在患有MEN4和骨髓性甲状腺癌的患者中,CDKN1B的新型可能致病性生殖系变异
Fernández Mercè1,2, Queralt Asla3,4, Francisco J Illana5
1Department of Endocrinology and Nutrition, Institut de Recerca Sant Pau (IR SANTPAU), Endo-ERN. Hospital de la Santa Creu i Sant Pau, Barcelona, Spain. mfmiro79@gmail.com.
多发性内分泌新陈代谢4型 (MEN4) 与CDKN1B基因变异有关. 这一案例突出了一个新的CDKN1B变异,导致MEN4和髓性甲状腺癌,强调对罕见内分泌疾病的基因测试.
科学领域:
- 内分泌学 在内分泌学.
- 遗传学 是一个遗传学.
- 在瘤学瘤学.
背景情况:
- 多发性内分泌新陈代谢4型 (MEN4) 是一种罕见的遗传疾病,由CDKN1B基因的生殖线变异引起,该基因编码了瘤抑制剂p27Kip1.1.
- MEN4与MEN1具有临床相似之处,因此诊断需要基因确认.
- p27Kip1在细胞循环调节和瘤抑制中起着至关重要的作用.
研究的目的:
- 报告一个独特的临床病例,该病例是患有甲状腺髓癌 (MTC) 和库辛病的患者.
- 为了确定患者罕见内分泌疾病的遗传基础.
- 描述已识别的基因变异及其对瘤发展的潜在影响.
主要方法:
- 临床病例介绍和详细的病史.
- 使用下一代测序 (NGS) 面板进行生殖系和体质遗传变异分析 (Oncomine Comprehensive Assay v3).
- 瘤组织中p27/Kip1表达的免疫组织化学分析.
- 对异构性丧失 (LOH) 的评估.
主要成果:
- 鉴定出了一种新型异合体生殖系CDKN1B变体 (c.536del),证实了MEN4.4的诊断.
- 该患者接受了没有生殖系RET变体的MTC,随后患上了库辛病.
- 在MTC中发现了一种致病性体质HRAS变异 (c.182A>G,p.(Gln61Arg),与生殖系CDKN1B变异一起. 在瘤中观察到弱的p27/Kip1核表达.
结论:
- 这项研究报告了一种与MEN4相关的新型CDKN1B生殖系变异,呈现MTC和库辛病.
- MTC,库辛病和一种新型CDKN1B变异的共存强调了罕见内分泌瘤患者全面基因评估的重要性.
- 这些发现有助于理解MEN4的遗传情景及其表型变异性.
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