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[家族性非髓样甲状腺癌(FNMTC):临床与遗传学最新进展]

[A Familial Non Medullary Thyroid Carcinoma (FNMTC) : a clinical and genetic update].

作者信息

Valdes-Socin H, Palmeira L, Burlacu M-C, Daly A-F, Bours V, Beckers A

机构信息

Service d'Endocrinologie, CHU de Liège, Site du Sart Tilman, Liège, Belgique.

Service d'Endocrinologie et Nutrition, Cliniques Universitaires St-Luc, Bruxelles.

出版信息

Rev Med Liege. 2016 Dec;71(12):557-561.

Abstract

The syndrome of Familial Non Medullary Thyroid Carcinoma (FNMTC) includes two or more patients with an isolated non-medullary thyroid cancer (papillary, follicular, anaplastic) within the same family. To diagnose FNMTC, the clinician must exclude a syndromic presentation such as the syndromes of Cowden, Gardner or Werner, and the Carney Complex. Up to now, a hundred families with FNMTC have been genetically studied, including forms with (Ch19p13.2) or without oxyphilia (Ch2q21), in association with a multinodular goiter (Ch14q32), or with a renal cancer (Ch1q21). Several candidate genes of susceptibility have been proposed: SRGAP1, NKX2-1, FOXE1 and HABP2. So far, it is considered that familial cases represent less than 5 % of thyroid cancers. Although rare, these cases represent a unique opportunity to improve our understanding of thyroid cancer. The identification of candidate genes will enrich our knowledge of thyroid cancer pathophysiology. Based on the literature and our experience of the follow-up of eight families with FNMTC, we discuss epidemiological, clinical, pathological and genetic aspects of FNMTC with a view to improve the diagnosis and treatment of this disease.

摘要

家族性非髓样甲状腺癌(FNMTC)综合征包括同一家庭中两名或更多患有孤立性非髓样甲状腺癌(乳头状、滤泡状、间变性)的患者。为诊断FNMTC,临床医生必须排除综合征表现,如考登综合征、加德纳综合征或维尔纳综合征以及卡尼综合征。到目前为止,已经对一百个患有FNMTC的家庭进行了遗传学研究,包括伴有嗜酸性变(19号染色体短臂13.2区)或不伴有嗜酸性变(2号染色体长臂21区)、伴有多结节性甲状腺肿(14号染色体长臂32区)或伴有肾癌(1号染色体长臂21区)的类型。已经提出了几个易感候选基因:SRGAP1、NKX2-1、FOXE1和HABP2。到目前为止,家族性病例被认为占甲状腺癌的比例不到5%。尽管罕见,但这些病例为增进我们对甲状腺癌的理解提供了独特的机会。候选基因的鉴定将丰富我们对甲状腺癌病理生理学的认识。基于文献以及我们对八个FNMTC家庭随访的经验,我们讨论了FNMTC的流行病学、临床、病理和遗传学方面,以期改善这种疾病的诊断和治疗。

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