Abstract

The vast majority of esophageal adenocarcinoma cases are sporadic and caused by somatic mutations. However, over the last decades several families have been identified with clustering of Barrett’s esophagus and esophageal adenocarcinoma. This observation suggests that one or more hereditary factors may play a role in the initiation of Barrett’s esophagus and esophageal adenocarcinoma in these families. A Dutch family with clustering of Barrett’s esophagus and esophageal adenocarcinoma was identified. Normal DNA obtained from the proband diagnosed with Barrett’s esophagus was analyzed with SNP array and exome sequencing. A custom-made panel consisting of potential germline variants was verified in the normal DNA of the affected family members. In addition, the respective tumors were analyzed for somatic loss of the wild type allele or the presence of an inactivating somatic mutation in the wild type allele. Exome sequencing revealed 244 candidate variants in the normal DNA of the proband, of which 212 variants were verified successfully. After the normal DNA of the affected family members was analyzed for the presence of the 212 potential germline variants and subsequently the respective tumors, only one potential germline variant in MSX1 (chr4: 4861985 T > G, c.359T > G, p.V120G, NM_002448) showed loss of the wild type allele in the tumor DNAs of the affected family members. A germline variant in MSX1 was identified in a Dutch family with clustering of Barrett’s esophagus and esophageal adenocarcinoma. This finding indicates that the germline defect in MSX1 may be associated with Barrett’s esophagus and cancer in this particular family.

Highlights

  • Esophageal adenocarcinoma (EAC) is a histopathological subtype of esophageal cancer, of which the incidence is rising rapidly over the last decades in Western countries [1,2,3]

  • To identify a possible germline defect in the affected family members, we investigated the normal DNA of a proband with a SNP array and exome sequencing

  • For the first time a germline variant in the MSX1 gene was identified in a family with clustering of Barrett’s esophagus (BE) and EAC with the aid of exome sequencing

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Summary

Introduction

Esophageal adenocarcinoma (EAC) is a histopathological subtype of esophageal cancer, of which the incidence is rising rapidly over the last decades in Western countries [1,2,3]. Other risk factors are high age, male gender, Caucasian ethnicity [4], and obesity [5]. The risk of developing EAC from BE is estimated at 0.12–0.5% per year [6, 7] and follows a multimorphological sequence, in which metaplasia evolves to low-grade dysplasia (LGD), high-grade dysplasia (HGD) and into invasive adenocarcinoma [8]. The vast majority of BE and EAC cases are sporadic and caused by somatic mutations, over the last decades several families have been identified with clustering of BE and EAC [9,10,11,12].

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