AIM:To analyze the prevalence of germline MLH1 and MSH2 gene mutations and evaluate the clinical characteristics of Hungarian hereditary non-polyposis colorectal cancer (HNPCC) families.
M E T H O D S :T h i r t y -s i x k i n d r e d s w e r e t e s t e d f o r m u t a t i o n s u s i n g c o n f o r m a t i o n s e n s i t i v e g e l electrophoreses, direct sequencing and also screening for genomic rearrangements applying multiplex ligationdependent probe amplification (MLPA).
RESULTS:Eighteen germline mutations (50%) were identified, 9 in MLH1 and 9 in MSH2 . Sixteen of these sequence alterations were considered pathogenic, the remaining two were non-conservative missense alterations occurring at highly conserved functional motifs. The majority of the definite pathogenic mutations (81%, 13/16) were found in families fulfilling the stringent Amsterdam Ⅰ/Ⅱ criteria, including three rearrangements revealed by MLPA (two in MSH2 and one in MLH1 ). However, in three out of sixteen HNPCCsuspected families (19%), a disease-causing alteration could be revealed. Furthermore, nine mutations described here are novel, and none of the sequence changes were found in more than one family.
CONCLUSION:Our study describes for the first time the prevalence and spectrum of germline mismatch repair gene mutations in Hungarian HNPCC and suspected-HNPCC families. The results presented here suggest that clinical selection criteria should be relaxed and detection of genomic rearrangements should be included in genetic screening in this population.