Publications by authors named "Win-Aung"

Background: Colorectal cancers (CRCs) from people with biallelic germline likely pathogenic/pathogenic variants in MUTYH or NTHL1 exhibit specific single base substitution (SBS) mutational signatures, namely combined SBS18 and SBS36 (SBS18+SBS36), and SBS30, respectively. The aim was to determine if adenomas from biallelic cases demonstrated these mutational signatures at diagnostic levels.

Methods: Whole-exome sequencing of FFPE tissue and matched blood-derived DNA was performed on 9 adenomas and 15 CRCs from 13 biallelic MUTYH cases, on 7 adenomas and 2 CRCs from 5 biallelic NTHL1 cases and on 27 adenomas and 26 CRCs from 46 non-hereditary (sporadic) participants.

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  • Colorectal cancers (CRCs) linked to biallelic germline variants show specific mutational signatures (SBS18+SBS36 and SBS30) that could also be present in adenomas, which are precursors to CRCs.
  • A study sequenced DNA from adenomas and CRCs in biallelic cases and compared them with sporadic cases to investigate these signatures.
  • Results indicated that adenomas in biallelic cases had similar mutational signature proportions as their corresponding CRCs, suggesting testing adenomas could enhance the detection of biallelic cases and improve variant classification for better CRC prevention strategies.
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  • Survivors of colorectal cancer are at risk for developing a second primary colorectal cancer, termed metachronous colorectal cancer, and identifying features of the first tumor could help improve surveillance strategies.
  • In a study of 6085 colorectal cancer cases from the Colon Cancer Family Registry, 138 (2.3%) developed metachronous CRC over an average follow-up of 12 years, with specific factors influencing their risk.
  • Notably, individuals with synchronous tumors were 3.4 times more likely, and those with MMR-deficient tumors had a 72% higher risk, while those with an undifferentiated histologic type were 77% less likely to develop a second cancer. Existing surveillance guidelines may need
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Genome-wide association studies (GWAS) have identified more than 200 common genetic variants independently associated with colorectal cancer (CRC) risk, but the causal variants and target genes are mostly unknown. We sought to fine-map all known CRC risk loci using GWAS data from 100,204 cases and 154,587 controls of East Asian and European ancestry. Our stepwise conditional analyses revealed 238 independent association signals of CRC risk, each with a set of credible causal variants (CCVs), of which 28 signals had a single CCV.

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Young breast and bowel cancers (e.g., those diagnosed before age 40 or 50 years) have far greater morbidity and mortality in terms of years of life lost, and are increasing in incidence, but have been less studied.

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  • The study examined the connection between certain bacteria (pks E. coli, Enterotoxigenic Bacteroides fragilis, and Fusobacterium nucleatum) and colorectal cancer (CRC) by analyzing DNA samples from various cohorts.
  • Results revealed that pks E. coli is linked to male CRC patients and a specific APC gene mutation, mainly in early-onset cases, while F. nucleatum correlates with various cancer traits including DNA repair deficiencies and specific tumor locations.
  • The findings suggest that pks E. coli might cause DNA damage related to the identified mutation, and F. nucleatum exists in both hereditary and sporadic factors of DNA mismatch repair deficiencies, highlighting the importance of the tumor environment for bacterial colon
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  • - A systematic review and meta-analysis were conducted to identify risk factors for metachronous colorectal cancer (CRC) and advanced neoplasia, analyzing 22 studies involving over 625,000 participants from various databases up to February 2021.
  • - Key findings indicated that individuals diagnosed with initial CRC alongside synchronous advanced lesions had significantly higher risks of developing metachronous CRC or advanced neoplasia, with risk ratios showing a strong correlation.
  • - Factors such as the location of the first CRC (distal versus proximal) and increasing age were significant, with the latter showing a consistent increase in risk for advanced neoplasia, while lifestyle factors did not demonstrate any notable associations.
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  • DEPTH (DEPendency of association on the number of Top Hits) is a method used to find candidate susceptibility regions linked to colorectal cancer by analyzing sequences of variants in the genome from large datasets.
  • In a study combining data from two major colorectal cancer research groups, DEPTH identified a significant number of candidate regions (569 in common between studies), and many of these were not detected using traditional genome-wide association study (GWAS) approaches.
  • The findings suggest that DEPTH could serve as a valuable tool alongside conventional GWAS for discovering new susceptibility regions, potentially improving understanding of genetic risks for colorectal cancer.
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  • The Prospective Lynch Syndrome Database (PLSD) gathers data on individuals with MMR variants to study cancer diagnosis and treatment outcomes, focusing on a newly expanded cohort.
  • The study includes over 8,500 patients from 25 countries, analyzing cancer incidence, mortality rates up to age 75, and survival rates after diagnosis.
  • Findings reveal that while gynecological cancers have high incidence rates among carriers, non-colorectal cancers lead to more deaths, highlighting the need for improved care for these patients.
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  • Routine screening for DNA mismatch repair (MMR) deficiency in certain tumors often results in unresolved cases labeled as suspected Lynch syndrome (SLS), with a study involving 135 such cases across Australia and New Zealand.
  • Targeted sequencing of tumors and matched blood samples revealed that 86.9% of these SLS cases could be classified into specific subtypes, primarily through the detection of double somatic MMR mutations.
  • The research indicates that implementing tumor-focused testing and MLH1 methylation assays in clinical settings can effectively clarify SLS diagnoses, leading to better surveillance and screening for patients.
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  • Routine screening for DNA mismatch repair deficiency in colorectal, endometrial, and sebaceous skin tumors has led to many unresolved cases suspected of Lynch syndrome, affecting 135 patients across Australia and New Zealand.
  • Targeted panel sequencing of tumors and matched blood DNA helped resolve 86.9% of these suspected cases by identifying various factors, including epimutations and germline MMR variants, with double somatic mutations being the most common cause.
  • The study suggests that incorporating tumor sequencing and methylation assays into clinical diagnostics could reduce unresolved cases and improve patient surveillance and screening strategies.
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Background: Birt-Hogg-Dubé (BHD) syndrome is a rare genetic syndrome caused by pathogenic or likely pathogenic germline variants in the gene. Patients with BHD syndrome have an increased risk of fibrofolliculomas, pulmonary cysts, pneumothorax and renal cell carcinoma. There is debate regarding whether colonic polyps should be added to the criteria.

