Journal List > J Korean Surg Soc > v.76(4) > 1010946

Ahn, Jang, Lee, Hwang, Song, Cho, and Kim: Germline Genetic Alterations in Intraductal Papillary Neoplasms Associated with Extrapancreatic Tumors

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.

Figures and Tables

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.
jkss-76-236-g001
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.
jkss-76-236-g002
Table 1
Reported cases of extrapancreatic tumor associated with IPMN
jkss-76-236-i001
Table 2
Hereditary tumor gene and its associated gastrointestinal cancer
jkss-76-236-i002

*HNPCC = hereditary non-polyposis colon cancer.

Table 3
Clinicopathologic characteristics of the patients
jkss-76-236-i003
Table 4
Sequence alterations detected in this study
jkss-76-236-i004

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