title: Effectiveness of the CRCAPRO program in identifying patients suspected for HNPCC.
abstract: Subjects affected by hereditary non-polyposis colorectal cancer exhibit a high susceptibility to colon and extracolonic tumours, due to MMR gene defects. Revised Bethesda criteria are used to select patients as candidates for genetic tests. Recently, the CRCAPRO model has been developed, based on family history of colorectal and endometrial cancers. Our study aims to evaluate the reliability of CRCAPRO in identifying mutation carriers. We used the CRCAPRO program to evaluate carrier probability risk in 99 patients fulfilling Amsterdam or Bethesda guidelines. MLH1 and MSH2 were studied by direct sequencing in all the 99 patients, and the study of microsatellite instability and of MMR proteins expression was performed. Nine MLH1 and nine MSH2 germline mutations were identified. Five out of the nine patients with MLH1 mutation showed a CRCAPRO risk evaluation of less than 20%. The same happened for four out of nine patients with MSH2 mutation. Of the 17 patients with an estimated risk of more than 80%, only four harboured a mutation, all in the MSH2 gene. The highest risk calculated by the CRCAPRO system in the nine carriers of a MLH1 mutation has been 31.7%. In our experience, the CRCAPRO program sensitivity and specificity appears to be low but needs to be further evaluated in larger samples.
authors.affiliation: Centro Regionale di Genetica Oncologica, Oncologia Medica, Università Politecnica delle Marche, Ancona, Italy. f.bianchi@univpm.it
authors.forename: F
authors.initials: F
authors.lastname: Bianchi
authors.forename: E
authors.initials: E
authors.lastname: Galizia
authors.forename: R
authors.initials: R
authors.lastname: Bracci
authors.forename: L
authors.initials: L
authors.lastname: Belvederesi
authors.forename: R
authors.initials: R
authors.lastname: Catalani
authors.forename: C
authors.initials: C
authors.lastname: Loretelli
authors.forename: G
authors.initials: G
authors.lastname: Giorgetti
authors.forename: C
authors.initials: C
authors.lastname: Ferretti
authors.forename: I
authors.initials: I
authors.lastname: Bearzi
authors.forename: E
authors.initials: E
authors.lastname: Porfiri
authors.forename: R
authors.initials: R
authors.lastname: Cellerino
mesh_terms: D048868:Adaptor Proteins, Signal Transducing; D000328:Adult; D000368:Aged; D002352:Carrier Proteins / Q000235:genetics / Q000378:metabolism; D003123:Colorectal Neoplasms, Hereditary Nonpolyposis / Q000175:diagnosis / Q000235:genetics* / Q000378:metabolism; D053843:DNA Mismatch Repair; D004252:DNA Mutational Analysis; D003936:Diagnosis, Computer-Assisted; D005260:Female; D005820:Genetic Testing / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D053842:Microsatellite Instability; D008875:Middle Aged; D000070957:MutL Protein Homolog 1; D051718:MutS Homolog 2 Protein / Q000235:genetics / Q000378:metabolism; D009687:Nuclear Proteins / Q000235:genetics / Q000378:metabolism; D012984:Software
chemical_list: D048868:Adaptor Proteins, Signal Transducing; D002352:Carrier Proteins; C501486:MLH1 protein, human; D009687:Nuclear Proteins; C497172:MSH2 protein, human; D000070957:MutL Protein Homolog 1; D051718:MutS Homolog 2 Protein