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Li J, Gu A, Nong XM, Zhai S, Yue ZY, Li MY, Liu Y. Six-Membered Aromatic Nitrogen Heterocyclic Anti-Tumor Agents: Synthesis and Applications. CHEM REC 2023; 23:e202300293. [PMID: 38010365 DOI: 10.1002/tcr.202300293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 10/19/2023] [Indexed: 11/29/2023]
Abstract
Cancer stands as a serious malady, posing substantial risks to human well-being and survival. This underscores the paramount necessity to explore and investigate novel antitumor medications. Nitrogen-containing compounds, especially those derived from natural sources, form a highly significant category of antitumor agents. Among these, antitumor agents with six-membered aromatic nitrogen heterocycles have consistently attracted the attention of chemists and pharmacologists. Accordingly, we present a comprehensive summary of synthetic strategies and clinical implications of these compounds in this review. This entails an in-depth analysis of synthesis pathways for pyridine, quinoline, pyrimidine, and quinazoline. Additionally, we explore the historical progression, targets, mechanisms of action, and clinical effectiveness of small molecule inhibitors possessing these structural features.
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Affiliation(s)
- Jiatong Li
- State Key Laboratory of Systems Medicine for Cancer, Shanghai Cancer Institute, Department of Biliary-Pancreatic Surgery, Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 160 Pujian Road, Shanghai, 200127, China
| | - Ao Gu
- State Key Laboratory of Systems Medicine for Cancer, Shanghai Cancer Institute, Department of Biliary-Pancreatic Surgery, Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 160 Pujian Road, Shanghai, 200127, China
| | - Xiao-Mei Nong
- State Key Laboratory of Systems Medicine for Cancer, Shanghai Cancer Institute, Department of Biliary-Pancreatic Surgery, Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 160 Pujian Road, Shanghai, 200127, China
| | - Shuyang Zhai
- State Key Laboratory of Systems Medicine for Cancer, Shanghai Cancer Institute, Department of Biliary-Pancreatic Surgery, Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 160 Pujian Road, Shanghai, 200127, China
| | - Zhu-Ying Yue
- State Key Laboratory of Systems Medicine for Cancer, Shanghai Cancer Institute, Department of Biliary-Pancreatic Surgery, Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 160 Pujian Road, Shanghai, 200127, China
| | - Meng-Yao Li
- State Key Laboratory of Systems Medicine for Cancer, Shanghai Cancer Institute, Department of Biliary-Pancreatic Surgery, Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 160 Pujian Road, Shanghai, 200127, China
| | - Yingbin Liu
- State Key Laboratory of Systems Medicine for Cancer, Shanghai Cancer Institute, Department of Biliary-Pancreatic Surgery, Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 160 Pujian Road, Shanghai, 200127, China
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Holm M, Vestergaard P, Poulsen MM, Rasmussen ÅK, Feldt-Rasmussen U, Bay M, Rolighed L, Londero S, Pedersen HB, Hahn CH, Rask KB, Nielsen HH, Gaustadnes M, Rossing MC, Hermann AP, Godballe C, Mathiesen JS. Primary Hyperparathyroidism in Multiple Endocrine Neoplasia Type 2A in Denmark 1930–2021: A Nationwide Population-Based Retrospective Study. Cancers (Basel) 2023; 15:2125. [PMID: 37046785 PMCID: PMC10093219 DOI: 10.3390/cancers15072125] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Revised: 03/29/2023] [Accepted: 03/31/2023] [Indexed: 04/05/2023] Open
Abstract
Studies of primary hyperparathyroidism (PHPT) in multiple endocrine neoplasia type 2A (MEN 2A) shows divergence in frequency, disease definition, reporting of clinical characteristics and traces of selection bias. This is a nationwide population-based retrospective study of PHPT in MEN 2A, suggesting a representative frequency, with complete reporting and a strict PHPT definition. The Danish MEN 2A cohort 1930-2021 was used. Of 204 MEN 2A cases, 16 had PHPT, resulting in a frequency of 8% (CI, 5-12). Age-related penetrance at 50 years was 8% (CI, 4-15). PHPT was seen in the American Thyroid Association moderate (ATA-MOD) and high (ATA-H) risk groups in 62% and 38% of carriers, respectively. Median age at PHPT diagnosis was 45 years (range, 21-79). A total of 75% were asymptomatic and 25% were symptomatic. Thirteen underwent parathyroid surgery, resulting in a cure of 69%, persistence in 8% and recurrence in 23%. In this first study with a clear PHPT definition and no selection bias, we found a lower frequency of PHPT and age-related penetrance, but a higher age at PHPT diagnosis than often cited. This might be affected by the Danish RET p.Cys611Tyr founder effect. Our study corroborates that PHPT in MEN 2A is often mild, asymptomatic and is associated with both ATA-MOD and ATA-H variants. Likelihood of cure is high, but recurrence is not infrequent and can occur decades after surgery.
