title: Evaluation of Lynch syndrome modifier genes in 748 MMR mutation carriers.
abstract: Several studies have reported that, in Lynch syndrome resulting from mutations of the mismatch repair (MMR) genes, a CA repeat ≤17 within the IGF1 promoter, SNPs within the xenobiotic metabolizing enzyme gene CYP1A1 and SNPs on 8q23.3 and 11q23.1 modify colorectal cancer (CRC) risk in MMR mutation carriers. We analysed the impact of these polymorphisms on CRC risk in 748 French MMR mutation carriers derived from 359 families. We also analysed the effect of the Novel 1 SNP (18q21), which has recently been shown to increase CRC risk in the general population. We observed a significant difference in the CRC-free survival time between males and females, between MSH2 and MSH6 mutation carriers and between MLH1 and MSH6, indicating that this series is representative of Lynch syndrome. In contrast, the univariate log-rank test, as well as multivariate Cox model analysis controlling for familial aggregation and mutated MMR gene, year of birth and gender showed that the polymorphic alleles tested were not associated with a significant CRC risk increase, neither on the entire sample nor among males and females. This discrepancy with previous reports might be explained both by the genetic heterogeneity between the different populations analysed and the allelic heterogeneity of the MMR mutations. We conclude that genotyping of these polymorphisms is not useful to evaluate CRC risk in MMR mutation carriers and to optimize their clinical follow-up.
authors.affiliation: Inserm U614, Faculty of Medicine, Institute for Biomedical Research and Innovation, University of Rouen, Rouen, France.
authors.forename: Solene
authors.initials: S
authors.lastname: Houlle
authors.forename: Françoise
authors.initials: F
authors.lastname: Charbonnier
authors.forename: Estelle
authors.initials: E
authors.lastname: Houivet
authors.forename: Julie
authors.initials: J
authors.lastname: Tinat
authors.forename: Marie-Pierre
authors.initials: MP
authors.lastname: Buisine
authors.forename: Olivier
authors.initials: O
authors.lastname: Caron
authors.forename: Jacques
authors.initials: J
authors.lastname: Benichou
authors.forename: Stéphanie
authors.initials: S
authors.lastname: Baert-Desurmont
authors.forename: Thierry
authors.initials: T
authors.lastname: Frebourg
mesh_terms: D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000235:genetics*; D003123:Colorectal Neoplasms, Hereditary Nonpolyposis / Q000235:genetics*; D053843:DNA Mismatch Repair; D004843:Epistasis, Genetic; D005260:Female; D005602:France; D020022:Genetic Predisposition to Disease; D006801:Humans; D008297:Male; D009154:Mutation; D019683:Penetrance