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Using age- and height-adjusted total kidney volume, the Mayo Clinic Imaging Classification provides a validated approach to assess the risk of chronic kidney disease (CKD) progression in autosomal dominant polycystic kidney disease (ADPKD), but requires excluding patients with atypical imaging patterns, whose clinical characteristics have been poorly defined. We report an analysis of the prevalence, clinical and genetic characteristics of patients with atypical polycystic kidney disease by imaging. Patients from the extended Toronto Genetic Epidemiology Study of Polycystic Kidney Disease recruited between 2016 and 2018 completed a standardized clinical questionnaire, kidney function assessment, genetic testing, and kidney imaging by magnetic resonance or computed tomography.

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Colorectal cancer (CRC) is a leading cause of mortality worldwide. We conducted a genome-wide association study meta-analysis of 100,204 CRC cases and 154,587 controls of European and east Asian ancestry, identifying 205 independent risk associations, of which 50 were unreported. We performed integrative genomic, transcriptomic and methylomic analyses across large bowel mucosa and other tissues.

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Objective: The unknown aetiology of Serrated Polyposis Syndrome (SPS) impedes risk prediction and prevention. We investigated risk factors for SPS, overall and stratified by World Health Organization (WHO) clinical criteria and by colorectal cancer (CRC).

Method: A retrospective case-control study involving a cross-sectional analysis from 350 unrelated individuals with SPS from the Genetics of Colonic Polyposis Study and 714 controls from the Australasian Colorectal Cancer Family Registry.

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Identifying tumor DNA mismatch repair deficiency (dMMR) is important for precision medicine. Tumor features, individually and in combination, derived from whole-exome sequenced (WES) colorectal cancers (CRCs) and panel-sequenced CRCs, endometrial cancers (ECs), and sebaceous skin tumors (SSTs) were assessed for their accuracy in detecting dMMR. CRCs (n = 300) with WES, where mismatch repair status was determined by immunohistochemistry, were assessed for microsatellite instability (MSMuTect, MANTIS, MSIseq, and MSISensor), Catalogue of Somatic Mutations in Cancer tumor mutational signatures, and somatic mutation counts.

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  • - The study aims to compare colorectal cancer (CRC) incidences between two groups: one group receiving mandatory colonoscopy surveillance (PLSD) and another group with retrospective data (IMRC) that did not have the same follow-up.
  • - Results from the PLSD showed higher CRC rates in carriers of MMR gene variants, particularly for path_MLH1 and path_MSH2, compared to the IMRC cohort, challenging previous expectations about cancer rates in these groups.
  • - The study concludes that while colonoscopy did reduce CRC incidences in paths_MPS2 carriers prior to age 50, it did not have the same effect for path_MLH1 and path_MSH2, suggesting the need for reevaluation of
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Background: The current risk stratification system defined by clinicopathological features does not identify the risk of recurrence in early-stage (stage I-II) colorectal cancer (CRC) with sufficient accuracy. We aimed to investigate whether DNA methylation could serve as a novel biomarker for predicting prognosis in early-stage CRC patients.

Methods: We analyzed the genome-wide methylation status of CpG loci using Infinium MethylationEPIC array run on primary tumor tissues and normal mucosa of early-stage CRC patients to identify potential methylation markers for prognosis.

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Purpose: Models used to predict the probability of an individual having a pathogenic homozygous or heterozygous variant in a mismatch repair gene, such as MMRpro, are widely used. Recently, MMRpro was updated with new colorectal cancer penetrance estimates. The purpose of this study was to evaluate the predictive performance of MMRpro and other models for individuals with a family history of colorectal cancer.

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Background: Colorectal cancer has a strong epigenetic component that is accompanied by frequent DNA methylation (DNAm) alterations in addition to heritable genetic risk. It is of interest to understand the interrelationship of germline genetics, DNAm, and colorectal cancer risk.

Methods: We performed a genome-wide methylation quantitative trait locus (meQTL) analysis in 1,355 people, assessing the pairwise associations between genetic variants and lymphocytes methylation data.

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Background: The incidence of colorectal cancer (CRC) among individuals aged younger than 50 years has been increasing. As screening guidelines lower the recommended age of screening initiation, concerns including the burden on screening capacity and costs have been recognized, suggesting that an individualized approach may be warranted. We developed risk prediction models for early-onset CRC that incorporate an environmental risk score (ERS), including 16 lifestyle and environmental factors, and a polygenic risk score (PRS) of 141 variants.

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Background: Tumor-infiltrating lymphocytes (TILs), especially CD8+ TILs, can be used for predicting immunotherapy responsiveness and survival outcome. However, the evaluation of CD8+ TILs currently relies on histopathological methodology with high variability. We therefore aimed to develop a DNA methylation signature for CD8+ TILs (CD8+ MeTIL) that could evaluate immune response and prognosis in colorectal cancer (CRC).

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