Document Type : Brief Report(s)
Authors
- Zeinab Abdollahi 1
- Mohammad Amin Tabatabaiefar 1, 2
- Mohammad Hassan Emami 3
- Mehrdad Zeinalian 1, 2, 4
1 Department of Genetics and Molecular Biology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
2 Pediatric Inherited Disease Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
3 Poursina Hakim Digestive Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
4 Iranians Cancer Control Charity Institute (MACSA), Isfahan, Iran
Abstract
Lynch syndrome (LS) predisposes individuals to early-onset colorectal and other Lynch-associated cancer. This disorder is an autosomal dominant genetic disturbance caused by germline mutations in one of the mismatch repair genes. Different clinical and molecular criteria are used to diagnose LS. Microsatellite instability testing and immunohistochemistry are two widely used methods for the molecular screening of LS-associated cancers. According to the immunohistochemistry and Microsatellite instability testing, we introduce three Persian families with Lynch-like syndrome (LLS) who met clinical Amsterdam-II criteria and their probands were mismatch repair deficient. In the case of immunohistochemistry-MLH1 absent, BRAF-V600E mutation was evaluated to rule out the sporadic colorectal cancer cases. No pathogenic germline variants were found by next generation sequencing method. Multiplex ligation-dependant probe amplification technique was done to find large in/dels within MLH1/MSH2 genes of the probands. A two-exon deletion within MLH1 gene was eventually identified in one of the patients. Finally, we have represented a molecular pipeline to diagnose LLS based on literature review and the introduced cases.
Keywords
How to cite this article:
Abdollahi Z, Tabatabaiefar MA, Emami MH, Zeinalian M. Lynch-like syndrome and its molecular approaches: a brief report and literature review. Middle East J Cancer. 2023;14(2):300-8. doi: 10. 30476/mejc.2022.92251.1650.
- Benson AB, Venook AP, Cederquist L, Chan E, Chen YJ, Cooper HS, et al. Colon Cancer, Version 1.2017, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw. 2017;15(3):370-98.
- Sehgal R, Sheahan K, O'Connell PR, Hanly AM, Martin ST, Winter DC. Lynch syndrome: an updated review. Genes (Basel). 2014;5(3):497-507. doi:10.3390/genes5030497.
- Lynch HT, Lynch JF, Attard TA. Diagnosis and management of hereditary colorectal cancer syndromes: Lynch syndrome as a model. CMAJ. 2009;181(5):273-80. doi: 10.1503/cmaj.071574.
- Lynch HT, Snyder CL, Shaw TG, Heinen CD, Hitchins MP. Milestones of Lynch syndrome: 1895-2015. Nat Rev Cancer. 2015;15(3):181-94. doi: 10.1038/nrc3878.
- Zeinalian M, Hashemzadeh-Chaleshtori M, Salehi R, Emami MH. Clinical aspects of microsatellite instability testing in colorectal cancer. Adv Biomed Res. 2018;7:28. doi: 10.4103/abr.abr_185_16.
- Shiovitz S, Copeland WK, Passarelli MN, Burnett-Hartman AN, Grady WM, Potter JD, et al. Characterisation of familial colorectal cancer type X, Lynch syndrome, and non-familial colorectal cancer. Br J Cancer. 2014;111(3):598-602. doi: 10.1038/bjc.2014.309.
- Jarvinen HJ, Renkonen-Sinisalo L, Aktan-Collan K, Peltomaki P, Aaltonen LA, Mecklin JP. Ten years after mutation testing for Lynch syndrome: cancer incidence and outcome in mutation-positive and mutationnegative family members. J Clin Oncol. 2009;27(28):4793-7. doi: 10.1200/JCO.2009.23.7784.
- Plazzer JP, Sijmons RH, Woods MO, Peltomaki P, Thompson B, Den Dunnen JT, et al. The In SiGHT database: utilizing 100 years of insights into Lynch syndrome. Fam Cancer. 2013;12(2):175-80. doi:10.1007/s10689-013-9616-0.
- Peltomaki P. Lynch syndrome genes. Fam Cancer. 2005;4(3):227-32. doi: 10.1007/s10689-004-7993-0.
- Boland CR, Koi M, Chang DK, Carethers JM. The biochemical basis of microsatellite instability and abnormal immunohistochemistry and clinical behavior in Lynch syndrome: from bench to bedside. Fam Cancer. 2008;7(1):41-52. doi: 10.1007/s10689-007-9145-9.
- Joost P, Veurink N, Holck S, Klarskov L, Bojesen A, Harbo M, et al. Heterogenous mismatch-repair status in colorectal cancer. Diagn Pathol. 2014; 26(9):126. doi: 10.1186/1746-1596-9-126.
