Mutations in PTCH and XPA heterozygosity in x-irradiated subjects with high multiplicity of basal cell carcinomas

Basal cell carcinomas (BCCs) were obtained from subjects who had been treated with x-ray for tinea capitis at mean age 8 yr (average dose 3.0 Gy) and who have developed multiple (>5) skin cancers 35-40 years later. By allelic loss analysis, 9/10 tumors from 3 patients exhibited loss of heterozygosity (LOH) in one or more microsatellite markers in chromosome location 9q22.3. The xeroderma pigmentosum A (XPA) and PTCH (nevoid BCC syndrome (NBCCS)) genes are located in region 9q22.3, and often LOH in the region means that alleles of both genes are lost. Mutations were found in the undeleted PTCH allele in 2/9 BCCs, which is consistent with the two-allele inactivation model. A similar analysis for the XPA gene showed 5/9 BCCs with probable inactivating mutations. In 1 patient 5/5 cancers and normal blood showed the same 14 base deletion in codon 256-260 indicating this person was an XPA heterozygote. The same 5 cancers exhibited LOH in region 9q22.3 making it likely that 1 allele of both PTCH and XPA were lost. These results suggest how 2 genes could combine to produce an increase in susceptibility to X-ray-induced carcinogenesis in connection with UV as a second exogenous carcinogen (Supported by NIEHS and NCI). (author)