1st Endocrine Section and Diabetes Center, Alexandra Hospital, Athens, Greece.
Clin Endocrinol (Oxf). 2012 Dec;77(6):857-62. doi: 10.1111/j.1365-2265.2012.04462.x.
Genetic screening for ret mutation has become routine practice in the evaluation of medullary thyroid carcinoma (MTC). Approximately 25% of these tumours are familial, and they occur as components of the multiple endocrine neoplasia type 2 syndromes (MEN 2A and 2B) or familial MTC. In familial cases, the majority of mutations are found in exons 10, 11, 13, 14 or 15 of the ret gene. A rare mutation involving exon 8 (G533C) has recently been reported in familial cases of MTC in Brazil and Greece; some of these cases were originally thought to be sporadic. The aim of this study was to re-evaluate a series of sporadic cases of MTC, with negative family history, and screen them for germline mutations in exon 8.
Genomic DNA was extracted from peripheral lymphocytes in 129 unrelated individuals who had previously been characterized as 'sporadic' based on the negative family history and negative screening for ret gene mutations. Samples were analysed in Applied Biosystems 7500 real-time PCR and confirmed by sequencing.
The G533C exon 8 mutation was identified in 10 of 129 patients with sporadic MTC. Asymptomatic gene carriers were subsequently identified in other family members.
In our study, we found that 7·75% patients with apparently sporadic MTC do carry G533C mutation involving exon 8 of ret. We feel that there is now a need to include exon 8 mutation screening in all patients diagnosed as sporadic MTC, in Greece.
在对甲状腺髓样癌(MTC)的评估中,RET 基因突变的遗传筛查已成为常规操作。这些肿瘤中约有 25%为家族性的,它们作为多发性内分泌肿瘤 2 型综合征(MEN 2A 和 2B)或家族性 MTC 的组成部分而发生。在家族性病例中,大多数突变发生在 RET 基因的外显子 10、11、13、14 或 15 中。最近在巴西和希腊的家族性 MTC 病例中报道了一种罕见的涉及外显子 8(G533C)的突变;其中一些病例最初被认为是散发性的。本研究的目的是重新评估一系列具有阴性家族史的散发性 MTC 病例,并对其外显子 8 中的种系突变进行筛查。
从 129 名先前根据阴性家族史和 RET 基因突变筛查结果被归类为“散发性”的无亲缘关系个体的外周淋巴细胞中提取基因组 DNA。应用生物系统 7500 实时 PCR 对样本进行分析,并通过测序进行确认。
在 129 例散发性 MTC 患者中发现了 10 例存在外显子 8 的 G533C 突变。随后在其他家族成员中发现了无症状的基因携带者。
在我们的研究中,我们发现,在我们诊断为散发性 MTC 的患者中,有 7.75%的患者确实携带涉及 RET 外显子 8 的 G533C 突变。我们认为,现在有必要在希腊所有被诊断为散发性 MTC 的患者中纳入外显子 8 突变筛查。