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Familial adenomatous polyposis (FAP)
1998-06-01
Sylviane Olschwang
 
Affiliation
INSERM U434, Fondation Jean Dausset - C.E.P.H., 27, rue Juliette Dodu, 75010 Paris, France
Identity
Name
Familial adenomatous polyposis (FAP)
Alias
Adenomatous polyposis of the colon , Gardner syndrome
Inheritance
autosomal dominant disorder; frequency is about 2.5\/10
5 newborns; neomutation in 20%; variable expressivity; penetrance close to 100% by the age of 40 yrs.
Omim
175100
Mesh
D011125
Orphanet
733 Familial adenomatous polyposis
Umls
C0032580
Clinics
Phenotype and clinics
multiple adenomatous polyps of the colon and the rectum
polyps also develop in the upper gastrointestinal tract
other: pigmented retinal lesions (congenital hypertrophy of the retinal pigment epithelium), jaw cysts, sebaceous cysts, desmoid tumours, and osteomas.
Neoplastic risk
- colorectal cancer(s) develop from the polyps through a dysplastic stage
- malignancies may be found in other sites: liver (hepatoblastoma), brain (medulloblastoma), thyroid.
Prognosis
colorectal cancer in early adult life (median age: 40 yrs) is the first cause of death in this disease.
Genes involved and Proteins
Description
tumour suppressor gene; the APC normal gene product interacts with the adherens junction proteins a and β-catenin
Germinal
FAP is caused by a highly heterogeneous spectrum of point mutations that represents a problem for molecular genetic diagnosis; but all the mutations are chain terminating and some correlations between the position of the mutation and the phenotypic consequences have been described:
- germline mutations between codons 1250 and 1464 are associated with profuse polyposis;
- an attenuated adenomatous polyposis coli (AAPC) is associated with mutations located very close to the 5-prime end of the APC gene;
- the extent of congenital hypertrophy of the retinal pigment epithelium (CHRPE) depends on the position of the protein-truncating mutation in APC; CHRPE lesions are almost always absent if the mutation occur before exon 9, but are consistently present if it occurs after this exon;
- patients with a mutation between codons 1445 and 1578 do not express CHRPE; however, these patients developed severe desmoid tumors.
To be noted
Hgmd
119682 APC
Databases
http:\/\/www.geneclinics.org\/profiles\/fap Familial Adenomatous Polyposis - GeneClinics
Article Bibliography
Pubmed ID
Last Year
Title
Authors
27476653
2016
Exome Sequencing Identifies Biallelic MSH3 Germline Mutations as a Recessive Subtype of Colorectal Adenomatous Polyposis.
Adam R et al
24161962
2014
Diagnosis, surveillance, and treatment strategies for familial adenomatous polyposis: rationale and update.
Aihara H et al
16317745
2006
Should children at risk for familial adenomatous polyposis be screened for hepatoblastoma and children with apparently sporadic hepatoblastoma be screened for APC germline mutations?
Aretz S et al
17238184
2007
Brain tumors in individuals with familial adenomatous polyposis: a cancer registry experience and pooled case report analysis.
Attard TM et al
15300576
2004
Genetic testing and phenotype in a large kindred with attenuated familial adenomatous polyposis.
Burt RW et al
26265988
2015
Duodenal adenoma surveillance in patients with familial adenomatous polyposis.
Campos FG et al
12135043
2002
Challenge in the differentiation between attenuated familial adenomatous polyposis and hereditary nonpolyposis colorectal cancer: case report with review of the literature.
Cao Y et al
26697262
2015
FAP Associated Papillary Thyroid Carcinoma: A Peculiar Subtype of Familial Nonmedullary Thyroid Cancer.
Cetta F et al
11257105
2001
The ABC of APC.
Fearnhead NS et al
8194700
1994
Phenotypic variability of familial adenomatous polyposis in 11 unrelated families with identical APC gene mutation.
