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1601966-03-Results-p01
[ "Hierarchical", "clustering", "of", "samples", "from", "colorectal", "tumors", "and", "normal", "colon", "epithelia.", "On", "the", "right,", "you", "find", "the", "chromosomal", "localization", "of", "the", "genes", "and", "the", "official", "HUGO", "symbol", "or", "prospective", "Affymetrix", "cluster", "ID.", "On", "the", "top,", "the", "binary", "tree", "of", "tissue", "samples", "based", "on", "gene", "expression", "is", "given.", "The", "tissue", "denominators", "either", "contain", "TR", "for", "tumor", "normal", " ", "colon", "epithelia.", "On", "the", "right,", "you", "find", "the", "chromosomal", "localization", "of", "the", "genes", "and", "the", "official", "HUGO", "symbol", "or", "prospective", "Affymetrix", "cluster", "ID.", "On", "the", "top,", "the", "binary", "tree", "of", "tissue", "samples", "based", "on", "gene", "expression", "is", "given.", "The", "tissue", "denominators", "either", "contain", "TR", "for", "tumor", "or", "E", "for", "epithelium", "and", "a", "code", "reflecting", "the", "identity", "of", "each", "patient.", "In", "the", "center,", "the", "expression", "values", "after", "normalization", "have", "been", "color-coded:", "light", "blue", "means", "high", "expression,", "black", "means", "low", "(or", "no)", "expression.", "Note", "that", "only", "a", "representative", "fraction", "of", "the", "514", "genes", "is", "visualized", "here", "(white", "bars", "replace", "some", "portions", "of", "original", "heat", "map).", "The", "right", "cluster", "contains", "only", "samples", "from", "normal", "colon", "epithelia,", "the", "left", "cluster", "is", "composed", "primarily", "of", "tumors", "along", "with", "some", "interspersed", "normal", "epithelial", "samples.", "Note", "that", "misplaced", "normal", "tissue", "(E)", "samples", "often", "cluster", "along", "with", "matching", "tumor", "(TR)", "samples", "from", "the", "same", "patient." ]
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Hierarchical clustering of samples from colorectal tumors and normal colon epithelia. On the right, you find the chromosomal localization of the genes and the official HUGO symbol or prospective Affymetrix cluster ID. On the top, the binary tree of tissue samples based on gene expression is given. The tissue denominators either contain TR for tumor normal colon epithelia. On the right, you find the chromosomal localization of the genes and the official HUGO symbol or prospective Affymetrix cluster ID. On the top, the binary tree of tissue samples based on gene expression is given. The tissue denominators either contain TR for tumor or E for epithelium and a code reflecting the identity of each patient. In the center, the expression values after normalization have been color-coded: light blue means high expression, black means low (or no) expression. Note that only a representative fraction of the 514 genes is visualized here (white bars replace some portions of original heat map). The right cluster contains only samples from normal colon epithelia, the left cluster is composed primarily of tumors along with some interspersed normal epithelial samples. Note that misplaced normal tissue (E) samples often cluster along with matching tumor (TR) samples from the same patient.
1360090-03-Results-p01
[ "**", "IGNORE", "LINE", "**" ]
[ 0, 0, 0, 0 ]
** IGNORE LINE **
1266026-04-Results-p01
[ "Ages", "at", "cancer", "can", "be", "used", "to", "estimate", "likely", "numbers", "of", "oncogenic", "mutations", "required", "before", "transformation", "[3-6,11].", "Average", "ages", "for", "sporadic", "MSI+,", "MSI-,", "and", "HNPCC", "cancers", "were", "respectively", "71.5,", "67.5,", "and", "50.3", "years", " ", "(Figure", "1A).", "For", "HNPCC", "cancers,", "estimated", "numbers", "of", "oncogenic", "mutations", "were", "between", "four", "and", "seven", "sporadic", "cancers", " ", "were", "further", "classified", "as", "sporadic", "(N", "=", "98", "or", "9.6%", "of", "all", "cancers)", "or", "HNPCC", "cancers", "MSI+", "cancers", "cancers", "MSI+", " ", "cancers.", "The", "MSI+", "cancers", "were", "further", "classified", "as", "sporadic", "(N", "=", "98", "or", "9.6%", "of", "all", "cancers)", "or", "HNPCC", "(N", "=", "29", "or", "2.9%", " ", "of", "all", "cancers)", "based", "on", "germline", "MLH1", "or", "MSH2", "mutations", "(Table", "1)." ]
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Ages at cancer can be used to estimate likely numbers of oncogenic mutations required before transformation [3-6,11]. Average ages for sporadic MSI+, MSI-, and HNPCC cancers were respectively 71.5, 67.5, and 50.3 years (Figure 1A). For HNPCC cancers, estimated numbers of oncogenic mutations were between four and seven sporadic cancers were further classified as sporadic (N = 98 or 9.6% of all cancers) or HNPCC cancers MSI+ cancers cancers MSI+ cancers. The MSI+ cancers were further classified as sporadic (N = 98 or 9.6% of all cancers) or HNPCC (N = 29 or 2.9% of all cancers) based on germline MLH1 or MSH2 mutations (Table 1).
1601966-03-Results-p04
[ "Up-regulation", "of", "mRNA", "expression", "in", "human", "chromosomal", "region", "8q11.23-q21.13", "(patient", "counts", "with", "coordinate", "down-regulation).", "Grayscale", "plot", "of", "cross-comparison", "of", "down-regulation", "patterns", "across", "patients", " ", "for", "gene", "pairs", "in", "a", "particular", "region.", "Both,", "horizontal", "and", "vertical", "axes", "comprise", "the", "same", "genes", "in", "chromosomal", "order.", "In", "each", "square", "total", "counts", "of", "patients", " ", "with", "consistent", "down-regulation", "in", "two", "genes", "are", "coded", "by", "different", "shades", "of", "gray.", "Dark", "squared", "regions", "along", "the", "diagonal", "indicate", "coordinated", "regulation", "in", "patient", "subgroups.", "View", "in", "conjunction", "with", "Figures", "6", "and", "7." ]
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Up-regulation of mRNA expression in human chromosomal region 8q11.23-q21.13 (patient counts with coordinate down-regulation). Grayscale plot of cross-comparison of down-regulation patterns across patients for gene pairs in a particular region. Both, horizontal and vertical axes comprise the same genes in chromosomal order. In each square total counts of patients with consistent down-regulation in two genes are coded by different shades of gray. Dark squared regions along the diagonal indicate coordinated regulation in patient subgroups. View in conjunction with Figures 6 and 7.
1619718-04-Results-p01
[ "Note:", "no", "result", "for", "KRAS", "in", "one", "sessile", "serrated", "adenoma", "(SSA)", "and", "one", "tubular", "adenoma", "(TA)", "or", "for", "BRAF", "in", "one", "TA.", "MGMT", "immunstaining", "not", "performed", "in", "15", "polyps", "(seven", "HPs,", "one", "SSA,", "one", "MP", "and", "six", "TAs)." ]
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Note: no result for KRAS in one sessile serrated adenoma (SSA) and one tubular adenoma (TA) or for BRAF in one TA. MGMT immunstaining not performed in 15 polyps (seven HPs, one SSA, one MP and six TAs).
1619718-04-Results-p02
[ "A,", "Serrated", "adenoma", "(SA)", "(BRAF", "mutation)", "with", "a", "‘hyperplastic’", "appearance", "but", "with", "architectural", "and", "cytological", "features", "of", "a", "non-adenomatous", "form", "of", "dysplasia.", "The", "latter", "include", "marked", "epithelial", "serration", "and", "surface", "papillarity", "and", "nuclei", "that", "are", "ovoid,", "vesicular", "and", "contain", "a", "prominent", "nucleolus", "(inset).", "The", "columnar", "cells", "(inset)", "contain", "apical", "mucin", "droplets,", "similar", "to", "sessile", "SA", "(SSA).", "B,", "Mixed", "polyp", "(BRAF", "mutation)", "comprising", "SSA", "(left)", "and", "SA", "with", "high-grade", "dyplasia", "showing", "back-to-back", "glands", "(right)", "and", "aberrant", "expression", "of", "p53", "(inset).", "C,D,", "Two", "mixed", "polyps", "(MPs)", "(both", "SA/tubulo-villous", "adenoma", "and", "with", "KRAS", "mutation)", "in", "which", "the", "serrated", "epithelium", "has", "an", "adenomatous", "appearance", "as", "evidenced", "by", "elongated", "hyperchomatic", "nuclei", "with", "marked", "stratification", "and", "a", "dark", "amphophilic", "cytoplasm.", "The", "pure", "adenomatous", "component", "is", "not", "shown.", "E,F,", "Low-", "and", "medium-power", "images", "of", "a", "SA", "(KRAS", "mutation)", "in", "which", "complex", "microacini", "have", "resulted", "in", "markedly", "serrated", "epithelial", "contours.", "The", "epithelium", "comprises", "numerous", "goblet", "cells", "and", "absorptive-type", "columnar", "cells", "with", "eosinophilic", "cytoplasm", "and", "is", "reminiscent", "of", "the", "goblet", "cell", "variant", "of", "hyperplastic", "polyp.", "These", "examples", "illustrate", "the", "range", "of", "appearances", "and", "genetic", "changes", "that", "are", "encompassed", "by", "‘traditional’", "SA." ]
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A, Serrated adenoma (SA) (BRAF mutation) with a ‘hyperplastic’ appearance but with architectural and cytological features of a non-adenomatous form of dysplasia. The latter include marked epithelial serration and surface papillarity and nuclei that are ovoid, vesicular and contain a prominent nucleolus (inset). The columnar cells (inset) contain apical mucin droplets, similar to sessile SA (SSA). B, Mixed polyp (BRAF mutation) comprising SSA (left) and SA with high-grade dyplasia showing back-to-back glands (right) and aberrant expression of p53 (inset). C,D, Two mixed polyps (MPs) (both SA/tubulo-villous adenoma and with KRAS mutation) in which the serrated epithelium has an adenomatous appearance as evidenced by elongated hyperchomatic nuclei with marked stratification and a dark amphophilic cytoplasm. The pure adenomatous component is not shown. E,F, Low- and medium-power images of a SA (KRAS mutation) in which complex microacini have resulted in markedly serrated epithelial contours. The epithelium comprises numerous goblet cells and absorptive-type columnar cells with eosinophilic cytoplasm and is reminiscent of the goblet cell variant of hyperplastic polyp. These examples illustrate the range of appearances and genetic changes that are encompassed by ‘traditional’ SA.
1334229-03-Methods-p01
[ "Tissue", "samples" ]
[ 0, 0 ]
Tissue samples
1557864-01-Abstract-p01
[ "Results" ]
[ 0 ]
Results
1266026-03-Methods-p01
[ "Specimens" ]
[ 0 ]
Specimens
1334229-03-Methods-p03
[ "Statistical", "analysis" ]
[ 0, 0 ]
Statistical analysis
1334229-01-Abstract-p01
[ "Mutations", "at", "the", "phosphorylation", "sites", "(codons", "31,", "33,", "37,", "and", "45)", "in", "the", "CTNNB1", "gene", "were", "observed", "in", "tumours", "from", "only", "5/464", "patients.", "Tumours", "with", "truncating", "APC", "mutations", "and", "activating", "K-ras", "mutations", "in", "codons", "12", "and", "13", "occurred", "at", "similar", "frequencies", "(37%", "(245/656)", "and", "36%", "(235/656),", "respectively).", "Seventeen", "percent", "of", "tumours", "harboured", "both", "an", "APC", "and", "a", "K-ras", "mutation", "(109/656).", "Nine", "percent", "of", "all", "tumours", "(58/656)", "lacked", "hMLH1", "hMLH1", "K-ras", ")", "pathways.", "A", "smaller", "proportion", "of", "cancers", "shows", "mismatch", "repair", "deficiency.", "The", "aim", "of", "this", "study", "was", "to", "analyse", "the", "co-occurrence", "of", "these", "genetic", "alterations", "in", "relation", "to", "tumour", "and", "patient", "characteristics." ]
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Mutations at the phosphorylation sites (codons 31, 33, 37, and 45) in the CTNNB1 gene were observed in tumours from only 5/464 patients. Tumours with truncating APC mutations and activating K-ras mutations in codons 12 and 13 occurred at similar frequencies (37% (245/656) and 36% (235/656), respectively). Seventeen percent of tumours harboured both an APC and a K-ras mutation (109/656). Nine percent of all tumours (58/656) lacked hMLH1 hMLH1 K-ras ) pathways. A smaller proportion of cancers shows mismatch repair deficiency. The aim of this study was to analyse the co-occurrence of these genetic alterations in relation to tumour and patient characteristics.
1601966-03-Results-p11
[ "The", "chromosomal", "region", "14q24.3", "has", "been", "implicated", "in", "colorectal", "cancer", "several", "times", "(see", "Table", "1).", "We", "found", "coordinated", "down-regulation", "of", "expression", "of", "genes", "in", "14q24.1-14q24.3", "(see", "Figures", "30,", "31,", "32).", "The", "region", "comprises", "the", "MLH3", "gene", "that", "is", "linked", "to", "hereditary", "non-polyposis", "colorectal", "cancer", "type", "7", "(HNPCC7).", "We", "note", "that", "also", "the", "FOS", "gene", "encoding", "one", "half", "of", "the", "bZIP", "dimer", "activator", "protein", "(AP-1)", "at", "14q24.3", "is", "strongly", "down-regulated.", "FOS", "is", "known", "as", "an", "oncogene", "and", "its", "down-regulation", "is", "therefore", "unexpected.", "However,", "deletions", "of", "14q24.3", "have", "been", "linked", "to", "metastatic", "CRC", "[36].", "In", "combination,", "these", "results", "suggest", "that", "there", "is", "a", "class", "II", "tumor", "metastasis", "suppressor", "in", "this", "region.", "This", "class", "II", "TSG", "is", "probably", "not", "MLH3", "FOS", "cancer", " ", "several", "times", "(see", "Table", "1).", "We", "found", "coordinated", "down-regulation", "of", "expression", "of", "genes", "in", "14q24.1-14q24.3", "(see", "Figures", "30,", "31,", "32).", "The", "region", "comprises", "the", "MLH3", "gene", "that", "is", "linked", "to", "hereditary", "non-polyposis", "colorectal", "patients", " ", "(analogous", "to", "Figures", "7,", "10,", "13).", "View", "this", "plot", "in", "conjunction", "with", "Figures", "27", "and", "29." ]
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The chromosomal region 14q24.3 has been implicated in colorectal cancer several times (see Table 1). We found coordinated down-regulation of expression of genes in 14q24.1-14q24.3 (see Figures 30, 31, 32). The region comprises the MLH3 gene that is linked to hereditary non-polyposis colorectal cancer type 7 (HNPCC7). We note that also the FOS gene encoding one half of the bZIP dimer activator protein (AP-1) at 14q24.3 is strongly down-regulated. FOS is known as an oncogene and its down-regulation is therefore unexpected. However, deletions of 14q24.3 have been linked to metastatic CRC [36]. In combination, these results suggest that there is a class II tumor metastasis suppressor in this region. This class II TSG is probably not MLH3 FOS cancer several times (see Table 1). We found coordinated down-regulation of expression of genes in 14q24.1-14q24.3 (see Figures 30, 31, 32). The region comprises the MLH3 gene that is linked to hereditary non-polyposis colorectal patients (analogous to Figures 7, 10, 13). View this plot in conjunction with Figures 27 and 29.
