Czetwertyńska Małgorzata, Kozłowicz-Gudzińska Izabela, Stachlewska-Nasfeter Elzbieta, Sromek M, Skasko Elzbieta, Paszko Zygmunt
Department of Nuclear Medicine and Oncological Endocrinology, Cancer Centre, Maria Sklodowska-Curie Memorial Institute of Oncology, Warsaw.
Endokrynol Pol. 2006 Jul-Aug;57(4):415-9.
The aim of this study was to analyse the distribution and frequency of mutations and their correlations with clinical phenotypes of patients with MTC, to reveal the differences between sporadic and familial type of MTC, and to describe the phenotypes of patients.
212 patients with medullary thyroid cancer (MTC) were treated in Cancer Centre in Warsaw between 1997 and 2005. In most patients, DNA isolated from peripheral blood leukocytes was tested for RET gene mutations by sequencing and accordingly MTC form was assessed. Genetic testing was performed in the relatives of patients with familial MTC in order to distinguish asymptomatic mutation carriers from noncarriers.
RET gene mutations were identified in 46 patients (22%). The others were found noncarriers and sporadic MTC was diagnosed. MEN 2A/FMTC syndrome (multiple endocrine neoplasia type 2A/ familial type of MTC) was diagnosed in 44 patients, MEN 2B syndrome (multiple endocrine neoplasia type 2B) in 2 patients. In patients with sporadic and familial MTC, age at diagnosis and multifocal occurrence was analysed, and the results were found to be in accordance with those of other research centres. However, the distribution and frequency of mutations, as well as some clinical data, such as the frequency of pheochromocytoma occurrence as the first manifestation of MEN syndrome, differed from the published data, and further studies are necessary to reveal the reasons of these differences.
DNA testing for RET gene mutations is reliable as a diagnostic tool and therefore it should be performed for screening of all patients with MTC or other diseases of MEN syndrome.
本研究旨在分析甲状腺髓样癌(MTC)患者的突变分布及频率及其与临床表型的相关性,揭示散发性和家族性MTC之间的差异,并描述患者的表型。
1997年至2005年期间,212例甲状腺髓样癌患者在华沙癌症中心接受治疗。大多数患者通过测序检测外周血白细胞中分离的DNA的RET基因突变,并据此评估MTC类型。对家族性MTC患者的亲属进行基因检测,以区分无症状突变携带者和非携带者。
46例患者(22%)检测到RET基因突变。其他患者未检测到突变,诊断为散发性MTC。44例患者诊断为MEN 2A/FMTC综合征(多发性内分泌腺瘤2A型/家族性MTC),2例患者诊断为MEN 2B综合征(多发性内分泌腺瘤2B型)。分析散发性和家族性MTC患者的诊断年龄和多灶性发生情况,结果与其他研究中心一致。然而,突变的分布和频率以及一些临床数据,如作为MEN综合征首发表现的嗜铬细胞瘤发生率,与已发表的数据不同,需要进一步研究以揭示这些差异的原因。
RET基因突变的DNA检测作为一种诊断工具是可靠的,因此应对所有MTC患者或MEN综合征的其他疾病患者进行筛查。