VALOR PREDITIVO DA MUTAÇÃO R337H DO GENE TP53 COMO UM MARCADOR CLÍNICO EM PACIENTES COM CÂNCER.

Abstract

Introduction: the R337H mutation of the TP53 gene was originated in the Brazilian population through a founder effect and is considered a molecular defect of low penetrance. In combination with some polymorphisms, the R337H mutation can increase the susceptibility to tumor. The frequency of the R337H mutation in Brazilian families is considered high when compared to the observed frequencies in other countries. The unambiguous association between the mutation, the emergence of different tumor types and the high number of individual that carry the mutation makes the R337H a relevant factor in public health, particularly in the prediction of cancer. Objective: This study aimed to investigate the predictive value of the R337H mutation of the TP53 gene as a clinical marker in cancer patients. Method: a systematic literature review (SLR) was carefully performed, by searching electronic scientific literature in LILACS, IBECS, MEDLINE, Pubmed and SciELO. Twelve articles, published in English between the years 2006 to 2013, were selected by performed the relevance tests I and II. Extraction of detailed data was independently performed by two investigators, following on extraction data protocol. Results: the R337H mutation was found in 287 of 1,548 patients with cancer, two of 750 women considered healthy, 200 of 887 family members of patients with adrenocortical tumor (ACT) carrying the R337H mutation, 12 of 647 health controls and in 442 of 171 630 newborns. Eight of the twelve selected references associated the R337H mutation with family history of 411 patients with the mutation. Four studies associated the R337H mutation prognosis. Conclusion: the frequency of the R337H mutation of the TP53 gene is considerably higher in the south and southeast regions of Brazil compared to other countries. The mutation was associated with family history of cancer, the increase of the positive predictive value and the decreased of negative predictive value at diagnosis, and poor prognosis in ACT and CPC patients with with the mutation.