Clinical and molecular characterization of patients fulfilling Chompret criteria for Li-Fraumeni syndrome in Southern Brazil

PLoS One. 2021 Sep 16;16(9):e0251639. doi: 10.1371/journal.pone.0251639. eCollection 2021.

Abstract

Li-Fraumeni syndrome (LFS) is an autosomal dominant cancer predisposition syndrome caused by pathogenic germline variants in the TP53 gene, characterized by a predisposition to the development of a broad spectrum of tumors at an early age. The core tumors related to LFS are bone and soft tissue sarcomas, premenopausal breast cancer, brain tumors, adrenocortical carcinomas (ACC), and leukemias. The revised Chompret criteria has been widely used to establish clinical suspicion and support TP53 germline variant testing and LFS diagnosis. Information on TP53 germline pathogenic variant (PV) prevalence when using Chompret criteria in South America and especially in Brazil is scarce. Therefore, the aim of this study was to characterize patients that fulfilled these specific criteria in southern Brazil, a region known for its high population frequency of a founder TP53 variant c.1010G>A (p.Arg337His), as known as R337H. TP53 germline testing of 191 cancer-affected and independent probands with LFS phenotype identified a heterozygous pathogenic/likely pathogenic variant in 26 (13.6%) probands, both in the DNA binding domain (group A) and in the oligomerization domain (group B) of the gene. Of the 26 carriers, 18 (69.23%) were R337H heterozygotes. Median age at diagnosis of the first tumor in groups A and B differed significantly in this cohort: 22 and 2 years, respectively (P = 0.009). The present study shows the clinical heterogeneity of LFS, highlights particularities of the R337H variant and underscores the need for larger collaborative studies to better define LFS prevalence, clinical spectrum and penetrance of different germline TP53 pathogenic variants.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Brazil
  • Child
  • Child, Preschool
  • Female
  • Germ-Line Mutation*
  • Humans
  • Infant
  • Li-Fraumeni Syndrome / genetics
  • Li-Fraumeni Syndrome / pathology*
  • Male
  • Middle Aged
  • Penetrance
  • Phenotype
  • Prevalence
  • Sequence Analysis, DNA / methods*
  • Tumor Suppressor Protein p53 / genetics*
  • Young Adult

Substances

  • TP53 protein, human
  • Tumor Suppressor Protein p53

Grants and funding

This study was funded by grants from Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) (Grant # 478430/2012-4), Fundação de Amparo à Pesquisa do Estado do Rio Grande do Sul (FAPERGS) (Grant # 16/2551-0000486-2), and Fundo de Incentivo à Pesquisa do Hospital de Clínicas de Porto Alegre (FIPE-HCPA) to PA-P. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.