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. 2000 Feb;82(4):827–832. doi: 10.1054/bjoc.1999.1007

Desmoids in familial adenomatous polyposis are monoclonal proliferations

S B Middleton 1, I M Frayling 2, R K S Phillips 1
PMCID: PMC2374411  PMID: 10732754

Abstract

Desmoids are poorly-understood, locally aggressive, non-metastasizing fibromatoses that occur with disproportionate frequency in patients with familial adenomatous polyposis (FAP). Their nature is controversial with arguments for and against a neoplastic origin. Neoplastic proliferations are by definition monoclonal, whereas reactive processes originate from a polyclonal background. We examined clonality of 25 samples of desmoid tissue from 11 female FAP patients by assessing patterns of X-chromosome inactivation to calculate a clonality ratio. Polymerase chain reaction (PCR) amplification of a polymorphic CAG short tandem repeat (STR) sequence adjacent to a methylation-sensitive restriction enzyme site within the human androgen receptor (HUMARA) gene using fluorescent-labelled primers enabled analysis of PCR products by Applied Biosystems Genescan IITMsoftware. Twenty-one samples from nine patients were informative for the assay. Samples from all informative cases comprised a median of 66% (range 0–75%) clonal cells but from the six patients with a clonality ratio ≤0.5 comprised a median of 71% (65–75%) clonal cells. FAP-associated desmoid tumours are true neoplasms. This may have implications in the development of improved treatment protocols for patients with these aggressive tumours. © 2000 Cancer Research Campaign

Keywords: desmoids, familial adenomatous polyposis, clonality, neoplasm, X-chromosome inactivation, HUMARA

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Selected References

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