CDH1-related hereditary diffuse gastric cancer syndrome: clinical variations and implications for counseling.
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Publication year
2012Source
International Journal of Cancer, 131, 2, (2012), pp. 367-76ISSN
Publication type
Article / Letter to editor
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Organization
Neurology
Pathology
Human Genetics
Tumorimmunology
Medical Oncology
Journal title
International Journal of Cancer
Volume
vol. 131
Issue
iss. 2
Page start
p. 367
Page end
p. 76
Subject
NCMLS 6: Genetics and epigenetic pathways of disease ONCOL 3: Translational research; ONCOL 1: Hereditary cancer and cancer-related syndromes; ONCOL 1: Hereditary cancer and cancer-related syndromes NCMLS 6: Genetics and epigenetic pathways of disease; ONCOL 3: Translational research; ONCOL 3: Translational research NCMLS 3: Tissue engineering and pathologyAbstract
CDH1 mutation carriers have a strongly increased risk of developing gastric cancer (GC) and lobular breast cancer (LBC). Clinical data of GC cases and surgical and histological data of prophylactic gastrectomies and mastectomies of all 10 Dutch CDH1 mutation families were collected. In vitro functional assays were performed to analyze the nature of the newly found missense mutation c.1748T>G (p.Leu583Arg). Ten different CDH1 mutations were found. Functional assays gave strong arguments for the pathogenic nature of the p.Leu583Arg mutation. The pedigrees comprised 36 GC cases (mean age 40 years, range 20-72 years) and one LBC case. Twenty-nine/37 carriers alive, aged 18-61 years, underwent prophylactic gastrectomy. Invasive GC-foci and premalignant abnormalities were detected in 2 and 25 patients, respectively. In four patients GC/signetring cell (SRC) foci were diagnosed at preoperative gastroscopy. Long-standing presence of SRCs without progression to invasive carcinoma was shown in two others. Multifocal LBC/LCIS was found in the two prophylactic mastectomy specimens. Clefts of lip and/or palate (CL/P) were reported in seven individuals from three families. The age at onset and aggressiveness of GC is highly variable, which has to be included in counseling on planning prophylactic gastrectomies. The incidence of LBC is expected to increase and prophylactic mastectomy needs to be considered. The relationship between CL/P and CDH1 needs further study to inform future parents from hereditary diffuse gastric cancer (HDGC) families adequately.
This item appears in the following Collection(s)
- Academic publications [238441]
- Electronic publications [122508]
- Faculty of Medical Sciences [90373]
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