title: The type of somatic mutation at APC in familial adenomatous polyposis is determined by the site of the germline mutation: a new facet to Knudson's 'two-hit' hypothesis.
abstract: APC is often cited as a prime example of a tumor suppressor gene. Truncating germline and somatic mutations (or, infrequently, allelic loss) occur in tumors in FAP (familial adenomatous polyposis). Most sporadic colorectal cancers also have two APC mutations. Clues from attenuated polyposis, missense germline variants with mild disease and the somatic mutation cluster region (codons 1,250-1,450) indicate, however, that APC mutations might not result in simple loss of protein function. We have found that FAP patients with germline APC mutations within a small region (codons 1,194-1,392 at most) mainly show allelic loss in their colorectal adenomas, in contrast to other FAP patients, whose 'second hits' tend to occur by truncating mutations in the mutation cluster region. Our results indicate that different APC mutations provide cells with different selective advantages, with mutations close to codon 1,300 providing the greatest advantage. Allelic loss is selected strongly in cells with one mutation near codon 1,300. A different germline-somatic APC mutation association exists in FAP desmoids. APC is not, therefore, a classical tumor suppressor. Our findings also indicate a new mechanism for disease severity: if a broader spectrum of mutations is selected in tumors, the somatic mutation rate is effectively higher and more tumors grow.
authors.affiliation: Molecular and Population Genetics Laboratory, Imperial Cancer Research Fund, 44, Lincoln's Inn Fields, London WC2A 3PX, UK.
authors.forename: H
authors.initials: H
authors.lastname: Lamlum
authors.forename: M
authors.initials: M
authors.lastname: Ilyas
authors.forename: A
authors.initials: A
authors.lastname: Rowan
authors.forename: S
authors.initials: S
authors.lastname: Clark
authors.forename: V
authors.initials: V
authors.lastname: Johnson
authors.forename: J
authors.initials: J
authors.lastname: Bell
authors.forename: I
authors.initials: I
authors.lastname: Frayling
authors.forename: J
authors.initials: J
authors.lastname: Efstathiou
authors.forename: K
authors.initials: K
authors.lastname: Pack
authors.forename: S
authors.initials: S
authors.lastname: Payne
authors.forename: R
authors.initials: R
authors.lastname: Roylance
authors.forename: P
authors.initials: P
authors.lastname: Gorman
authors.forename: D
authors.initials: D
authors.lastname: Sheer
authors.forename: K
authors.initials: K
authors.lastname: Neale
authors.forename: R
authors.initials: R
authors.lastname: Phillips
authors.forename: I
authors.initials: I
authors.lastname: Talbot
authors.forename: W
authors.initials: W
authors.lastname: Bodmer
authors.forename: I
authors.initials: I
authors.lastname: Tomlinson
mesh_terms: D000236:Adenoma / Q000235:genetics / Q000473:pathology; D011125:Adenomatous Polyposis Coli / Q000235:genetics* / Q000473:pathology; D000483:Alleles; D001483:Base Sequence; D003062:Codon / Q000235:genetics; D015179:Colorectal Neoplasms / Q000235:genetics* / Q000473:pathology; D004252:DNA Mutational Analysis; D005091:Exons / Q000235:genetics; D005192:Family Health; D018222:Desmoid Tumors / Q000235:genetics / Q000473:pathology; D016368:Frameshift Mutation / Q000235:genetics; D017353:Gene Deletion; D005787:Gene Frequency; D017491:Genes, APC / Q000235:genetics*; D018095:Germ-Line Mutation / Q000235:genetics*; D006801:Humans; D008957:Models, Genetic; D009154:Mutation / Q000235:genetics*
chemical_list: D003062:Codon