Division of Endocrinology, The Hospital for Sick Children, Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada.
Department of Pediatrics, Division of Hematology and Oncology and Greehey Children's Cancer Research Institute, The University of Texas Health Science Center at San Antonio, San Antonio, Texas.
Clin Cancer Res. 2017 Jul 1;23(13):e123-e132. doi: 10.1158/1078-0432.CCR-17-0548.
Children and adolescents who present with neuroendocrine tumors are at extremely high likelihood of having an underlying germline predisposition for the multiple endocrine neoplasia (MEN) syndromes, including MEN1, MEN2A and MEN2B, MEN4, and hyperparathyroid-jaw tumor (HPT-JT) syndromes. Each of these autosomal dominant syndromes results from a specific germline mutation in unique genes: MEN1 is due to pathogenic variants (11q13), MEN2A and MEN2B are due to pathogenic variants (10q11.21), MEN4 is due to pathogenic variants (12p13.1), and the HPT-JT syndrome is due to pathogenic variants (1q25). Although each of these genetic syndromes share the presence of neuroendocrine tumors, each syndrome has a slightly different tumor spectrum with specific surveillance recommendations based upon tumor penetrance, including the age and location for which specific tumor types most commonly present. Although the recommended surveillance strategies for each syndrome contain similar approaches, important differences do exist among them. Therefore, it is important for caregivers of children and adolescents with these syndromes to become familiar with the unique diagnostic criteria for each syndrome, and also to be aware of the specific tumor screening and prophylactic surgery recommendations for each syndrome. .
患有神经内分泌肿瘤的儿童和青少年极有可能存在多发性内分泌肿瘤(MEN)综合征的种系易感性倾向,包括 MEN1、MEN2A 和 MEN2B、MEN4 和甲状旁腺-颌骨肿瘤(HPT-JT)综合征。这些常染色体显性综合征中的每一种都是由独特基因中的特定种系突变引起的:MEN1 是由于致病性变异(11q13),MEN2A 和 MEN2B 是由于致病性变异(10q11.21),MEN4 是由于致病性变异(12p13.1),而 HPT-JT 综合征是由于致病性变异(1q25)。尽管这些遗传综合征都存在神经内分泌肿瘤,但每个综合征的肿瘤谱略有不同,根据肿瘤穿透性,有特定的监测建议,包括特定肿瘤类型最常见出现的年龄和位置。尽管每个综合征的推荐监测策略包含相似的方法,但它们之间确实存在重要差异。因此,对于患有这些综合征的儿童和青少年的照顾者来说,熟悉每个综合征的独特诊断标准以及了解每个综合征的特定肿瘤筛查和预防性手术建议非常重要。