1. Lynch syndrome identification in a Brazilian cohort of endometrial cancer screened by a universal approach.
- Author
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Rosa RCA, Santis JO, Teixeira LA, Molfetta GA, Dos Santos JTT, Ribeiro VDS, Chahud F, Ribeiro-Silva A, Brunaldi MO, Silva WA Jr, and Ferraz VEF
- Subjects
- Adult, Aged, Aged, 80 and over, Biomarkers, Tumor analysis, Brazil epidemiology, Colorectal Neoplasms, Hereditary Nonpolyposis complications, Colorectal Neoplasms, Hereditary Nonpolyposis genetics, Colorectal Neoplasms, Hereditary Nonpolyposis prevention & control, DNA Methylation, DNA Mismatch Repair, DNA Mutational Analysis, Endometrial Neoplasms diagnosis, Endometrial Neoplasms pathology, Endometrial Neoplasms prevention & control, Endometrium pathology, Female, Genetic Counseling organization & administration, Genetic Counseling statistics & numerical data, Germ-Line Mutation, Heterozygote, Humans, Immunohistochemistry, Microsatellite Instability, Middle Aged, Prevalence, Prospective Studies, Retrospective Studies, Biomarkers, Tumor genetics, Colorectal Neoplasms, Hereditary Nonpolyposis epidemiology, Early Detection of Cancer statistics & numerical data, Endometrial Neoplasms genetics
- Abstract
Objective: To report the frequency of Lynch syndrome (LS) in a cohort of patients from Southeast Brazil bearing endometrial cancer (EC), using a tumor screening universal approach., Methods: A total of 242 endometrial carcinomas were screened by immunohistochemistry (IHC) and microsatellite instability (MSI) for detection of DNA mismatch repair deficiency (dMMR). MLH1 methylation was assessed to identify sporadic cases. Patients with dMMR tumors were recruited for germline variant analysis by next-generation sequencing of the MLH1, MSH2, MSH6, PMS2, and EPCAM genes., Results: Ninety-three out of 242 tumors (38.5%) were classified as dMMR based on MSI and IHC results. Of these, 54 cases were selected for germline analysis, and 37/54 (68.5%) were available for sequencing. Ten patients (10/37, 27%) harbored germline pathogenic or likely pathogenic variants, most of them in the MSH6 gene (4/10, 40%). Seven variants of uncertain significance were found. Eight novel germline variants were identified. The LS prevalence in our cohort was of at least 4.1%. LS patients presented lower mean age at cancer diagnosis compared with patients diagnosed with sporadic EC. Individuals with dMMR tumors, without germline pathogenic variants detected in LS-genes ("Lynch-like" syndrome), had an intermediate mean age at cancer diagnosis between LS and sporadic cases., Conclusion: This is the first report of the LS prevalence in EC screened by a universal approach in Brazil. Our findings contribute to a better understanding of the mutational landscape of this syndrome in Brazil, which is relevant for improved identification, genetic counseling, prevention and control of cancer in LS., Competing Interests: Declaration of competing interest The authors declared no potential conflicts of interest regarding the research, authorship, and/or publication of this article., (Copyright © 2020 Elsevier Inc. All rights reserved.)
- Published
- 2020
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