J Korean Surg Soc.  2009 Apr;76(4):236-245. 10.4174/jkss.2009.76.4.236.

Germline Genetic Alterations in Intraductal Papillary Neoplasms Associated with Extrapancreatic Tumors

• Ahn YJ
• Jang JY
• Lee SE
• Hwang DW
• Song YS
• Cho DY
• Kim SW

• KMID: 1465062
• DOI: http://doi.org/10.4174/jkss.2009.76.4.236

Abstract

PURPOSE: IPMN (Intraductal papillary mucinous neoplasm) is frequently reported in combination with a variety of extrapancreatic tumors. The IPMN in these patients might represent the phenotypes of genes associated with multiple tumor syndrome. The aim of this study was to confirm the presence of germline mutations in the p53, MLH1, MSH2, BRCA1/2, and E-cadherin genes known to be associated with gastrointestinal malignancies in hereditary tumor syndromes such as Li-Fraumeni syndrome, HNPCC, Hereditary Breast/Ovarian cancer, and Hereditary diffuse gastric cancer.
METHODS
14 patients with IPMN with extrapancreatic tumors (6 gastric cancers, 5 colorectal cancers, 1 gastric GIST, 2 hepatocellular carcinomas, 1 AoV cancer) who underwent resection were enrolled in this study. We performed PCR (Polymerase chain reaction) and direct sequencing analysis for the p53, MLH1, MSH2 and CDH-1 genes. Multiplex PCR, F-CSGE (fluorescent conformation sensitive gel electrophoresis) and direct sequencing was performed for BRCA1/2 genes.
RESULTS
We identified two novel mutations in the p53 gene (exon 1, codon 31, GTC>CTC, Glu-->Gln) and the CDH-1 gene (exon 14, codon 2218, CCC>TCC, Pro-->Ser). For BRCA1, we identified 11 identical coding SNP (exon 11, codon 3232, AAG>AGG, Glu-->Gly) among 13 patients with a high allele frequency (46.1%) compared with the 30.1% reported in Korean breast cancer patients. For BRCA2, we identified a coding SNP with an allele frequency of 2.6% (exon 11, codon 2578, AAG>AGG, Met-->Val).
CONCLUSION
Germline alterations of the p53 and E-Cadherin genes in IPMN patients with extrapancreatic cancer suggest that IPMN could be a manifestation of multiple tumor syndrome.

Keyword

IPMN; Extrapancreatic tumor; Germline mutation

MeSH Terms

Breast Neoplasms
Cadherins
Carcinoma, Hepatocellular
Clinical Coding
Codon
Colorectal Neoplasms
Gene Frequency
Genes, p53
Germ-Line Mutation
Humans
Li-Fraumeni Syndrome
Mucins
Multiplex Polymerase Chain Reaction
Phenotype
Polymerase Chain Reaction
Stomach Neoplasms
Cadherins
Codon
Mucins

Figure

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  Fig. 1 The DNA sequence of exon 1 PCR product of p53 gene of IPMN patient (M/69, moderate dysplasia) with synchronous colon cancer. Point mutation of codon 31 in exon 1.

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  Fig. 2 The DNA sequence of exon 14 PCR product of CDH-1 gene of IPMN patient (F/68, adenoma) with rectal cancer. Point mutation of codon 2218.

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