accepted: 06/16/2017] [Indexed: 12/30/2022] Open
Abstract
We compared gene expression in low and high-grade intraepithelial dysplastic polyps from pigs carrying an APC1311 truncating mutation orthologous to human APC1309, analysing whole samples and microdissected dysplastic epithelium. Gene set enrichment analysis revealed differential expression of gene sets similar to human normal mucosa versus T1 stage polyps. Transcriptome analysis of whole samples revealed many differentially-expressed genes reflecting immune infiltration. Analysis of microdissected dysplastic epithelium was markedly different and showed increased expression in high-grade intraepithelial neoplasia of several genes known to be involved in human CRC; and revealed possible new roles for GBP6 and PLXND1. The pig model thus facilitates analysis of CRC pathogenesis.
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Morak M, Laner A, Bacher U, Keiling C, Holinski-Feder E. MUTYH-associated polyposis - variability of the clinical phenotype in patients with biallelic and monoallelic MUTYH mutations and report on novel mutations. Clin Genet 2011; 78:353-63. [PMID: 20618354 DOI: 10.1111/j.1399-0004.2010.01478.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
To further characterize 215 APC mutation-negative patients with colorectal neoplasias classified in classical, attenuated, or atypical familial adenomatous polyposis (FAP) coli we performed mutation screening in the Mut Y homologue (MUTYH) gene. The incidence was 15% for biallelic and 3.7% for monoallelic MUTYH mutations. We describe six novel MUTYH mutations in biallelic constellation and two novel monoallelic missense mutations. Of 33 MUTYH-associated polyposis coli (MAP) patients 57% were attenuated familial adenomatous polyposis (AFAP) patients, 10% display early-onset classical FAP and 18% had only few adenomas at higher age. Biallelic cases had a high incidence of extracolonic polyposis in 32% and colorectal cancer (CRC) in 33% of the cases. The clinical picture of MAP ranged from classical FAP or synchronous CRC at age 30 years to few adenomas at age 54 years without evidence of CRC, initially suspected for hereditary non-polyposis colorectal cancer (HNPCC). The mean age of onset was 43 years, with 11 (33%) patients being younger than 40 years of age, indicating that the clinical manifestation can be earlier than so far reported. Monoallelic MUTYH mutation carriers had a positive family history in seven of eight cases allowing the hypothesis of a disease-causing synergism of MUTYH mutations with other genes.
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Affiliation(s)
- M Morak
- University Hospital of the Ludwig-Maximilians-University, Campus Innenstadt, Munich, Germany
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Albuquerque C, Baltazar C, Filipe B, Penha F, Pereira T, Smits R, Cravo M, Lage P, Fidalgo P, Claro I, Rodrigues P, Veiga I, Ramos JS, Fonseca I, Leitão CN, Fodde R. Colorectal cancers show distinct mutation spectra in members of the canonical WNT signaling pathway according to their anatomical location and type of genetic instability. Genes Chromosomes Cancer 2010; 49:746-59. [PMID: 20544848 DOI: 10.1002/gcc.20786] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
It is unclear whether the mutation spectra in WNT genes vary among distinct types of colorectal tumors. We have analyzed mutations in specific WNT genes in a cohort of 52 colorectal tumors and performed a meta-analysis of previous studies. Notably, significant differences were found among the mutation spectra. We have previously shown that in familial adenomatous polyposis, APC somatic mutations are selected to provide the "just-right" level of WNT signaling for tumor formation. Here, we found that APC mutations encompassing at least two beta-catenin down-regulating motifs (20 a.a. repeats) are significantly more frequent in microsatellite unstable (MSI-H) than in microsatellite stable (MSS) tumors where truncations retaining less than two repeats are more frequent (P = 0.0009). Moreover, in cases where both APC hits are detected, selection for mutations retaining a cumulative number of two 20 a.a. repeats became apparent in MSI-H tumors (P = 0.001). This type of mutations were also more frequent in proximal versus distal colonic tumors, regardless of MSI status (P = 0.0008). Among MSI-H tumors, CTNNB1 mutations were significantly more frequent in HNPCC than in sporadic lesions (28% versus 6%, P < 10-6) and were preferentially detected in the proximal colon, independently of MSI status (P = 0.017). In conclusion, the observed spectra of WNT gene mutations in colorectal tumors are likely the result from selection of specific levels of beta-catenin signaling, optimal for tumor formation in the context of specific anatomical locations and forms of genetic instability. We suggest that this may underlie the preferential location of MMR deficient tumors in the proximal colon.
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Affiliation(s)
- Cristina Albuquerque
- Centro de Investigação de Patobiologia Molecular (CIPM), Instituto Português de Oncologia de Lisboa Francisco Gentil, EPE, Lisboa, Portugal.
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Filipe B, Baltazar C, Albuquerque C, Fragoso S, Lage P, Vitoriano I, Mão de Ferro S, Claro I, Rodrigues P, Fidalgo P, Chaves P, Cravo M, Nobre Leitão C. APCorMUTYHmutations account for the majority of clinically well-characterized families with FAP and AFAP phenotype and patients with more than 30 adenomas. Clin Genet 2009; 76:242-55. [DOI: 10.1111/j.1399-0004.2009.01241.x] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Aretz S, Uhlhaas S, Goergens H, Siberg K, Vogel M, Pagenstecher C, Mangold E, Caspari R, Propping P, Friedl W. MUTYH-associated polyposis: 70 of 71 patients with biallelic mutations present with an attenuated or atypical phenotype. Int J Cancer 2006; 119:807-14. [PMID: 16557584 DOI: 10.1002/ijc.21905] [Citation(s) in RCA: 160] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
To determine the frequency, mutation spectrum and phenotype of the recently described autosomal recessive MUTYH-associated polyposis (MAP), we performed a systematic search for MUTYH (MYH) mutations by sequencing the complete coding region of the gene in 329 unselected APC mutation-negative index patients with the clinical diagnosis of familial adenomatous polyposis (FAP) or attenuated FAP (AFAP). Biallelic germline mutations in MUTYH were identified in 55 of the 329 unselected patients (17%) and in another 9 selected index cases. About one-fifth (20%) of the 64 unrelated MAP patients harboured none of the 2 hot-spot missense mutations Y165C and/or G382D. Including 7 affected relatives, almost all MAP patients presented with either an attenuated (80%) or with an atypical phenotype (18%). Fifty percentage of the MAP patients had colorectal cancer at diagnosis. Duodenal polyposis was found in 18%, thyroid and stomach cancer in 1 case, other extraintestinal manifestations associated with FAP were not observed. In 8 families, vertical segregation was suspected; in 2 of these families, biallelic mutations were identified in 2 generations. Monoallelic changes with predicted functional relevance were found in 0.9% of the 329 patients, which is in accordance with the carrier frequency in the general population. In conclusion, biallelic MUTYH mutations are the underlying genetic basis in a substantial fraction of patients with adenomatous polyposis. The phenotype of MAP is best characterised as attenuated or atypical, respectively. Colorectal surveillance starting at about 18 years of age is recommended for biallelic mutation carriers and siblings of MAP patients, who refuse predictive testing.
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Affiliation(s)
- Stefan Aretz
- Institute of Human Genetics, University of Bonn, Bonn, Germany.
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