2386495-05-Discussion-p04
[ "The", "61", "different", "APC", "mutations", "listed", "in", "Additional", "file", "2", "were", "identified", "among", "81", "of", "the", "96", "families", "of", "the", "Swedish", "Polyposis", "Registry", "that", "were", "screened", "for", "APC", "mutations.", "Fifteen", "of", "the", "cases", "shown", "to", "be", "APC-mutation", "negative", "where", "all", "subjected", "to", "mutational", "screening", "of", "the", "MUTYH", "gene", "and", "six", "of", "them", "were", "shown", "to", "carry", "biallelic", "MUTYH", "mutations", "(reported", "in", "Kanter", "Smoler", "et", "al[31]).", "The", "overall", "mutation-detection", "rate", "in", "APC", "and", "MUTYH", "among", "the", "families", "in", "our", "study", "was", "thus", "90%.", "In", "total,", "84%", "of", "the", "families", "carried", "APC", "mutations", "while", "6%", "where", "positive", "for", "biallelic", "MUTYH", "mutations.", "The", "mutation-detection", "rate", "we", "have", "reached", "in", "this", "study", "is", "notably", "high.", "In", "fact,", "a", "disease-causing", "mutation", "was", "detected", "in", "all", "cases", "who", "presented", "with", "a", "classical", "FAP", "phenotype", "(except", "for", "family", "1", "(C152),", "where", "we", "have", "clear", "indications", "for", "inactivation", "of", "the", "APC", "transcription).", "The", "mutation-negative", "patients", "all", "display", "an", "attenuated", "form", "of", "disease.", "However,", "as", "we", "have", "also", "found", "subtle", "mutations", "in", "the", "APC", "gene", "in", "patients", "with", "attenuated", "FAP", "attenuated", " ", "FAP,", "we", "have", "to", "consider", "inactivation", "of", "APC", " ", "to", "be", "responsible", "for", "some", "of", "these", "FAP", "affected", " ", "by", "the", "disease", "(Figure", "6", "shows", "part", "of", "the", "pedigree).", "However,", "no", "pathogenic", "mutation", "had", "been", "detected", "after", "screening", "the", "whole", "coding", "region", "of", "the", "APC", "gene", "but", "as", "the", "family", "did", "show", "positive", "linkage", "to", "the", "APC", "locus", "we", "decided", "to", "perform", "expression", "analyses", "and", "evidence", "of", "lowered", "APC", "expression", "was", "obtained", "by", "quantitative", "real-time", "PCR", "(Figure", "5A).", "The", "result", "was", "supported", "by", "the", "indication", "of", "a", "lower", "expression", "from", "the", "T-allele", "from", "analysis", "of", "the", "APC", "c.5465A", ">", "T", "polymorphism", "in", "the", "cDNA", "sequencing", "diagram", "of", "two", "affected", "family", "members", "(Figure", "5B).", "The", "search", "for", "mutations", "in", "the", "DNA", "sequence", "of", "the", "APC", "promoters", "has", "been", "initiated,", "but", "no", "pathogenic", "change", "has", "been", "detected", "to", "this", "date.", "The", "possibility", "of", "the", "pathogenic", "change", "being", "epigenetic", "will", "have", "to", "be", "investigated", "further.", "Hypermethylation", "of", "CpG", "sites", "in", "the", "promoter", "of", "APC", "has", "been", "reported", "as", "a", "means", "of", "gene", "silencing", "in", "colorectal", "tumors", "[46-49].", "To", "the", "best", "of", "the", "authors'", "knowledge", "no", "germ-line", "inactivation", "of", "APC", "caused", "by", "promoter", "hypermethylation", "has", "been", "reported.", "However,", "cases", "of", "pathogenic", "germline", "epimutations", "have", "been", "identified", "in", "the", "MLH1", "gene,", "which", "causes", "hereditary", "non-polyposis", "CRC", "[50,51]." ]
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The 61 different APC mutations listed in Additional file 2 were identified among 81 of the 96 families of the Swedish Polyposis Registry that were screened for APC mutations. Fifteen of the cases shown to be APC-mutation negative where all subjected to mutational screening of the MUTYH gene and six of them were shown to carry biallelic MUTYH mutations (reported in Kanter Smoler et al[31]). The overall mutation-detection rate in APC and MUTYH among the families in our study was thus 90%. In total, 84% of the families carried APC mutations while 6% where positive for biallelic MUTYH mutations. The mutation-detection rate we have reached in this study is notably high. In fact, a disease-causing mutation was detected in all cases who presented with a classical FAP phenotype (except for family 1 (C152), where we have clear indications for inactivation of the APC transcription). The mutation-negative patients all display an attenuated form of disease. However, as we have also found subtle mutations in the APC gene in patients with attenuated FAP attenuated FAP, we have to consider inactivation of APC to be responsible for some of these FAP affected by the disease (Figure 6 shows part of the pedigree). However, no pathogenic mutation had been detected after screening the whole coding region of the APC gene but as the family did show positive linkage to the APC locus we decided to perform expression analyses and evidence of lowered APC expression was obtained by quantitative real-time PCR (Figure 5A). The result was supported by the indication of a lower expression from the T-allele from analysis of the APC c.5465A > T polymorphism in the cDNA sequencing diagram of two affected family members (Figure 5B). The search for mutations in the DNA sequence of the APC promoters has been initiated, but no pathogenic change has been detected to this date. The possibility of the pathogenic change being epigenetic will have to be investigated further. Hypermethylation of CpG sites in the promoter of APC has been reported as a means of gene silencing in colorectal tumors [46-49]. To the best of the authors' knowledge no germ-line inactivation of APC caused by promoter hypermethylation has been reported. However, cases of pathogenic germline epimutations have been identified in the MLH1 gene, which causes hereditary non-polyposis CRC [50,51].
1266026-05-Discussion-p01
[ "In", "agreement", "with", "prior", "studies,", "there", "were", "seven", "mutations", "estimated", "for", "sporadic", "MSI-", "Finnish", "cancers", "[4],", "and", "seven", "or", "eight", "mutations", "for", "MSI+", "cancers.", "A", "requirement", "for", "more", "alterations", "before", "tranformation", "for", "sporadic", "MSI+", "compared", "to", "sporadic", "MSI-", "cancers", "may", "help", "explain", "why", "sporadic", "MSI+", "cancers", "are", "a", "minority", "of", "all", "colorectal", "cancers", "and", "occur", "in", "slightly", "older", "patients", "[19,20].", "Although", "numbers", "of", "oncogenic", "mutations", "before", "transformation", "are", "similar", "between", "sporadic", "MSI+", "and", "MSI-", "cancers,", "their", "identities", "likely", "differ", "[7,8]." ]
[ 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0 ]
In agreement with prior studies, there were seven mutations estimated for sporadic MSI- Finnish cancers [4], and seven or eight mutations for MSI+ cancers. A requirement for more alterations before tranformation for sporadic MSI+ compared to sporadic MSI- cancers may help explain why sporadic MSI+ cancers are a minority of all colorectal cancers and occur in slightly older patients [19,20]. Although numbers of oncogenic mutations before transformation are similar between sporadic MSI+ and MSI- cancers, their identities likely differ [7,8].
1619718-04-Results-p01
[ "Frequency", "of", "KRAS", "and", "BRAF", "mutation", "and", "loss", "of", "expression", "of", "O-6-methylguanine", "DNA", "methyltransferase", "(MGMT)", "by", "polyp", "type" ]
[ 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0 ]
Frequency of KRAS and BRAF mutation and loss of expression of O-6-methylguanine DNA methyltransferase (MGMT) by polyp type
1601966-03-Results-p12
[ "Down-regulation", "of", "mRNA", "expression", "in", "human", "chromosomal", "region", "14q24.1-14q24.3", "–", "the", "FOS", " ", "region", "(patient", "counts", "with", "coordinate", "up-regulation).", "Grayscale", "cross-comparison", "plot", "of", "up-regulation", "patterns", "across", "patients", "(analogous", "to", "Figures", "7,", "10,", "13).", "View", "this", "plot", "in", "conjunction", "with", "Figures", "30", "and", "32." ]
[ 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 21, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0 ]
Down-regulation of mRNA expression in human chromosomal region 14q24.1-14q24.3 – the FOS region (patient counts with coordinate up-regulation). Grayscale cross-comparison plot of up-regulation patterns across patients (analogous to Figures 7, 10, 13). View this plot in conjunction with Figures 30 and 32.
2386495-01-Abstract-p01
[ "The", "dominantly", "inherited", "condition", "familial", "adenomatous", "polyposis", "(FAP)", "is", "caused", "by", "germline", "mutations", "in", "the", "APC", "gene.", "Finding", "the", "causative", "mutations", "has", "great", "implications", "for", "the", "families.", "Correlating", "the", "genotypes", "to", "the", "phenotypes", "could", "help", "to", "improve", "the", "diagnosis", "and", "follow-up", "of", "patients." ]
[ 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0 ]
The dominantly inherited condition familial adenomatous polyposis (FAP) is caused by germline mutations in the APC gene. Finding the causative mutations has great implications for the families. Correlating the genotypes to the phenotypes could help to improve the diagnosis and follow-up of patients.
1334229-01-Abstract-p01
[ "Mutations", "at", "the", "phosphorylation", "sites", "(codons", "31,", "33,", "37,", "and", "45)", "in", "the", "CTNNB1", "gene", "were", "observed", "in", "tumours", "from", "only", "5/464", "patients.", "Tumours", "with", "truncating", "APC", "mutations", "and", "activating", "K-ras", "mutations", "in", "codons", "12", "and", "13", "occurred", "at", "similar", "frequencies", "(37%", "(245/656)", "and", "36%", "(235/656),", "respectively).", "Seventeen", "percent", "of", "tumours", "harboured", "both", "an", "APC", "and", "a", "K-ras", "mutation", "(109/656).", "Nine", "percent", "of", "all", "tumours", "(58/656)", "lacked", "hMLH1", "expression.", "Patients", "harbouring", "a", "tumour", "with", "absent", "hMLH1", "expression", "were", "older,", "more", "often", "women,", "more", "often", "had", "proximal", "colon", "CTNNB1", " ", "gene", "were", "observed", "in", "tumours", "from", "only", "5/464", "patients.", "Tumours", "with", "truncating", "APC", "mutations", "and", "activating", "K-ras", "mutations", "in", "codons", "12", "and", "13", "occurred", "at", "similar", "frequencies", "(37%", "(245/656)", "and", "36%", "(235/656),", "respectively).", "Seventeen", "percent", "of", "tumours", "harboured", "both", "an", "APC", "and", "a", "K-ras", "mutation", "(109/656).", "Nine", "percent", "of", "all", "tumours", "(58/656)", "lacked", "hMLH1", "expression.", "Patients", "harbouring", "a", "tumour", "with", "absent", "hMLH1", "expression", "were", "older,", "more", "often", "women,", "more", "often", "had", "proximal", "colon", "tumours", "that", "showed", "poorer", "differentiation", "women", ",", "more", "often", "had", "proximal", "colon", "tumours", "that", "showed", "poorer", "differentiation", "when", "compared", "to", "patients", "harbouring", "tumours", "with", "an", "APC", "and/or", "K-ras", "mutation." ]
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Mutations at the phosphorylation sites (codons 31, 33, 37, and 45) in the CTNNB1 gene were observed in tumours from only 5/464 patients. Tumours with truncating APC mutations and activating K-ras mutations in codons 12 and 13 occurred at similar frequencies (37% (245/656) and 36% (235/656), respectively). Seventeen percent of tumours harboured both an APC and a K-ras mutation (109/656). Nine percent of all tumours (58/656) lacked hMLH1 expression. Patients harbouring a tumour with absent hMLH1 expression were older, more often women, more often had proximal colon CTNNB1 gene were observed in tumours from only 5/464 patients. Tumours with truncating APC mutations and activating K-ras mutations in codons 12 and 13 occurred at similar frequencies (37% (245/656) and 36% (235/656), respectively). Seventeen percent of tumours harboured both an APC and a K-ras mutation (109/656). Nine percent of all tumours (58/656) lacked hMLH1 expression. Patients harbouring a tumour with absent hMLH1 expression were older, more often women, more often had proximal colon tumours that showed poorer differentiation women , more often had proximal colon tumours that showed poorer differentiation when compared to patients harbouring tumours with an APC and/or K-ras mutation.
1619718-05-Discussion-p05
[]
[]
1334229-05-Discussion-p02
[ "The", "method", "for", "mutation", "analysis", "of", "the", "APC", "mutation", "cluster", "region", "and", "exon", "1", "of", "K-ras", "is", "based", "on", "nested", "amplification", "and", "direct", "sequencing", "of", "purified", "PCR", "fragments,", "a", "highly", "sensitive", "method.", "Since", "no", "screening", "step", "was", "performed", "prior", "to", "the", "sequencing", "of", "the", "gene", "fragments,", "it", "is", "unlikely", "that", "mutations", "would", "have", "escaped", "detection.", "The", "reproducibility", "of", "the", "applied", "assays", "was", "good,", "with", "a", "reproducibility", "of", "85%", "and", "88%", "for", "APC", "and", "K-ras,", "respectively.", "Arguably,", "this", "indicates", "the", "extent", "of", "heterogeneity", "present", "in", "the", "tumour", "samples." ]
[ 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0 ]
The method for mutation analysis of the APC mutation cluster region and exon 1 of K-ras is based on nested amplification and direct sequencing of purified PCR fragments, a highly sensitive method. Since no screening step was performed prior to the sequencing of the gene fragments, it is unlikely that mutations would have escaped detection. The reproducibility of the applied assays was good, with a reproducibility of 85% and 88% for APC and K-ras, respectively. Arguably, this indicates the extent of heterogeneity present in the tumour samples.
1619718-05-Discussion-p04
[ "The", "interpretation", "of", "immunostaining", "for", "p53", "is", "problematic", "insofar", "as", "increased", "expression", "of", "the", "wild-type", "protein", "occurs", "in", "areas", "of", "increased", "proliferation", "and", "must", "be", "distinguished", "from", "the", "diffuse", "and", "strong", "nuclear", "staining", "associated", "with", "retained", "mutant", "protein.", "However,", "several", "studies", "have", "described", "low", "frequencies", "of", "p53", "expression", "in", "TAs", "with", "low-grade", "dysplasia45,46", "and", "even", "in", "VAs.47", "Conversely,", "there", "is", "general", "agreement", "that", "aberrant", "p53", "expression", "is", "closely", "associated", "with", "the", "presence", "of", "high-grade", "dysplasia", "amounting", "to", "carcinoma", "in", "situ.34,46,48", "Aberrant", "retention", "of", "presumed", "mutant", "nuclear", "p53", "was", "rarely", "observed", "in", "the", "present", "series,", "although", "it", "occurred", "more", "frequently", "in", "serrated", "polyps", "with", "dysplasia", "(12%)", "than", "in", "adenomas", "(1%).", "One", "of", "the", "polyps", "with", "aberrant", "expression", "of", "p53", "was", "a", "mixed", "polyp", "with", "BRAF", "mutation", "(Figure", "1B).", "Had", "it", "not", "been", "removed,", "this", "polyp", "may", "have", "progressed", "within", "a", "short", "time", "frame", "to", "the", "subset", "of", "CRC", "with", "BRAF", "mutation,", "DNA", "methylation,", "TP53", "mutation", "and", "DNA", "microsatellite", "stable", "status", "(a", "‘fusion’", "pathway", "shown", "in", "Table", "3).49,50" ]
[ 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0 ]
The interpretation of immunostaining for p53 is problematic insofar as increased expression of the wild-type protein occurs in areas of increased proliferation and must be distinguished from the diffuse and strong nuclear staining associated with retained mutant protein. However, several studies have described low frequencies of p53 expression in TAs with low-grade dysplasia45,46 and even in VAs.47 Conversely, there is general agreement that aberrant p53 expression is closely associated with the presence of high-grade dysplasia amounting to carcinoma in situ.34,46,48 Aberrant retention of presumed mutant nuclear p53 was rarely observed in the present series, although it occurred more frequently in serrated polyps with dysplasia (12%) than in adenomas (1%). One of the polyps with aberrant expression of p53 was a mixed polyp with BRAF mutation (Figure 1B). Had it not been removed, this polyp may have progressed within a short time frame to the subset of CRC with BRAF mutation, DNA methylation, TP53 mutation and DNA microsatellite stable status (a ‘fusion’ pathway shown in Table 3).49,50
1557864-05-Discussion-p02
[ "Since", "ovarian", "cancer", "is", "a", "heterogeneous", "disease", "characterized", "by", "various", "histological", "types", "which", "may", "have", "different", "MSI", "frequencies,", "the", "number", "of", "specimens", "analyzed", "is", "very", "important", "in", "characterizing", "a", "feature", "that", "may", "be", "uncommon", "such", "as", "MSI.", "We", "therefore,", "made", "a", "summary", "of", "20", "studies", "totaling", "1315", "ovarian", "carcinomas", "heterogeneous", "MLH1", "MLH1", "ovarian", "cancer", " ", "in", "vivo.", "Seven", "of", "the", "75", "ovarian", "carcinomas", "showed", "MLH1", "promoter", "methylation.", "We", "confirmed", "whether", "the", "observed", "MLH1", "promoter", "methylation", "results", "in", "the", "inactivation", "of", "the", "gene", "by", "determining", "the", "MLH1", "mRNA", "expression", "with", "quantitative", "RT-PCR.", "The", "six", "tumors", "with", "low", "level", "MLH1", "promoter", "methylation", "appeared", "to", "express", "MLH1", "at", "mRNA", "levels", "similar", "to", "that", "of", "the", "unmethylated", "tumors.", "Thus", "a", "low", "level", "of", "methylation", "does", "not", "result", "in", "an", "altered", "expression", "of", "the", "MLH1", "gene.", "In", "contrast,", "the", "abundant", "methylation", "seen", "in", "the", "remaining", "carcinoma", "was", "associated", "with", "the", "lowest", "MLH1", "mRNA", "expression", "level", "of", "all", "50", "ovarian", "carcinomas", "tested.", "However,", "none", "of", "the", "ovarian", "carcinomas", "showed", "MSI", "for", "BAT25,", "BAT26", "and", "for", "BAT40", "or", "D2S123", "which", "suggests", "a", "frequency", "of", "MMR", "inactivation", "of", "0%.", "The", "low", "MLH1", "mRNA", "expression", "seen", "in", "the", "abundant", "methylated", "carcinoma", "might", "be", "sufficient", "enough", "for", "a", "functional", "MMR", "which", "results", "in", "the", "observed", "absence", "of", "MSI." ]
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Since ovarian cancer is a heterogeneous disease characterized by various histological types which may have different MSI frequencies, the number of specimens analyzed is very important in characterizing a feature that may be uncommon such as MSI. We therefore, made a summary of 20 studies totaling 1315 ovarian carcinomas heterogeneous MLH1 MLH1 ovarian cancer in vivo. Seven of the 75 ovarian carcinomas showed MLH1 promoter methylation. We confirmed whether the observed MLH1 promoter methylation results in the inactivation of the gene by determining the MLH1 mRNA expression with quantitative RT-PCR. The six tumors with low level MLH1 promoter methylation appeared to express MLH1 at mRNA levels similar to that of the unmethylated tumors. Thus a low level of methylation does not result in an altered expression of the MLH1 gene. In contrast, the abundant methylation seen in the remaining carcinoma was associated with the lowest MLH1 mRNA expression level of all 50 ovarian carcinomas tested. However, none of the ovarian carcinomas showed MSI for BAT25, BAT26 and for BAT40 or D2S123 which suggests a frequency of MMR inactivation of 0%. The low MLH1 mRNA expression seen in the abundant methylated carcinoma might be sufficient enough for a functional MMR which results in the observed absence of MSI.
1619718-02-Introduction-p01
[ "The", "addition", "of", "molecular", "profiling", "to", "polyp", "description", "offers", "hope", "of", "a", "more", "objective", "and", "therefore", "reproducible", "approach", "to", "the", "classification", "of", "colorectal", "adenomas.", "The", "genetic", "evolutionary", "paradigm", "envisages", "a", "linear", "sequence", "of", "changes", "beginning", "with", "bi-allelic", "inactivation", "of", "APC", "adenomas", ".", "Establishing", "a", "risk", "profile", "on", "the", "basis", "of", "the", "traditional", "features", "of", "adenoma", " ", "is", "therefore", "not", "always", "straightforward." ]
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The addition of molecular profiling to polyp description offers hope of a more objective and therefore reproducible approach to the classification of colorectal adenomas. The genetic evolutionary paradigm envisages a linear sequence of changes beginning with bi-allelic inactivation of APC adenomas . Establishing a risk profile on the basis of the traditional features of adenoma is therefore not always straightforward.
