The utility of alpha-fetoprotein screening in Beckwith-Wiedemann syndrome

Am J Med Genet A. 2017 Mar;173(3):581-584. doi: 10.1002/ajmg.a.38068. Epub 2017 Feb 4.

Abstract

Beckwith-Wiedemann syndrome (BWS) is one of the most common cancer predisposition disorders. As a result, BWS patients receive tumor screening as part of their clinical management. Until recently, this screening has been employed uniformly across all genetic and epigenetic causes of BWS, including the utilization of ultrasonography to detect abdominal tumors and alpha-fetoprotein (AFP) to detect hepatoblastoma. The advancements in our understanding of the genetics and epigenetics leading to BWS has evolved over time, and has led to the development of genotype/phenotype correlations. As tumor risk appears to correlate with genetic and epigenetic causes of BWS, several groups have proposed alterations to tumor screening protocols based on the etiology of BWS, with the elimination of AFP as a screening measure and the elimination of all screening measures in BWS patients with loss of methylation at the KCNQ1OT1:TSS-DMR 2 (IC2). There are many challenges to this suggestion, as IC2 patients may have additional factors that contribute to risk of hepatoblastoma including fetal growth patterns, relationship with assisted reproductive technologies, and the regulation of the IC2 locus. © 2017 Wiley Periodicals, Inc.

Keywords: Beckwith-Wiedemann syndrome; alpha-fetoprotein; hepatoblastoma; tumor screening.

Publication types

  • Letter

MeSH terms

  • Beckwith-Wiedemann Syndrome / blood*
  • Beckwith-Wiedemann Syndrome / complications*
  • Beckwith-Wiedemann Syndrome / genetics
  • Biomarkers, Tumor*
  • DNA Methylation
  • Early Detection of Cancer
  • Hepatoblastoma / diagnosis*
  • Hepatoblastoma / etiology*
  • Humans
  • Liver Neoplasms / diagnosis*
  • Liver Neoplasms / etiology*
  • Mass Screening
  • Potassium Channels, Voltage-Gated / genetics
  • Ultrasonography
  • alpha-Fetoproteins*

Substances

  • Biomarkers, Tumor
  • KCNQ1OT1 long non-coding RNA, human
  • Potassium Channels, Voltage-Gated
  • alpha-Fetoproteins