Giardiello FM et al
22851115
2012
Prevalence and phenotypes of APC and MUTYH mutations in patients with multiple colorectal adenomas.
Grover S et al
31487681
2019
NCCN Guidelines Insights: Genetic/Familial High-Risk Assessment: Colorectal, Version 2.2019.
Gupta S et al
24310308
2014
ACMG technical standards and guidelines for genetic testing for inherited colorectal cancer (Lynch syndrome, familial adenomatous polyposis, and MYH-associated polyposis).
Hegde M et al
11199368
2000
Impact of screening examinations on survival in familial adenomatous polyposis.
Heiskanen I et al
17258512
2007
Prevalence of thyroid cancer in familial adenomatous polyposis syndrome and the role of screening ultrasound examinations.
Herraiz M et al
22561515
2012
Hereditary mixed polyposis syndrome is caused by a 40-kb upstream duplication that leads to increased and ectopic expression of the BMP antagonist GREM1.
Jaeger E et al
21173694
2011
Screening for thyroid cancer in patients with familial adenomatous polyposis.
Jarrar AM et al
21039432
2011
Constitutional mismatch repair-deficiency syndrome presenting as colonic adenomatous polyposis: clues from the skin.
Jasperson KW et al
1037059
1976
Clinical significance of the house dust mite (Dermatophagoides pteronyssinus) in asthmatic children in Japan.
Kabasawa Y et al
21228663
2011
Defining phenotypes and cancer risk in hyperplastic polyposis syndrome.
Kalady MF et al
22704577
2012
Small bowel endoscopy in familial adenomatous polyposis and Lynch syndrome.
Koornstra JJ et al
27087319
2016
Point Mutations in Exon 1B of APC Reveal Gastric Adenocarcinoma and Proximal Polyposis of the Stomach as a Familial Adenomatous Polyposis Variant.
Li J et al
16998667
2006
The genetics of FAP and FAP-like syndromes.
Lipton L et al
19414146
2009
Familial adenomatous polyposis.
Macrae F et al
18063416
2008
American founder mutation for attenuated familial adenomatous polyposis.
Neklason DW et al
21063417
2011
Evaluation of management of desmoid tumours associated with familial adenomatous polyposis in Dutch patients.
Nieuwenhuis MH et al
23263490
2013
Germline mutations affecting the proofreading domains of POLE and POLD1 predispose to colorectal adenomas and carcinomas.
Palles C et al
27343414
2016
The first European family with gastric adenocarcinoma and proximal polyposis of the stomach: case report and review of the literature.
Repak R et al
11099951
2000
The adenomatous polyposis coli (APC) tumour suppressor--genetics, function and disease.
Sieber OM et al
20528895
2011
Risk factors predicting desmoid occurrence in patients with familial adenomatous polyposis: a meta-analysis.
Sinha A et al
2571019
1989
Upper gastrointestinal cancer in patients with familial adenomatous polyposis.
Spigelman AD et al
22425061
2012
The prevalence of thyroid cancer and benign thyroid disease in patients with familial adenomatous polyposis may be higher than previously recognized.
Steinhagen E et al
25645574
2015
ACG clinical guideline: Genetic testing and management of hereditary gastrointestinal cancer syndromes.
Syngal S et al
18194984
2008
Guidelines for the clinical management of familial adenomatous polyposis (FAP).
Vasen HF et al
25938944
2015
A germline homozygous mutation in the base-excision repair gene NTHL1 causes adenomatous polyposis and colorectal cancer.
Weren RD et al
21813476
2012
Gastric adenocarcinoma and proximal polyposis of the stomach (GAPPS): a new autosomal dominant syndrome.
Worthley DL et al
16042583
2005
Phenotype associated with recessively inherited mutations in DNA mismatch repair (MMR) genes.
de Vos M et al
22265391
2012
Surgical management for advanced duodenal adenomatosis and duodenal cancer in Dutch patients with familial adenomatous polyposis: a nationwide retrospective cohort study.
van Heumen BW et al
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