1619718-01-Abstract-p01
[ "Methods", "and", "results" ]
[ 0, 0, 0 ]
Methods and results
3034663-05-Discussion-p01
[ "The", "frequency", "of", "variants", "in", "unaffected", "controls", "is", "used", "often", "to", "distinguish", "between", "neutral", "and", "potentially", "deleterious", "variants.", "If", "the", "frequency", "of", "a", "variant", "among", "a", "few", "hundred", "controls", "is", "≥1%,", "it", "is", "highly", "unlikely", "to", "be", "a", "high-risk", "variant.", "In", "such", "cases,", "it", "is", "still", "possible", "that", "the", "variant", "will", "be", "associated", "with", "a", "modest", "risk", "of", "the", "disease", "[3].", "Case-control", "studies", "enable", "quantification", "of", "the", "disease", "risk", "associated", "with", "the", "variant.", "The", "main", "disadvantage", "of", "such", "analyses", "is", "that", "a", "large", "sample", "size", "is", "required", "to", "obtain", "sufficient", "power", "to", "detect", "the", "lower", "risk", "level.", "The", "sample", "size", "required", "is", "related", "inversely", "to", "the", "frequency", "of", "the", "variant", "in", "the", "population.", "The", "sample", "size", "used", "in", "the", "present", "study", "resulted", "in", "80%", "power", "to", "detect", "an", "OR", "of", "3.0", "(two-sided", "test;", "alpha", "level,", "5%).", "The", "frequency", "of", "the", "p.Lys618Ala", "variant", "in", "our", "control", "series", "was", "2.7%", "and", "no", "significant", "differences", "were", "observed", "in", "the", "sporadic", "cases", "CRC-predisposing", "syndrome", "hereditary", " ", "CRC-predisposing", "syndrome", "and", "accounts", "for", "3%", "of", "unselected", "CRC", "cases.", "A", "significant", "proportion", "of", "DNA", "variations", "found", "in", "patients", "suspected", "of", "having", "LS", "are", "UVs", "(", "32%", ",", "18%", "and", "38%", "for", "MLH1", ",", "MSH2", "and", "MSH6,", "respectively)", "[6].", "The", "pathogenicity", "of", "the", "MLH1", "p.Lys618Ala", "variant", "remains", "controversial", "because", "of", "conflicting", "data", "[InSiGHT,", "http://www.insight-group.org]", "(Figure", "5)." ]
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The frequency of variants in unaffected controls is used often to distinguish between neutral and potentially deleterious variants. If the frequency of a variant among a few hundred controls is ≥1%, it is highly unlikely to be a high-risk variant. In such cases, it is still possible that the variant will be associated with a modest risk of the disease [3]. Case-control studies enable quantification of the disease risk associated with the variant. The main disadvantage of such analyses is that a large sample size is required to obtain sufficient power to detect the lower risk level. The sample size required is related inversely to the frequency of the variant in the population. The sample size used in the present study resulted in 80% power to detect an OR of 3.0 (two-sided test; alpha level, 5%). The frequency of the p.Lys618Ala variant in our control series was 2.7% and no significant differences were observed in the sporadic cases CRC-predisposing syndrome hereditary CRC-predisposing syndrome and accounts for 3% of unselected CRC cases. A significant proportion of DNA variations found in patients suspected of having LS are UVs ( 32% , 18% and 38% for MLH1 , MSH2 and MSH6, respectively) [6]. The pathogenicity of the MLH1 p.Lys618Ala variant remains controversial because of conflicting data [InSiGHT, http://www.insight-group.org] (Figure 5).
1360090-03-Results-p01
[ "BRAF", "mutations", "showed", "no", "association", "with", "TP53", "mutations", "and", "were", "mutually", "exclusive", "with", "the", "presence", "of", "KRAS", "mutations", "(Table", "2).", "In", "contrast,", "BRAF", "mutations", "were", "approximately", "10-fold", "more", "frequent", "in", "MSI+", "and", "CIMP+", "tumors", "compared", "to", "tumors", "without", "these", "phenotypes.", "A", "strong", "association", "was", "also", "seen", "with", "methylation", "of", "the", "MLH1", "gene", "promoter", "and", "in", "particular", "with", "methylation", "of", "its", "proximal", "region.", "We", "have", "previously", "examined", "the", "methylation", "status", "of", "7", "different", "CpG", "islands", "in", "this", "CRC", "series", "[18].", "The", "mean", "number", "of", "these", "methylated", "sites", "was", "3-fold", "higher", "in", "tumors", "with", "BRAF", "mutation", "compared", "to", "those", "without", "(2.6", "±", "1.7", "vs", "0.8", "±", "1.0;", "P", "<", "0.001).", "Multivariate", "analysis", "revealed", "that", "MSI+", "was", "the", "only", "significant", "independent", "predictor", "of", "BRAF", "mutation", "(RR", "=", "6.3,", "95%CI", "[1.2–32.3];", "P", "=", "0.028)", "in", "a", "model", "that", "included", "CIMP+,", "tumor", "site,", "histological", "grade,", "presence", "of", "infiltrating", "lymphocytes", "and", "mucinous", "appearance." ]
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BRAF mutations showed no association with TP53 mutations and were mutually exclusive with the presence of KRAS mutations (Table 2). In contrast, BRAF mutations were approximately 10-fold more frequent in MSI+ and CIMP+ tumors compared to tumors without these phenotypes. A strong association was also seen with methylation of the MLH1 gene promoter and in particular with methylation of its proximal region. We have previously examined the methylation status of 7 different CpG islands in this CRC series [18]. The mean number of these methylated sites was 3-fold higher in tumors with BRAF mutation compared to those without (2.6 ± 1.7 vs 0.8 ± 1.0; P < 0.001). Multivariate analysis revealed that MSI+ was the only significant independent predictor of BRAF mutation (RR = 6.3, 95%CI [1.2–32.3]; P = 0.028) in a model that included CIMP+, tumor site, histological grade, presence of infiltrating lymphocytes and mucinous appearance.
1334229-03-Methods-p02
[ "All", "464", "samples", "without", "a", "truncating", "APC", "mutation", "(n", "=", "411)", "and", "all", "samples", "with", "absent", "hMLH1", "expression", "(n", "=", "58", "72", "of", "the", "737", " ", "patients", "with", "sufficient", "DNA", "yield,", "one", "or", "more", "fragments", "of", "the", "mutation", "cluster", "region", "could", "not", "be", "amplified", "and", "these", "patients", "were", "not", "included", "in", "this", "study." ]
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All 464 samples without a truncating APC mutation (n = 411) and all samples with absent hMLH1 expression (n = 58 72 of the 737 patients with sufficient DNA yield, one or more fragments of the mutation cluster region could not be amplified and these patients were not included in this study.
2275286-04-Results-p02
[ "*Amsterdam", "criteria", "II" ]
[ 0, 0, 0 ]
*Amsterdam criteria II
1360090-03-Results-p01
[ "a", "Data", "was", "unavailable", "for", "MSI", "status", "in", "40", "cases,", "methylation", "status", "in", "83", "cases,", "KRAS", "mutation", "in", "26", "cases", "and", "TP53", "mutation", "in", "26", "cases" ]
[ 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0 ]
a Data was unavailable for MSI status in 40 cases, methylation status in 83 cases, KRAS mutation in 26 cases and TP53 mutation in 26 cases
1373649-03-Methods-p02
[ "After", "establishing", "the", "familial", "mutation", "in", "the", "proband's", "mother,", "located", "in", "the", "exon", "12", "of", "hMSH2", "gene,", "it", "was", "searched", "in", "the", "proband's", "sisters", "mother", "mother", "mother", "mother", " ", "(BM)", "and", "father", "father", " ", "(BF)." ]
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After establishing the familial mutation in the proband's mother, located in the exon 12 of hMSH2 gene, it was searched in the proband's sisters mother mother mother mother (BM) and father father (BF).
1266026-04-Results-p01
[ "Ages", "at", "cancer", "can", "be", "used", "to", "estimate", "likely", "numbers", "of", "oncogenic", "mutations", "required", "before", "transformation", "[3-6,11].", "Average", "ages", "for", "sporadic", "MSI+,", "MSI-,", "and", "HNPCC", "cancers", "MSI-", ",", "and", "HNPCC", "cancers", "cancer", "germline", "MLH1", "or", "MSH2", "mutations", " ", "(Table", "1)." ]
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Ages at cancer can be used to estimate likely numbers of oncogenic mutations required before transformation [3-6,11]. Average ages for sporadic MSI+, MSI-, and HNPCC cancers MSI- , and HNPCC cancers cancer germline MLH1 or MSH2 mutations (Table 1).
1557864-01-Abstract-p01
[ "Seven", "of", "the", "75", "ovarian", "carcinomas", "showed", "MLH1", " ", "promoter", "methylation,", "however,", "none", "of", "these", "showed", "MSI.", "Forty-six", "of", "these", "patients", "received", "platinum-based", "chemotherapy", "(11", "non-responders,", "34", "responders,", "one", "unknown", "response).", "The", "resistance", "seen", "in", "the", "eleven", "non-responders", "was", "not", "related", "to", "MSI", "and", "therefore", "also", "not", "to", "MMR", "inactivation." ]
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Seven of the 75 ovarian carcinomas showed MLH1 promoter methylation, however, none of these showed MSI. Forty-six of these patients received platinum-based chemotherapy (11 non-responders, 34 responders, one unknown response). The resistance seen in the eleven non-responders was not related to MSI and therefore also not to MMR inactivation.
3034663-03-Methods-p01
[ "The", "median", "age", "of", "patients", "in", "the", "sporadic", "CRC", "group", "was", "70", "years", "(range,", "52-93", "years),", "47", "years", "(range,", "21-87", "years)", "for", "the", "familial", "group", "and", "71", "years", "(range,", "25-96", "years)", "for", "the", "controls.", "The", "sex", "distribution", "was", "58%", "men", "and", "42%", "women", "for", "the", "sporadic", "CRC", "group", "and", "53.3%", "men", "and", "46.7%", "women", "for", "the", "controls." ]
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The median age of patients in the sporadic CRC group was 70 years (range, 52-93 years), 47 years (range, 21-87 years) for the familial group and 71 years (range, 25-96 years) for the controls. The sex distribution was 58% men and 42% women for the sporadic CRC group and 53.3% men and 46.7% women for the controls.
1334229-03-Methods-p03
[ "The", "χ2", "test", "and", "Cramérs", "V", "test", "were", "used", "to", "estimate", "the", "association", "of", "the", "co-occurrence", "of", "K-ras", "and", "APC", "gene", "mutations.", "Characteristics", "of", "patients", "(age", "at", "diagnosis,", "sex,", "family", "history", "of", "colorectal", "cancer)", "and", "tumours", "(tumour", "sub-localisation,", "Dukes'", "stage", "and", "tumour", "differentiation)", "were", "compared", "between", "patients", "with", "and", "without", "an", "activating", "K-ras", " ", "or", "a", "truncating", "APC", "mutation", "as", "well", "as", "patients", "harbouring", "tumours", "with", "and", "without", "hMLH1", "expression,", "using", "Students", "T-test", "(age", "at", "diagnosis)", "and", "χ2", "tests", "(sex,", "family", "history", "of", "colorectal", "cancer,", "tumour", "sub-localisation,", "Dukes'", "stage", "and", "differentiation).", "Additionally,", "patient", "and", "tumour", "characteristics", "of", "tumours", "with", "an", "activating", "K-ras", "colorectal", "tumour", " ", "tissue", "with", "normal", "adjacent", "mucosa,", "were", "used", "for", "immunohistochemistry.", "Endogenous", "peroxidase", "activity", "was", "blocked", "by", "3%", "H2O2.", "Slides", "were", "submitted", "to", "microwave", "antigen", "retrieval", "in", "1", "mM", "EDTA", "buffer", "(pH", "8.0)", "and", "incubated", "with", "10%", "normal", "horse", "serum", "for", "ten", "min", "at", "room", "temperature.", "Then,", "sections", "were", "incubated", "overnight", "at", "4°C", "with", "mouse", "monoclonal", "antibodies", "against", "hMLH1", "protein", "(clone", "G168-15,", "PharMingen,", "San", "Diego,", "CA)", "at", "a", "1:100", "dilution.", "Antibody", "binding", "was", "detected", "by", "incubating", "the", "sections", "at", "room", "temperature", "with", "the", "peroxidase-labelled", "DAKO", "Envision", "System", "(DAKO,", "Carpinteris,", "CA),", "using", "DAB", "as", "a", "chromogen.", "Sections", "were", "counterstained", "with", "diluted", "haematoxylin." ]
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The χ2 test and Cramérs V test were used to estimate the association of the co-occurrence of K-ras and APC gene mutations. Characteristics of patients (age at diagnosis, sex, family history of colorectal cancer) and tumours (tumour sub-localisation, Dukes' stage and tumour differentiation) were compared between patients with and without an activating K-ras or a truncating APC mutation as well as patients harbouring tumours with and without hMLH1 expression, using Students T-test (age at diagnosis) and χ2 tests (sex, family history of colorectal cancer, tumour sub-localisation, Dukes' stage and differentiation). Additionally, patient and tumour characteristics of tumours with an activating K-ras colorectal tumour tissue with normal adjacent mucosa, were used for immunohistochemistry. Endogenous peroxidase activity was blocked by 3% H2O2. Slides were submitted to microwave antigen retrieval in 1 mM EDTA buffer (pH 8.0) and incubated with 10% normal horse serum for ten min at room temperature. Then, sections were incubated overnight at 4°C with mouse monoclonal antibodies against hMLH1 protein (clone G168-15, PharMingen, San Diego, CA) at a 1:100 dilution. Antibody binding was detected by incubating the sections at room temperature with the peroxidase-labelled DAKO Envision System (DAKO, Carpinteris, CA), using DAB as a chromogen. Sections were counterstained with diluted haematoxylin.
2275286-01-Abstract-p01
[ "In", "146", "prospectively", "recruited", "consecutive", "patients", "with", "clinically", "proven", "colorectal", "cancer,", "MSI", "carriers", "were", "identified", "by", "analysis", "of", "tumor", "tissue", "using", "multiplex", "fluorescence", "polymerase", "chain", "reaction", "(PCR)", "using", "the", "NCI", "recommended", "panel", "and", "classified", "into", "microsatellite", "instability-low", "(MSI-L),", "microsatellite", "instability-high", "(MSI-H)", "and", "microsatellite", "stable", "(MSS)", "groups.", "Immunohistochemical", "staining", "for", "MSH2,", "MSH6", "and", "MLH1", "on", "tissue", "microarrays", "(TMAs)", "was", "performed,", "and", "methylation", "of", "the", "MLH1", "promoter", "was", "analyzed", "by", "quantitative", "methylation", "specific", "PCR", "(MSP).", "Germline", "mutation", "analysis", "of", "blood", "samples", "was", "performed", "for", "MSH2,", "MSH6", "and", "MLH1", "genes." ]
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In 146 prospectively recruited consecutive patients with clinically proven colorectal cancer, MSI carriers were identified by analysis of tumor tissue using multiplex fluorescence polymerase chain reaction (PCR) using the NCI recommended panel and classified into microsatellite instability-low (MSI-L), microsatellite instability-high (MSI-H) and microsatellite stable (MSS) groups. Immunohistochemical staining for MSH2, MSH6 and MLH1 on tissue microarrays (TMAs) was performed, and methylation of the MLH1 promoter was analyzed by quantitative methylation specific PCR (MSP). Germline mutation analysis of blood samples was performed for MSH2, MSH6 and MLH1 genes.
