title: Somatic BRAF-V600E mutations in familial colorectal cancer.
abstract: The BRAF gene is mutated in 4% to 12% of unselected colorectal cancers, particularly those with high microsatellite instability and in premalignant lesions, such as serrated adenomas and hyperplastic polyps. However, it has been shown that activating BRAF mutations are almost never found in tumors from hereditary nonpolyposis colorectal cancer patients. To evaluate the role of oncogenic BRAF mutations in non-hereditary nonpolyposis colorectal cancer/non-familial adenomatous polyposis familial colorectal cancer, we did a mutation screening of the most common BRAF mutation, the V600E mutation, in 194 colorectal tumors from patients with a positive family history of the disease. The BRAF-V600E mutation was identified in 100% (8 of 8) of microsatellite-unstable tumors and in 9.7% (18 of 186) of microsatellite-stable tumors. Interestingly, families with extracolonic tumors showed a much higher mutation frequency (17.5%) compared with families with colonic cancer only (3.5%; P = 0.009). In addition, we studied colonoscopic results from 448 family members who had been under colonoscopic surveillance for several years. Subjects from families where the V600E mutation was identified had less adenomas compared with those from families where no BRAF mutation had been found (odds ratio, 8.5; 95% confidence interval, 1.1-64.6). These findings indicate that adenomas might be less important in the cancer development in the group of families with BRAF-V600E mutations and indirectly support a previous hypothesis that tumors might develop through the hyperplastic polyp-serrated adenoma pathway. In conclusion, our results suggest that BRAF-V600E mutations are mainly involved in colorectal cancer families characterized by an increased risk of other common malignancies.
authors.affiliation: Department of Molecular Medicine and Surgery, Karolinska Hospital, S-17176 Stockholm, Sweden.
authors.forename: Jana
authors.initials: J
authors.lastname: Vandrovcova
authors.forename: Kristina
authors.initials: K
authors.lastname: Lagerstedt-Robinsson
authors.forename: Lars
authors.initials: L
authors.lastname: Påhlman
authors.forename: Annika
authors.initials: A
authors.lastname: Lindblom
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000150:complications / Q000235:genetics*; D004252:DNA Mutational Analysis; D005192:Family Health; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D008297:Male; D053842:Microsatellite Instability; D018895:Microsatellite Repeats; D008875:Middle Aged; D009154:Mutation; D048493:Proto-Oncogene Proteins B-raf / Q000235:genetics*; D012306:Risk
chemical_list: C482119:BRAF protein, human; D048493:Proto-Oncogene Proteins B-raf