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Increased risk for colorectal adenomas and cancer in mono-allelic MUTYH mutation carriers: results from a cohort of North-African Jews

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Abstract

Bi-allelic MUTYH gene mutations are associated with a clinical phenotype of multiple colorectal adenomas and an increased risk for colorectal cancer (CRC). It is unclear whether mono-allelic MUTYH gene carriers (heterozygotes) are also at increased risk for even few adenomas or cancer. In order to clarify an association between MUTYH heterozygotes and adenomas, we evaluated the frequency and types of MUTYH mutations and variants in 72 North-African Jews having few (≥3) colorectal adenomas with or without early onset (<50 years) CRC compared to 29 healthy controls. Germ-line DNA was analyzed for a panel of 6 MUTYH mutations and variants, and Sanger sequencing of the entire MUTYH gene was performed for mono-allelic MUTYH mutation carriers. APC gene mutations and Lynch syndrome were excluded in the relevant cases according to accepted clinical criteria. Twenty-two of the 72 adenoma subjects (30.5 %) had MUTYH mutations or variants. Nine were homozygotes or compound heterozygotes: all had >10 adenomas and one had CRC. Thirteen others were mono-allelic carriers (heterozygotes) of a single MUTYH mutation: six had more than ten adenomas and seven had less than ten adenomas; of these 13 mono-allelic carriers, six had a neoplasm: three CRCs and three extra-intestinal tumors. Eleven of the thirteen mono-allelic carriers with adenomas had a family history of cancer in first or second degree relatives. A multivariable model showed positive correlation between G396D, Y179C and 1186 ins GG mutations and number of adenomas (OR 8.6, 10.2 and 14.4, respectively). The Q324H variant was negatively associated with the number of adenomatous polyps (OR −5.23). In conclusion, MUTYH mutations are prevalent among Jews of North-African origin with colorectal adenomas with or without early onset CRC. Mono-allelic MUTYH carriers with a family history of cancer had a clinical phenotype that varied from having only few adenomas to multiple (>10) adenomas. These findings support MUTYH testing in patients with even few adenomas and suggest the consideration of increased surveillance in mono-allelic carriers with a family history of cancer.

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Abbreviations

AFAP:

Attenuated familial adenomatous polyposis

CRC:

Colorectal cancer

FAP:

Familial adenomatous polyposis

MAP:

MUTYH-associated polyposis

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Acknowledgments

We would like to express our sincere appreciation to the late Professor Paul Rozen. This study could not have been performed without his assistance and his profound intellectual contribution. Our thanks to the patients, department doctors and nurses for their cooperation, and especially to Serena Rosner, Sara Pel, Ziona Samuel and Sally Zimmerman for their assistance. This work was supported by the Sestopali Fund for Gastrointestinal Cancer Prevention and Katzman Family Foundation at Tel-Aviv University.

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Authors and Affiliations

  1. Departmant of Gastroenterology, Tel-Aviv Sourasky Medical Center, 6 Weizmann St., 64239, Tel Aviv, Israel

    Guy Rosner, Yael Etzion Daniel, Hana Strul, Naomi Fliss-Isakov, Meirav Ben-Yehoiada, Erwin Santo, Zamir Halpern & Revital Kariv

  2. Human Molecular Genetics and Pharmacogenetics, Migal - Galilee Bio-Technology Center, Kiryat-Shmona, Israel

    Dani Bercovich

  3. Tel-Hai Academic College, Kiryat-Shmona, Israel

    Dani Bercovich

  4. Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel

    Guy Rosner, Hana Strul, Naomi Fliss-Isakov, Erwin Santo, Zamir Halpern & Revital Kariv

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  1. Guy Rosner
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  2. Dani Bercovich
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Correspondence to Guy Rosner.

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Rosner, G., Bercovich, D., Daniel, Y.E. et al. Increased risk for colorectal adenomas and cancer in mono-allelic MUTYH mutation carriers: results from a cohort of North-African Jews. Familial Cancer 14, 427–436 (2015). https://doi.org/10.1007/s10689-015-9799-7

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  • DOI: https://doi.org/10.1007/s10689-015-9799-7

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