Elucidation of the occurrence of extracolonic cancers in Lynch syndrome

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dc.contributor.advisorRamesar, Ren_ZA
dc.contributor.authorKalideen, Kushaen_ZA
dc.date.accessioned2014-07-28T14:57:29Z
dc.date.available2014-07-28T14:57:29Z
dc.date.issued2008en_ZA
dc.descriptionIncludes abstract.
dc.descriptionIncludes bibliographical references (leaves 126-147).
dc.description.abstractLynch Syndrome, also known as Hereditary Non-Polyposis Colorectal Cancer (HNPCC) (OMIM #120435), is a familial disorder resulting from mutations within DNA MMR genes. Effective surveillance, diagnosis and treatment of the disorder is complicated due to the phenotypic and genetic heterogeneity of lynch syndrome, which exhibits an autosomal dominant mode of inheritance. Determine the molecular pathology of extracolonic cancers in Lynch syndrome and to elucidate whether or not the occurrence of these extracolonic cancers are a direct result of the mismatch repair deficiency. First, a modifier study was performed assessing the effect of a variant within the DNA MMR gene hMLH1 in a cohort of individuals predisposed to Lynch syndrome in order to examine a potential epistatic effect in the gene. In order to obtain a genetic signature of Lynch associated tumours, germline DNA and corresponding tumour DNA was isolated from Lynch syndrome patients. The genetic material was assessed via a panel of microsatellite rich genes and MS-MLPA. Finally, in silico analyses were undertaken assessing microarray data from microsatellite unstable colorectal and endometrial cancers to characterise novel candidate genes. The modifier study did not prove fruitful as no association was found between the hMLH1 promoter variant and site of cancer in individuals predisposed to Lynch syndrome. An association was observed heterozygous and homozygous variant genotypes and an increased risk of colorectal cancer, regardless of predisposing mutation (p = 0.000181). Two tumour suppressor genes; HIC1 and TIMP3, were found to be methylated in the tumour samples in the germline/tumour tissue study. This study also showed instability of the Erβ gene in the majority of tumour samples. Bioinformatic analysis utilising existing microarray data resulted in common under-expression of four genes and common overexpression in three genes in microsatellite unstable colorectal and endometrial cancers. Further investigation into the modifier study and elucidation of a genetic signature in MMR deficient, MSI cancers. The results obtained in this study contribute to the increasing body of knowledge in the field and the various stages of malignancies should be assessed for a more informative result. Genetic and functional studies should be performed on the information garnered from the bioinformatics analysis. Overall evaluation and molecular classification of Lynch syndrome tumours may guide better diagnosis, surveillance and treatment of those at risk.en_ZA
dc.identifier.apacitationKalideen, K. (2008). <i>Elucidation of the occurrence of extracolonic cancers in Lynch syndrome</i>. (Thesis). University of Cape Town ,Faculty of Health Sciences ,Department of Clinical Laboratory Sciences. Retrieved from http://hdl.handle.net/11427/3167en_ZA
dc.identifier.chicagocitationKalideen, Kusha. <i>"Elucidation of the occurrence of extracolonic cancers in Lynch syndrome."</i> Thesis., University of Cape Town ,Faculty of Health Sciences ,Department of Clinical Laboratory Sciences, 2008. http://hdl.handle.net/11427/3167en_ZA
dc.identifier.citationKalideen, K. 2008. Elucidation of the occurrence of extracolonic cancers in Lynch syndrome. University of Cape Town.en_ZA
dc.identifier.ris TY - Thesis / Dissertation AU - Kalideen, Kusha AB - Lynch Syndrome, also known as Hereditary Non-Polyposis Colorectal Cancer (HNPCC) (OMIM #120435), is a familial disorder resulting from mutations within DNA MMR genes. Effective surveillance, diagnosis and treatment of the disorder is complicated due to the phenotypic and genetic heterogeneity of lynch syndrome, which exhibits an autosomal dominant mode of inheritance. Determine the molecular pathology of extracolonic cancers in Lynch syndrome and to elucidate whether or not the occurrence of these extracolonic cancers are a direct result of the mismatch repair deficiency. First, a modifier study was performed assessing the effect of a variant within the DNA MMR gene hMLH1 in a cohort of individuals predisposed to Lynch syndrome in order to examine a potential epistatic effect in the gene. In order to obtain a genetic signature of Lynch associated tumours, germline DNA and corresponding tumour DNA was isolated from Lynch syndrome patients. The genetic material was assessed via a panel of microsatellite rich genes and MS-MLPA. Finally, in silico analyses were undertaken assessing microarray data from microsatellite unstable colorectal and endometrial cancers to characterise novel candidate genes. The modifier study did not prove fruitful as no association was found between the hMLH1 promoter variant and site of cancer in individuals predisposed to Lynch syndrome. An association was observed heterozygous and homozygous variant genotypes and an increased risk of colorectal cancer, regardless of predisposing mutation (p = 0.000181). Two tumour suppressor genes; HIC1 and TIMP3, were found to be methylated in the tumour samples in the germline/tumour tissue study. This study also showed instability of the Erβ gene in the majority of tumour samples. Bioinformatic analysis utilising existing microarray data resulted in common under-expression of four genes and common overexpression in three genes in microsatellite unstable colorectal and endometrial cancers. Further investigation into the modifier study and elucidation of a genetic signature in MMR deficient, MSI cancers. The results obtained in this study contribute to the increasing body of knowledge in the field and the various stages of malignancies should be assessed for a more informative result. Genetic and functional studies should be performed on the information garnered from the bioinformatics analysis. Overall evaluation and molecular classification of Lynch syndrome tumours may guide better diagnosis, surveillance and treatment of those at risk. DA - 2008 DB - OpenUCT DP - University of Cape Town LK - https://open.uct.ac.za PB - University of Cape Town PY - 2008 T1 - Elucidation of the occurrence of extracolonic cancers in Lynch syndrome TI - Elucidation of the occurrence of extracolonic cancers in Lynch syndrome UR - http://hdl.handle.net/11427/3167 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/3167
dc.identifier.vancouvercitationKalideen K. Elucidation of the occurrence of extracolonic cancers in Lynch syndrome. [Thesis]. University of Cape Town ,Faculty of Health Sciences ,Department of Clinical Laboratory Sciences, 2008 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/3167en_ZA
dc.language.isoengen_ZA
dc.publisher.departmentDepartment of Clinical Laboratory Sciencesen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.subject.otherMedicineen_ZA
dc.titleElucidation of the occurrence of extracolonic cancers in Lynch syndromeen_ZA
dc.typeMaster Thesis
dc.type.qualificationlevelMasters
dc.type.qualificationnameMScen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceThesisen_ZA
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