Table 2.
Syndrome | Diagnostic criteria |
---|---|
Peutz-Jeghers Syndrome |
(1) Two or more histologically confirmed PJS-type hamartomatous polyps, or (2) Any number of PJS-type polyps detected in an individual, who has a family history of PJS in (a) close relative(s) or (3) Characteristic mucocutaneous pigmentations in an individual, who has a family history of PJS in a close relative(s) or (4) Any number of PJS-type polyps in an individual who also has characteristic mucocutaneous pigmentations |
Juvenile Polyposis Syndrome |
(1) More than five juvenile polyps in the colorectum or (2) Multiple juvenile polyps throughout the GI-tract or (3) Any number of juvenile polyps and a family history of JPS |
POLE-associated polyposis | Heterozygosity for a pathogenic missense variant in the exonuclease domain (exon 9–14) of POLE, especially p.Leu424Val (Biallelic truncating/splice variants is associated with IMAGe syndrome (MIM: 614732)) and FILS syndrome (MIM: 615139)) |
POLD1-associated polyposis | Heterozygosity for a pathogenic missense variant in the exonuclease domain (exons 6–12) of POLD1 |
AXIN2-associated polyposis | Heterozygosity for a pathogenic variant in AXIN2, especially in exon 8 |
MUTYH- NTHL1-MSH3- or MLH3-associated polyposis | Biallelic pathogenic variants in the relevant gene (MUTYH, NTHL1, MSH3, MLH3,) |
Constitutional mismatch repair deficiency syndrome | Biallelic pathogenic variants in an MMR gene (MLH1, MSH2, MSH6, and PMS2, mainly PMS2. Biallelic carriers of highly penetrant variants are not viable and will die before birth |
GREM1-associated mixed polyposis | Heterozygosity for a duplication upstream of GREM1 |
Serrated Polyposis Syndrome |
(1) At least five serrated lesions/polyps proximal to the rectum, all being 5 or more mm in size with two or more being at least 10 mm in size. (2) More than 20 serrated lesions/polyps of any size distributed throughout the large bowel, with at least five being proximal to the rectum. |
Polyposis with unknown etiology |
(1) At least one family member has had from 20 to 30 (dependent on age) to 99* colorectal polyps, and (2) screening of the relevant genes has not detected a pathogenic variant that can explain the family history, and (3) no other etiology to the gastrointestinal polyps/cancers observed in the family (e.g. genetic syndromes, inflammatory bowel disease etc.) is likely Furthermore, a family history with a significant occurrence of colorectal adenomas/polyps in two or more relatives can indicate a clinically significant predisposition. *If the patient or a relative has had over 100 polyps, the guidelines for FAP should be used |