2386495-05-Discussion-p03
[ "Two", "novel", "germline", "APC", "mutations", "that", "introduce", "different", "cryptic", "splice", "sites", "are", "characterized", "in", "this", "study.", "Both", "mutations", "result", "in", "the", "aberrant", "splicing", "of", "APC", "exons", "7", "and", "8", "and", "prematurely", "truncated", "APC", "protein,", "and", "both", "are", "defined", "as", "pathogenic.", "The", "aberrant", "splicing", "identified", "in", "patient", "C496", "(c.835-7T", ">", "G)", "is", "caused", "by", "an", "introduction", "of", "a", "new", "active", "splice", "site", "6", "bp", "upstream", "of", "the", "wildtype", "AG", "splice", "site", "of", "intron", "7.", "This", "acceptor", "site", "is", "apparently", "preferred", "by", "the", "splicing", "machinery,", "as", "shown", "by", "the", "results", "of", "the", "cDNA", "sequencing", "(Figure", "3).", "The", "c.834G", ">", "C", "substitution", "at", "the", "last", "nucleotide", "of", "exon", "7", "in", "patient", "C633,", "would", "theoretically", "introduce", "a", "missense", "mutation", "at", "codon", "278.", "However,", "as", "demonstrated", "by", "the", "cDNA", "sequencing", "results", "(Figure", "4)", "the", "mutation", "leads", "to", "the", "use", "of", "a", "cryptic", "splice", "donor", "site", "11", "bp", "upstream", "in", "exon", "7.", "This", "real", "outcome", "of", "the", "mutation", "would", "easily", "have", "been", "overlooked", "unless", "the", "RNA-based", "methods", "had", "been", "used.", "Other", "examples", "of", "aberrant", "splicing", "of", "the", "APC", "gene", "due", "to", "missense", "mutations", "have", "recently", "been", "described", "[16].", "One", "case", "of", "use", "of", "aberrant", "splice-acceptor", "site", "of", "APC", "exon", "8", "has", "been", "reported", "previously", "in", "a", "patient", "with", "classical", "polyposis", "[15].", "However,", "an", "alternative", "acceptor", "splice", "site", "(c.845-17A", ">", "G)", "in", "intron", "7", "has", "been", "reported", "from", "a", "patient", "patient", "case", "case", " ", "of", "APC", "mosaicism" ]
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Two novel germline APC mutations that introduce different cryptic splice sites are characterized in this study. Both mutations result in the aberrant splicing of APC exons 7 and 8 and prematurely truncated APC protein, and both are defined as pathogenic. The aberrant splicing identified in patient C496 (c.835-7T > G) is caused by an introduction of a new active splice site 6 bp upstream of the wildtype AG splice site of intron 7. This acceptor site is apparently preferred by the splicing machinery, as shown by the results of the cDNA sequencing (Figure 3). The c.834G > C substitution at the last nucleotide of exon 7 in patient C633, would theoretically introduce a missense mutation at codon 278. However, as demonstrated by the cDNA sequencing results (Figure 4) the mutation leads to the use of a cryptic splice donor site 11 bp upstream in exon 7. This real outcome of the mutation would easily have been overlooked unless the RNA-based methods had been used. Other examples of aberrant splicing of the APC gene due to missense mutations have recently been described [16]. One case of use of aberrant splice-acceptor site of APC exon 8 has been reported previously in a patient with classical polyposis [15]. However, an alternative acceptor splice site (c.845-17A > G) in intron 7 has been reported from a patient patient case case of APC mosaicism
2275286-01-Abstract-p01
[ "Abstract" ]
[ 0 ]
Abstract
2386495-04-Results-p03
[ "When", "investigating", "patient", "C496", "with", "RNA-based", "PTT,", "an", "aberrant", "APC", "polypeptide", "pattern", "was", "detected", "(data", "not", "shown).", "Sequencing", "of", "the", "corresponding", "cDNA", "fragment", "identified", "a", "change", "in", "the", "beginning", "of", "exon", "8", "(Figure", "3).", "Genomic", "sequencing", "of", "exon", "8", "and", "the", "flanking", "intron", "sequences", "lead", "to", "the", "discovery", "of", "the", "c.835-7T", ">", "G", "mutation", "(Figure", "3A).", "The", "base", "substitution", "introduces", "a", "new", "AG", "splice-acceptor", "site", "eight", "bases", "upstream", "of", "exon", "8.", "Owing", "to", "the", "use", "of", "this", "new", "splice", "site", "the", "last", "six", "bases", "of", "intron", "7", "are", "included", "in", "the", "transcript,", "resulting", "in", "premature", "truncation", "(Figure", "3B).", "The", "entire", "APC", "coding", "region", "of", "the", "patient", "was", "sequenced", "and", "no", "other", "pathogenic", "variants", "were", "detected.", "A", "search", "for", "deletion", "or", "duplication", "of", "one", "or", "more", "exon", "in", "the", "APC", "gene", "by", "MLPA", "was", "also", "carried", "out", "with", "negative", "result." ]
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When investigating patient C496 with RNA-based PTT, an aberrant APC polypeptide pattern was detected (data not shown). Sequencing of the corresponding cDNA fragment identified a change in the beginning of exon 8 (Figure 3). Genomic sequencing of exon 8 and the flanking intron sequences lead to the discovery of the c.835-7T > G mutation (Figure 3A). The base substitution introduces a new AG splice-acceptor site eight bases upstream of exon 8. Owing to the use of this new splice site the last six bases of intron 7 are included in the transcript, resulting in premature truncation (Figure 3B). The entire APC coding region of the patient was sequenced and no other pathogenic variants were detected. A search for deletion or duplication of one or more exon in the APC gene by MLPA was also carried out with negative result.
1619718-01-Abstract-p01
[ "Advanced", "colorectal", "polyps", "with", "the", "molecular", "and", "morphological", "features", "of", "serrated", "polyps", "and", "adenomas:", "concept", "of", "a", "‘fusion’", "pathway", "to", "colorectal", "cancer" ]
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Advanced colorectal polyps with the molecular and morphological features of serrated polyps and adenomas: concept of a ‘fusion’ pathway to colorectal cancer
1619718-04-Results-p02
[ "A,", "Serrated", "adenoma", "(SA)", "(BRAF", "mutation)", "with", "a", "‘hyperplastic’", "appearance", "but", "with", "architectural", "and", "cytological", "features", "of", "a", "non-adenomatous", "form", "of", "dysplasia.", "The", "latter", "include", "marked", "epithelial", "serration", "and", "surface", "papillarity", "and", "nuclei", "that", "are", "ovoid,", "vesicular", "and", "contain", "a", "prominent", "nucleolus", "(inset).", "The", "columnar", "cells", "(inset)", "contain", "apical", "mucin", "droplets,", "similar", "to", "sessile", "SA", "(SSA).", "B,", "Mixed", "polyp", "(BRAF", "mutation)", "comprising", "SSA", "(left)", "and", "SA", "with", "high-grade", "dyplasia", "showing", "back-to-back", "glands", "(right)", "and", "aberrant", "expression", "of", "p53", "(inset).", "C,D,", "Two", " ", "mixed", "polyps", "(MPs)", "(both", "SA/tubulo-villous", "adenoma", "and", "with", "KRAS", "mutation)", "in", "which", "the", "serrated", "epithelium", "has", "an", "adenomatous", "appearance", "as", "evidenced", "by", "elongated", "hyperchomatic", "nuclei", "with", "marked", "stratification", "and", "a", "dark", "amphophilic", "cytoplasm.", "The", "pure", "adenomatous", "component", "is", "not", "shown.", "E,F,", "Low-", "and", "medium-power", "images", "of", "a", "SA", "(KRAS", "mutation)", "in", "which", "complex", "microacini", "have", "resulted", "in", "markedly", "serrated", "epithelial", "contours.", "The", "epithelium", "comprises", "numerous", "goblet", "cells", "and", "absorptive-type", "columnar", "cells", "with", "eosinophilic", "cytoplasm", "and", "is", "reminiscent", "of", "the", "goblet", "cell", "variant", "of", "hyperplastic", "polyp.", "These", "examples", "illustrate", "the", "range", "of", "appearances", "and", "genetic", "changes", "that", "are", "encompassed", "by", "‘traditional’", "SA." ]
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A, Serrated adenoma (SA) (BRAF mutation) with a ‘hyperplastic’ appearance but with architectural and cytological features of a non-adenomatous form of dysplasia. The latter include marked epithelial serration and surface papillarity and nuclei that are ovoid, vesicular and contain a prominent nucleolus (inset). The columnar cells (inset) contain apical mucin droplets, similar to sessile SA (SSA). B, Mixed polyp (BRAF mutation) comprising SSA (left) and SA with high-grade dyplasia showing back-to-back glands (right) and aberrant expression of p53 (inset). C,D, Two mixed polyps (MPs) (both SA/tubulo-villous adenoma and with KRAS mutation) in which the serrated epithelium has an adenomatous appearance as evidenced by elongated hyperchomatic nuclei with marked stratification and a dark amphophilic cytoplasm. The pure adenomatous component is not shown. E,F, Low- and medium-power images of a SA (KRAS mutation) in which complex microacini have resulted in markedly serrated epithelial contours. The epithelium comprises numerous goblet cells and absorptive-type columnar cells with eosinophilic cytoplasm and is reminiscent of the goblet cell variant of hyperplastic polyp. These examples illustrate the range of appearances and genetic changes that are encompassed by ‘traditional’ SA.
1601966-03-Results-p10
[ "5q22.2-5q23.1" ]
[ 0 ]
5q22.2-5q23.1
2275286-04-Results-p02
[ "P", "=", "0.112" ]
[ 0, 0, 0 ]
P = 0.112
2386495-02-Background-p01
[ "The", "majority", "of", "germline", "APC", "mutations", "identified", "in", "FAP", "families", "cause", "truncations", "in", "this", "multifunctional", "protein", "[6,7].", "The", "APC", "APC", "germline", "APC", "mutations", "1p32.1-p34.3", ")", "and", "is", "inherited", "in", "a", "recessive", "manner", "[4,5]." ]
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The majority of germline APC mutations identified in FAP families cause truncations in this multifunctional protein [6,7]. The APC APC germline APC mutations 1p32.1-p34.3 ) and is inherited in a recessive manner [4,5].
2275286-01-Abstract-p01
[ "In", "146", "prospectively", "recruited", "consecutive", "patients", "with", "clinically", "proven", "colorectal", "cancer,", "MSI", "carriers", "were", "identified", "by", "analysis", "of", "tumor", "tissue", "using", "multiplex", "fluorescence", "polymerase", "chain", "reaction", "(PCR)", "using", "the", "NCI", "recommended", "panel", "and", "classified", "into", "microsatellite", "instability-low", "(MSI-L),", "microsatellite", "instability-high", "(MSI-H)", "and", "microsatellite", "stable", "(MSS)", "groups.", "Immunohistochemical", "staining", "for", "MSH2,", "MSH6", "and", "MLH1", "on", "tissue", "microarrays", "(TMAs)", "was", "performed,", "and", "methylation", "of", "the", "MLH1", "promoter", "was", "analyzed", "by", "quantitative", "methylation", "specific", "PCR", "(MSP).", "Germline", "mutation", "analysis", "of", "blood", "samples", "was", "performed", "for", "MSH2,", "MSH6", "and", "MLH1", "genes." ]
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In 146 prospectively recruited consecutive patients with clinically proven colorectal cancer, MSI carriers were identified by analysis of tumor tissue using multiplex fluorescence polymerase chain reaction (PCR) using the NCI recommended panel and classified into microsatellite instability-low (MSI-L), microsatellite instability-high (MSI-H) and microsatellite stable (MSS) groups. Immunohistochemical staining for MSH2, MSH6 and MLH1 on tissue microarrays (TMAs) was performed, and methylation of the MLH1 promoter was analyzed by quantitative methylation specific PCR (MSP). Germline mutation analysis of blood samples was performed for MSH2, MSH6 and MLH1 genes.
1266026-05-Discussion-p01
[ "An", "epigenetic", "mechanism", "may", "help", "explain", "why", "sporadic", "MSI+", "cancers", "require", "more", "than", "one", "additional", "somatic", "alteration", "relative", "to", "HNPCC", " ", "cancers.", "Inactivation", "of", "the", "normal", "MMR", "allele", "occurs", "through", "mutation", "(usually", "LOH", "[15])", "in", "HNPCC", " ", "whereas", "MMR", "loss", "in", "sporadic", "MSI+", "cancers", "is", "associated", "with", "MLH1", "promoter", "methylation", "[16,17].", "CpG", "islands", "may", "be", "\"protected\"", "from", "methylation", "because", "most", "are", "unmethylated", "at", "birth", "and", "usually", "remain", "unmethylated", "throughout", "life", "[18].", "Epigenetic", "MLH1", "inactivation", "may", "require", "at", "least", "two", "cis", "acting", "somatic", "alterations---loss", "of", "a", "mechanism", "that", "normally", "prevents", "methylation,", "followed", "by", "the", "accumulation", "of", "methylation", "at", "sufficient", "numbers", "of", "CpG", "sites", "to", "silence", "expression." ]
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An epigenetic mechanism may help explain why sporadic MSI+ cancers require more than one additional somatic alteration relative to HNPCC cancers. Inactivation of the normal MMR allele occurs through mutation (usually LOH [15]) in HNPCC whereas MMR loss in sporadic MSI+ cancers is associated with MLH1 promoter methylation [16,17]. CpG islands may be "protected" from methylation because most are unmethylated at birth and usually remain unmethylated throughout life [18]. Epigenetic MLH1 inactivation may require at least two cis acting somatic alterations---loss of a mechanism that normally prevents methylation, followed by the accumulation of methylation at sufficient numbers of CpG sites to silence expression.
1373649-04-Results-and-discussion-p01
[ "Our", "work", "shows", "that", "the", "absence", "of", "proband's", "non-tumor", "DNA", "for", "MSI", "testing", "can", "be", "overcome", "by", "studying", "the", "alleles", "carried", "by", "his", "progenitors", "avoiding", "the", "need", "for", "initial", "sequencing", "of", "the", "obligate", "carrier." ]
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Our work shows that the absence of proband's non-tumor DNA for MSI testing can be overcome by studying the alleles carried by his progenitors avoiding the need for initial sequencing of the obligate carrier.
2275286-03-Methods-p04
[ "**", "IGNORE", "LINE", "**" ]
[ 0, 0, 0, 0 ]
** IGNORE LINE **
1373649-02-Background-p01
[ "This", "autosomal", "dominantly", "inherited", "disorder", "is", "caused", "by", "germline", "mutations", "in", "genes", "coding", "proteins", "responsible", "for", "the", "repair", "of", "DNA", "replication", "errors,", "which", "are", "referred", "to", "as", "DNA", "mismatch", "repair", "(MMR)", "genes", "[5].", "DNA", "mismatch", "repair", "machinery", "plays", "a", "critical", "role", "in", "genomic", "stability,", "including", "correction", "of", "mispaired", "bases", "associated", "with", "DNA", "replication", "and", "recombination.", "Germline", "mutations", "in", "one", "allele", "of", "any", "of", "these", "genes", "followed", "by", "the", "somatic", "loss", "or", "inactivation", "of", "the", "wild-type", "allele", "leads", "to", "a", "defective", "mismatch", "repair", "mechanism.", "The", "current", "\"gold", "standard\"", "for", "assessing", "tumor", "DNA", "MMR", "activity", "is", "molecular", "microsatellite", "instability", "(MSI)", "testing.", "In", "most", "cases,", "it", "involves", "extracting", "DNA", "from", "both", "tumor", "and", "normal", "tissue.", "The", "DNA", "is", "subjected", "to", "polymerase", "chain", "reaction", "(PCR)", "amplification", "of", "five", "or", "more", "different", "chromosomal", "loci", "that", "compare", "\"microsatellites\",", "running", "the", "PCR", "products", "through", "a", "gel", "to", "separate", "DNA", "fragments", "by", "size,", "comparing", "the", "tumor-normal", "pairs,", "and", "scoring", "for", "differences", "between", "the", "two.", "Instability", "at", "two", "or", "more", "out", "of", "five", "markers", "defines", "a", "tumor", "as", "MSI-H", "and", "prompts", "further", "analysis,", "as", "sequencing", "of", "DNA", "MMR", "genes.", "A", "number", "of", "them", "have", "been", "associated", "with", "HNPCC,", "including", "hMSH2", ",", "hMLH1,", "hPMS1,", "hPMS2,", "hMSH3,", "and", "hMSH6.", "Most", "of", "the", "HNPCC", "families", "in", "which", "mutations", "have", "been", "identified", "involved", "hMSH2", "HNPCC", "families", " ", "[4]." ]
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This autosomal dominantly inherited disorder is caused by germline mutations in genes coding proteins responsible for the repair of DNA replication errors, which are referred to as DNA mismatch repair (MMR) genes [5]. DNA mismatch repair machinery plays a critical role in genomic stability, including correction of mispaired bases associated with DNA replication and recombination. Germline mutations in one allele of any of these genes followed by the somatic loss or inactivation of the wild-type allele leads to a defective mismatch repair mechanism. The current "gold standard" for assessing tumor DNA MMR activity is molecular microsatellite instability (MSI) testing. In most cases, it involves extracting DNA from both tumor and normal tissue. The DNA is subjected to polymerase chain reaction (PCR) amplification of five or more different chromosomal loci that compare "microsatellites", running the PCR products through a gel to separate DNA fragments by size, comparing the tumor-normal pairs, and scoring for differences between the two. Instability at two or more out of five markers defines a tumor as MSI-H and prompts further analysis, as sequencing of DNA MMR genes. A number of them have been associated with HNPCC, including hMSH2 , hMLH1, hPMS1, hPMS2, hMSH3, and hMSH6. Most of the HNPCC families in which mutations have been identified involved hMSH2 HNPCC families [4].
1266026-05-Discussion-p02
[]
[]
1601966-03-Results-p01
[ "Hierarchical", "clustering", "of", "samples", "from", "colorectal", "tumors", "and", "normal", "colon", "epithelia.", "On", "the", "right,", "you", "find", "the", "chromosomal", "localization", "of", "the", "genes", "and", "the", "official", "HUGO", "symbol", "or", "prospective", "Affymetrix", "cluster", "ID.", "On", "the", "top,", "the", "binary", "tree", "of", "tissue", "samples", "based", "on", "gene", "expression", "is", "given.", "The", "tissue", "denominators", "either", "contain", "TR", "for", "tumor", "or", "E", "for", "epithelium", "and", "a", "code", "reflecting", "the", "identity", "of", "each", "patient.", "In", "the", "center,", "the", "expression", "values", "after", "normalization", "have", "been", "color-coded:", "light", "blue", "means", "high", "expression,", "black", "means", "low", "(or", "no)", "expression.", "Note", "that", "only", "a", "representative", "fraction", "of", "the", "514", "genes", "is", "visualized", "here", "(white", "bars", "replace", "some", "portions", "of", "original", "heat", "map).", "The", "right", "cluster", "contains", "only", "samples", "from", "normal", " ", "colon", "epithelia,", "the", "left", "cluster", "is", "composed", "primarily", "of", "tumors", "along", "with", "some", "interspersed", "normal", "epithelial", "samples.", "Note", "that", "misplaced", "normal", "tissue", "(E)", "samples", "often", "cluster", "along", "with", "matching", "tumor", "tissues", " ", "mainly", "clustered", "together", "with", "matching", "tumor", " ", "samples", "from", "same", "patients.", "This", "suggests", "that", "coalescence", "between", "tumor", "and", "normal", "samples", "from", "the", "same", "patients", "could", "be", "due", "to", "patient-specific", "gene", "expression", "characteristics.", "As", "the", "majority", "of", "normal", "samples", "could", "be", "clearly", "separated", "from", "tumors,", "we", "concluded", "that", "our", "data", "set", "is", "well", "suited", "to", "explore", "differences", "in", "gene", "expression", "between", "normal", "and", "tumor", "cells", "of", "colorectal", "origin." ]
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Hierarchical clustering of samples from colorectal tumors and normal colon epithelia. On the right, you find the chromosomal localization of the genes and the official HUGO symbol or prospective Affymetrix cluster ID. On the top, the binary tree of tissue samples based on gene expression is given. The tissue denominators either contain TR for tumor or E for epithelium and a code reflecting the identity of each patient. In the center, the expression values after normalization have been color-coded: light blue means high expression, black means low (or no) expression. Note that only a representative fraction of the 514 genes is visualized here (white bars replace some portions of original heat map). The right cluster contains only samples from normal colon epithelia, the left cluster is composed primarily of tumors along with some interspersed normal epithelial samples. Note that misplaced normal tissue (E) samples often cluster along with matching tumor tissues mainly clustered together with matching tumor samples from same patients. This suggests that coalescence between tumor and normal samples from the same patients could be due to patient-specific gene expression characteristics. As the majority of normal samples could be clearly separated from tumors, we concluded that our data set is well suited to explore differences in gene expression between normal and tumor cells of colorectal origin.
