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Previous Volume 338:879-887 March 26, 1998 Number 13 Next

	Full Text PDF Editorial by Clurman, B. E. Letters Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited PubMed Citation

ABSTRACT

Background Germ-line mutations in the CDKN2A tumor-suppressor gene (also known as p16, p16 ^INK4a, and MTS1) have been linked to the development of melanoma in some families with inherited melanoma. Whether mutations in CDKN2A confer a predisposition to sporadic (nonfamilial) melanoma is not known. In some patients with sporadic melanoma, one or more additional primary lesions develop, suggesting that some of these patients have an underlying genetic susceptibility to the cancer. We hypothesized that this predisposition might be due to germ-line CDKN2A mutations.

Methods We used the polymerase chain reaction, single-strand conformation polymorphism analysis, and direct DNA sequencing to identify germ-line mutations in the CDKN2A gene in patients with multiple primary melanomas who did not have family histories of the disease. A quantitative yeast two-hybrid assay was used to evaluate the functional importance of the CDKN2A variants.

Results Of 33 patients with multiple primary melanomas, 5 (15 percent; 95 percent confidence interval, 4 percent to 27 percent) had germ-line CDKN2A mutations. These included a 24-bp insertion at the 5' end of the coding sequence, three missense mutations (Arg24Pro, Met53Ile, and Ser56Ile), and a 2-bp deletion at position 307 to 308 (resulting in a truncated CDKN2A protein). In three families, CDKN2A mutations identical to those in the probands were found in other family members. In two families with mutations, we uncovered previously unknown evidence of family histories of melanoma.

Conclusions Some patients with multiple primary melanomas but without family histories of the disease have germ-line mutations of the CDKN2A gene. The presence of multiple primary melanomas may signal a genetic susceptibility to melanoma not only in the index patient but also in family members, who may benefit from melanoma-surveillance programs.

Source Information

From the Institute of Medical Sciences (J. Monzon, D.H., N.J.L.), the Department of Medical Biophysics (L.L., H.B., D.H., N.J.L.), and the Departments of Dermatology (L.F.) and Preventive Medicine and Biostatistics (J. McLaughlin), University of Toronto, Toronto; the Genetic Epidemiology Branch, National Cancer Institute, Bethesda, Md. (A.M.G., M.A.T.); and the Division of Medical Oncology, Toronto–Sunnybrook Regional Cancer Centre, Toronto (N.J.L.).

Address reprint requests to Dr. Lassam at Toronto–Sunnybrook Regional Cancer Centre, 2075 Bayview Ave., Toronto, ON M4N 3M5, Canada.

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CDKN2A Mutations in Multiple Primary Melanomas
Bystryn J.-C., Hughes-Davies T.H., Lassam N. J., Hogg D., McLaughlin J.
Extract | Full Text  
N Engl J Med 1998; 339:347-348, Jul 30, 1998. Correspondence

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