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Chairun Nur

Prasetya

Lynch syndrome

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Ny. WH (46 yrs)

Ca Mamae 40 th

Ca Colon Tranvers

um 48th

 TumorGanasOtak 11th

Ca Mamae20 th

Ca Mamae31 th

Ca Mamae31 th (op.2x)

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Tn Jaman (65 yrs)

Ca Mamae 40 th

Ca Usus

4 th

 TumorGanasOtak 20 thCa Usus

3 th

Ca Usus

40 th

Ca Usus48 th

Ca Usus0 th Ca Usus40 th

Ca

!e"t

um40 thCa

!e"tum40 th

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American Cancer Society Inc. 200! Cancer Statistic 200

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Karsinogenesis

#0 $ %pora&'k %omat'" Mutat'on

20 30 $ am'l'al

10 $ *nher'&'te&3 + $ ,-n"h %-n&rom

Vogelstein et al – N.Engl.J. Med. 1988; 319 : 525 – 32

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Mr. AH 42 yrs " #ynch I 

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Defnition

,-n"h s-n&rome 's an 'nher'&'te& "on&'t'onthat 'ves a person a h'her r'sk o/ "an"erso/ the &'est've tra"t -ne"olo'" tra"t an&

other oran.

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Identifcation o lynchsyndrome

Clinical

re&'"t'on mo&els

 Tumor test'nGerml'ne test'n

Un'versal test'n

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Identifcation o lynch syndrome

 $l %&'"ni( %)N$ 2**8; 88 : 819 – 49 

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 $l %&'"ni( %)N$ 2**8; 88 : 819 – 49 

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Clinical

CriteriaDiagnose

Sensitift

y

Spesifsit

y

mster&am * alseeat've

40 $(T'&ak%pes'k)

mster&am ** 22 $ 58 $

6hates&a 82 $ ## $

*7C Test'n 83 $ 85 $

M%* Test'n 8+ $ 50 $+1, Road -E( )olon and Re!tal %&rgery 2**(/g. 353 – 01

+2, $l %&'"ni( %)N$ 2**8; 88 : 819 – 49

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,-n"h %-n&rome enot'peUs'a 40 +0 tahunolon rox'mal (0980$)

%'nkronous : metakronous

;'/erens'as' 'h >a'k )

+1, indor NM( J$M$ 2**0; 290 : 15* – 1

+2, yn!" -( %einars in %&rgi!al n!ology 2***;18 : 3*5 – 13

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 Options

Inter'ention %ecommenation

)olonos!o/y Eery 12 y 6eginning at age 2*+M1,( 25 +M%2,( or 3* +M%07 PM%2,

Endoetrialsa/ling

Eery 1 y 6eginning at age 3*35

-ransaginal % Eery 1 y 6eginning at age 3*35

rinalysis it"!ytology

Eery 12 y 6eginning at age 2535

istory 7 Ea reie o< systes

Eery 1 y 6eginning at age 21

indor NM( J$M$ 2**0; 290 : 15* – 1

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 Ter'ma as'h