Estimated Prevalence, Tumor Spectrum, and Neurofibromatosis Type 1-Like Phenotype of CDKN2A-Related Melanoma-Astrocytoma Syndrome

被引：5

作者：

Sargen, Michael R. ^{[1
,2
]}

Kim, Jung ^{[2
]}

Potjer, Thomas P. ^{[3
]}

Velthuizen, Mary E. ^{[4
]}

Martir-Negron, Arelis E. ^{[5
]}

Odia, Yazmin ^{[5
]}

Helgadottir, Hildur ^{[6
,7
]}

Hatton, Jessica N. ^{[2
]}

Haley, Jeremy S. ^{[8
]}

Thone, Gretchen ^{[8
]}

Widemann, Brigitte C. ^{[9
]}

Gross, Andrea M. ^{[9
]}

Yohe, Marielle E. ^{[9
,10
]}

Kaplan, Rosandra N. ^{[9
]}

Shern, Jack F. ^{[9
]}

Sundby, R. Taylor ^{[9
]}

Astiazaran-Symonds, Esteban ^{[11
]}

Yang, Xiaohong R. ^{[2
]}

Carey, David J. ^{[8
]}

Tucker, Margaret A. ^{[2
]}

Stewart, Douglas R. ^{[2
]}

Goldstein, Alisa M. ^{[2
]}

机构：

[1] NCI, Div Canc Epidemiol & Genet, 9609 Med Ctr Dr, Room 6E-542, Rockville, MD 20850 USA

[2] NIH, Div Canc Epidemiol & Genet, NCI, Rockville, MD USA

[3] Leiden Univ, Dept Clin Genet, Med Ctr, Leiden, Netherlands

[4] Univ Med Ctr Utrecht, Dept Genet, Div Labs Pharm & Biomed Genet, Utrecht, Netherlands

[5] Baptist Hlth South Florida, Miami Canc Inst, Miami, FL USA

[6] Karolinska Inst, Dept Oncol & Pathol, Stockholm, Sweden

[7] Karolinska Univ Hosp, Stockholm, Sweden

[8] Geisinger Hlth Syst, Geisinger Clin, Dept Genom Hlth, Danville, PA USA

[9] NCI, Ctr Canc Res, Pediat Oncol Branch, NIH, Bethesda, MD USA

[10] Ctr Canc Res, Lab Cell & Dev Signaling, Frederick, MD USA

[11] Univ Arizona, Coll Med, Dept Med, Tucson, AZ USA

来源：

JAMA DERMATOLOGY | 2023年 / 159卷 / 10期

基金：

美国国家卫生研究院;

关键词：

HIGH-RISK; CDKN2A;

D O I：

10.1001/jamadermatol.2023.2621

中图分类号：

R75 [皮肤病学与性病学];

学科分类号：

100206 ;

摘要：

IMPORTANCE Knowledge about the prevalence and tumor types of CDKN2A-related melanoma-astrocytoma syndrome (MAS) is limited and could improve disease recognition. OBJECTIVE To estimate the prevalence and describe the tumor types of MAS. DESIGN, SETTING, AND PARTICIPANTS This retrospective cohort study analyzed all available MAS cases from medical centers in the US (2 sites) and Europe (2 sites) and from biomedical population genomic databases (UK Biobank [United Kingdom], Geisinger MyCode [US]) between January 1, 1976, and December 31, 2020. Patients with MAS with CDKN2A germline pathogenic variants and 1 or more neural tumors were included. Data were analyzed from June 1, 2022, to January 31, 2023. MAIN OUTCOMES AND MEASURES Disease prevalence and tumor frequency. RESULTS Prevalence of MAS ranged from 1 in 170 503 (n = 1 case; 95% CI, 1:30 098-1: 965 887) in Geisinger MyCode (n = 170 503; mean [SD] age, 58.9 [19.1] years; 60.6% women; 96.2% White) to 1 in 39 149 (n = 12 cases; 95% CI, 1:22 396-1:68 434) in UK Biobank (n = 469 789; mean [SD] age, 70.0 [8.0] years; 54.2% women; 94.8% White). Among UK Biobank patients with MAS (n = 12) identified using an unbiased genomic ascertainment approach, brain neoplasms (4 of 12, 33%; 1 glioblastoma, 1 gliosarcoma, 1 astrocytoma, 1 unspecified type) and schwannomas (3 of 12, 25%) were the most common malignant and benign neural tumors, while cutaneous melanoma (2 of 12, 17%) and head and neck squamous cell carcinoma (2 of 12, 17%) were the most common nonneural malignant neoplasms. In a separate case series of 14 patients with MAS from the US and Europe, brain neoplasms (4 of 14, 29%; 2 glioblastomas, 2 unspecified type) and malignant peripheral nerve sheath tumor (2 of 14, 14%) were the most common neural cancers, while cutaneous melanoma (4 of 14, 29%) and sarcomas (2 of 14, 14%; 1 liposarcoma, 1 unspecified type) were the most common nonneural cancers. Cutaneous neurofibromas (7 of 14, 50%) and schwannomas (2 of 14, 14%) were also common. In 1 US family, a father and son with MAS had clinical diagnoses of neurofibromatosis type 1 (NF1). Genetic testing of the son detected a pathogenic CDKN2A splicing variant (c.151-1G>C) and was negative for NF1 genetic alterations. In UK Biobank, 2 in 150 (1.3%) individuals with clinical NF1 diagnoses had likely pathogenic variants in CDKN2A, including 1 individual with no detected variants in the NF1 gene. CONCLUSIONS AND RELEVANCE This cohort study estimates the prevalence and describes the tumors of MAS. Additional studies are needed in genetically diverse populations to further define population prevalence and disease phenotypes.

引用

页码：1112 / 1118

页数：7