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中国人群中由CDC73基因种系大片段缺失或点突变引起的家族性孤立性原发性甲状旁腺功能亢进症/甲状旁腺功能亢进-颌骨肿瘤综合征

Familial isolated primary hyperparathyroidism/hyperparathyroidism-jaw tumour syndrome caused by germline gross deletion or point mutations of CDC73 gene in Chinese.

作者信息

Kong Jing, Wang Ou, Nie Min, Shi Jie, Hu Yingying, Jiang Yan, Li Mei, Xia Weibo, Meng Xunwu, Xing Xiaoping

机构信息

Key laboratory of Endocrinology, Ministry of Health, Department of Endocrinology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China.

出版信息

Clin Endocrinol (Oxf). 2014 Aug;81(2):222-30. doi: 10.1111/cen.12461. Epub 2014 May 6.

Abstract

OBJECTIVE

Hyperparathyroidism-jaw tumour syndrome (HPT-JT) and familial isolated primary hyperparathyroidism (FIHP) are two subtypes of familial primary hyperparathyroidism, which are rarely reported in Chinese population. Here, we reported three FIHP families and one HPT-JT family with long-term follow-up and genetic analysis.

DESIGN AND METHODS

A total of 22 patients, from four FIHP/HPT-JT families of Chinese descent, were recruited and genomic DNA was extracted from their peripheral blood lymphocytes. Direct sequencing for MEN1, CDC73, CASR gene was conducted. Reverse transcription PCR (RT-PCR) and quantitative real-time PCR (qRT-PCR) were used to study the effect of splice site mutations and gross deletion mutations. Immunohistochemistry was performed to analyse parafibromin expression in parathyroid tumours. Genotype-phenotype correlations were assessed through clinical characteristics and long-term follow-up data.

RESULTS

Genetic analysis revealed four CDC73 germline mutations that were responsible for the four kindreds, including two novel point mutation (c.157 G>T and IVS3+1 G>A), one recurrent point mutation (c.664 C>T) and one deletion mutation (c.307+?_513-?del exons 4, 5, 6). RT-PCR confirmed that IVS3+1 G>A generated an aberrant transcript with exon3 deletion. Immunohistochemical analysis demonstrated reduced nuclear parafibromin expression in tumours supporting the pathogenic effects of these mutations.

CONCLUSIONS

This study supplies information on mutations and phenotypes of HPT-JT/FIHP syndrome in Chinese. Screening for gross deletion and point mutations of the CDC73 gene is necessary in susceptible subjects.

摘要

目的

甲状旁腺功能亢进-颌骨肿瘤综合征(HPT-JT)和家族性孤立性原发性甲状旁腺功能亢进(FIHP)是家族性原发性甲状旁腺功能亢进的两种亚型,在中国人群中鲜有报道。在此,我们报告了三个FIHP家系和一个HPT-JT家系,并进行了长期随访和基因分析。

设计与方法

招募了来自四个华裔FIHP/HPT-JT家系的22名患者,从他们外周血淋巴细胞中提取基因组DNA。对MEN1、CDC73、CASR基因进行直接测序。采用逆转录聚合酶链反应(RT-PCR)和定量实时聚合酶链反应(qRT-PCR)研究剪接位点突变和大片段缺失突变的影响。进行免疫组织化学分析甲状旁腺肿瘤中 parafibromin 的表达。通过临床特征和长期随访数据评估基因型-表型相关性。

结果

基因分析发现四个CDC73种系突变,分别对应四个家系,包括两个新的点突变(c.157 G>T和IVS3+1 G>A)、一个复发性点突变(c.664 C>T)和一个缺失突变(c.307+?_513-?del外显子4、5、6)。RT-PCR证实IVS3+1 G>A产生了一个缺失外显子3的异常转录本。免疫组织化学分析显示肿瘤中核 parafibromin 表达降低,支持这些突变的致病作用。

结论

本研究提供了中国人群中HPT-JT/FIHP综合征的突变和表型信息。对易感个体进行CDC73基因大片段缺失和点突变筛查是必要的。

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