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PMS2 (postmeiotic segregation increased 2 [S. cerevisiae]) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants

CPT4 code

Name of the Procedure:

PMS2 (Postmeiotic Segregation Increased 2 [S. cerevisiae]) Genetic Analysis for Known Familial Variants

Summary

This genetic test analyzes specific variants in the PMS2 gene, which can indicate an increased risk of hereditary non-polyposis colorectal cancer (HNPCC), also known as Lynch syndrome. By identifying known familial variants, doctors can assess a person's predisposition to this condition.

Purpose

Medical Condition or Problem Addressed:

Hereditary non-polyposis colorectal cancer (HNPCC) or Lynch syndrome, which increases the risk of colorectal and other types of cancer.

Goals or Expected Outcomes:
  • Identification of known familial variants in the PMS2 gene.
  • Early diagnosis and risk assessment for Lynch syndrome.
  • Personalized management and prevention strategies for at-risk individuals.

Indications

Symptoms or Conditions:
  • Family history of colorectal cancer or related cancers.
  • Presence of cancer at a young age in family members.
  • Previous genetic testing indicating possible Lynch syndrome.
Patient Criteria:
  • Individuals with a family history of HNPCC/Lynch syndrome.
  • Patients with known familial genetic variants.
  • Those undergoing comprehensive genetic screening for cancer risk.

Preparation

Pre-Procedure Instructions:
  • No fasting or medication adjustments are usually required.
  • Patients may need to provide a family medical history.
  • A blood or saliva sample is required for the test.
Diagnostic Tests or Assessments:
  • Completion of a family history questionnaire.
  • Possible prior genetic counseling session to discuss inherited cancer risk.

Procedure Description

  1. A healthcare provider collects a blood or saliva sample from the patient.
  2. The sample is labeled and sent to a laboratory specializing in genetic testing.
  3. DNA is extracted and analyzed using molecular techniques to identify the presence of known familial variants in the PMS2 gene.
Tools and Technology:
  • Lab equipment for DNA extraction and analysis.
  • Molecular diagnostic tools like PCR and sequencing platforms.
Anesthesia or Sedation:
  • Not applicable, as the procedure involves minimal discomfort.

Duration

  • Sample collection takes about 5-15 minutes.
  • Laboratory analysis can take several days to a few weeks, depending on the lab's workload.

Setting

  • Outpatient clinic or genetic testing laboratory.

Personnel

  • Phlebotomist or nurse for sample collection.
  • Geneticists and lab technicians for sample analysis.
  • Genetic counselor or physician for interpretation and discussion of results.

Risks and Complications

Common Risks:
  • Minor discomfort or bruising at the sample collection site.
Rare Risks:
  • Psychological impact of test results.
Complications:
  • Misinterpretation of results, though this is rare with proper genetic counseling.

Benefits

  • Early detection and management of cancer risk.
  • Informed decisions about preventive measures, such as more frequent screenings.
Realization of Benefits:
  • Patients can learn and implement preventive strategies soon after obtaining results.

Recovery

Post-Procedure Care:
  • No specific post-procedure care needed; patients can resume normal activities immediately.
Recovery Time:
  • Immediate recovery; no downtime required.
Follow-Up Appointments:
  • Genetic counseling session to discuss results and next steps.

Alternatives

Other Treatment Options:
  • Comprehensive genetic panel testing that includes multiple genes associated with cancer risk.
  • Regular cancer screening without genetic testing.
Pros and Cons:
  • Comprehensive panels may provide more information but can be costlier.
  • Regular screening without genetic testing may miss early diagnostic opportunities.

Patient Experience

During the Procedure:
  • Minor discomfort during sample collection.
After the Procedure:
  • Little to no physical discomfort.
  • Potential anxiety while waiting for results, which can be mitigated by counseling.
Pain Management and Comfort Measures:
  • Sample collection is typically quick and minimally invasive, requiring only basic comfort measures like applying a cold pack for bruising, if necessary.

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