1619718-05-Discussion-p03
[ "Concept", "of", "discrete", "colorectal", "lesions", "and", "progression", "to", "colorectal", "cancer", "via", "independent", "pathways" ]
[ 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0 ]
Concept of discrete colorectal lesions and progression to colorectal cancer via independent pathways
1619718-03-Materials-and-methods-p02
[ "This", "was", "undertaken", "on", "all", "adenomas", "and", "all", "serrated", "polyps", "with", "dysplasia", "(traditional", "SA", "and", "MP).", "Most", "of", "these", "polyps", "had", "been", "immunostained", "previously", "for", "MGMT.24", "Following", "deparaffinization", "and", "rehydration", "of", "4-µm", "sections", "and", "antigen", "retrieval", "using", "ethylene", "diamine", "tetra-acetic", "acid", "and", "microwaving,", "the", "sections", "were", "subjected", "to", "peroxidase", "blockade", "(Dako", "EnVision", "bottle", "1;", "Mississauga,", "Canada)", "and", "then", "incubated", "in", "10%", "goat", "serum", "to", "minimize", "non-specific", "staining.", "They", "were", "subsequently", "incubated", "with", "the", "primary", "anti-p53", "antibody", "(DO-7,", "from", "DakoCytomation,", "Mississauga,", "Canada)", "at", "a", "dilution", "of", "1", ":", "100", "for", "60", "min", "at", "37°C.", "After", "washing,", "the", "sections", "were", "incubated", "with", "secondary", "antibody", "(EnVision", "bottle", "2)", "for", "30", "min,", "washed", "again", "and", "then", "developed", "with", "the", "chromogen", "AEC", "for", "30", "min.", "Finally,", "the", "sections", "were", "counterstained", "with", "Gill's", "haematoxylin.", "Polyps", "were", "scored", "as", "showing", "loss", "of", "expression", "of", "MGMT", "if", "there", "was", "complete", "absence", "of", "nuclear", "expression", "throughout", "one", "or", "more", "crypts.", "Polyps", "were", "scored", "as", "positive", "for", "aberrant", "p53", "expression", "V599E", ")", "was", "performed", "by", "a", "real-time", "PCR-based", "allelic", "discrimination", "method", "as", "previously", "described.29", "Briefly,", "real-time", "PCR", "was", "performed", "using", "allele-specific", "primers", "designed", "to", "amplify", "selectively", "the", "wild-type", "(T1796)", "and", "mutant", "(A1796)", "BRAF", "alleles.", "The", "primer", "sequences", "were", "as", "follows:", "V,", "5′-GTGATTTTGGTCTAGCTACtGT;", "E,", "5′-CGCGGCCGGCCGCGGCGGTGATTTTGGTCTAGCTACcGA;", "AS,", "5′-TAGCCTCAATTCTTACCATCCAC.", "PCR", "amplification", "and", "melting", "curve", "analysis", "were", "performed", "on", "a", "Rotor-gene", "3000", "(Corbett", "Research,", "NSW,", "Australia).", "Genomic", "DNA", "was", "amplified", "in", "a", "15-µl", "volume", "containing", "1", "×", "Platinum", "SYBR", "Green", "qPCR", "SuperMix-UDG", "(Invitrogen,", "Carlsbad,", "CA,", "USA),", "forward", "primer", "V", "(300", "nm),", "forward", "primer", "E", "(900", "nm)", "and", "reverse", "primer", "AS", "(300", "nm).", "The", "cycling", "conditions", "were", "as", "follows:", "50°C", "for", "2", "min,", "95°C", "for", "2", "min,", "40", "cycles", "of", "95°C", "for", "15", "s", "and", "60°C", "for", "60", "s.", "After", "amplification,", "samples", "were", "subjected", "to", "a", "temperature", "ramp", "from", "60°C", "to", "99°C,", "rising", "1°C", "each", "step.", "For", "wild-type", "samples,", "single", "peaks", "were", "observed", "at", "80°C", "while", "samples", "containing", "mutant", "alleles", "produced", "single", "peaks", "at", "85°C." ]
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This was undertaken on all adenomas and all serrated polyps with dysplasia (traditional SA and MP). Most of these polyps had been immunostained previously for MGMT.24 Following deparaffinization and rehydration of 4-µm sections and antigen retrieval using ethylene diamine tetra-acetic acid and microwaving, the sections were subjected to peroxidase blockade (Dako EnVision bottle 1; Mississauga, Canada) and then incubated in 10% goat serum to minimize non-specific staining. They were subsequently incubated with the primary anti-p53 antibody (DO-7, from DakoCytomation, Mississauga, Canada) at a dilution of 1 : 100 for 60 min at 37°C. After washing, the sections were incubated with secondary antibody (EnVision bottle 2) for 30 min, washed again and then developed with the chromogen AEC for 30 min. Finally, the sections were counterstained with Gill's haematoxylin. Polyps were scored as showing loss of expression of MGMT if there was complete absence of nuclear expression throughout one or more crypts. Polyps were scored as positive for aberrant p53 expression V599E ) was performed by a real-time PCR-based allelic discrimination method as previously described.29 Briefly, real-time PCR was performed using allele-specific primers designed to amplify selectively the wild-type (T1796) and mutant (A1796) BRAF alleles. The primer sequences were as follows: V, 5′-GTGATTTTGGTCTAGCTACtGT; E, 5′-CGCGGCCGGCCGCGGCGGTGATTTTGGTCTAGCTACcGA; AS, 5′-TAGCCTCAATTCTTACCATCCAC. PCR amplification and melting curve analysis were performed on a Rotor-gene 3000 (Corbett Research, NSW, Australia). Genomic DNA was amplified in a 15-µl volume containing 1 × Platinum SYBR Green qPCR SuperMix-UDG (Invitrogen, Carlsbad, CA, USA), forward primer V (300 nm), forward primer E (900 nm) and reverse primer AS (300 nm). The cycling conditions were as follows: 50°C for 2 min, 95°C for 2 min, 40 cycles of 95°C for 15 s and 60°C for 60 s. After amplification, samples were subjected to a temperature ramp from 60°C to 99°C, rising 1°C each step. For wild-type samples, single peaks were observed at 80°C while samples containing mutant alleles produced single peaks at 85°C.
1373649-03-Methods-p01
[ "Peripheral", "blood", "was", "collected", "from", "the", "three", "consulting", "family", "members", "and", "the", "proband's", "father", "tumor", "unaffected", "carrier", "malignancy", "mother", "Three", " ", "first-degree", "relatives", "(mother", "and", "two", "sisters)", "of", "a", "male", "who", "died", "of", "poorly", "differentiated", "colorectal", "adenocarcinoma", "at", "age", "23", "contacted", "us", "for", "genetic", "counseling.", "A", "detailed", "family", "and", "medical", "history", "was", "obtained", "through", "interview", "with", "the", "proband", "relatives", "and", "their", "consent", "for", "release", "of", "medical", "records", "and", "use", "of", "the", "pathological", "tissue", "blocks", "still", "available." ]
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Peripheral blood was collected from the three consulting family members and the proband's father tumor unaffected carrier malignancy mother Three first-degree relatives (mother and two sisters) of a male who died of poorly differentiated colorectal adenocarcinoma at age 23 contacted us for genetic counseling. A detailed family and medical history was obtained through interview with the proband relatives and their consent for release of medical records and use of the pathological tissue blocks still available.
2386495-05-Discussion-p02
[ "The", "fraction", "of", "large", "deletions", "of", "all", "APC", "mutations", "identified", "in", "the", "Swedish", "patients", "was", "9%,", "which", "is", "higher", "than", "the", "5%", "of", "large", "deletions", "reported", "in", "[38].", "The", "relatively", "large", "number", "of", "gross", "deletions", "identified", "could", "be", "a", "result", "of", "the", "thorough", "analysis", "applied", "for", "every", "patient,", "including", "the", "use", "of", "the", "MLPA", "technique.", "It", "is", "noteworthy", "that", "no", "deletion", "of", "APC", "exon", "4", "in", "patient", "3765", "was", "detected", "using", "MLPA", "although", "it", "had", "been", "identified", "and", "confirmed", "by", "other", "methods.", "A", "still", "untested", "possibility", "is", "that", "exon", "4", "has", "been", "translocated", "to", "another", "chromosomal", "locus", "and", "thus", "generates", "the", "positive", "MLPA", "result." ]
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The fraction of large deletions of all APC mutations identified in the Swedish patients was 9%, which is higher than the 5% of large deletions reported in [38]. The relatively large number of gross deletions identified could be a result of the thorough analysis applied for every patient, including the use of the MLPA technique. It is noteworthy that no deletion of APC exon 4 in patient 3765 was detected using MLPA although it had been identified and confirmed by other methods. A still untested possibility is that exon 4 has been translocated to another chromosomal locus and thus generates the positive MLPA result.
1619718-04-Results-p01
[ "Frequency", "of", "KRAS", "and", "BRAF", "mutation", "and", "loss", "of", "expression", "of", "O-6-methylguanine", "DNA", "methyltransferase", "(MGMT)", "by", "polyp", "type" ]
[ 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0 ]
Frequency of KRAS and BRAF mutation and loss of expression of O-6-methylguanine DNA methyltransferase (MGMT) by polyp type
1619718-05-Discussion-p02
[ "Serrated", "polyps", "with", "dysplasia,", "i.e.", "MPs", "and", "SAs,", "together", "comprised", "only", "2%", "of", "the", "overall", "consecutive", "series", "of", "1250", "polyps", ".", "While", "mutation", "serrated", " ", "polyps", "comprise", "conventional", "HPs", "and", "the", "variant", "lesion", "which", "has", "been", "described", "as", "SSA.", "In", "this", "study,", "SSAs", "accounted", "for", "approximately", "3%", "of", "the", "overall", "series", "of", "polyps", "and", "were", "more", "age-related", "than", "HPs.", "Importantly,", "SSAs", "have", "been", "linked", "with", "the", "subset", "of", "colorectal", "cancer", "with", "BRAF", "mutation,", "DNA", "methylation,", "MSI", "and", "serrated", "architecture.14,18,37", "In", "this", "study", "there", "was", "a", "high", "frequency", "of", "BRAF", "mutation", "in", "conventional", "HPs", "(67%)", "as", "well", "as", "in", "SSAs", "(81%).", "Previous", "reports", "have", "shown", "very", "similar", "results", "for", "BRAF", "mutation", "in", "SSA,16", "but", "higher", "frequencies", "of", "KRAS", "mutation", "and", "lower", "frequencies", "of", "BRAF", "mutation", "in", "HPs.12,16,38", "As", "mentioned", "in", "Materials", "and", "methods,", "there", "had", "been", "selection", "of", "larger", "HPs", "in", "an", "earlier", "cell", "kinetic", "study", "involving", "the", "same", "material.", "Large", "HPs", "are", "more", "likely", "to", "include", "the", "subset", "described", "as", "‘microvesicular’,", "in", "which", "the", "columnar", "cells", "contain", "apical", "mucin", "droplets", "within", "small", "vesicles", "while", "goblet", "cells", "are", "rendered", "inconspicuous.25BRAF", "mutation", "occurs", "more", "frequently", "in", "the", "microvesicular", "variant", "of", "HP.16", "By", "contrast,", "KRAS", "mutation", "occurs", "much", "more", "commonly", "in", "the", "goblet", "cell", "variant", "of", "HP,", "which", "is", "usually", "small,", "located", "in", "the", "left", "colon", "or", "rectum", "and", "deviates", "minimally", "from", "normal", "colorectal", "mucosa", "in", "terms", "of", "differentiation", "and", "architecture.16,25", "The", "latter", "were", "under-represented", "in", "this", "series", "(details", "not", "shown)." ]
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Serrated polyps with dysplasia, i.e. MPs and SAs, together comprised only 2% of the overall consecutive series of 1250 polyps . While mutation serrated polyps comprise conventional HPs and the variant lesion which has been described as SSA. In this study, SSAs accounted for approximately 3% of the overall series of polyps and were more age-related than HPs. Importantly, SSAs have been linked with the subset of colorectal cancer with BRAF mutation, DNA methylation, MSI and serrated architecture.14,18,37 In this study there was a high frequency of BRAF mutation in conventional HPs (67%) as well as in SSAs (81%). Previous reports have shown very similar results for BRAF mutation in SSA,16 but higher frequencies of KRAS mutation and lower frequencies of BRAF mutation in HPs.12,16,38 As mentioned in Materials and methods, there had been selection of larger HPs in an earlier cell kinetic study involving the same material. Large HPs are more likely to include the subset described as ‘microvesicular’, in which the columnar cells contain apical mucin droplets within small vesicles while goblet cells are rendered inconspicuous.25BRAF mutation occurs more frequently in the microvesicular variant of HP.16 By contrast, KRAS mutation occurs much more commonly in the goblet cell variant of HP, which is usually small, located in the left colon or rectum and deviates minimally from normal colorectal mucosa in terms of differentiation and architecture.16,25 The latter were under-represented in this series (details not shown).
3034663-03-Methods-p02
[ "MLH1", "promoter", "hypermethylation", "by", "Methylation", "Sensitive", "Multiplex", "Ligation-dependent", "Probe", "Amplification", "(MS-MLPA),", "and", "BRAF", "p.Val600Glu", "mutation", "by", "direct", "sequencing", "from", "tumor", "DNA", "was", "also", "assess", "when", "MLH1", "loss", "of", "expression", "was", "detected." ]
[ 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0 ]
MLH1 promoter hypermethylation by Methylation Sensitive Multiplex Ligation-dependent Probe Amplification (MS-MLPA), and BRAF p.Val600Glu mutation by direct sequencing from tumor DNA was also assess when MLH1 loss of expression was detected.
1601966-03-Results-p10
[ "5q22.2-5q23.1" ]
[ 0 ]
5q22.2-5q23.1
1557864-01-Abstract-p01
[ "The", "treatment", "of", "ovarian", "cancer", "is", "hindered", "by", "intrinsic", "or", "acquired", "resistance", "to", "platinum-based", "chemotherapy.", "The", "aim", "of", "this", "study", "is", "to", "determine", "the", "frequency", "of", "mismatch", "repair", "(MMR)", "inactivation", "in", "ovarian", "cancer", "and", "its", "association", "with", "resistance", "to", "platinum-based", "chemotherapy." ]
[ 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0 ]
The treatment of ovarian cancer is hindered by intrinsic or acquired resistance to platinum-based chemotherapy. The aim of this study is to determine the frequency of mismatch repair (MMR) inactivation in ovarian cancer and its association with resistance to platinum-based chemotherapy.
1619718-04-Results-p03
[ "Sixty-two", "TAs,", "22", "TVAs/VAs,", "15", "SAs", "and", "10", "MPs", "were", "immunostained", "for", "p53.", "Weak", "expression", "of", "nuclear", "p53", "occurred", "frequently", "within", "the", "proliferative", "compartment", "in", "all", "types", "of", "polyps", "and", "was", "ignored.", "Aberrant", "p53", "expression", "was", "observed", "in", "only", "four", "mutation", "KRAS", " ", "mutation", "occurred", "in", "3/25", "(12%)", "adenomas", "with", "no", "MGMT", "loss", "<", " ", "10", "mm", ",", "KRAS", "mutation", "occurred", "in", "3/25", "(12%)", "adenomas", "with", "no", "MGMT", "loss", "but", "in", "4/8", "(50%)", "adenomas", "with", "MGMT", "loss", "(P", "<", "0.04).", "Since", "there", "were", "few", "KRAS", "mutations", "in", "this", "subset", "and", "most", "KRAS", "mutations", "(5/7)", "were", "G→A,", "it", "was", "not", "possible", "to", "demonstrate", "an", "association", "between", "MGMT", "loss", "and", "G→A", "mutation", "in", "KRAS." ]
[ 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 11, 5, 21, 0, 0, 0, 0, 0, 0, 0, 0, 7, 8, 8, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0 ]
Sixty-two TAs, 22 TVAs/VAs, 15 SAs and 10 MPs were immunostained for p53. Weak expression of nuclear p53 occurred frequently within the proliferative compartment in all types of polyps and was ignored. Aberrant p53 expression was observed in only four mutation KRAS mutation occurred in 3/25 (12%) adenomas with no MGMT loss <   10 mm , KRAS mutation occurred in 3/25 (12%) adenomas with no MGMT loss but in 4/8 (50%) adenomas with MGMT loss (P < 0.04). Since there were few KRAS mutations in this subset and most KRAS mutations (5/7) were G→A, it was not possible to demonstrate an association between MGMT loss and G→A mutation in KRAS.
