Hereditary non-polyposis colon cancer
| Lynch syndrome | |
|---|---|
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| Micrograph showing tumor-infiltrating lymphocytes (in a colorectal cancer), a finding associated with MSI-H tumours, as may be seen in Lynch syndrome. H&E stain. | |
| Classification and external resources | |
| Specialty | oncology |
| ICD-10 | C18-C20 |
| ICD-9-CM | 153.0-154.1 |
| OMIM | 120435 609310 114400 |
| DiseasesDB | 5812 |
| MeSH | D003123 |
| GeneReviews | |
| Orphanet | 144 |
Lynch syndrome (HNPCC or hereditary nonpolyposis colorectal cancer) is an autosomal dominant genetic condition that has a high risk of colon cancer as well as other cancers including endometrial cancer (second most common), ovary, stomach, small intestine, hepatobiliary tract, upper urinary tract, brain, and skin. The increased risk for these cancers is due to inherited mutations that impair DNA mismatch repair. It is a type of cancer syndrome.
Henry T. Lynch, Professor of Medicine at Creighton University Medical Center, characterized the syndrome in 1966. In his earlier work, he described the disease entity as "cancer family syndrome." The term "Lynch syndrome" was coined in 1984 by other authors; Lynch named the condition HNPCC in 1985. Since then the two terms have been used interchangeably, until later advances in the understanding of the genetics of the disease led to the term HNPCC falling out of favour.
Other sources reserve the term "Lynch syndrome" when there is a known DNA mismatch repair defect, and use the term "familial colorectal cancer type X" when the Amsterdam criteria are met but there is no known DNA mismatch repair defect. The putative "type X" families appear to have a lower overall incidence of cancer and lower risk for non-colorectal cancers than families with documented DNA mismatch repair deficiency. About 35% of patients meeting Amsterdam criteria do not have a DNA-mismatch-repair gene mutation.
Complicating matters is the presence of an alternative set of criteria, known as the "Bethesda Guidelines."
Three major groups of MSI-H (MSI, MicroSatellite Instability) cancers can be recognized by histopathological criteria:
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