Hansford J R, Mulligan L M
Department of Pathology, Queen's University, Kingston, Ontario K7L 3N6, Canada.
J Med Genet. 2000 Nov;37(11):817-27. doi: 10.1136/jmg.37.11.817.
Multiple endocrine neoplasia type 2 (MEN 2) is an inherited cancer syndrome characterised by medullary thyroid carcinoma (MTC), with or without phaeochromocytoma and hyperparathyroidism. MEN 2 is unusual among cancer syndromes as it is caused by activation of a cellular oncogene, RET. Germline mutations in the gene encoding the RET receptor tyrosine kinase are found in the vast majority of MEN 2 patients and somatic RET mutations are found in a subset of sporadic MTC. Further, there are strong associations of RET mutation genotype and disease phenotype in MEN 2 which have led to predictions of tissue specific requirements and sensitivities to RET activity. Our ability to identify genetically, with high accuracy, subjects with MEN 2 has revolutionised our ability to diagnose, predict, and manage this disease. In the past few years, studies of RET and its normal ligand and downstream interactions and the signalling pathways it activates have clarified our understanding of the roles played by RET in normal cell survival, proliferation, and differentiation, as well as in disease. Here, we review the current knowledge of the normal functions of RET and the effects of mutations of this gene in tumorigenesis and in normal development.
2型多发性内分泌肿瘤(MEN 2)是一种遗传性癌症综合征,其特征为甲状腺髓样癌(MTC),可伴有或不伴有嗜铬细胞瘤和甲状旁腺功能亢进。MEN 2在癌症综合征中较为特殊,因为它是由细胞癌基因RET激活引起的。绝大多数MEN 2患者中可发现编码RET受体酪氨酸激酶的基因存在种系突变,散发性MTC的一部分患者中可发现体细胞RET突变。此外,MEN 2中RET突变基因型与疾病表型之间存在很强的关联,这使得人们能够预测组织对RET活性的特定需求和敏感性。我们高精度地从基因层面识别MEN 2患者的能力,彻底改变了我们对这种疾病的诊断、预测和管理能力。在过去几年中,对RET及其正常配体、下游相互作用以及它激活的信号通路的研究,使我们对RET在正常细胞存活、增殖、分化以及疾病中的作用有了更清晰的认识。在此,我们综述了关于RET正常功能的当前知识以及该基因的突变在肿瘤发生和正常发育中的影响。