3034663-03-Methods-p01
[ "No", "familial", "history", "of", "cancer", "was", "available", "from", "the", "control", "group.", "Patients", "diagnosed", "at", "an", "age", "over", "50", "years", "and", "not", "referred", "to", "Genetic", "Counselling", "Units", "were", "considered", "as", "sporadic", "CRC.", "Samples", "from", "sporadic", "CRC", "patients", "were", "obtained", "from", "the", "Elche", "University", "Hospital", "BioBank", "and", "the", "Castellon", "Provincial", "Hospital", "BioBank.", "Written", "consent", "to", "be", "included", "in", "the", "respective", "biobanks", "was", "obtained", "from", "each", "patient.", "CRC", "patients,", "as", "index", "subjects", "from", "families", "with", "suspicion", "of", "LS", "that", "attended", "Genetic", "Counselling", "at", "the", "Cancer", "Units", "of", "the", "Elche", "and", "La", "Fe", "Hospitals,", "were", "recruited.", "The", "study", "was", "approved", "by", "the", "Ethics", "Committee", "of", "the", "Elche", "University", "Hospital." ]
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No familial history of cancer was available from the control group. Patients diagnosed at an age over 50 years and not referred to Genetic Counselling Units were considered as sporadic CRC. Samples from sporadic CRC patients were obtained from the Elche University Hospital BioBank and the Castellon Provincial Hospital BioBank. Written consent to be included in the respective biobanks was obtained from each patient. CRC patients, as index subjects from families with suspicion of LS that attended Genetic Counselling at the Cancer Units of the Elche and La Fe Hospitals, were recruited. The study was approved by the Ethics Committee of the Elche University Hospital.
1334229-04-Results-p01
[]
[]
3034663-03-Methods-p02
[ "MLH1", "promoter", "hypermethylation", "by", "Methylation", "Sensitive", "Multiplex", "Ligation-dependent", "Probe", "Amplification", "(MS-MLPA),", "and", "BRAF", "familial", "group", " ", "and", "nine", "from", "the", "sporadic", "CRC", "group)", "was", "screened", "for", "MSI", "status", "using", "five", "mononucleotide", "markers", "(BAT26,", "BAT25,", "NR21,", "NR24", "and", "NR27)", "and", "multiplex", "PCR", "as", "previously", "described", "by", "Buhard", "et", "al", "[8]." ]
[ 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 21, 9, 10, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0 ]
MLH1 promoter hypermethylation by Methylation Sensitive Multiplex Ligation-dependent Probe Amplification (MS-MLPA), and BRAF familial group and nine from the sporadic CRC group) was screened for MSI status using five mononucleotide markers (BAT26, BAT25, NR21, NR24 and NR27) and multiplex PCR as previously described by Buhard et al [8].
2386495-02-Background-p01
[ "The", "majority", "of", "germline", "APC", "mutations", "identified", "in", "FAP", "families", "cause", "truncations", "in", "this", "multifunctional", "protein", "[6,7].", "The", "APC", "truncations", "most", "often", "occur", "as", "the", "result", "of", "nonsense", "APC", "mutations", "or", "frameshifts", "caused", "by", "small", "deletions/insertions.", "Large", "APC", "deletions", "are", "found", "in", "a", "limited", "number", "of", "FAP", "cases.", "By", "using", "methods", "such", "as", "quantitative", "real-time", "PCR", "(polymerase", "chain", "reaction)", "or", "MLPA", "(multiplex", "ligation-dependent", "probe", "amplification)", "rather", "than", "conventional", "mutation-detection", "techniques,", "we", "can", "achieve", "higher", "detection", "rates", "of", "large", "deletions", "[8-12].", "The", "number", "of", "reported", "characterized", "APC", " ", "splice-site", "mutations", "is", "comparatively", "low", "[13-17].", "Approximately", "10–15%", "of", "the", "FAP", "patients", "could", "have", "a", "reduced", "or", "absent", "APC", " ", "expression", "[18].", "The", "cause", "of", "the", "reduced", "expression", "is", "not", "known", "but", "the", "patients", "show", "a", "similar", "phenotype", "to", "those", "with", "an", "identified", "truncating", "APC", "mutation", "[19-21].", "It", "has", "been", "shown", "that", "a", "decrease", "of", "approximately", "50%", "of", "the", "expression", "of", "an", "allele", "can", "result", "in", "a", "predisposition", "to", "FAP", "[20].", "Germline", "APC-mutation", "mosaicism", "in", "FAP", "patients", "has", "been", "reported", "[22-25]", "but", "is", "not", "generally", "included", "in", "the", "mutation", "screening", "procedure", "provided", "by", "most", "labs", "owing", "to", "the", "technical", "difficulties", "encountered", "with", "these", "analyses." ]
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The majority of germline APC mutations identified in FAP families cause truncations in this multifunctional protein [6,7]. The APC truncations most often occur as the result of nonsense APC mutations or frameshifts caused by small deletions/insertions. Large APC deletions are found in a limited number of FAP cases. By using methods such as quantitative real-time PCR (polymerase chain reaction) or MLPA (multiplex ligation-dependent probe amplification) rather than conventional mutation-detection techniques, we can achieve higher detection rates of large deletions [8-12]. The number of reported characterized APC splice-site mutations is comparatively low [13-17]. Approximately 10–15% of the FAP patients could have a reduced or absent APC expression [18]. The cause of the reduced expression is not known but the patients show a similar phenotype to those with an identified truncating APC mutation [19-21]. It has been shown that a decrease of approximately 50% of the expression of an allele can result in a predisposition to FAP [20]. Germline APC-mutation mosaicism in FAP patients has been reported [22-25] but is not generally included in the mutation screening procedure provided by most labs owing to the technical difficulties encountered with these analyses.
1334229-04-Results-p01
[ "Of", "656", "tumours", "for", "which", "the", "other", "molecular", "alterations,", "i.e.", "mutations", "proximal", "colon", "patient", " ", "characteristics", "of", "seven", "colorectal", "tumours", "that", "harboured", "a", "mutation", "in", "CTNNB1", "exon", "3.", "In", "five", "colorectal", "cancers,", "a", "CTNNB1", "mutation", "that", "would", "lead", "to", "loss", "of", "one", "of", "the", "Ser/Thr", "phosphorylation", "sites", "and", "subsequent", "stabilisation", "of", "the", "protein,", "occurred", "at", "codons", "37", "and", "45,", "all", "were", "C→T", "transitions,", "leading", "to", "Ser→Phe", "amino", "acid", "changes", "and", "occurred", "in", "the", "proximal", "colon.", "All", "bar", "one", "also", "had", "an", "activating", "mutation", "in", "the", "K-ras", "gene.", "Three", "of", "these", "five", "tumours", "showed", "hMLH1", "deficiency.", "Two", "colorectal", "cancer", "patients", "truncating", "APC", "mutation", " ", "or", "lacked", "hMLH1", "expression,", "were", "analysed", "for", "mutations", "in", "exon", "3", "of", "the", "CTNNB1", "gene.", "Table", "1", "describes", "the", "tumour", "and", "patient", "characteristics", "of", "seven", "colorectal", "tumours", "that", "harboured", "a", "mutation", "in", "CTNNB1", "exon", "3.", "In", "five", "colorectal", "cancers,", "a", "CTNNB1", "mutation", "that", "would", "lead", "to", "loss", "of", "one", "of", "the", "Ser/Thr", "phosphorylation", "sites", "and", "subsequent", "stabilisation", "of", "the", "protein,", "occurred", "at", "codons", "37", "and", "45,", "all", "were", "C→T", "transitions,", "leading", "to", "Ser→Phe", "amino", "acid", "changes", "464", "of", "656", " ", "patients,", "which", "did", "not", "harbour", "a", "truncating", "APC", "mutation", "or", "lacked", "hMLH1", "expression,", "were", "analysed", "for", "mutations", "in", "exon", "3", "of", "the", "CTNNB1", "gene.", "Table", "1", "describes", "the", "tumour", "and", "patient", "characteristics", "of", "seven", "colorectal", "tumours", "that", "harboured", "a", "mutation", "in", "CTNNB1", "exon", "3.", "In", "five", "colorectal", "cancers,", "a", "CTNNB1", "mutation", "that", "would", "lead", "to", "loss", "of", "one", "of", "the", "Ser/Thr", "phosphorylation", "sites", "and", "subsequent", "stabilisation", "of", "the", "protein,", "occurred", "at", "codons", "37", "and", "45,", "all", "were", "C→T", "transitions,", "leading", "to", "Ser→Phe", "amino", "acid", "changes", "and", "occurred", "in", "the", "proximal", "colon.", "All", "bar", "one", "also", "had", "an", "activating", "mutation", "in", "the", "K-ras", "gene.", "Three", "of", "these", "five", "tumours", "showed", "hMLH1", "deficiency.", "Two", "colorectal", "cancer", "patients", "harboured", "a", "mutation", "in", "the", "CTNNB1", "gene,", "that", "did", "not", "occur", "at", "the", "Ser/Thr", "phosphorylation", "sites,", "but", "would", "result", "in", "an", "amino", "acid", "alteration", "at", "codons", "22", "and", "29,", "the", "effects", "of", "which", "are", "unknown.", "Because", "of", "the", "very", "low", "frequency", "of", "tumours", "harbouring", "a", "CTNNB1", "mutation,", "these", "mutations", "were", "not", "included", "in", "further", "analyses.", "In", "addition,", "mutation", "analysis", "of", "remaining", "samples", "was", "abandoned,", "since", "this", "was", "deemed", "irrelevant", "as", "these", "harboured", "truncating", "APC", "mutations", "and", "are", "considered", "to", "be", "unlikely", "to", "also", "have", "CTNNB1", "mutations", "[7]." ]
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Of 656 tumours for which the other molecular alterations, i.e. mutations proximal colon patient characteristics of seven colorectal tumours that harboured a mutation in CTNNB1 exon 3. In five colorectal cancers, a CTNNB1 mutation that would lead to loss of one of the Ser/Thr phosphorylation sites and subsequent stabilisation of the protein, occurred at codons 37 and 45, all were C→T transitions, leading to Ser→Phe amino acid changes and occurred in the proximal colon. All bar one also had an activating mutation in the K-ras gene. Three of these five tumours showed hMLH1 deficiency. Two colorectal cancer patients truncating APC mutation or lacked hMLH1 expression, were analysed for mutations in exon 3 of the CTNNB1 gene. Table 1 describes the tumour and patient characteristics of seven colorectal tumours that harboured a mutation in CTNNB1 exon 3. In five colorectal cancers, a CTNNB1 mutation that would lead to loss of one of the Ser/Thr phosphorylation sites and subsequent stabilisation of the protein, occurred at codons 37 and 45, all were C→T transitions, leading to Ser→Phe amino acid changes 464 of 656 patients, which did not harbour a truncating APC mutation or lacked hMLH1 expression, were analysed for mutations in exon 3 of the CTNNB1 gene. Table 1 describes the tumour and patient characteristics of seven colorectal tumours that harboured a mutation in CTNNB1 exon 3. In five colorectal cancers, a CTNNB1 mutation that would lead to loss of one of the Ser/Thr phosphorylation sites and subsequent stabilisation of the protein, occurred at codons 37 and 45, all were C→T transitions, leading to Ser→Phe amino acid changes and occurred in the proximal colon. All bar one also had an activating mutation in the K-ras gene. Three of these five tumours showed hMLH1 deficiency. Two colorectal cancer patients harboured a mutation in the CTNNB1 gene, that did not occur at the Ser/Thr phosphorylation sites, but would result in an amino acid alteration at codons 22 and 29, the effects of which are unknown. Because of the very low frequency of tumours harbouring a CTNNB1 mutation, these mutations were not included in further analyses. In addition, mutation analysis of remaining samples was abandoned, since this was deemed irrelevant as these harboured truncating APC mutations and are considered to be unlikely to also have CTNNB1 mutations [7].
3034663-03-Methods-p01
[ "Methods" ]
[ 0 ]
Methods
3034663-05-Discussion-p02
[ "Herein,", "we", "describe", "the", "coexistence", "of", "the", "p.Lys618Ala", "variant", "with", "deleterious", "variants", "in", "another", "two", "unrelated", "LS", "families.", "In", "one", "family,", "the", "allele", "distribution", "of", "the", "pathogenic", "and", "unclassified", "variant", "was", "in", "trans,", "in", "the", "other", "family", "the", "pathogenic", "variant", "was", "detected", "in", "the", "MSH6", "gene", "and", "only", "the", "deleterious", "variant", "co-segregated", "with", "the", "disease", "in", "both", "families.", "This", "evidence", "indicates", "that", "the", "p.Lys618Ala", "variant", "is", "not", "deleterious." ]
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Herein, we describe the coexistence of the p.Lys618Ala variant with deleterious variants in another two unrelated LS families. In one family, the allele distribution of the pathogenic and unclassified variant was in trans, in the other family the pathogenic variant was detected in the MSH6 gene and only the deleterious variant co-segregated with the disease in both families. This evidence indicates that the p.Lys618Ala variant is not deleterious.
1601966-03-Results-p10
[ "5q22.2-5q23.1" ]
[ 0 ]
5q22.2-5q23.1
1557864-03-Methods-p02
[ "Quantitative", "RT-PCR", "analysis", "was", "used", "to", "measure", "the", "mRNA", "expression", "levels", "of", "MLH1,", "MSH2,", "MSH3,", "MSH6", "and", "PMS2", "in", "the", "eight", "ovarian", "cancer", "cell", "lines", "and", "50", "of", "the", "75", "eight", "MSH6", " ", "and", "PMS2", "in", "the", "eight", "ovarian", "cancer", "cell", "lines", "and", "50", "of", "the", "75", "ovarian", "cancer", "specimens", "of", "which", "RNA", "was", "available.", "Thirty-six", "of", "these", "50", "patients", "received", "platinum-based", "chemotherapy", "(7", "non-responders,", "28", "responders", "and", "one", "patients", "with", "unknown", "response).", "The", "following", "20×", "assay-on-demand", "primers", "and", "FAM-TAMRA", "labeled", "probe-mix", "from", "Applied", "Biosystems", "were", "used;", "for", "MLH1", "(Hs00179866_m1),", "MSH2", "Thirty-six", "of", "these", "50", " ", "patients", "received", "platinum-based", "chemotherapy", "(7", "non-responders,", "28", "responders", "and", "one", "patients", "with", "unknown", "response).", "The", "following", "20×", "assay-on-demand", "primers", "and", "FAM-TAMRA", "labeled", "probe-mix", "from", "Applied", "Biosystems", "were", "used;", "for", "MLH1", "(Hs00179866_m1),", "MSH2", "(Hs00179887_m1),", "MSH3", "patients", " ", "with", "unknown", "response).", "The", "following", "20×", "assay-on-demand", "primers", "and", "FAM-TAMRA", "labeled", "probe-mix", "from", "Applied", "Biosystems", "were", "used;", "for", "MLH1", "(Hs00179866_m1),", "MSH2", "(Hs00179887_m1),", "MSH3", "(Hs00267239_m1),", "MSH6", "28", "non-responders", "colon", "cancer", " ", "cell", "lines", "SW48", "with", "a", "methylated", "MLH1", "promoter", "and", "SW480", "with", "an", "unmethylated", "MLH1", "promoter,", "were", "used", "as", "positive", "and", "negative", "control", "respectively." ]
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Quantitative RT-PCR analysis was used to measure the mRNA expression levels of MLH1, MSH2, MSH3, MSH6 and PMS2 in the eight ovarian cancer cell lines and 50 of the 75 eight MSH6 and PMS2 in the eight ovarian cancer cell lines and 50 of the 75 ovarian cancer specimens of which RNA was available. Thirty-six of these 50 patients received platinum-based chemotherapy (7 non-responders, 28 responders and one patients with unknown response). The following 20× assay-on-demand primers and FAM-TAMRA labeled probe-mix from Applied Biosystems were used; for MLH1 (Hs00179866_m1), MSH2 Thirty-six of these 50 patients received platinum-based chemotherapy (7 non-responders, 28 responders and one patients with unknown response). The following 20× assay-on-demand primers and FAM-TAMRA labeled probe-mix from Applied Biosystems were used; for MLH1 (Hs00179866_m1), MSH2 (Hs00179887_m1), MSH3 patients with unknown response). The following 20× assay-on-demand primers and FAM-TAMRA labeled probe-mix from Applied Biosystems were used; for MLH1 (Hs00179866_m1), MSH2 (Hs00179887_m1), MSH3 (Hs00267239_m1), MSH6 28 non-responders colon cancer cell lines SW48 with a methylated MLH1 promoter and SW480 with an unmethylated MLH1 promoter, were used as positive and negative control respectively.
3034663-02-Background-p01
[ "The", "results", "of", "sequence-based", "genetic", "tests", "may", "be", "reported", "to", "physicians", "as:", "1)", "positive,", "in", "which", "a", "mutation", "that", "clearly", "disrupts", "gene", "function", "is", "detected", "and", "is", "highly", "likely", "to", "have", "clinical", "consequences;", "2)", "a", "genetic", "variant", "is", "detected", "but", "it", "is", "not", "known", "whether", "the", "variant", "has", "any", "effect", "on", "gene", "function", "that", "might", "confer", "an", "increased", "cancer", "risk", "(these", "variants", "are", "known", "as", "variants", "of", "uncertain/unclassified", "significance", "or", "unclassified", "variants", "[UVs]);", "and", "3)", "negative,", "in", "which", "deleterious", "variant", "or", "UV", "is", "detected", "[1]." ]
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The results of sequence-based genetic tests may be reported to physicians as: 1) positive, in which a mutation that clearly disrupts gene function is detected and is highly likely to have clinical consequences; 2) a genetic variant is detected but it is not known whether the variant has any effect on gene function that might confer an increased cancer risk (these variants are known as variants of uncertain/unclassified significance or unclassified variants [UVs]); and 3) negative, in which deleterious variant or UV is detected [1].
