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National Cancer Institute®
Ultima Vez Modificado: 1 de mayo del 2002
UI - 11916155
AU - van Stolk RU
TI - Familial and inherited colorectal cancer: endoscopic screening and surveillance.
SO - Gastrointest Endosc Clin N Am 2002 Jan;12(1):111-33
AD - Department of Medicine, Northwestern University School of Medicine, Chicago, Illinois, USA.
Familial risk of colorectal cancer is very common. The high-risk inherited syndromes are well described and much is known about the genetics and the effectiveness of registration, endoscopic surveillance, and appropriate intervention in these patients. The inherited syndromes, however, are extremely rare. There is a large group of patients in our population who can benefit from risk stratification based on the number of their relatives with colon cancer or adenomas and the age at which those relatives developed neoplasm. The GI endoscopist has a vital role in recommending and providing colonoscopic screening for this large group of patients.
UI - 11960572
AU - Wu G; Wu W; Hegde M; Fawkner M; Chong B; Love D; Su LK; Lynch P; Snow K;
TI - Richards CS Detection of sequence variations in the adenomatous polyposis coli (APC) gene using denaturing high-performance liquid chromatography.
SO - Genet Test 2001 Winter;5(4):281-90
AD - The Diagnostic Sequencing Laboratory, Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX 77030, USA.
We have evaluated the usefulness of denaturing high performance liquid chromatography (dHPLC) for scanning the adenomatous polyposis coli (APC) gene for point mutations, small deletions, and insertions. Our assay consists of 28 sets of primers to amplify the 15 exons of the APC gene. All PCR reactions were amplified simultaneously using the same reaction conditions in a 96-well format and then analyzed by dHPLC, using empirically determined optimum temperatures for partial fragment denaturation. Previously studied DNA specimens from 47 familial adenomatous polyposis (FAP) patients were analyzed by dHPLC and all mutations were correctly identified and confirmed by sequence analysis. This approach identified a single-base substitution in exon 6 and a 2-bp insertion in exon 15 that initially had not been detected by single-strand conformational polymorphism (SSCP) analysis. A novel mutation in exon 15 of the APC gene, 2065delG (codon 689) that had previously been undetected by the protein truncation test (PTT) was also identified by dHPLC. We present our validation studies of dHPLC technology for APC gene analysis in terms of sensitivity and specificity and compare it to current standard scanning technologies including PTT, SSCP, and conformational sensitive gel electrophoresis (CSGE).
UI - 11977532
AU - Katai M; Sakurai A; Fukushima Y
TI - [Genetic testing and counseling for familial tumor syndromes]
SO - Gan To Kagaku Ryoho 2002 Apr;29(4):502-7
AD - Division of Molecular and Clinical Genetics, Shinshu University Hospital.
Recent developments in molecular biology have increased our understanding of the genetics of familial tumor syndromes. Isolation of the responsible genes has made it possible to identify gene carriers before they manifest clinical symptoms, which enables early detection of disease and at times prophylactic surgery. Indications for genetic testing of susceptible family members, however, should be carefully considered. Genetic counseling must be provided to clients before genetic tests. Patients should be provided with the latest knowledge on the disease and appropriately informed of the benefits and possible problems associated with genetic test, as such information is essential for clients to decide whether they will undergo such tests. Genetic medicine is not sufficiently available at present in Japan. Establishment of genetic services that deal with genetic counseling, family support and ethical, social and legal issues is strongly desired.
UI - 11977536
AU - Gondo N; Nakagawa K; Yanagi H; Yamamura T
TI - [Familial adenomatous polyposis (FAP)--diagnosis and management]
SO - Gan To Kagaku Ryoho 2002 Apr;29(4):532-8
AD - Second Department of Surgery, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan.
