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Br J Cancer ; 112(8): 1392-7, 2015 Apr 14.
Article in English | MEDLINE | ID: mdl-25742478

ABSTRACT

BACKGROUND: Somatic mutations affecting components of the Ras-MAPK pathway are a common feature of cancer, whereas germline Ras pathway mutations cause developmental disorders including Noonan, Costello, and cardio-facio-cutaneous syndromes. These 'RASopathies' also represent cancer-prone syndromes, but the quantitative cancer risks remain unknown. METHODS: We investigated the occurrence of childhood cancer including benign and malignant tumours of the central nervous system in a group of 735 individuals with germline mutations in Ras signalling pathway genes by matching their information with the German Childhood Cancer Registry. RESULTS: We observed 12 cases of cancer in the entire RASopathy cohort vs 1.12 expected (based on German population-based incidence rates). This corresponds to a 10.5-fold increased risk of all childhood cancers combined (standardised incidence ratio (SIR)=10.5, 95% confidence interval=5.4-18.3). The specific cancers included juvenile myelomonocytic leukaemia=4; brain tumour=3; acute lymphoblastic leukaemia=2; rhabdomyosarcoma=2; and neuroblastoma=1. The childhood cancer SIR in Noonan syndrome patients was 8.1, whereas that for Costello syndrome patients was 42.4. CONCLUSIONS: These data comprise the first quantitative evidence documenting that the germline mutations in Ras signalling pathway genes are associated with increased risks of both childhood leukaemia and solid tumours.


Subject(s)
Costello Syndrome/genetics , Ectodermal Dysplasia/genetics , Failure to Thrive/genetics , Heart Defects, Congenital/genetics , Neoplasms/epidemiology , Noonan Syndrome/genetics , ras Proteins/genetics , Adolescent , Child , Child, Preschool , Costello Syndrome/pathology , Ectodermal Dysplasia/pathology , Facies , Failure to Thrive/pathology , Female , Germ-Line Mutation , Germany/epidemiology , Heart Defects, Congenital/pathology , Humans , Infant , Male , Neoplasms/etiology , Neoplasms/pathology , Noonan Syndrome/pathology , Registries , Risk Factors , Signal Transduction
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