Review Article

Novel Implications in Molecular Diagnosis of Lynch Syndrome

Table 1

Hereditary colon cancer syndromes: clinical and genetic features. (AD, autosomal dominant; AR, autosomal recessive).

Disease
(OMIM)
GeneIncidenceInheritanceMutation identified (%)PenetranceClinical features

Hereditary nonpolyposis colorectal cancer (HNPCC) (114500)MLH1, MSH2, MSH6, PMS2, MLH3, EPCAM1 in 400ADPoint mutation, large rearrangements (60–80%)90%Proximal CRC, endometrial carcinoma, ovarian tumors, small bowel carcinoma, urinary tract carcinoma

Classical familial adenomatous polyposis (FAP)(175100)APC1 in 8000ADPoint mutation, large rearrangements (80–90%)<100%100 to >500 adenomatous polyps of large bowel, duodenum, stomach

Attenuated FAP (AFAP) (175100)APC<1 in 8000ADPoint mutation, large rearrangements (20–30%)<100%10 to 100 adenomatous polyps of large bowel, duodenum, stomach

MUTYH-associated polyposis (MAP) (608456)MUTYH<1 in 10000ARPoint mutation, large rearrangements (15–20%)<100%20 to 100 adenomatous polyps of large bowel, duodenum, stomach

Muir Torre syndrome (HNPCC) (158320)MLH1, MSH2<1 in 400ADPoint mutation, large rearrangements (60–80%)90%CRC, endometrial carcinoma multiple sebaceous adenomas, epithelioma, keratoacanthoma

Turcot syndrome (HNPCC) (276300)APC, PMS2, MLH1<1 in 400ADPoint mutation, large rearrangements (60–80%)90%CRC, glioblastoma, cerebellar medulloblastoma

Peutz-Jeghers syndrome (PJS) (175200)STK11 (LKB1)1 in 200000ADPoint mutation, large rearrangements (90%)95–100%<20 juvenile polyps (PJ) of large bowel, duodenum, stomach, mucocutaneous/perioral hyperpigmentation, ovarian tumors, breast cancer

Juvenile polyposis syndrome (JPS) (174900)SMAD4, BMPR1A1 in 100000ADPoint mutation, large rearrangements (60%)90–100%5 to 100 JP of large bowel, duodenum, stomach, gastric cancer

Cowden syndrome (CS) (158350)PTEN1 in 200000ADPoint mutation, large rearrangements (80%)90–95%Multiple JP/lipomas of large bowel, duodenum, stomach, mucocutaneous tumors, breast cancer, endometrial carcinoma, thyroid cancer

Bannayan-Ruvalcaba-Riley syndrome (BRRS) (153480)PTEN1 in 200000ADPoint mutation, large rearrangements (60%)90–95%Multiple JP/lipomas of large bowel, duodenum, stomach, microcephaly, developmental delay, hemangiomatosis