Population-based risk estimates of Wilms tumor in sporadic aniridia. A comprehensive mutation screening procedure of PAX6 identifies 80% of mutations in aniridia.
Aniridia is a severe eye disease characterized by iris hypoplasia; both sporadic cases and familial cases with an autosomal dominant inheritance exist. Mutations in the PAX6 gene have been shown to be the genetic cause of the disease. Some of the sporadic cases are caused by large chromosomal deletions, some of which also include the Wilms tumor gene (WAGR syndrome), resulting in an increased risk of developing Wilms tumor. Based on the unique registration of both cancer and aniridia cases in Denmark, we have made the most accurate risk estimate to date for Wilms tumor in sporadic aniridia. We have found that patients with sporadic aniridia have a relative risk of 67 (confidence interval: 8.1-241) of developing Wilms tumor. Among patients investigated for mutations, Wilms tumor developed in only two patients out of 5 with the Wilms tumor gene (WT1) deleted. None of the patients with smaller chromosomal deletions or intragenic mutations were found to develop Wilms tumor. Our observations suggest a smaller risk for Wilms tumor than previous estimates, and that tumor development requires deletion of WT1. We report a strategy for the mutational analysis of aniridia cases resulting in the detection of mutations in 68% of sporadic cases and 89% of familial cases. We also report four novel mutations in PAX6, and furthermore, we have discovered a new alternatively spliced form of PAX6.
Grønskov
K
K
Department of Medical Genetics, The John F. Kennedy Institute, Gl. Landevej 7, DK2600 Glostrup, Denmark. kag@kennedy.dk
Olsen
J H
JH
Sand
A
A
Pedersen
W
W
Carlsen
N
N
Bak Jylling
A M
AM
Lyngbye
T
T
Brøndum-Nielsen
K
K
Rosenberg
T
T
D017398:Alternative Splicing; D000595:Amino Acid Sequence; D015783:Aniridia / Q000150:complications / Q000453:epidemiology* / Q000235:genetics*; D001483:Base Sequence; D017931:DNA Primers / Q000235:genetics; D003718:Denmark / Q000453:epidemiology; D005136:Eye Proteins; D005260:Female; D017353:Gene Deletion; D016162:Genes, Wilms Tumor; D005828:Genetics, Population; D018398:Homeodomain Proteins / Q000235:genetics*; D006801:Humans; D007680:Kidney Neoplasms / Q000150:complications / Q000453:epidemiology* / Q000235:genetics*; D008297:Male; D008969:Molecular Sequence Data; D009154:Mutation; D000071841:PAX6 Transcription Factor; D051761:Paired Box Transcription Factors; D012097:Repressor Proteins; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012307:Risk Factors; D017386:Sequence Homology, Amino Acid; D009396:Wilms Tumor / Q000150:complications / Q000453:epidemiology* / Q000235:genetics*
D017931:DNA Primers; D005136:Eye Proteins; D018398:Homeodomain Proteins; D000071841:PAX6 Transcription Factor; C000605730:PAX6 protein, human; D051761:Paired Box Transcription Factors; D012097:Repressor Proteins