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Rossi BM, Palmero EI, López-Kostner F, Sarroca C, Vaccaro CA, Spirandelli F, Ashton-Prolla P, Rodriguez Y, de Campos Reis Galvão H, Reis RM, Escremim de Paula A, Capochin Romagnolo LG, Alvarez K, Della Valle A, Neffa F, Kalfayan PG, Spirandelli E, Chialina S, Gutiérrez Angulo M, Castro-Mujica MDC, Sanchez de Monte J, Quispe R, da Silva SD, Rossi NT, Barletta-Carrillo C, Revollo S, Taborga X, Morillas LL, Tubeuf H, Monteiro-Santos EM, Piñero TA, Dominguez-Barrera C, Wernhoff P, Martins A, Hovig E, Møller P, Dominguez-Valentin M. A survey of the clinicopathological and molecular characteristics of patients with suspected Lynch syndrome in Latin America. BMC Cancer 2017; 17:623. [PMID: 28874130 PMCID: PMC5586063 DOI: 10.1186/s12885-017-3599-4] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Accepted: 08/23/2017] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Genetic counselling and testing for Lynch syndrome (LS) have recently been introduced in several Latin America countries. We aimed to characterize the clinical, molecular and mismatch repair (MMR) variants spectrum of patients with suspected LS in Latin America. METHODS Eleven LS hereditary cancer registries and 34 published LS databases were used to identify unrelated families that fulfilled the Amsterdam II (AMSII) criteria and/or the Bethesda guidelines or suggestive of a dominant colorectal (CRC) inheritance syndrome. RESULTS We performed a thorough investigation of 15 countries and identified 6 countries where germline genetic testing for LS is available and 3 countries where tumor testing is used in the LS diagnosis. The spectrum of pathogenic MMR variants included MLH1 up to 54%, MSH2 up to 43%, MSH6 up to 10%, PMS2 up to 3% and EPCAM up to 0.8%. The Latin America MMR spectrum is broad with a total of 220 different variants which 80% were private and 20% were recurrent. Frequent regions included exons 11 of MLH1 (15%), exon 3 and 7 of MSH2 (17 and 15%, respectively), exon 4 of MSH6 (65%), exons 11 and 13 of PMS2 (31% and 23%, respectively). Sixteen international founder variants in MLH1, MSH2 and MSH6 were identified and 41 (19%) variants have not previously been reported, thus representing novel genetic variants in the MMR genes. The AMSII criteria was the most used clinical criteria to identify pathogenic MMR carriers although microsatellite instability, immunohistochemistry and family history are still the primary methods in several countries where no genetic testing for LS is available yet. CONCLUSION The Latin America LS pathogenic MMR variants spectrum included new variants, frequently altered genetic regions and potential founder effects, emphasizing the relevance implementing Lynch syndrome genetic testing and counseling in all of Latin America countries.
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Affiliation(s)
| | - Edenir Inêz Palmero
- Molecular Oncology Research Center, Barretos Cancer Hospital, Barretos, SP Brazil
| | | | - Carlos Sarroca
- Hospital Fuerzas Armadas, Grupo Colaborativo Uruguayo, Investigación de Afecciones Oncológicas Hereditarias (GCU), Montevideo, Uruguay
| | | | - Florencia Spirandelli
- Servicio de Coloproctologia y Asesoria Genetica en Cancer, Hospital Español de Rosario, Rosario, Argentina
| | - Patricia Ashton-Prolla
- Departamento de Genética da Universidade Federal do Rio Grande do Sul (UFRGS) e Serviço de Genética Médica do Hospital de Clinicas de Porto Alegre (HCPA) & Rede Brasileira de Câncer Hereditário, Porto Alegre, Rio Grande Do Sul Brazil
| | | | | | - Rui Manuel Reis
- Molecular Oncology Research Center, Barretos Cancer Hospital & Life and Health Sciences Research Institute (ICVS), Health Sciences School, University of Minho, Braga, Portugal
- ICVS/3B’s-PT Government Associate Laboratory, Braga, Guimarães Portugal
| | | | | | - Karin Alvarez
- Laboratorio de Oncología y Genética Molecular, Clínica Los Condes, Santiago, Chile
| | - Adriana Della Valle
- Hospital Fuerzas Armadas, Grupo Colaborativo Uruguayo, Investigación de Afecciones Oncológicas Hereditarias (GCU), Montevideo, Uruguay
| | - Florencia Neffa
- Hospital Fuerzas Armadas, Grupo Colaborativo Uruguayo, Investigación de Afecciones Oncológicas Hereditarias (GCU), Montevideo, Uruguay
| | | | - Enrique Spirandelli
- Servicio de Coloproctologia y Asesoria Genetica en Cancer, Hospital Español de Rosario, Rosario, Argentina
| | - Sergio Chialina
- Servicio de Coloproctologia y Asesoria Genetica en Cancer, Hospital Español de Rosario, Rosario, Argentina
| | | | | | | | - Richard Quispe
- Laboratorio de Genética Molecular del Instituto de Servicios de Laboratorio de Diagnóstico e Investigación en Salud (SELADIS), La Paz, Bolivia
| | - Sabrina Daniela da Silva
- Lady Davis Institute for Medical Research and Segal Cancer Center, Jewish General Hospital, Montreal, Quebec, Canada
- Department of Otolaryngology-Head and Neck Surgery, McGill University, Montreal, Quebec, Canada
| | | | - Claudia Barletta-Carrillo
- Equipo Funcional de Genética y Biologia Molecular, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru
| | - Susana Revollo
- Laboratorio de Genética Molecular del Instituto de Servicios de Laboratorio de Diagnóstico e Investigación en Salud (SELADIS), La Paz, Bolivia
| | - Ximena Taborga
- Laboratorio de Genética Molecular del Instituto de Servicios de Laboratorio de Diagnóstico e Investigación en Salud (SELADIS), La Paz, Bolivia
| | | | - Hélène Tubeuf
- Inserm-U1079-IRIB, UNIROUEN, Normandie Univ, Normandy Centre for Genomic and Personalized Medicine, Rouen, France
- Interactive Biosoftware, Rouen, France
| | | | - Tamara Alejandra Piñero
- Instituto de Ciencias Basicas y Medicina Experimental (ICBME), Hospital Italiano, Buenos Aires, Argentina
| | - Constantino Dominguez-Barrera
- Department of Preventive Medicine, Faculty of Medicine, Universidad Nacional Mayor de San Marcos (UNMSM), Lima, Peru
| | - Patrik Wernhoff
- Department of Clinical Molecular Biology (EpiGen), Akershus University Hospital, Lørenskog, Norway
| | - Alexandra Martins
- Inserm-U1079-IRIB, UNIROUEN, Normandie Univ, Normandy Centre for Genomic and Personalized Medicine, Rouen, France
| | - Eivind Hovig
- Department of Tumor Biology, Institute for Cancer Research, Oslo University Hospital, Oslo, Norway
- Institute of Cancer Genetics and Informatics, Oslo University Hospital, Oslo, Norway
| | - Pål Møller
- Department of Tumor Biology, Institute for Cancer Research, Oslo University Hospital, Oslo, Norway
- Department of Medical Genetics, Oslo University Hospital, Oslo, Norway
- Department of Human Medicine, Universität Witten/Herdecke, Witten, Germany
| | - Mev Dominguez-Valentin
- Department of Tumor Biology, Institute for Cancer Research, Oslo University Hospital, Oslo, Norway
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