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Poster display session: Basic science, Endocrine tumours, Gastrointestinal tumours - colorectal & non-colorectal, Head and neck cancer (excluding thyroid), Melanoma and other skin tumours, Neuroendocrine tumours, Thyroid cancer, Tumour biology & pathology

4984 - Germline mutations in Chinese colorectal cancer patients with mismatch repair deficiency

Date

21 Oct 2018

Session

Poster display session: Basic science, Endocrine tumours, Gastrointestinal tumours - colorectal & non-colorectal, Head and neck cancer (excluding thyroid), Melanoma and other skin tumours, Neuroendocrine tumours, Thyroid cancer, Tumour biology & pathology

Topics

Translational Research

Tumour Site

Colon and Rectal Cancer

Presenters

Ying Yuan

Citation

Annals of Oncology (2018) 29 (suppl_8): viii150-viii204. 10.1093/annonc/mdy281

Authors

Y. Yuan1, L. Zhu2, D. Xu3, C. Liu4, X. Mao5

Author affiliations

  • 1 Medical Oncology, 2nd Affiliated Hospital of Zhejiang University University School of Medicine, 310009 - Hangzhou/CN
  • 2 Department Of Medical Oncology, The Second Affiliated Hospital of Zhejiang University School of Medicine, 310009 - Hangzhou/CN
  • 3 Surgical oncology, 2nd Affiliated Hospital of Zhejiang University School of Medicine, 310009 - Hangzhou/CN
  • 4 Bioinformatics, Burning Rock Biotech, 510000 - Guangzhou/CN
  • 5 Medicine, Burning Rock Biotech, 510000 - Guangzhou/CN

Resources

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Abstract 4984

Background

Mismatch repair deficiency (dMMR) due to germline mutations in DNA repair genes including MLH1, MSH2, MSH6 and PMS2, or somatic aberrant silencing of MLH1, is a well-established feature for Lynch syndrome, a major type of hereditary colorectal cancer (CRC). The purpose of this study is to derive prevalence of germline MMR gene mutations in Chinese population with dMMR CRC.

Methods

ColonCore panel is designed for simultaneous detection of microsatellite instabiligy (MSI) status of 22 regions and mutations in 38 CRC-related genes. Whole exons of the 38 genes were covered by the panel. The MSI phenotype detection method was a read-count-distribution-based approach. It utilized the coverage ratio of a specific set of repeat lengths as the main characteristic of each microsatellite locus, and categorized a locus as unstable if the coverage ratio was less than a given threshold. The MSI status of a sample was determined by the percentage of unstable loci in the given sample.

Results

Among 1394 postsurgical CRC patients whose MMR status were detected by immunohistochemistry (IHC), 99 patients were dMMR, accounting for 7.1%. The concordance rate was 92.3% between MSI and IHC. Next, we investigated the germline mutation spectrum of dMMR patients. About 26.3% patients harbored pathogenic germline MMR gene mutations, with 13%, 6%, 5% and 2% of patients carrying pathogenic MLH1, MSH2, MSH6 and PMS2 mutations, respectively. Specially, about 30% pathogenic MLH1 mutation occured in splice region. Among patients with pathogenic MMR gene mutations, their first cancer was diagnosed ranging from 22 to 69 years old with median age at diagnosis was 50, and only 57% have a family history of ≥ 1 relative with Lynch syndrome related cancers. Furthermore, 3% harbored pathogenic mutations in other genes. Approximately, 17% of patients harbored MMR gene variants of unknown significance (VUS) and 26% harbored other VUS. The remaining 28% of patients had no pathogenic or VUS mutations from this panel.

Conclusions

The prevalence rate of germline pathogenic mutations is 26% in dMMR CRC patients, accounting for 1.8% of all resectable CRC patients. Median age at diagnosis of Lynch syndrome related cancers is 50 years old and nearly 40% Lynch syndrome patients have no family history.

Clinical trial identification

Legal entity responsible for the study

Ying Yuan.

Funding

Burning Rock Biotech.

Editorial Acknowledgement

Disclosure

C. Liu: Burning Rock Biotech. All other authors have declared no conflicts of interest.

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