Gardner D G
Department of Medicine, University of California, San Francisco, School of Medicine, USA.
Adv Intern Med. 1997;42:597-627.
The MEN syndrome are autosomal-dominant disorders of endocrine tissues, characterized by tumor development and in many instances, hormonal hypersecretory states. The genetic lesion in MEN I appears to involve a tumor suppressor locus on the long arm of chromosomes 11 but the identity of the affected gene and its role in contributing to dysregulation of endocrine cell function remain unknown. The lesion in MEN II has been localized to the RET protooncogene locus in the pericentromeric region of chromosome 10. This putative single transmembrane-domain, tyrosine kinase-linked receptor is selectively mutated to produce a constitutively activated protein and presumably an undampened growth-promoting signal to the target cell. Additional studies focused on these genes and their products should facilitate the screening and treatment of patients affected with these disorders and, potentially, provide more information about the role that these genes play in the normal growth and development of endocrine tissues. Such information should prove valuable in deciphering the pathogenetic mechanisms underlying the development of the more common sporadic endocrine tumors.
多发性内分泌腺瘤综合征是内分泌组织的常染色体显性疾病,其特征为肿瘤形成,在许多情况下还伴有激素分泌过多状态。MEN I中的基因损伤似乎涉及11号染色体长臂上的一个肿瘤抑制基因座,但受影响基因的身份及其在内分泌细胞功能失调中的作用仍不清楚。MEN II中的损伤已定位到10号染色体着丝粒周围区域的RET原癌基因座。这种推测的单跨膜结构域、酪氨酸激酶连接受体发生选择性突变,产生一种组成型激活蛋白,并可能向靶细胞发出不受抑制的生长促进信号。针对这些基因及其产物的进一步研究应有助于对受这些疾病影响的患者进行筛查和治疗,并有可能提供更多关于这些基因在正常内分泌组织生长和发育中所起作用的信息。这些信息在解释更常见的散发性内分泌肿瘤发生的致病机制方面应具有重要价值。