Colorectal cancer 'Treatment/Family history'Women are at high risk of uterine and ovarian cancer
Jul 25, 2024
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Some patients with colorectal cancer have been confirmed to have 'Lynch Syndrome', and women with 'Lynch Syndrome' are reported to have a high probability of being diagnosed with gynecological cancer such as endometrial cancer and ovarian cancer.
Lynch Syndrome is a genetic cancer syndrome caused by mutations in genes (MLH1, MSH2, MSH6, PMS1, and PMS2) that repair damage that occurs during DNA replication from parents. Because it is an autosomal dominant inheritance, when one of the parents has a genetic mutation, it has a 50% chance of being inherited to a child, and cancer develops earlier than non-Lynch syndrome people.
Men with Lynch syndrome-related genetic mutations have a 60-80% lifetime risk of developing colorectal cancer, women have a 40-60% risk of developing colorectal cancer, a 40-60% risk of developing endometrial cancer, and a 5-20% risk of ovarian cancer.
Professor Park Byung-kwan of the colorectal surgery department at Chung-Ang University Hospital confirmed that about 2% to 4% of patients with colorectal cancer have mutations in genes diagnosed as Lynch syndrome (MLH1, MSH2, MSH6, PMS2, etc.)"If you have a patient with colorectal cancer in your family or have been diagnosed with endometrial cancer, stomach cancer, ovarian cancer, pancreatic cancer, ureteral cancer, biliary cancer, brain tumor, etc., it is necessary to diagnose Lynch syndrome through examination. "
Professor Park Byung-kwan then said "It is recommended that patients with Lynch syndrome among those who have not been diagnosed with cancer undergo colonoscopy every 1-2 years because colon polyps are known to develop rapidly into cancer."
These days, when cancer is diagnosed, mutations in these genes can be screened through tissue immunostaining or next-generation sequencing methods using cancer tissue or blood, and once the mutation is found, the family only needs to test the mutation part, so it can be confirmed at a lower cost.
High-risk groups that can suspect lynching syndrome include those diagnosed with colorectal cancer under the age of 50, those with more than three colorectal cancer patients in a household or those diagnosed with lynching syndrome-related cancer. It is possible to screen for lynching syndrome by immunohistochemical tests (IHC) using cancer tissue and microscopic molecular instability (MSI) tests.
Although there are no exact research reports on how many genetic mutations there are related to lynching syndrome in Korean women, a research paper published in the International Journal by Professor Lee Eun-joo of the Cancer Center at Chung-Ang University Hospital in 2021 reported that 20 types of mutations were found in lynching syndrome-related genes in 25 women with endometrial cancer.
In addition, according to a domestic case in which endometrial cancer was diagnosed six years after colon cancer in Lynch syndrome, which was announced by the Korean Society of Obstetricians and Gynecologists, we introduce a case in which a 36-year-old woman was diagnosed with endometrial cancer six years after undergoing surgery for colon cancer and underwent surgery, which was confirmed to have a gene sequencing (MSH2) mutation corresponding to Lynch syndrome.
Professor Lee Eun-joo of the obstetrics and gynecology department at Chung-Ang University Hospital said, "Lynching syndrome is a genetic disease that causes not only colon cancer but also endometrial cancer and ovarian cancer. If a woman has lynching syndrome through colon cancer, a gynecological examination must be performed. Considering the age, gene type of mutant gene, marital and birth family planning, it is necessary to consider not only periodic tests but also surgery to prevent the risk of gynecological cancer."
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bellho@sportschosun.com
