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Genetic aberrance of sporadic MEN 2A component tumours: analysis of RET
Nam Hoon Cho1, Hyun Woo Lee, Shin Young Lim
1Department of Pathology, Yonsei University College of Medicine, Seoul, South Korea. cho1988@yumc.yonsei.ac.kr
Aim:
The molecular pathogenesis of familial multiple endocrine neoplasia (MEN) type 2 (parathyroid adenoma with medullary thyroid carcinoma and adrenal pheochromocytoma) is associated with a germ-line mutation in the RET proto-oncogene. We undertook this study to clarify the relationship between the tumorigenesis of apparently sporadic MEN type 2 component endocrine tumours and RET mutations.
Methods:
Direct sequencing for RET exon 10, 11, 12, 13, 14, 15 and 16 and immunohistochemistry for RET monoclonal antibody were performed on the archival tissues of 84 cases of sporadic endocrine tumours, including 22 medullary thyroid carcinomas (MTCs), 35 adrenal pheochromocytomas (APCs), 18 paragangliomas (PGs), and nine parathyroid adenomas (PTAs).
Results:
PCR-based direct sequencing revealed somatic point missense mutation within 22.7% of exon 13 of the RET proto-oncogene (four cases of E768D, one case of S7781) in MTCs. No RET genotype and morphological association was observed in MTCs or APCs. APCs revealed significantly lower levels of immunoexpression of RET, even versus PGs.
Conclusions:
The genetic mutation in RET is relatively low in incidence, and likely to play an insignificant role in the molecular pathogenesis of sporadic MTC. The molecular bases of PG and APC seem to be different despite their embryological and histological similarities.
Insights
Genetic mutations in the RET proto-oncogene are uncommon in sporadic medullary thyroid carcinoma (MTC). These RET mutations appear to play an insignificant role in the development of sporadic MTC and other endocrine tumors.
Area of Science:
- Endocrinology
- Oncology
- Molecular Genetics
Background:
- Familial multiple endocrine neoplasia (MEN) type 2 is linked to germline RET proto-oncogene mutations.
- The role of RET mutations in sporadic endocrine tumors, particularly MEN 2 components, requires clarification.
Purpose of the Study:
- To investigate the association between RET mutations and the tumorigenesis of sporadic MEN 2 component tumors.
- To determine the incidence and significance of RET mutations in sporadic medullary thyroid carcinomas, adrenal pheochromocytomas, paragangliomas, and parathyroid adenomas.
Main Methods:
- Direct sequencing of RET exons 10-16 and immunohistochemistry for RET were performed on 84 archival cases of sporadic endocrine tumors.
- Tumor types included medullary thyroid carcinomas (MTCs), adrenal pheochromocytomas (APCs), paragangliomas (PGs), and parathyroid adenomas (PTAs).
Main Results:
- Somatic point missense mutations in RET exon 13 were identified in 22.7% of sporadic MTCs.
- No significant association between RET genotype and morphology was found in MTCs or APCs.
- Adrenal pheochromocytomas showed significantly lower RET immunoexpression compared to paragangliomas.
Conclusions:
- RET gene mutations have a low incidence and likely play a minor role in the molecular pathogenesis of sporadic MTC.
- The molecular mechanisms underlying paragangliomas and adrenal pheochromocytomas appear distinct, despite shared embryological and histological features.
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