Tso A W K, Rong R, Lo C Y, Tan K C B, Tiu S C, Wat N M S, Xu J Y, Villablanca A, Larsson C, Teh B T, Lam K S L
Department of Medicine, University of Hong Kong, and Department of Medicine, Queen Elizabeth Hospital, Hong Kong.
Clin Endocrinol (Oxf). 2003 Jul;59(1):129-35. doi: 10.1046/j.1365-2265.2003.01812.x.
Multiple endocrine neoplasia type 1 (MEN1) is characterized by a triad of neoplasia affecting the parathyroid glands, enteropancreatic endocrine tissue and the anterior pituitary gland.
In order to define the prevalence of MEN1 germ-line mutations in Southern Chinese patients with MEN1 syndrome, we performed direct sequencing of the entire open reading frame of the MEN1 gene for 12 index patients and their first-degree relatives.
Six patients had familial MEN1 syndrome and six had apparently sporadic disease. Nine different germ-line mutations at the MEN1 gene were identified, including three novel mutations [248-249delTT in exon 2, K559X(AAG --> TAG) in exon 10 and IVS 2nt + 2(G --> T) in intron 2]. All patients with familial MEN1 syndrome were heterozygous carriers of a germ-line mutation and MEN1-related disorders were only evident in their first-degree relatives who also carried the mutation. All patients with an enteropancreatic lesion were mutation carriers and the absence of mutation in three apparently sporadic MEN1 patients with only hyperparathyroidism and pituitary microadenoma might represent the presence of MEN1 phenocopy.
The finding of MEN1 germ-line mutation in all patients with familial MEN1 syndrome suggests that genetic screening should be useful in our population to identify affected individuals within a kindred and allow early detection of MEN1-related tumours.
1型多发性内分泌腺瘤病(MEN1)的特征是甲状旁腺、肠胰腺内分泌组织和垂体前叶出现肿瘤三联征。
为了确定中国南方MEN1综合征患者中MEN1种系突变的患病率,我们对12例索引患者及其一级亲属的MEN1基因整个开放阅读框进行了直接测序。
6例患者患有家族性MEN1综合征,6例患者表现为散发性疾病。在MEN1基因中鉴定出9种不同的种系突变,包括3种新突变[外显子2中的248-249delTT、外显子10中的K559X(AAG→TAG)和内含子2中的IVS 2nt+2(G→T)]。所有家族性MEN1综合征患者都是种系突变的杂合携带者,且MEN1相关疾病仅在同样携带该突变的一级亲属中明显。所有患有肠胰腺病变的患者都是突变携带者,3例仅患有甲状旁腺功能亢进和垂体微腺瘤的散发性MEN1患者未检测到突变,这可能代表存在MEN1表型模拟。
在所有家族性MEN1综合征患者中均发现MEN1种系突变,这表明基因筛查有助于在我们的人群中识别家族中的受影响个体,并能早期发现MEN1相关肿瘤。