Familial adenomatous polyposis (FAP) is characterized by more than hundreds of colorectal adenomas, colorectal cancer in early adult life, extracolonic features and genetic inheritance. Not only surgical management of FAP (IAA, IACA and IRA) but also methodology of APC gene test is almost established. Surveillance program and management of extracolonic manifestation is going to contribute to patient's prognosis. And now in Japan, two clinical intervention and chemoprevention trial studies of FAP are going on. As these reasons, FAP is most comprehensive model for understanding status quo and future problem of familial cancer syndromes. However, there are many counseling issues of FAP family members, choice of opportunity and method for diagnosis, surveillance, chemoprevention, surgery and to inform family member about hereditary risk. So, Cancer Genetic Counseling for FAP family members must be provided for their lifetime long.
UI - 11950865
AU - Albuquerque C; Cravo M; Cruz C; Lage P; Chaves P; Fidalgo P; Suspiro A;
TI - Nobre Leitao C Genetic characterisation of patients with multiple colonic polyps.
SO - J Med Genet 2002 Apr;39(4):297-302
UI - 11987443
AU - Chikhaoui Y; Gelinas H; Joseph L; Lance JM
TI - Cost-minimization analysis of genetic testing versus clinical screening of at-risk relatives for familial adenomatous polyposis.
SO - Int J Technol Assess Health Care 2002 Winter;18(1):67-80
AD - Quebec Agency for Health Services and Technology Assessment.
OBJECTIVE: Familial adenomatous polyposis (FAP) is a well-known hereditary colorectal cancer-predisposing syndrome. Genetic testing for colorectal cancer risk is now part of standard medical practice, but very little is known about the economic impact of this technology. The aim of this study was to assess, from a healthcare system perspective, the direct costs of two strategies for screening at-risk relatives of FAP patients: clinical screening versus genetic testing for FAP. METHODS: A systematic review of the literature was carried out. Additional information was gathered from experts in research and clinical laboratories and in hospital departments. A decision tree was constructed to compare per-person and per-family costs of the two strategies for screening at-risk relatives of FAP patients. Sensitivity analysis was performed to assess the stability of the model across the full range of plausible values for all key parameters. RESULTS: According to the decision analysis, with FAP screening starting at puberty, the average screening costs are $3,181 and $2,259 (Canadian dollars), respectively, for the clinical screening and the genetic testing strategies. Genetic screening is cost saving up to a first screening age of 36. Sensitivity analysis shows that the results of the baseline analysis hold across a variety of assumptions concerning the parameter values. CONCLUSIONS: The genetic testing strategy is cost saving relative to the clinical screening alternative. Apart from its lower costs, it is associated with many other benefits. Accordingly, under predefined conditions, predictive genetic testing seems to be the optimal screening strategy for FAP.
UI - 11920286
AU - Howe JR; Shellnut J; Wagner B; Ringold JC; Sayed MG; Ahmed AF; Lynch PM;
TI - Amos CI; Sistonen P; Aaltonen LA Common deletion of SMAD4 in juvenile polyposis is a mutational hotspot.
SO - Am J Hum Genet 2002 May;70(5):1357-62
AD - Department of Surgery, University of Iowa College of Medicine, Iowa City, IA 52242-1086, USA. firstname.lastname@example.org
Juvenile polyposis (JP) is an autosomal dominant syndrome in which affected patients develop upper- and/or lower-gastrointestinal (GI) polyps. A subset of families with JP have germline mutations in the SMAD4 (MADH4) gene and are at increased risk of GI cancers. To date, six families with JP have been described as having the same SMAD4 deletion (1244-1247delAGAC). The objective of the present study is to determine whether this deletion is a common ancestral mutation or a mutational hotspot. DNA from members of four families with JP, from Iowa, Mississippi, Texas, and Finland, that had this 4-bp deletion was used to genotype 15 simple tandem repeat polymorphism (STRP) markers flanking the SMAD4 gene, including 2 new STRPs within 6.3 and 70.9 kb of the deletion. Haplotypes cosegregating with JP in each family were constructed, and the distances of the closest markers were determined from the draft sequence of the human genome. No common haplotype was observed in these four families with JP. A 14-bp region containing the deletion had four direct repeats and one inverted repeat. Because no common ancestor was suggested by haplotype analysis and the sequence flanking the deletion contains repeats frequently associated with microdeletions, this common SMAD4 deletion in JP most likely represents a mutational hotspot.
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