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Combined use of molecular and biomarkers for presymptomatic carrier risk assessment in familial adenomatous polyposis: Implications for screening guidelines

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Diseases of the Colon & Rectum

Abstract

Predictive carrier testing for the inherited disorder of familial adenomatous polyposis (FAP) can be conducted using DNA markers linked to the FAP locus. The presence of characteristic hypertrophic retinal lesions has been advocated as useful biomarkers for FAP. We have compared molecular linkage and retinal screening techniques by evaluating the presymptomatic carrier risk of 40 at-risk individuals from 15 FAP families. Linkage analysis was informative in all and retinal lesion analysis in 25 cases. For informative at-risk population, predictive diagnosis by both techniques was completely concordant and identified 15 members at “high” and 10 at “low” risk of inheriting FAP. Because of the unique advantages offered by each technique, a strategy integrating both techniques will increase the number of FAP families that can be screened presymptomatically. Identification of individuals at high risk of polyposis will improve their clinical surveillance and further reduce the incidence of colorectal cancer in FAP families.

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References

  1. Bussey HJ. Familial polyposis coli. Family studies, histopathology, differential diagnosis, and results of treatment. Baltimore: Johns Hopkins University Press, 1975.

    Google Scholar 

  2. Gardner EJ, Richards RC. Multiple cutaneous and subcutaneous lesions occurring simultaneously with hereditary polyposis and osteomatosis. Am J Human Genet 1953;5:139–47.

    CAS  Google Scholar 

  3. Traboulsi EI, Krush AJ, Gardner EJ,et al. Prevalence and importance of pigmented ocular fundus lesions in Gardner's syndrome. N Engl J Med 1987;316:661–7.

    Article  PubMed  CAS  Google Scholar 

  4. Blair NP, Trempe CL. Hypertrophy of the retinal pigment epithelium associated with Gardner's syndrome. Am J Ophthalmol 1980;90:661–7.

    PubMed  CAS  Google Scholar 

  5. Leppard BJ, Bussey HJ. Epidermoid cysts, polyposis coli and Gardner's syndrome. Br J Surg 1975;62:387–93.

    PubMed  CAS  Google Scholar 

  6. Sondergaard JO, Bulow S, Jarvinen H, Wolf J, Witt IN, Tetens G. Dental anomalies in familial polyposis coli. Acta Odontol Scand 1987;45:61–3.

    PubMed  CAS  Google Scholar 

  7. Iida M, Yao T, Watanabe H, Itoh H, Iwashita A. Fundic gland polyposis in patients without familial adenomatosis coli: its incidence and clinical features. Gastroenterology 1984;86:1437–42.

    PubMed  CAS  Google Scholar 

  8. Jones IT, Fazio VW, Weakly FL, Jagelman DG, Lavery IC, McGannon E. Desmoid tumors in familial polyposis coli. Ann Surg 1986;204:94–7.

    PubMed  CAS  Google Scholar 

  9. Romania A, Zakov N, McGannon BS, Schroeder T, Heyen F, Jagelman DG. Congenital hypertrophy of the retinal pigment epithelium in familial adenomatous polyposis. Ophthalmology 1989;96:879–84.

    PubMed  CAS  Google Scholar 

  10. Bodmer WF, Bailey CJ, Bodmer J,et al. Localization of the gene for familial polyposis coli on chromosome 5. Nature 1987;328:614–6.

    Article  PubMed  CAS  Google Scholar 

  11. Leppert M, Dobbs M, Scambler P,et al. The gene for familial adenomatous polyposis maps to the long arm of chromosome 5. Science 1987;238:1411–3.

    PubMed  CAS  Google Scholar 

  12. Nakamura Y, Lathrop M, Leppert M,et al. Localization of the genetic defect in familial adenomatous polyposis within a small region of chromosome 5. Am J Hum Genet 1988;43:638–44.

    PubMed  CAS  Google Scholar 

  13. Tops CM, Wijnen JT, Griffioen G,et al. Presymptomatic diagnosis of familial adenomatous polyposis by bridging DNA markers. Lancer 1989;2:1361–3.

    Article  CAS  Google Scholar 

  14. Dunlop MG, Wyllie AH, Nakamura Y,et al. Genetic linkage map of six polymorphic DNA markers around the gene for familial adenomatous polyposis on chromosome 5. Am J Hum Genet 1990;47:982–7.

    PubMed  CAS  Google Scholar 

  15. Groden J, Thilveris A, Samowitz W,et al. Identification and characterization of the familial adenomatous polyposis coli gene. Cell 1991;66:589–600.

    Article  PubMed  CAS  Google Scholar 

  16. Kinzler KW, Nilbert MC, Su LK,et al. Identification of FAP locus genes from chromosome 5q21. Science 1991;253:661–5.

    PubMed  CAS  Google Scholar 

  17. Joslyn G, Carlson M, Thilveris A,et al. Identification of deletion mutations and three new genes at the familial polyposis locus. Cell 1991;66:601–13.

    Article  PubMed  CAS  Google Scholar 

  18. Nishisho I, Nakamura Y, Miyoshi Y,et al. Mutations of chromosomes 5q21 genes in FAP and colorectal cancer patients. Science 1991;253:665–9.

    PubMed  CAS  Google Scholar 

  19. Miyoshi Y, Ando H, Nagase H,et al. Germ-line mutations of the APC gene in 53 familial adenomatous polyposis patients. Proc Natl Acad Sci USA 1992;89:4452–6.

    PubMed  CAS  Google Scholar 

  20. Dunlop MG, Wyllie AH, Steel CM, Piris J, Evans HJ. Linked DNA markers for presymptomatic diagnosis of familial adenomatous polyposis. Lancet 1991;337:313–6.