- Lindor NM, Burgart LJ, Leontovich O, Goldberg RM, Cunningham JM, Sargent DJ, et al. Immunohistochemistry versus microsatellite instability testing in phenotyping colorectal tumors. J Clin Oncol. 2002;20(4):1043-8. doi: 10.1200/JCO.2002.20.4.1043.
- Parsons R, Li GM, Longley MJ, Fang WH, Papadopoulos N, Jen J, et al. Hypermutability and mismatch repair deficiency in RER+ tumor cells. Cell. 1993;75(6):1227-36. doi: 10.1016/0092-8674(93)90331-j.
- Umar A, Boland CR, Terdiman JP, Syngal S, de la Chapelle A, Ruschoff J, et al. Revised Bethesda Guidelines for hereditary nonpolyposis colorectal cancer (Lynch syndrome) and microsatellite instability. J Natl Cancer Inst. 2004; 96(4):261-8. doi:10.1093/jnci/djh034.
- Casey G, Lindor NM, Papadopoulos N, Thibodeau SN, Moskow J, Steelman S, et al. Conversion analysis for mutation detection in MLH1 and MSH2 in patients with colorectal cancer. JAMA. 2005;293(7):799-809. doi: 10.1001/jama.293.7.799.
- Morak M, Massdorf T, Locher M, Holinski-Feder E. Disease-causing gene-flanking genomic rearrangements in HNPCC patients. Hered Cancer Clin Pract. 2011; 9(Suppl 1):P28. doi: 10.1186/1897-4287-9-S1-P28.
- Hitchins MP. The role of epigenetics in Lynch syndrome. Fam Cancer. 2013;12(2):189-205. doi:10.1007/s10689-013-9613-3.
- Heinen CD, Rasmussen L. Determining the functional significance of mismatch repair gene missense variants using biochemical and cellular assays. Hered Cancer Clin Pract. 2012;10(1):9. doi: 10.1186/1897-4287-10-9.
- Thompson BA, Spurdle AB, Plazzer J-P, Greenblatt MS, Akagi K, Al-Mulla F, et al. Application of a five tiered scheme for standardized classification of 2,360 unique mismatch repair gene variants lodged on the InSiGHT locus-specific database. Nat Genet. 2014;46(2):107-15. doi: 10.1038/ng.2854.
- Hamilton SR. BRAF mutation and microsatellite instability status in colonic and rectal carcinoma: context really does matter. J Natl Cancer Inst. 2013;105(15):1075-7. doi: 10.1093/jnci/djt189.
- Bessa X, Balleste B, Andreu M, Castells A, Bellosillo B, Balaguer F, et al. A prospective, multicenter, population-based study of BRAF mutational analysis for Lynch syndrome screening. Clin Gastroenterol Hepatol. 2008; 6(2): 206-14. doi: 10.1016/j.cgh.2007.10.011.
- Gille JJ, Hogervorst FB, Pals G, Wijnen JT, van Schooten RJ, Dommering CJ, et al. Genomic deletions of MSH2 and MLH1 in colorectal cancer families detected by a novel mutation detection approach. Br J Cancer. 2002;87(8):892-7. doi: 10.1038/sj.bjc.6600565.
- Svrcek M, Lascols O, Cohen R, Collura A, Jonchere V, Flejou JF, et al. MSI/MMR-deficient tumor diagnosis: Which standard for screening and for diagnosis? Diagnostic modalities for the colon and other sites: Differences between tumors. Bull Cancer. 2019; 106(2): 119-28. doi: 10.1016/j.bulcan.2018.12.008.
- Pal A, Greenblatt HM, Levy Y. Prerecognition diffusion mechanism of human DNA mismatch repair proteins along DNA: Msh2-Msh3 versus Msh2-Msh6. Biochemistry. 2020; 59(51):4822-32. doi:10.1021/acs.biochem.0c00669.
- Hitchins MP, Wong JJL, Suthers G, Suter CM, Martin DIK, Hawkins NJ, et al. Inheritance of a cancer associated MLH1 germ-line epimutation. N Engl J Med. 2007; 356(7): 697-705. doi: 10.1056/NEJMoa064522.
- Morak M, Koehler U, Schackert HK, Steinke V, Royer-Pokora B, Schulmann K, et al. Biallelic MLH1 SNP cDNA expression or constitutional promoter methylation can hide genomic rearrangements causing Lynch syndrome. J Med Genet. 2011; 48(8): 513-9. doi: 10.1136/jmedgenet-2011-100050.
- Ligtenberg MJL, Kuiper RP, Chan TL, Goossens M, Hebeda KM, Voorendt M, et al. Heritable somatic methylation and inactivation of MSH2 in families with Lynch syndrome due to deletion of the 3 exons of TACSTD1. Nat Genet. 2009; 41(1): 112-7. doi:10.1038/ng.283.