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[促肾上腺皮质激素分泌性垂体肿瘤(促肾上腺皮质激素瘤)的分子遗传学异常:基础研究及临床应用前景]

[Molecular genetic abnormalities in ACTH-secreting pituitary tumors (corticotropinomas): fundamental research and prospects for use in clinical practice].

作者信息

Lapshina A M

机构信息

Endocrinology Research Centre.

出版信息

Probl Endokrinol (Mosk). 2023 Nov 2;70(3):23-30. doi: 10.14341/probl13273.

Abstract

In recent years, a large number of studies have been carried out to research molecular genetic abnormalities in ACTH--secreting pituitary tumors. This review presents a comprehensive analysis of exome studies results (germline and somatic mutations, chromosomal abnormalities in corticotropinomas which developed as part of hereditary syndromes MEN 1, 2, 4, DICER1, Carney complex etc., and isolated tumors, respectively) and transcriptome (specific genes expression profiles in hormonally active and inactive corticotropinomas, regulation of cell cycles and signal pathways). Modern technologies (next-generation sequencing - NGS) allow us to study the state of the microRNAome, DNA methylome and inactive chromatin sites, in particular using RNA sequencing. Thus, a wide range of fundamental studies is shown, the results of which allow us to identify and comprehend the key previously known and new pathogenesis mechanisms and biomarkers of corticotropinomas. The characteristics of the most promising molecular genetic factors that can be used in clinical practice for screening and earlier diagnosis of hereditary syndromes and isolated corticotropinomas, differential diagnosis of various forms of endogenous hypercorticism, sensitivity to existing and potential therapies and personalized outcome determination of Cushing`s disease.

摘要

近年来,已经开展了大量研究来探究促肾上腺皮质激素(ACTH)分泌型垂体瘤的分子遗传异常。本综述对全外显子组研究结果(分别为种系和体细胞突变、作为遗传性综合征MEN 1、2、4、DICER1、卡尼综合征等一部分发生的促肾上腺皮质激素瘤以及散发性肿瘤中的染色体异常)和转录组(激素活性和无活性促肾上腺皮质激素瘤中的特定基因表达谱、细胞周期调控和信号通路)进行了全面分析。现代技术(新一代测序 - NGS)使我们能够研究微小RNA组状态、DNA甲基化组和无活性染色质位点,特别是使用RNA测序。因此,展示了广泛的基础研究,其结果使我们能够识别和理解促肾上腺皮质激素瘤先前已知的关键发病机制和新发病机制以及生物标志物。最有前景的分子遗传因素的特征,这些因素可用于临床实践中遗传性综合征和散发性促肾上腺皮质激素瘤的筛查和早期诊断、各种形式的内源性皮质醇增多症的鉴别诊断、对现有和潜在治疗的敏感性以及库欣病个性化结局的确定。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dbc5/11334230/6fce18b6eedb/problendo-70-13273-g001.jpg

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