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Lynch Syndrome (HNPCC): Symptoms, Causes, and Outlooks

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Causes, Screening and Diagnosis".

Deadline for manuscript submissions: closed (1 March 2026) | Viewed by 3763

Special Issue Editor


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Guest Editor
Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, 80131 Naples, Italy
Interests: Lynch syndrome; FAP; MAP; Cowden syndrome; PTEN hamartoma tumor syndrome; epithelial–mesenchymal transition; study of low risk-alleles; functional assay of unclassified MMR variants
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Special Issue Information

Dear Colleagues,

Lynch syndrome (LS) is an autosomal dominant genetic disorder associated with germline mutations in DNA mismatch repair (MMR) genes. Carriers of pathogenic variants in these genes are at increased risk of developing colorectal cancer and/or LS-associated cancer. The loss of the MMR complex determines, at the somatic level (colorectal cancer), a condition defined as microsatellite instability (MSI) or mismatch repair deficiency (dMMR). Unfortunately, not all colorectal cancers with MSI or dMMR have pathogenic germline mutations in the MMR genes. This condition also often occurs in families with a strong predisposition to the development of tumors; therefore, the identification of genetic predisposition as a cause of cancer becomes very important for the preventive management of these families. Next-generation sequencing (NGS) applied to detect germline pathogenetic variants in subjects with dMMR/MSI cancer is now carried out through the use of panels that use an increasing number of predisposition genes, allowing the identification of pathogenic variants in genes not associated with Lynch syndrome. At the same time, the application of NGS also identifies a substantial number of rare genetic variants of uncertain significance in the MMR genes that could also be the cause of pathology, except that, in these cases, the pathogenetic assessment requires further molecular biology investigations, such as functional assays. The correct interpretation of all the variants that could be the cause of the onset of the tumor is of fundamental importance for the decision-making process on treatment as well as for the prognosis and endoscopic management of carrier patients and their healthy family members. This Special Issue will highlight all of these aspects of Lynch syndrome in order to advance our knowledge on the best path forward for the management of patients with Lynch syndrome.

In this Special Issue, original research articles and reviews are welcome.

I look forward to receiving your contributions.

Dr. Francesca Duraturo
Guest Editor

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Keywords

  • Lynch syndrome
  • genotype–phenotype correlation
  • highly immunogenic frame-shift neo-peptides
  • immunotherapy
  • mismatch repair genes
  • unclassified genetic variants
  • new role of MMR proteins
  • miRNAs
  • functional assay MMR deficiency

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Published Papers (1 paper)

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Review

43 pages, 3834 KB  
Review
Lynch Syndrome in Focus: A Multidisciplinary Review of Cancer Risk, Clinical Management, and Special Populations
by Seyma Eroglu, Ilhan Birsenogul, Alexandra P. Bowen, Joseph F. Doyle, Stephen E. Pupkin, Joaquin Villar, Christopher M. Tarney, Edwin Gandia, Danielle M. Pastor and Juvianee I. Estrada-Veras
Cancers 2025, 17(24), 3981; https://doi.org/10.3390/cancers17243981 - 13 Dec 2025
Cited by 3 | Viewed by 2876
Abstract
Lynch syndrome (LS), also known as hereditary nonpolyposis colorectal cancer (HNPCC), is a hereditary cancer syndrome significantly increasing the risk of colorectal cancer (CRC) and various extracolonic cancers, including endometrial, ovarian, and gastric cancers. LS results from germline pathogenic variants (GPVs) in DNA [...] Read more.
Lynch syndrome (LS), also known as hereditary nonpolyposis colorectal cancer (HNPCC), is a hereditary cancer syndrome significantly increasing the risk of colorectal cancer (CRC) and various extracolonic cancers, including endometrial, ovarian, and gastric cancers. LS results from germline pathogenic variants (GPVs) in DNA mismatch repair (MMR) genes, such as MLH1, MSH2, MSH6, and PMS2, leading to microsatellite instability (MSI). This review explores the multifaceted aspects of LS, covering clinical presentation, genetic underpinnings, and emerging therapeutic strategies. The discussion explores the importance of identifying at-risk individuals, facilitating personalized cancer surveillance and prevention strategies. Molecular insights into distinguishing between sporadic and LS-associated cancers are also examined, with a focus on somatic testing methods, including MSI and immunohistochemistry (IHC). The gynecological cancer risks, particularly those related to endometrial and ovarian malignancies, are addressed, underscoring the need for early detection and risk-reducing interventions. Recent advancements in the management of colorectal and other LS-related cancers are highlighted, with particular attention to the growing role of immunotherapy, including immune checkpoint inhibitors, and immunoprevention strategies. With ongoing advances in our understanding of LS, opportunities for earlier detection, more effective prevention, and innovative treatments continue to expand. This narrative review adopts a multidisciplinary approach to provide a comprehensive understanding of LS, from its genetic basis to current clinical and therapeutic practices, with the ultimate goal of improving patient outcomes and enhancing the quality of care. Full article
(This article belongs to the Special Issue Lynch Syndrome (HNPCC): Symptoms, Causes, and Outlooks)
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