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Lack of evidence for germline RNF43 mutations in patients with serrated polyposis syndrome from a large multinational study
  1. Daniel D Buchanan1,2,
  2. Mark Clendenning1,
  3. Li Zhuoer1,
  4. Jenna R Stewart1,
  5. Sharelle Joseland2,
  6. Sonja Woodall3,
  7. Julie Arnold3,
  8. Kara Semotiuk4,
  9. Melyssa Aronson4,
  10. Spring Holter4,
  11. Steven Gallinger5,
  12. Mark A Jenkins2,
  13. Kevin Sweet6,
  14. Finlay A Macrae7,8,9,
  15. Ingrid M Winship7,8,
  16. Susan Parry3,
  17. Christophe Rosty1,10,11
  18. on behalf of the Genetics of Colonic Polyposis Study
  1. 1Colorectal Oncogenomics Group, Genetic Epidemiology Laboratory, Department of Pathology, The University of Melbourne, Parkville, Victoria, Australia
  2. 2Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia
  3. 3New Zealand Familial Gastrointestinal Cancer Service, Auckland, New Zealand
  4. 4Zane Cohen Centre for Digestive Diseases, Familial Gastrointestinal Cancer Registry, Mt Sinai Hospital, Toronto, Ontario, Canada
  5. 5Lunenfeld Tanenbaum Research Institute, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada 
  6. 6Division of Human Genetics, Ohio State University Medical Centre, Columbus, Ohio, USA
  7. 7Department of Medicine, The University of Melbourne, Parkville, Victoria, Australia
  8. 8Genetic Medicine and Family Cancer Clinic, Royal Melbourne Hospital, Parkville, Australia
  9. 9Department of Colorectal Medicine and Genetics, Royal Melbourne Hospital, Parkville, Victoria, Australia
  10. 10Envoi Specialist Pathologists, Herston, Queensland, Australia
  11. 11School of Medicine, The University of Queensland, Herston, Queensland, Australia
  1. Correspondence to Dr Daniel D Buchanan, Colorectal Oncogenomics Group, Genetic Epidemiology Laboratory, Department of Pathology and Centre for Epidemiology and Biostatistics, University of Melbourne, Parkville, VIC 3010, Australia; daniel.buchanan{at}unimelb.edu.au

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Serrated polyposis syndrome (SPS) is characterised by the occurrence of multiple serrated polyps in the large bowel. Defined clinically by the 2010 revised WHO, SPS is associated with an increased risk of colorectal cancer (CRC) for affected individuals and their first-degree relatives. Yan et al1 recently reported their findings from whole-exome sequencing (WES) of six individuals with SPS from four families, identifying a single family carrying a germline likely pathogenic variant in RNF43 (c.953-1 G>A, c.953_954delAG, p.E318fs). In this family, six carriers were identified, five of whom met the WHO criteria for SPS. This adds to two previous reports of germline mutations within RNF43 in individuals with SPS or who developed multiple serrated polyps.2 ,3 The current study by Yan et al1 also importantly showed loss of second wildtype allele in 16 serrated polyps, five adenomatous polyps, and in the rectal adenocarcinoma from carriers through somatic single nucleotide variants or loss of heterozygosity, adding further weight to a potential role of RNF43 in the development of colonic serrated neoplasia.

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