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越南甲状腺髓样癌患者RET基因突变特征:单中心分析

Characteristics of RET gene mutations in Vietnamese medullary thyroid carcinoma patients: a single-center analysis.

作者信息

Pham Van Hung, Pham Quoc Thang, Nguyen Minh, Ngo Hoa Nhat, Luu Thao Thi Thu, Minh Nha Dao Thi, Đặng Trâm, Thai Anh Tu, Vu Hoang Anh, Ngo Dat Quoc

机构信息

Faculty of Nursing and Medical Technology, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam.

University Medical Center Ho Chi Minh City, Ho Chi Minh City, Vietnam.

出版信息

J Pathol Transl Med. 2025 Mar;59(2):125-132. doi: 10.4132/jptm.2025.01.18. Epub 2025 Mar 14.

Abstract

BACKGROUND

The RET gene point mutation is the main molecular alteration involved in medullary thyroid carcinoma (MTC) tumorigenesis. Previous studies in Vietnam mainly consisted of case reports, with limited data on larger sample sizes. In this study, we investigated RET gene mutations in exons 10, 11, and 16 and analyzed clinicopathological features of a series of Vietnamese MTC patients.

METHODS

We collected 33 tissue samples from patients with MTC and analyzed RET mutations using the Sanger sequencing method. The relationship between hotspot RET mutations (exons 10, 11, 16) and clinicopathological features were investigated.

RESULTS

Among the 33 analyzed cases, 17 tumors (52%) harbored RET mutations in exon 10, 11, or 16. A total of 10 distinct genetic alterations were identified, including eight missense mutations and two short indels. Of these, seven were classified as pathogenic mutations based on previous publications, with p.M918T being the most frequent (4 cases), followed by p.C634R (3 cases) and p.C618R (3 cases). Mutations were significantly associated with specific histological patterns, such as the nested/insular pattern (p=.026), giant cells (p=.007), nuclear pleomorphism (p=.018), stippled chromatin (p=.044), and amyloid deposits (p=.024). No mutations were found in germline analyses, suggesting these were somatic alterations.

CONCLUSIONS

Our results provided the first comprehensive analysis of RET mutations in Vietnamese MTC patients. The most frequent mutation was p.M918T, followed by p.C634R and p.C618R. Mutations in these three exons were linked to specific histopathological features. Information on mutational profiles of patients with MTC will further aid in the development of targeted therapeutics to ensure effective disease management.

摘要

背景

RET基因点突变是甲状腺髓样癌(MTC)肿瘤发生过程中的主要分子改变。越南以往的研究主要是病例报告,大样本数据有限。在本研究中,我们调查了外显子10、11和16中的RET基因突变,并分析了一系列越南MTC患者的临床病理特征。

方法

我们收集了33例MTC患者的组织样本,采用桑格测序法分析RET突变。研究了热点RET突变(外显子10、11、16)与临床病理特征之间的关系。

结果

在33例分析病例中,17例肿瘤(52%)在外显子10、11或16中存在RET突变。共鉴定出10种不同的基因改变,包括8种错义突变和2种短插入缺失。其中,根据以往文献,7种被分类为致病突变,p.M918T最为常见(4例),其次是p.C634R(3例)和p.C618R(3例)。突变与特定的组织学模式显著相关,如巢状/岛状模式(p = 0.026)、巨细胞(p = 0.007)、核多形性(p = 0.018)、点状染色质(p = 0.044)和淀粉样沉积物(p = 0.024)。在种系分析中未发现突变,表明这些是体细胞改变。

结论

我们的结果首次对越南MTC患者的RET突变进行了全面分析。最常见的突变是p.M918T,其次是p.C634R和p.C618R。这三个外显子中的突变与特定的组织病理学特征相关。MTC患者的突变谱信息将进一步有助于开发靶向治疗方法,以确保有效的疾病管理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b5c2/12010869/bdec4f389741/jptm-2025-01-18f1.jpg

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