Abstract:The intestinal polyposis syndromes are characterised by multiple polyps of the large bowel, increased risk of colorectal cancer and a variety of extra-colonic manifestations. Most are caused by high-penetrance germline mutations in genes that affect signalling pathways (Wnt, BMP or mTOR) or the repair of base substitution mutations. However, there are exceptions to these rules: Lynch syndrome usually presents with few polyps; and hyperplastic (serrated) polyposis currently has no known genetic cause. Polyp mor… Show more
“…Familial EC has been linked to germline mutations in the mismatch repair genes associated with Lynch Syndrome (LS), or to germline mutations in PTEN associated with Cowden Syndrome [5, 6]. A recent study has shown that germline missense mutations of POLE and POLD1 genes lead to development of polymerase proofreading-associated polyposis, which is similar to LS with regards to tumor spectrum, including an increased risk of ECs [7].…”
BackgroundEndometrial carcinoma (EC) accounts for 5.8% of all cancers in Saudi females. Although most ECs are sporadic, 2–5% tend to be familial, being associated with Lynch syndrome and Cowden syndrome. In this study, we attempted to uncover the frequency, spectrum and phenotype of germline mutations in the proofreading domain of POLE and POLD1 genes in a large cohort of ECs from Middle Eastern region.MethodsWe performed Capture sequencing and Sanger sequencing to screen for proofreading domains of POLE and POLD1 genes in 432 EC cases, followed by evaluation of protein expression using immunohistochemistry. Variant interpretation was performed using PolyPhen-2, MutationAssessor, SIFT, CADD and Mutation Taster.ResultsIn our cohort, four mutations (0.93%) were identified in 432 EC cases, two each in POLE and POLD1 proofreading domains. Furthermore, low expression of POLE and POLD1 was noted in 41.1% (170/1414) and 59.9% (251/419) of cases, respectively. Both the cases harboring POLE mutation showed high nuclear expression of POLE protein, whereas, of the two POLD1 mutant cases, one case showed high expression and another case showed low expression of POLD1 protein.ConclusionsOur study shows that germline mutations in POLE and POLD1 proofreading region are a rare cause of EC in Middle Eastern population. However, it is still feasible to screen multiple cancer related genes in EC patients from Middle Eastern region using multigene panels including POLE and POLD1.
“…Familial EC has been linked to germline mutations in the mismatch repair genes associated with Lynch Syndrome (LS), or to germline mutations in PTEN associated with Cowden Syndrome [5, 6]. A recent study has shown that germline missense mutations of POLE and POLD1 genes lead to development of polymerase proofreading-associated polyposis, which is similar to LS with regards to tumor spectrum, including an increased risk of ECs [7].…”
BackgroundEndometrial carcinoma (EC) accounts for 5.8% of all cancers in Saudi females. Although most ECs are sporadic, 2–5% tend to be familial, being associated with Lynch syndrome and Cowden syndrome. In this study, we attempted to uncover the frequency, spectrum and phenotype of germline mutations in the proofreading domain of POLE and POLD1 genes in a large cohort of ECs from Middle Eastern region.MethodsWe performed Capture sequencing and Sanger sequencing to screen for proofreading domains of POLE and POLD1 genes in 432 EC cases, followed by evaluation of protein expression using immunohistochemistry. Variant interpretation was performed using PolyPhen-2, MutationAssessor, SIFT, CADD and Mutation Taster.ResultsIn our cohort, four mutations (0.93%) were identified in 432 EC cases, two each in POLE and POLD1 proofreading domains. Furthermore, low expression of POLE and POLD1 was noted in 41.1% (170/1414) and 59.9% (251/419) of cases, respectively. Both the cases harboring POLE mutation showed high nuclear expression of POLE protein, whereas, of the two POLD1 mutant cases, one case showed high expression and another case showed low expression of POLD1 protein.ConclusionsOur study shows that germline mutations in POLE and POLD1 proofreading region are a rare cause of EC in Middle Eastern population. However, it is still feasible to screen multiple cancer related genes in EC patients from Middle Eastern region using multigene panels including POLE and POLD1.
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