A 21-Year-Old Woman Is Hospitalized for Elective Subtotal Colectomy with Ileo-Rectal

A 21-year-old woman is hospitalized for elective subtotal colectomy with ileo-rectal anastomosis due to abnormal colonoscopic findings.  She underwent screening colonoscopy because of family history of colon cancer.  Her maternal grandfather died of metastatic colon cancer, and her mother was also recently diagnosed with colon cancer.  The patient has no other medical problems, takes no medications, and does not use tobacco, alcohol, or illicit drugs.  The surgery is performed with no operative complications.  Numerous lesions are present throughout the resected colon, some of which are shown in the histopathology exhibit below. Genetic testing is most likely to reveal a germline mutation resulting in which of the following effects?

A) Abnormality of RAS signaling protein
B) Absence of regulatory TP53 protein
C) Defective repair of DNA mismatches
D) Increase in cellular telomerase activity
E) Loss of functional APC protein

Correct Answer:

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