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[DICER1综合征:临床多样性、内分泌表现及诊断特征]

[DICER1 syndrome: clinical variety endocrine manifestations and features of diagnostics].

作者信息

Novokreshennih E E, Kolodkina A A, Bezlepkina O B

机构信息

Endocrinology Research Centre.

出版信息

Probl Endokrinol (Mosk). 2023 Oct 16;70(2):78-85. doi: 10.14341/probl13383.

Abstract

DICER1 syndrome is a rare genetic disorder with the progressive development of malignant and non-malignant diseases in childhood. The cause of this syndrome is a dusfunction of the endoribonuclease DICER, which plays an important role in the processing of microRNAs with subsequent regulation of the control of the expression of oncogenes and tumor suppressor genes. Clinical manifestations of dyseropathies is very different and may include both endocrine manifestations - multinodular goiter, differentiated thyroid cancers, ovarian stromal tumors, pituitary blastoma, and non-endocrine formations - pleuropulmonary blastoma, cystic nephroma, pineoblastoma. The presence of somatic mutations of the DICER1 gene is a resultant stage in the pathogenesis of dyseropathies, determining the further path of oncogenesis. At present, DICER1 syndrome is diagnosed extremely rarely, which leads to late detection of the components of the disease in the patient, late diagnosis of neoplasms, lack of family counseling. Diagnosis at the early stages of the disease, the development of screening programs for the management of these patients allows minimizing the risks of developing more malignant, aggressive forms of the disease.

摘要

DICER1综合征是一种罕见的遗传性疾病,儿童期会逐渐发展出恶性和非恶性疾病。该综合征的病因是核糖核酸内切酶DICER功能障碍,它在微小RNA的加工过程中起重要作用,随后调控癌基因和抑癌基因的表达控制。发育异常疾病的临床表现非常不同,可能包括内分泌表现——多结节性甲状腺肿、分化型甲状腺癌、卵巢间质瘤、垂体母细胞瘤,以及非内分泌性肿物——胸膜肺母细胞瘤、囊性肾瘤、松果体母细胞瘤。DICER1基因的体细胞突变是发育异常疾病发病机制的一个结果阶段,决定了肿瘤发生的进一步路径。目前,DICER1综合征的诊断极为罕见,这导致患者疾病组成部分的检测延迟、肿瘤的诊断延迟以及缺乏家庭咨询。在疾病早期进行诊断,制定针对这些患者管理的筛查项目,可将发展为更恶性、侵袭性更强的疾病形式的风险降至最低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fc3e/11145573/afb0a7e73438/problendo-70-13383-g001.jpg

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