1266026-01-Abstract-p01
[ "Methods" ]
[ 0 ]
Methods
1619718-04-Results-p01
[ "Mutation", "frequencies", "for", "both", "KRAS", "(P", "<", "0.0001)", "and", "BRAF", "(P", "<", "0.0001)", "are", "distributed", "differently", "across", "the", "seven", "classes", "of", "polyp", "(see", "Results", "for", "individual", "comparisons).", "Distribution", "of", "MGMT", "loss", "differs", "across", "the", "seven", "classes", "of", "polyp", "(P", "<", "0.001)." ]
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Mutation frequencies for both KRAS (P < 0.0001) and BRAF (P < 0.0001) are distributed differently across the seven classes of polyp (see Results for individual comparisons). Distribution of MGMT loss differs across the seven classes of polyp (P < 0.001).
1334229-03-Methods-p02
[ "The", "semi-nested", "PCR", "products", "from", "samples", "without", "a", "truncating", "APC", "APC", " ", "gene", "are", "found", "within", "the", "mutation", "cluster", "region", "(codons", "1286–1520).", "Mutation", "analysis", "of", "the", "mutation", "cluster", "region", "was", "performed", "on", "adenocarcinoma", "DNA", "using", "nested", "PCR", "for", "amplification", "of", "the", "mutation", "cluster", "region", "as", "four", "overlapping", "DNA", "fragments", "followed", "by", "direct", "sequencing", "of", "purified", "fragments,", "as", "previously", "described", "[28].", "An", "alternative", "nested", "PCR", "strategy", "was", "performed", "when", "nested", "PCR", "failed", "for", "any", "of", "the", "fragments,", "using", "different", "primers.", "The", "detection", "limit", "was", "5%", "mutated", "DNA", "and", "duplicate", "experiments", "revealed", "good", "reproducibility", "(85%)[28].", "From", "72", "of", "the", "737", "patients", "with", "sufficient", "DNA", "yield,", "one", "or", "more", "fragments", "of", "the", "mutation", "cluster", "region", "could", "not", "be", "amplified", "and", "these", "patients", "were", "not", "included", "in", "this", "study." ]
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The semi-nested PCR products from samples without a truncating APC APC gene are found within the mutation cluster region (codons 1286–1520). Mutation analysis of the mutation cluster region was performed on adenocarcinoma DNA using nested PCR for amplification of the mutation cluster region as four overlapping DNA fragments followed by direct sequencing of purified fragments, as previously described [28]. An alternative nested PCR strategy was performed when nested PCR failed for any of the fragments, using different primers. The detection limit was 5% mutated DNA and duplicate experiments revealed good reproducibility (85%)[28]. From 72 of the 737 patients with sufficient DNA yield, one or more fragments of the mutation cluster region could not be amplified and these patients were not included in this study.
1601966-03-Results-p11
[ "Down-regulation", "of", "mRNA", "expression", "in", "human", "chromosomal", "region", "5q22.2-5q23.1", "–", "the", "APC", "region", "(patient", "counts", "with", "coordinate", "up-regulation).", "Grayscale", "cross-comparison", "plot", "of", "up-regulation", "patterns", "across", "patients", "(analogous", "to", "Figures", "7,", "10,", "13).", "View", "this", "plot", "in", "conjunction", "with", "Figures", "27", "and", "29." ]
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Down-regulation of mRNA expression in human chromosomal region 5q22.2-5q23.1 – the APC region (patient counts with coordinate up-regulation). Grayscale cross-comparison plot of up-regulation patterns across patients (analogous to Figures 7, 10, 13). View this plot in conjunction with Figures 27 and 29.
1334229-01-Abstract-p01
[ "Results" ]
[ 0 ]
Results
2275286-04-Results-p02
[ "Clinical", "features", "of", "patients", "in", "MSI", "group", "with", "MMR", "gene", "mutations" ]
[ 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0 ]
Clinical features of patients in MSI group with MMR gene mutations
1619718-03-Materials-and-methods-p03
[ "**", "IGNORE", "LINE", "**" ]
[ 0, 0, 0, 0 ]
** IGNORE LINE **
2275286-04-Results-p02
[ "Clinical", "features", "of", "patients", "in", "the", "MSI", "group", "with", "MMR", "gene", "mutations" ]
[ 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0 ]
Clinical features of patients in the MSI group with MMR gene mutations
1619718-04-Results-p02
[ "With", "respect", "to", "the", "25", "serrated", "polyps", "with", "dysplasia,", "only", "five", "occurred", "in", "the", "proximal", "colon", " ", "(up", "to", "the", "splenic", "flexure).", "Two", "of", "these", "had", "BRAF", "mutation", "(both", "Group", "A)", "and", "two", "had", "KRAS", "mutation", "(both", "Group", "B).", "Seven", "of", "the", "11", "BRAF", "mutations", "occurred", "in", "polyps", "derived", "from", "the", "left", "colon", "or", "rectum", "(remaining", "two", "polyps", "with", "BRAF", "mutation", "from", "site", "unknown).", "The", "three", " ", "Group", "A", "SAs", "with", "KRAS", "mutation", "(all", "from", "the", "left", "colon", "epithelial", "serration", " ", "and", "surface", "papillarity", "and", "nuclei", "that", "are", "ovoid,", "vesicular", "and", "contain", "a", "prominent", "nucleolus", "(inset).", "The", "columnar", "cells", "(inset)", "contain", "apical", "mucin", "droplets,", "similar", "to", "sessile", "SA", "(SSA).", "B,", "Mixed", "polyp", "(BRAF", "mutation)", "comprising", "SSA", "(left)", "and", "SA", "with", "high-grade", "dyplasia", "showing", "back-to-back", "glands", "(right)", "and", "aberrant", "expression", "of", "p53", "(inset).", "C,D,", "Two", "mixed", "polyps", "(MPs)", "(both", "SA/tubulo-villous", "adenoma", "and", "with", "KRAS", "mutation)", "in", "which", "the", "serrated", "epithelium", "has", "an", "adenomatous", "appearance", "as", "evidenced", "by", "elongated", "hyperchomatic", "nuclei", "with", "marked", "stratification", "and", "a", "dark", "amphophilic", "cytoplasm.", "The", "pure", "adenomatous", "component", "is", "not", "shown.", "E,F,", "Low-", "and", "medium-power", "images", "of", "a", "SA", "(KRAS", "mutation)", "in", "which", "complex", "microacini", "have", "resulted", "in", "markedly", "serrated", "epithelial", "contours.", "The", "epithelium", "comprises", "numerous", "goblet", "cells", "and", "absorptive-type", "columnar", "cells", "with", "eosinophilic", "cytoplasm", "and", "is", "reminiscent", "of", "the", "goblet", "cell", "variant", "of", "hyperplastic", "polyp.", "These", "examples", "illustrate", "the", "range", "of", "appearances", "and", "genetic", "changes", "that", "are", "encompassed", "by", "‘traditional’", "SA." ]
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With respect to the 25 serrated polyps with dysplasia, only five occurred in the proximal colon (up to the splenic flexure). Two of these had BRAF mutation (both Group A) and two had KRAS mutation (both Group B). Seven of the 11 BRAF mutations occurred in polyps derived from the left colon or rectum (remaining two polyps with BRAF mutation from site unknown). The three Group A SAs with KRAS mutation (all from the left colon epithelial serration and surface papillarity and nuclei that are ovoid, vesicular and contain a prominent nucleolus (inset). The columnar cells (inset) contain apical mucin droplets, similar to sessile SA (SSA). B, Mixed polyp (BRAF mutation) comprising SSA (left) and SA with high-grade dyplasia showing back-to-back glands (right) and aberrant expression of p53 (inset). C,D, Two mixed polyps (MPs) (both SA/tubulo-villous adenoma and with KRAS mutation) in which the serrated epithelium has an adenomatous appearance as evidenced by elongated hyperchomatic nuclei with marked stratification and a dark amphophilic cytoplasm. The pure adenomatous component is not shown. E,F, Low- and medium-power images of a SA (KRAS mutation) in which complex microacini have resulted in markedly serrated epithelial contours. The epithelium comprises numerous goblet cells and absorptive-type columnar cells with eosinophilic cytoplasm and is reminiscent of the goblet cell variant of hyperplastic polyp. These examples illustrate the range of appearances and genetic changes that are encompassed by ‘traditional’ SA.
2386495-02-Background-p01
[ "The", "majority", "of", "germline", "APC", "mutations", "identified", "in", "FAP", "families", "cause", "truncations", "in", "this", "multifunctional", "protein", "[6,7].", "The", "APC", "truncations", "most", "often", "occur", "as", "the", "result", "of", "nonsense", "APC", "mutations", "or", "frameshifts", "caused", "by", "small", "deletions/insertions.", "Large", "APC", "deletions", "are", "found", "in", "a", "limited", "number", "of", "FAP", "cases.", "By", "using", "methods", "such", "as", "quantitative", "real-time", "PCR", "(polymerase", "chain", "reaction)", "or", "MLPA", "(multiplex", "ligation-dependent", "probe", "amplification)", "rather", "than", "conventional", "mutation-detection", "techniques,", "we", "can", "achieve", "higher", "detection", "rates", "of", "large", "deletions", "[8-12].", "The", "number", "of", "reported", "characterized", "APC", "splice-site", "mutations", "is", "comparatively", "low", "[13-17].", "Approximately", "10–15%", "of", "the", "FAP", "patients", "could", "have", "a", "reduced", "or", "absent", "APC", "expression", "[18].", "The", "cause", "of", "the", "reduced", "expression", "is", "not", "known", "but", "the", "patients", "show", "a", "similar", "phenotype", "to", "those", "with", "an", "identified", "truncating", "APC", "mutation", "[19-21].", "It", "has", "been", "shown", "that", "a", "decrease", "of", "approximately", "50%", "of", "the", "expression", "of", "an", "allele", "can", "result", "in", "a", "predisposition", "to", "FAP", "[20].", "Germline", "APC-mutation", "mosaicism", "in", "FAP", "patients", "has", "been", "reported", "[22-25]", "but", "is", "not", "generally", "included", "in", "the", "mutation", "screening", "procedure", "provided", "by", "most", "labs", "owing", "to", "the", "technical", "difficulties", "encountered", "with", "these", "analyses." ]
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The majority of germline APC mutations identified in FAP families cause truncations in this multifunctional protein [6,7]. The APC truncations most often occur as the result of nonsense APC mutations or frameshifts caused by small deletions/insertions. Large APC deletions are found in a limited number of FAP cases. By using methods such as quantitative real-time PCR (polymerase chain reaction) or MLPA (multiplex ligation-dependent probe amplification) rather than conventional mutation-detection techniques, we can achieve higher detection rates of large deletions [8-12]. The number of reported characterized APC splice-site mutations is comparatively low [13-17]. Approximately 10–15% of the FAP patients could have a reduced or absent APC expression [18]. The cause of the reduced expression is not known but the patients show a similar phenotype to those with an identified truncating APC mutation [19-21]. It has been shown that a decrease of approximately 50% of the expression of an allele can result in a predisposition to FAP [20]. Germline APC-mutation mosaicism in FAP patients has been reported [22-25] but is not generally included in the mutation screening procedure provided by most labs owing to the technical difficulties encountered with these analyses.
2386495-05-Discussion-p04
[ "Mutation-detection", "frequency" ]
[ 0, 0 ]
Mutation-detection frequency
1557864-01-Abstract-p01
[ "No", "MMR", "inactivation", "was", "detected", "in", "75", "ovarian", "carcinoma", "specimens", "MLH1", " ", "promoter", "methylation", "status", "(methylation", "specific", "PCR", "on", "bisulfite", "treated", "DNA)", "and", "mRNA", "expression", "of", "MLH1,", "MSH2,", "MSH3,", "MSH6", "and", "PMS2", "(quantitative", "RT-PCR)", "in", "75", "ovarian", "carcinomas", "and", "eight", "ovarian", "cancer", "cell", "lines" ]
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No MMR inactivation was detected in 75 ovarian carcinoma specimens MLH1 promoter methylation status (methylation specific PCR on bisulfite treated DNA) and mRNA expression of MLH1, MSH2, MSH3, MSH6 and PMS2 (quantitative RT-PCR) in 75 ovarian carcinomas and eight ovarian cancer cell lines
2275286-03-Methods-p01
[ "Extraction", "of", "genomic", "DNA" ]
[ 0, 0, 0, 0 ]
Extraction of genomic DNA
2386495-03-Methods-p01
[ "Patient", "C896,", "with", "only", "five", "adenomas,", "was", "included", "because", "of", "a", "family", "history", "of", "FAP.", "Patient", "C107", "underwent", "her", "first", "colonoscopy", "due", "to", "intestinal", "bleeding", "at", "age", "47.", "At", "diagnosis,", "10–20", "small", "(less", "than", "10", "mm)", "polyps", "were", "found", "in", "most", "colorectal", "parts.", "Tubular", "and", "tubulovillous", "adenomas", "mutations", " ", "at", "other", "genetic", "laboratories", "and", "15", "families", "remain", "to", "be", "tested.", "We", "have", "previously", "reported", "six", "of", "these", "patients", "who", "carried", "bi-allelic", "MUTYH", "mutations", "[31].", "Probands", "were", "defined", "as", "those", "diagnosed", "on", "the", "basis", "of", "the", "occurrence", "of", "symptoms", "and", "irrespective", "of", "other", "cases", "in", "the", "family", "and", "call-up", "patients,", "as", "those", "identified", "as", "subjects", "at", "risk", "on", "the", "basis", "of", "studies", "of", "pedigrees", "and", "found", "to", "have", "FAP.", "De", "novo", "mutations", "were", "defined", "in", "those", "individuals", "where", "none", "of", "the", "parents", "carried", "the", "mutation", "or", "where", "the", "parents", "had", "a", "negative", "colonoscopy", "after", "the", "age", "of", "50", "or", "died", "of", "a", "non-FAP", "related", "cause", "after", "the", "age", "of", "75.", "All", "patients", "have", "given", "their", "consent", "and", "the", "local", "ethics", "committees", "have", "approved", "the", "study.", "The", "clinical", "features", "of", "index", "patients", "of", "each", "of", "the", "families", "analyzed", "are", "listed", "in", "Additional", "file", "1", "and", "Table", "1." ]
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Patient C896, with only five adenomas, was included because of a family history of FAP. Patient C107 underwent her first colonoscopy due to intestinal bleeding at age 47. At diagnosis, 10–20 small (less than 10 mm) polyps were found in most colorectal parts. Tubular and tubulovillous adenomas mutations at other genetic laboratories and 15 families remain to be tested. We have previously reported six of these patients who carried bi-allelic MUTYH mutations [31]. Probands were defined as those diagnosed on the basis of the occurrence of symptoms and irrespective of other cases in the family and call-up patients, as those identified as subjects at risk on the basis of studies of pedigrees and found to have FAP. De novo mutations were defined in those individuals where none of the parents carried the mutation or where the parents had a negative colonoscopy after the age of 50 or died of a non-FAP related cause after the age of 75. All patients have given their consent and the local ethics committees have approved the study. The clinical features of index patients of each of the families analyzed are listed in Additional file 1 and Table 1.
3034663-02-Background-p01
[ "The", "results", "of", "sequence-based", "genetic", "tests", "may", "be", "reported", "to", "physicians", "as:", "1)", "positive,", "in", "which", "a", "mutation", "that", "clearly", "disrupts", "gene", "function", "is", "detected", "and", "is", "highly", "likely", "to", "have", "clinical", "consequences;", "2)", "a", "genetic", "variant", "is", "detected", "but", "it", "is", "not", "known", "whether", "the", "variant", "has", "any", "effect", "on", "gene", "function", "that", "might", "confer", "an", "increased", "cancer", "risk", "(these", "variants", "are", "known", "as", "variants", "of", "uncertain/unclassified", "significance", "or", "unclassified", "variants", "[UVs]);", "and", "3)", "negative,", "in", "which", "deleterious", "variant", "or", "UV", "is", "detected", "[1]." ]
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The results of sequence-based genetic tests may be reported to physicians as: 1) positive, in which a mutation that clearly disrupts gene function is detected and is highly likely to have clinical consequences; 2) a genetic variant is detected but it is not known whether the variant has any effect on gene function that might confer an increased cancer risk (these variants are known as variants of uncertain/unclassified significance or unclassified variants [UVs]); and 3) negative, in which deleterious variant or UV is detected [1].
1601966-03-Results-p03
[ "Gain", "of", "expression", "in", "region", "8q11.23-q21.13", "is", "strongest", "in", "a", "small", "interval", "(8q12.1)", "that", "spans", "genes", "from", "TCEA1", "to", "PLAG1", "(see", "Figures", "6,", "7,", "8).", "There", "have", "been", "numerous", "reports", "of", "copy", "number", "gains", "of", "chromosome", "8q", "in", "CRC", "[18,21,23,25]", "which", "suggests", "a", "possible", "mechanism", "leading", "to", "over-expression", "in", "our", "patients.", "The", "known", "blood", "cell", "oncogene", "LYN", "is", "located", "in", "this", "interval", "and", "it", "is", "up-regulated", "in", "several", "of", "our", "tumor", "samples.", "It", "has", "been", "reported", "before", "that", "LYN", "is", "expressed", "in", "colorectal", "tumors", "[26].", "The", "concerted", "up-regulation", "of", "LYN", "along", "with", "other", "genes", "in", "this", "region", "suggests", "a", "role", "for", "LYN", "in", "CRC.", "Another", "interesting", "gene", "in", "this", "interval", "is", "PLAG1", "(", "pleomorphic", "adenoma", "gene", "1", "Tumor", "-associated", "genes", "are", "located", "within", "expression", "islands", "or", "in", "near", "vicinity." ]
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Gain of expression in region 8q11.23-q21.13 is strongest in a small interval (8q12.1) that spans genes from TCEA1 to PLAG1 (see Figures 6, 7, 8). There have been numerous reports of copy number gains of chromosome 8q in CRC [18,21,23,25] which suggests a possible mechanism leading to over-expression in our patients. The known blood cell oncogene LYN is located in this interval and it is up-regulated in several of our tumor samples. It has been reported before that LYN is expressed in colorectal tumors [26]. The concerted up-regulation of LYN along with other genes in this region suggests a role for LYN in CRC. Another interesting gene in this interval is PLAG1 ( pleomorphic adenoma gene 1 Tumor -associated genes are located within expression islands or in near vicinity.
