Vol. 14. Núm. 4.
Páginas 175-184 (Marzo 2024)

Actualización
Síndrome de Lynch. Cáncer de colon familiar no sindrómico

Lynch syndrome (hereditary nonpolyposis colon cancer). Nonsyndromic familial colon cancer

M. Sierra MoralesI. Bartolomé OterinoS. Redondo EvangelistaP. García CentenoA. Santos Rodríguez
Doi : https://10.1016/j.med.2024.02.020
Opciones
Resumen

El síndrome de Lynch es el síndrome hereditario de cáncer colorrectal (CCR) más común, siendo respon-sable de un 2%-4% de todos los casos de CCR a nivel global. Sigue un patrón de herencia autosómico dominante y se define por la presencia de una variante patogénica en línea germinal de alguno de los genes que codifican para las proteínas reparadoras del ADN (MMR), MLH1, MSH2, MSH6, PMS2, o en el extremo 3’ del gen EPCAM. Este síndrome condiciona un mayor riesgo de desarrollar CCR y cáncer de endometrio, además de otros tumores. Su diagnóstico se basa en criterios clínicos que tienen en cuenta los antecedentes familiares y personales de tumores, la detección de un fenotipo deficitario para MMR en el tejido tumoral y en el estudio genético en línea germinal de los individuos con riesgo de presentarlo. Su diagnóstico precoz permite establecer estrategias de cribado de cara a intentar prevenir o detectar la presencia de tumores en fases precoces que, en el caso del CCR, han demostrado aumentar la supervivencia. En el CCR familiar no sindrómico se incluyen aquellos casos que presentan un componente familiar sin un mecanismo molecular bien establecido, y que se pueden beneficiar de un seguimiento más intensivo que el que se establece en la población general.

Palabras clave
Lynch
Cáncer colorrectal
Hereditario
Abstract

Lynch syndrome is the most common hereditary colorectal cancer (CRC) syndrome. It accounts for 2% to 4% of all CRC cases globally. It follows an autosomal dominant inheritance pattern and is defined by the presence of a pathogenic germline variant of one of the genes that encodes for DNA repair proteins (MMR), MLH1, MSH2, MSH6, PMS2, or at the 3’ end of the EPCAM gene. This syndrome entails a greater risk of developing CRC and endometrial cancer, in addition to other tumors. Its diagnosis is based on clinical criteria that take into account the family and personal history of cancer, the detection of a deficient MMR phenotype in the tumor tissue, and a genetic study of the germline of individuals at risk of having it. Its early diagnosis allows for establishing screening strategies to try to prevent or detect the presence of tumors in early stages which, in the case of CRC, has been shown to increase survival. Nonsyndromic familial CRC includes cases that have a familial component without a well-established molecular mechanism. They may benefit from more intensive follow-up than what is established for the general population.

Keywords
Lynch
Colorectal cancer
Hereditary

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