    Article  PubMed  CAS  Google Scholar 

  21. Burn J, Chapman P, Delhanty J,et al. The UK northern region genetic register for familial adenomatous polyposis coli: use of age of onset congenital hypertrophy of the retinal pigment epithelium, and DNA markers in risk calculations. J Med Genet 1991;28:289–96.

    PubMed  CAS  Google Scholar 

  22. Koorey DJ, McCaughan GW, Trent RJ, Gallagher ND. Risk estimation in familial adenomatous polyposis using DNA probes linked to the familial adenomatous polyposis gene. Gut 1992;33:530–4.

    PubMed  CAS  Google Scholar 

  23. MacDonald F, Morton DG, Rindl PM,et al. Predictive diagnosis of familial adenomatous polyposis with linked DNA markers: a population based study. BMJ 1992;304:869–72.

    Article  PubMed  CAS  Google Scholar 

  24. Houlston R, Slack J, Murday V. Risk estimates for screening adenomatous polyposis coli. Lancet 1990;335:484.

    Article  PubMed  CAS  Google Scholar 

  25. Heyen F, Jagelman DG, Romania A,et al. Predictive value of congenital hypertrophy of the retinal pigment epithelium as a clinical marker of familial adenomatous polyposis. Dis Colon Rectum 1990;33:52–5.

    PubMed  Google Scholar 

  26. Giardello FM, Offerhaus GJ, Traboulsi EI,et al. Value of combined phenotypic markers in identifying inheritance of familial adenomatous polyposis. Gut 1991;32:1170–4.

    PubMed  Google Scholar 

  27. Ott J. Analysis of human genetic linkage. Baltimore: Johns Hopkins University Press, 1985.

    Google Scholar 

  28. Sambrook J, Fritsch EF, Maniatis T. Molecular cloning: a laboratory manual. 2nd ed. Cold Spring: Harbor Laboratory Press, 1989.

    Google Scholar 

  29. Breukel C, Tops C, Ras E, Meera Khan P. Msp1 RFLP at the D5S122 locus tightly linked to APC. Nucleic Acids Res 1991;19:685.

    PubMed  CAS  Google Scholar 

  30. Spirio L, Joslyn G, Nelson L, Leppert M, White R. A CA repeat 30–70 KB downstream from the adenomatous polyposis coli (APC) gene. Nucleic Acids Res 1991;19:6348.

    PubMed  CAS  Google Scholar 

  31. Winjen J, Tops C, Breukel C,et al. CA repeat polymorphism from YAC JW25 at the D5S318 locus, distal to adenomatous polyposis coli (APC). Nucleic Acids Res 1991;19:6965.

    Google Scholar 

  32. Feinberg A, Vogelstein B. A technique for radiolabeling DNA restriction endonuclease fragments to high specific activity. Anal Biochem 1984;137:266–7.

    Article  PubMed  CAS  Google Scholar 

  33. Berk T, Cohen Z, McLeod RS, Parker JA. Congenital hypertrophy of the retinal pigment epithelium as a marker for familial adenomatous polyposis. Dis Colon Rectum 1988;31:253–7.

    PubMed  CAS  Google Scholar 

  34. Caspari R, Friedl W, Propping P. Misleading phenotype in kindred with familial adenomatous polyposis. Lancet 1992;339:1064.

    Article  PubMed  CAS  Google Scholar 

  35. Morton DG, MacDonald F, Cachon-Gonzales MB,et al. The use of DNA from paraffin wax preserved tissue for predictive diagnosis in familial adenomatous polyposis. J Med Genet 1992;29:571–3.

    Article  PubMed  CAS  Google Scholar 

  36. Peterson GM, Slack J, Nakamura Y. Screening guidelines and premorbid diagnosis of familial adenomatous polyposis using linkage. Gastroenterology 1991;100:1658–64.

    PubMed  Google Scholar 

  37. Neale K, Ritchie S, Thompson JP. Screening of offspring of patients with familial adenomatous polyposis: the St. Mark's Hospital polyposis register experience. In: Herrera L, ed. Familial adenomatous polyps. New York: A. R. Liss, 1990:61–6.

    Google Scholar 

  38. Bussey HJ, Veale AM, Morson BC. Genetics of gastrointestinal polyposis. Gastroenterology 1978;74:1325–30.

    PubMed  CAS  Google Scholar 

  39. Murday V, Slack J. Inherited disorders associated with colorectal cancer. Cancer Surv 1989;8:139–57.

    PubMed  CAS  Google Scholar 

  40. Utsunomiya J. Pathology, genetics, and management of hereditary gastrointestinal polyposes. In: Lynch HT, Hirayama T, eds. Genetic epidemiology of cancer. Boca Raton: CRC Press, 1989:219–49.

    Google Scholar 

  41. Leppert M, Burt R, Hughes JP,et al. Genetic analysis of an inherited predisposition to colon cancer in a family with a variable number of adenomatous polyps. N Engl J Med 1990;322:904–8.

    Article  PubMed  CAS  Google Scholar 

  42. Spirio L, Otternd B, Stauffer D,et al. Linkage of a variant or attenuated form of adenomatous polyposis coli to the adenomatous polyposis coli (APC) locus. Am J Hum Genet 192;51:92–100.

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Read at the meeting of the meeting of The American Society of Colon and Rectal Surgeons, San Francisco, California, June 12 to 17, 1992.

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Bapat, B.V., Parker, J.A., Berk, T. et al. Combined use of molecular and biomarkers for presymptomatic carrier risk assessment in familial adenomatous polyposis: Implications for screening guidelines. Dis Colon Rectum 37, 165–171 (1994). https://doi.org/10.1007/BF02047541

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