1557864-02-Background-p01
[ "DNA", "mismatch", "repair", "(MMR)", "is", "divided", "into", "three", "steps:", "initiation,", "excision", "and", "resynthesis", "(Figure", "1).", "Several", "proteins", "are", "involved", "in", "the", "initiation", "of", "MMR", "including", "the", "three", "MutS-homologs,", "MSH2,", "MSH3", "and", "MSH6.", "The", "MutS", "homologs", "form", "a", "heterodimer", "that", "recognizes", "DNA", "damage;", "the", "MSH2", "and", "MSH6", "dimer", "(the", "hMutSα", "complex)", "recognizes", "base-base", "mismatches", "and", "single", "base", "loops", "whereas", "the", "MSH2", "and", "MSH3", "dimer", "(hMutSβ", "complex)", "recognizes", "insertion/deletion", "loops", "of", "more", "then", "one", "base.", "After", "the", "recognition", "of", "the", "DNA", "damage", "the", "binding", "of", "a", "heterodimer", "of", "the", "MutS-homologs", "MLH1", "and", "PMS2", "(the", "hMutLα", "complex)", "leads", "to", "the", "further", "initiation", "of", "MMR.", "Other", "known", "and", "still", "unknown", "proteins", "involved", "in", "the", "last", "two", "steps", "of", "MMR,", "the", "excision", "of", "the", "damaged", "strand", "and", "the", "resynthesis,", "are", "recruited", "subsequently.", "Proteins", "known", "to", "be", "involved", "are", "exonuclease", "ExoI,", "proliferating", "cell", "nuclear", "antigen", "(PCNA),", "DNA", "polymerase", "δ", "and", "perhaps", "ε", "and", "in", "addition", "based", "on", "its", "association", "with", "DNA", "polymerase", "δ", "and", "PCNA,", "DNA", "ligase", "I", "[8,9]." ]
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DNA mismatch repair (MMR) is divided into three steps: initiation, excision and resynthesis (Figure 1). Several proteins are involved in the initiation of MMR including the three MutS-homologs, MSH2, MSH3 and MSH6. The MutS homologs form a heterodimer that recognizes DNA damage; the MSH2 and MSH6 dimer (the hMutSα complex) recognizes base-base mismatches and single base loops whereas the MSH2 and MSH3 dimer (hMutSβ complex) recognizes insertion/deletion loops of more then one base. After the recognition of the DNA damage the binding of a heterodimer of the MutS-homologs MLH1 and PMS2 (the hMutLα complex) leads to the further initiation of MMR. Other known and still unknown proteins involved in the last two steps of MMR, the excision of the damaged strand and the resynthesis, are recruited subsequently. Proteins known to be involved are exonuclease ExoI, proliferating cell nuclear antigen (PCNA), DNA polymerase δ and perhaps ε and in addition based on its association with DNA polymerase δ and PCNA, DNA ligase I [8,9].
2275286-04-Results-p02
[ "The", "mutation", "between", "the", "MSI-L", "and", "MSI-H" ]
[ 0, 0, 0, 0, 0, 0, 0 ]
The mutation between the MSI-L and MSI-H
3034663-03-Methods-p02
[ "Statistical", "analysis" ]
[ 0, 0 ]
Statistical analysis
2275286-01-Abstract-p01
[ "In", "146", "prospectively", "recruited", "consecutive", "patients", "with", "clinically", "proven", "colorectal", "cancer,", "MSI", "carriers", "were", "identified", "by", "analysis", "of", "tumor", "tissue", "using", "multiplex", "fluorescence", "polymerase", "chain", "reaction", "(PCR)", "using", "the", "NCI", "recommended", "panel", "and", "classified", "into", "microsatellite", "instability-low", "(MSI-L),", "microsatellite", "instability-high", "(MSI-H)", "and", "microsatellite", "stable", "(MSS)", "groups.", "Immunohistochemical", "staining", "for", "MSH2,", "MSH6", "and", "MLH1", "on", "tissue", "microarrays", "(TMAs)", "was", "performed,", "and", "methylation", "of", "the", "MLH1", "promoter", "was", "analyzed", "by", "quantitative", "methylation", "specific", "PCR", "(MSP).", "Germline", "mutation", "analysis", "of", "blood", "samples", "was", "performed", "for", "MSH2,", "MSH6", "and", "MLH1", "genes." ]
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In 146 prospectively recruited consecutive patients with clinically proven colorectal cancer, MSI carriers were identified by analysis of tumor tissue using multiplex fluorescence polymerase chain reaction (PCR) using the NCI recommended panel and classified into microsatellite instability-low (MSI-L), microsatellite instability-high (MSI-H) and microsatellite stable (MSS) groups. Immunohistochemical staining for MSH2, MSH6 and MLH1 on tissue microarrays (TMAs) was performed, and methylation of the MLH1 promoter was analyzed by quantitative methylation specific PCR (MSP). Germline mutation analysis of blood samples was performed for MSH2, MSH6 and MLH1 genes.
3034663-03-Methods-p01
[ "No", "familial", "history", "of", "cancer", "was", "available", "from", "the", "control", "group.", "Patients", "diagnosed", "at", "an", "age", "over", "50", "years", "and", "not", "referred", "to", "Genetic", "Counselling", "Units", "were", "considered", "as", "sporadic", "CRC.", "Samples", "from", "sporadic", "CRC", "patients", "were", "obtained", "from", "the", "Elche", "University", "Hospital", "BioBank", "and", "the", "Castellon", "Provincial", "Hospital", "BioBank.", "Written", "consent", "to", "be", "included", "in", "the", "respective", "biobanks", "was", "obtained", "from", "each", "patient.", "CRC", "patients,", "as", "index", "subjects", "from", "families", "with", "suspicion", "of", "LS", "that", "attended", "Genetic", "Counselling", "at", "the", "Cancer", "Units", "of", "the", "Elche", "and", "La", "Fe", "Hospitals,", "were", "recruited.", "The", "study", "was", "approved", "by", "the", "Ethics", "Committee", "of", "the", "Elche", "University", "Hospital." ]
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No familial history of cancer was available from the control group. Patients diagnosed at an age over 50 years and not referred to Genetic Counselling Units were considered as sporadic CRC. Samples from sporadic CRC patients were obtained from the Elche University Hospital BioBank and the Castellon Provincial Hospital BioBank. Written consent to be included in the respective biobanks was obtained from each patient. CRC patients, as index subjects from families with suspicion of LS that attended Genetic Counselling at the Cancer Units of the Elche and La Fe Hospitals, were recruited. The study was approved by the Ethics Committee of the Elche University Hospital.
1601966-03-Results-p08
[ "Down-regulation", "of", "mRNA", "expression", "in", "human", "chromosomal", "region", "1p36.13-1p36.11", "(patient", "counts", "with", "coordinate", "down-regulation).", "Grayscale", "plot", "of", "cross-comparison", "of", "down-regulation", "patterns", "across", "patients", "for", "gene", "pairs", "in", "a", "particular", "region.", "Both,", "horizontal", "and", "vertical", "axes", "comprise", "the", "same", "genes", "in", "chromosomal", "order.", "In", "each", "square", "total", "counts", "of", "patients", "with", "consistent", "down-regulation", "in", "two", "genes", "are", "coded", "by", "different", "shades", "of", "gray.", "Dark", "squared", "regions", "along", "the", "diagonal", "indicate", "coordinated", "regulation", "in", "patient", "subgroups.", "Note,", "that", "many", "more", "patients", "show", "down-regulation", "as", "indicated", "by", "dark", "spots", "in", "this", "plot", "than", "up-regulation", "as", "indicated", "by", "dark", "spots", "in", "Figure", "10.", "This", "region", "has", "been", "reported", "in", "other", "studies", "to", "be", "frequently", "deleted", "in", "colorectal", "cancer", "(see", "Table", "4).", "This", "is", "the", "most", "significantly", "down-regulated", "region", "of", "our", "analysis.", "Note", "the", "expression", "of", "potential", "tumor", "genes", "PLA2G2A,", "E2F2,", "and", "CDC42", "." ]
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Down-regulation of mRNA expression in human chromosomal region 1p36.13-1p36.11 (patient counts with coordinate down-regulation). Grayscale plot of cross-comparison of down-regulation patterns across patients for gene pairs in a particular region. Both, horizontal and vertical axes comprise the same genes in chromosomal order. In each square total counts of patients with consistent down-regulation in two genes are coded by different shades of gray. Dark squared regions along the diagonal indicate coordinated regulation in patient subgroups. Note, that many more patients show down-regulation as indicated by dark spots in this plot than up-regulation as indicated by dark spots in Figure 10. This region has been reported in other studies to be frequently deleted in colorectal cancer (see Table 4). This is the most significantly down-regulated region of our analysis. Note the expression of potential tumor genes PLA2G2A, E2F2, and CDC42 .
1619718-02-Introduction-p01
[ "The", "addition", "of", "molecular", "profiling", "to", "polyp", "description", "offers", "hope", "of", "a", "more", "objective", "and", "therefore", "reproducible", "approach", "to", "the", "classification", "of", "colorectal", "adenomas.", "The", "genetic", "evolutionary", "paradigm", "envisages", "a", "linear", "sequence", "of", "changes", "beginning", "with", "bi-allelic", "inactivation", "of", "APC,", "followed", "by", "oncogenic", "KRAS", "mutation", "and", "culminating", "in", "inactivation", "of", "TP53", "at", "the", "transition", "from", "adenoma", "to", "carcinoma.5", "While", "there", "is", "good", "evidence", "that", "KRAS", "mutation", "is", "associated", "with", "advanced", "adenoma", "features6", "and", "could", "therefore", "be", "used", "as", "objective", "evidence", "of", "aggression,", "this", "approach", "has", "a", "number", "of", "limitations.", "First,", "KRAS", "mutation", "also", "occurs", "frequently", "in", "dysplastic", "aberrant", "crypt", "foci", "(microadenomas)", "and", "in", "some", "small", "tubular", "adenomas,", "suggesting", "that", "KRAS", "mutation", "may", "initiate", "a", "subset", "of", "small", "adenomas", "with", "limited", "potential", "for", "progression.6,7", "Second,", "around", "70%", "of", "CRCs", "lack", "mutation", "of", "KRAS.8", "From", "this", "it", "follows", "that", "most", "of", "the", "precancerous", "lesions", "that", "eventually", "become", "cancers", "do", "not", "in", "fact", "have", "KRAS", "mutation.", "There", "is", "increasing", "evidence", "that", "CRC", "evolves", "through", "a", "number", "of", "pathways", "and", "the", "traditional", "adenoma–carcinoma", "sequence,", "with", "its", "accompanying", "genetic", "steps,", "provides", "a", "surprisingly", "narrow", "window", "of", "understanding", "of", "this", "multipathway", "reality.9" ]
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The addition of molecular profiling to polyp description offers hope of a more objective and therefore reproducible approach to the classification of colorectal adenomas. The genetic evolutionary paradigm envisages a linear sequence of changes beginning with bi-allelic inactivation of APC, followed by oncogenic KRAS mutation and culminating in inactivation of TP53 at the transition from adenoma to carcinoma.5 While there is good evidence that KRAS mutation is associated with advanced adenoma features6 and could therefore be used as objective evidence of aggression, this approach has a number of limitations. First, KRAS mutation also occurs frequently in dysplastic aberrant crypt foci (microadenomas) and in some small tubular adenomas, suggesting that KRAS mutation may initiate a subset of small adenomas with limited potential for progression.6,7 Second, around 70% of CRCs lack mutation of KRAS.8 From this it follows that most of the precancerous lesions that eventually become cancers do not in fact have KRAS mutation. There is increasing evidence that CRC evolves through a number of pathways and the traditional adenoma–carcinoma sequence, with its accompanying genetic steps, provides a surprisingly narrow window of understanding of this multipathway reality.9
2386495-01-Abstract-p01
[ "Conclusion" ]
[ 0 ]
Conclusion
2275286-06-Conclusion-p01
[ "**", "IGNORE", "LINE", "**" ]
[ 0, 0, 0, 0 ]
** IGNORE LINE **
2386495-05-Discussion-p03
[ "The", "phenotype", "of", "patient", "C107", "does", "not", "fit", "the", "generally", "accepted", "genotype-phenotype", "correlation", "of", "AFAP,", "in", "which", "the", "disease-causing", "mutations", "are", "situated", "either", "in", "the", "5'", "or", "3'", "regions", "or", "the", "alternatively", "spliced", "part", "of", "exon", "9", "(see", "the", "introduction).", "A", "speculative", "reason", "for", "the", "attenuated", "phenotype", "could", "be", "that", "the", "patient", "is", "mosaic", "in", "the", "epithelial", "cells", "of", "the", "colon.", "The", "parents", "of", "patient", "C107", "of", "age", "73", "and", "80", "years", "as", "well", "as", "her", "three", "children,", "age", "31–40", "years,", "were", "free", "of", "polyps.", "No", "CRC", "has", "been", "diagnosed", "on", "either", "the", "maternal", "or", "paternal", "side", "of", "the", "family.", "The", "mutation", "was", "not", "detected", "in", "blood", "samples", "from", "the", "patient's", "parents", "or", "from", "her", "three", " ", "children.", "It", "is", "possible", "that", "either", "gonadal", "or", "somatic", "mosaicism", "exists", "in", "patient", "C107." ]
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The phenotype of patient C107 does not fit the generally accepted genotype-phenotype correlation of AFAP, in which the disease-causing mutations are situated either in the 5' or 3' regions or the alternatively spliced part of exon 9 (see the introduction). A speculative reason for the attenuated phenotype could be that the patient is mosaic in the epithelial cells of the colon. The parents of patient C107 of age 73 and 80 years as well as her three children, age 31–40 years, were free of polyps. No CRC has been diagnosed on either the maternal or paternal side of the family. The mutation was not detected in blood samples from the patient's parents or from her three children. It is possible that either gonadal or somatic mosaicism exists in patient C107.
1619718-01-Abstract-p01
[ "Thirty-two", "sessile", "serrated", "adenomas", "(SSA),", "10", "mixed", "polyps", "(MP),", "15", "traditional", "serrated", "adenomas", "(SA),", "49", "hyperplastic", "polyps", "(HP)", "and", "84", "adenomas", "were", "assessed", "for", "mutation", "of", "KRAS", "and", "BRAF", "and", "aberrant", "expression", "of", "p53.", "The", "findings", "were", "correlated", "with", "loss", "of", "expression", "of", "O-6-methylguanine", "DNA", "methyltransferase", "(MGMT).", "KRAS", "mutation", "occurred", "more", "frequently", "(26.5%)", "than", "BRAF", "mutation", "(4.8%)", "in", "adenomas", "(P", "<", "0.001)", "and", "particularly", "in", "adenomas", "with", "villous", "architecture", "(50%).", "Loss", "of", "expression", "of", "MGMT", "correlated", "with", "KRAS", "mutation", "in", "small", "tubular", "adenomas", "(P", "<", "0.04).", "BRAF", "mutation", "was", "frequent", "in", "HPs", "(67%)", "and", "SSAs", "(81%),", "while", "KRAS", "mutation", "was", "infrequent", "(4%", "and", "3%,", "respectively).", "Of", "MPs", "and", "SAs,", "72%", "serrated", " ", "polyps", "and", "adenomas:", "concept", "of", "a", "‘fusion’", "pathway", "to", "colorectal", "cancer" ]
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Thirty-two sessile serrated adenomas (SSA), 10 mixed polyps (MP), 15 traditional serrated adenomas (SA), 49 hyperplastic polyps (HP) and 84 adenomas were assessed for mutation of KRAS and BRAF and aberrant expression of p53. The findings were correlated with loss of expression of O-6-methylguanine DNA methyltransferase (MGMT). KRAS mutation occurred more frequently (26.5%) than BRAF mutation (4.8%) in adenomas (P < 0.001) and particularly in adenomas with villous architecture (50%). Loss of expression of MGMT correlated with KRAS mutation in small tubular adenomas (P < 0.04). BRAF mutation was frequent in HPs (67%) and SSAs (81%), while KRAS mutation was infrequent (4% and 3%, respectively). Of MPs and SAs, 72% serrated polyps and adenomas: concept of a ‘fusion’ pathway to colorectal cancer
3034663-04-Results-p02
[ "Pedigree", "for", "Family", "#3", "(CRC:", "Colorectal", "cancer;", "ESC:", "Oesophageal", "cancer;", "LC:", "Lung", "cancer)." ]
[ 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0 ]
Pedigree for Family #3 (CRC: Colorectal cancer; ESC: Oesophageal cancer; LC: Lung cancer).
1557864-03-Methods-p02
[ "Quantitative", "RT-PCR", "analysis", "was", "used", "to", "measure", "the", "mRNA", "expression", "levels", "of", "MLH1,", "MSH2", "carcinomas", " ", "were", "analysed", "with", "three", "or", "four", "MSI", "markers.", "A", "PCR", "containing", "α-32PdATP,", "was", "performed", "on", "100", "ng", "DNA.", "PCR", "products", "were", "separated", "on", "a", "denaturing", "6%", "polyacrylamide", "gel.", "After", "electrophoresis,", "gels", "were", "dried", "on", "blotting", "paper", "on", "a", "vacuum", "gel", "dryer", "and", "exposed", "to", "x-ray", "film.", "The", "films", "were", "evaluated", "by", "visual", "inspection." ]
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Quantitative RT-PCR analysis was used to measure the mRNA expression levels of MLH1, MSH2 carcinomas were analysed with three or four MSI markers. A PCR containing α-32PdATP, was performed on 100 ng DNA. PCR products were separated on a denaturing 6% polyacrylamide gel. After electrophoresis, gels were dried on blotting paper on a vacuum gel dryer and exposed to x-ray film. The films were evaluated by visual inspection.
2275286-01-Abstract-p01
[ "Background" ]
[ 0 ]
Background