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Squamous Cell Carcinoma

    Table 3. Genes Associated with Fanconi Anemia (FA)

    GeneLocusApproximate Incidence Among FA Patients (%)Pattern of Disease Transmission
    AR = autosomal recessive; XLR =X-linked recessive.
    FANCA(OMIM)16q24.3~70AR
    FANCB(OMIM)Xp22.31RareXLR
    FANCC(OMIM)9q22.3~10AR
    FANCD1(BRCA2) (OMIM)13q12.3RareAR
    FANCD2(OMIM)3p25.3RareAR
    FANCE(OMIM)6p21.3~10AR
    FANCF(OMIM)11p15RareAR
    FANCG(XRCC9) (OMIM)9p13~10AR
    FANCI(KIAA1794) (OMIM)15q25-26RareAR
    FANCJ(BACH1/BRIP1) (OMIM)17q22.3RareAR
    FANCL(PHF9/POG) (OMIM)2p16.1RareAR
    FANCM(Hef) (OMIM)14q21.3RareAR
    FANCN(PALB2) (OMIM)16p12.1RareAR

    The proteins involved with DNA crosslink repairs have been termed the FANC pathway because of their involvement with Fanconi anemia.[133] They interact with several other proteins associated with hereditary cancer risk, including those for Bloom syndrome and ataxia-telangiectasia. Further investigation has revealed that FANCD1 is the same gene as BRCA2, a gene that causes predisposition to breast and ovarian cancer.[134] Other Fanconi anemia genes, FANCJ (BRIP1) and FANCN (PALB2), have also been identified as rare breast cancer susceptibility genes.[135] (Refer to the PDQ summary on Genetics of Breast and Ovarian Cancer for more information about BRCA2, BRIP1, and PALB2.) Individuals who are heterozygous carriers of other Fanconi anemia–associated mutations do not appear to have an increased risk of cancer, with the possible exception of a twofold increase in breast cancer incidence in FANCC mutation carriers.[136]

    Dyskeratosis congenita (Zinsser-Cole-Engman syndrome)

    Dyskeratosis congenita, like Werner syndrome, results in premature aging and is considered a progeroid disease. The classic clinical triad for diagnosis includes dysplastic nails, reticular pigmentation of the chest and neck, and oral leukoplakia. In addition, individuals with this disorder are at markedly increased risk of myelodysplastic syndrome, acute leukemia, and bone marrow failure. Ocular, dental, neurologic, gastrointestinal, pulmonary, and skeletal abnormalities have also been described in conjunction with this disease, but clinical expressivity is variable.[137] Developmental delay may also be present in variants of dyskeratosis congenita, such as Hoyeraal Hreidarsson syndrome and Revesz syndrome.

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