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81.
Sickle cell disease: imaging of cerebrovascular complications 总被引:3,自引:0,他引:3
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Lower cancer incidence in Amsterdam-I criteria families without mismatch repair deficiency: familial colorectal cancer type X 总被引:9,自引:0,他引:9
Lindor NM Rabe K Petersen GM Haile R Casey G Baron J Gallinger S Bapat B Aronson M Hopper J Jass J LeMarchand L Grove J Potter J Newcomb P Terdiman JP Conrad P Moslein G Goldberg R Ziogas A Anton-Culver H de Andrade M Siegmund K Thibodeau SN Boardman LA Seminara D 《JAMA》2005,293(16):1979-1985
Context Approximately 60% of families that meet the Amsterdam-I criteria (AC-I) for hereditary nonpolyposis colorectal cancer (HNPCC) have a hereditary abnormality in a DNA mismatch repair (MMR) gene. Cancer incidence in AC-I families with MMR gene mutations is reported to be very high, but cancer incidence for individuals in AC-I families with no evidence of an MMR defect is unknown. Objective To determine if cancer risks in AC-I families with no apparent deficiency in DNA MMR are different from cancer risks in AC-I families with DNA MMR abnormalities. Design, Setting, and Participants Identification (1997-2001) of 161 AC-I pedigrees from multiple population- and clinic-based sources in North America and Germany, with families grouped into those with (group A) or without (group B) MMR deficiency by tumor testing. A total of 3422 relatives were included in the analyses. Main Outcome Measures Cancer incidence in groups A and B (excluding the 3 affected members used to define each pedigree as AC-I) and computed age- and sex-adjusted standardized incidence ratios (SIRs) using Surveillance, Epidemiology, and End Results data. Results Group A families from both population- and clinic-based series showed increased incidence of the HNPCC-related cancers. Group B families showed increased incidence only for colorectal cancer (SIR, 2.3; 95% confidence interval, 1.7-3.0) and to a lesser extent than group A (SIR, 6.1; 95% confidence interval, 5.2-7.2) (P<.001). Conclusions Families who fulfill AC-I criteria but who have no evidence of a DNA MMR defect do not share the same cancer incidence as families with HNPCC-Lynch syndrome (ie, hereditary MMR deficiency). Relatives in such families have a lower incidence of colorectal cancer than those in families with HNPCC-Lynch syndrome, and incidence may not be increased for other cancers. These families should not be described or counseled as having HNPCC-Lynch syndrome. To facilitate distinguishing these entities, the designation of "familial colorectal cancer type X" is suggested to describe this type of familial aggregation of colorectal cancer. 相似文献
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When applied humanities is used as a framework, the educational innovation described in this article provides a more balanced view of aging than occurs in most nursing programs. Five video narratives and focused discussion questions, intended to mitigate the "otherness" of old age, are described. Rationales and sample student responses are provided. 相似文献
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The relationship between the gingival inflammation and plaque scores of patients who had received kidney transplants and were taking immunosuppressive drugs to combat rejection pheomena was compared with data from a control group. Equivalent plaque scores were associated with less gingival inflammation in the patients taking the immunosuppressive drugs. While there was no signficant difference between the plaque scores of the two groups the control group displayed signficantly more gingival inflammation. The implications of these results with respect to possible etiological mechanisms operating in periodontal disease are discussed. 相似文献