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中国遗传性髓样甲状腺癌患者的兄弟姐妹:对 RET 致癌基因检测的意义。

Chinese siblings with hereditary medullary thyroid carcinoma caused by RET mutation: implications for RET oncogene detection.

机构信息

Department of Oncology, Tongji Hospital, Tongji Medical College of Huazhong University of Science & Technology, No.1095 Jie Fang Avenue, Wuhan, 430030, Hubei, China.

Department of Medical Case, Tongji Hospital, Tongji Medical College of Huazhong University of Science & Technology, Wuhan, China.

出版信息

BMC Endocr Disord. 2020 May 14;20(1):64. doi: 10.1186/s12902-020-0544-3.

Abstract

BACKGROUND

Hereditary medullary thyroid carcinoma (MTC) is mainly caused by germline mutations in the RET proto-oncogene, which accounts for 20-30% of all MTC according to foreign studies. However, no English literatures have reported Chinese hereditary MTC. Here, we reported two Chinese brothers with MTC that caused by germline RET mutation.

CASE PRESENTATION

The younger brother was diagnosed with MTC at 29 years ago and suffered recurrence more than 10 years. For elder brother, the diagnosis of MTC was made by postoperative pathological examination at age 61. Both patients received total thyroidectomy and lymph node dissection. Since they had a significant family history for MTC, genetic detection was performed and identified a germline mutation in RET exon 10 (p.C620Y). This mutation was also detected in their offspring, indicating a moderate risk of MTC.

CONCLUSIONS

This is the first report presenting a Chinese family with hereditary MTC caused by the RET p.C620Y variant. This case series emphasize the importance of genetic detection of RET proto-oncogene for MTC patients, and bring out managements for individuals after detection of RET mutations.

摘要

背景

遗传性髓样甲状腺癌(MTC)主要由原癌基因 RET 的种系突变引起,根据国外研究,占所有 MTC 的 20-30%。然而,目前尚无英文文献报道中国遗传性 MTC。在这里,我们报道了两例由 RET 种系突变引起的中国兄弟遗传性 MTC。

病例介绍

弟弟在 29 年前被诊断为 MTC,并在 10 多年前复发。对于哥哥,MTC 的诊断是在 61 岁时通过术后病理检查做出的。两位患者均接受了甲状腺全切除术和淋巴结清扫术。由于他们有 MTC 的显著家族史,进行了基因检测,发现 RET 外显子 10(p.C620Y)存在种系突变。该突变也在他们的后代中检测到,提示 MTC 的中度风险。

结论

这是首例报告中国家族遗传性 MTC 由 RET p.C620Y 变异引起的病例。该病例系列强调了对 MTC 患者进行 RET 原癌基因突变检测的重要性,并提出了 RET 突变检测个体的管理建议。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/85a4/7222469/6541eef6e9fc/12902_2020_544_Fig1_HTML.jpg

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