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Affiliation(s)
- Magnus Holm
- Department of ORL Head & Neck Surgery and Audiology, Odense University Hospital, 5000 Odense, Denmark; (M.H.); (M.B.); (C.G.)
| | - Peter Vestergaard
- Steno Diabetes Center North Denmark, Aalborg University Hospital, 9100 Aalborg, Denmark;
| | - Morten Møller Poulsen
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, 8200 Aarhus, Denmark;
| | - Åse Krogh Rasmussen
- Department of Endocrinology and Metabolism, Copenhagen University Hospital, 2100 Copenhagen, Denmark; (Å.K.R.); (U.F.-R.); (M.C.R.)
| | - Ulla Feldt-Rasmussen
- Department of Endocrinology and Metabolism, Copenhagen University Hospital, 2100 Copenhagen, Denmark; (Å.K.R.); (U.F.-R.); (M.C.R.)
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark
| | - Mette Bay
- Department of ORL Head & Neck Surgery and Audiology, Odense University Hospital, 5000 Odense, Denmark; (M.H.); (M.B.); (C.G.)
| | - Lars Rolighed
- Department of ORL Head & Neck Surgery, Aarhus University Hospital, 8200 Aarhus, Denmark; (L.R.); (S.L.)
| | - Stefano Londero
- Department of ORL Head & Neck Surgery, Aarhus University Hospital, 8200 Aarhus, Denmark; (L.R.); (S.L.)
| | | | - Christoffer Holst Hahn
- Department of ORL Head & Neck Surgery and Audiology, Rigshospitalet, Copenhagen University Hospital, 2100 Copenhagen, Denmark; (C.H.H.); (K.B.R.)
| | - Klara Bay Rask
- Department of ORL Head & Neck Surgery and Audiology, Rigshospitalet, Copenhagen University Hospital, 2100 Copenhagen, Denmark; (C.H.H.); (K.B.R.)
| | - Heidi Hvid Nielsen
- Department of Clinical Biochemistry, Zealand University Hospital, 4000 Roskilde, Denmark;
| | - Mette Gaustadnes
- Department of Molecular Medicine, Aarhus University Hospital, 8200 Aarhus, Denmark;
| | - Maria Caroline Rossing
- Department of Endocrinology and Metabolism, Copenhagen University Hospital, 2100 Copenhagen, Denmark; (Å.K.R.); (U.F.-R.); (M.C.R.)
- Center for Genomic Medicine, Copenhagen University Hospital, 2100 Copenhagen, Denmark
| | | | - Christian Godballe
- Department of ORL Head & Neck Surgery and Audiology, Odense University Hospital, 5000 Odense, Denmark; (M.H.); (M.B.); (C.G.)
- Department of Clinical Research, University of Southern Denmark, 5000 Odense, Denmark
| | - Jes Sloth Mathiesen
- Department of ORL Head & Neck Surgery and Audiology, Odense University Hospital, 5000 Odense, Denmark; (M.H.); (M.B.); (C.G.)
- Department of Clinical Research, University of Southern Denmark, 5000 Odense, Denmark
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3
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Lee JY, Kim SY, Jo KH, Mo EY, Kim ES, Kim HS, Han JH, Moon SD. Clinical features and signaling effects of RET D631Y variant multiple endocrine neoplasia type 2 (MEN2). Korean J Intern Med 2022; 37:398-410. [PMID: 34905813 PMCID: PMC8925960 DOI: 10.3904/kjim.2021.311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 11/02/2021] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND/AIMS Germline mutations of the rearranged during transfection (RET) gene cause multiple endocrine neoplasia type 2 (MEN2). About 85% of RET mutations in MEN2 occur in codon Cys634. The RET D631Y mutation has recently been discovered, and we have studied its molecular expression and clinical consequences. METHODS We analyzed the clinical characteristics of a total of 34 D631Y variant MEN2 individuals from seven families. We also constructed wild-type and mutant C630Y, D631Y, and C634R/W expression vectors and investigated their effects on signaling pathways and ability to correct the phenotypes of RET mutant cells. RESULTS The median ages at diagnosis of pheochromocytoma and medullary thyroid carcinoma (MTC) were higher in patients with RET D631Y variant MEN2 than in those with the C634R/W variant (49:53.5 years vs. 33.5:27 years, respectively), and the penetration of the D631Y mutation with respect to MTC was lower than that of the C634R/W mutation (32.3% vs. 90%). The effects of the mutant vectors on phosphorylation of RET signaling molecules and focus formation were significantly different from those of wild type, but there were no significant differences between the mutants. D631Y scored significantly higher for chemotaxis and wound healing than C630Y, but lower than C634R and C634W. CONCLUSION We suggest that the tumorigenic potential conferred by the D631Y mutation is lower than that conferred by the C634R/W mutation, but higher than that conferred by C630Y. Thus, the risk level of the RET D631Y variant appears to be higher than that of C630Y and lower than that of C634R/W.
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Affiliation(s)
- Ji-young Lee
- Department of Biomedicine and Health Science, The Catholic University of Korea, Seoul,
Korea
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul,
Korea
| | - Su Yeon Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul,
Korea
| | - Kwan Hoon Jo
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Incheon,
Korea
| | - Eun Yeong Mo
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Incheon,
Korea
| | - Eun Sook Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Incheon,
Korea
| | - Hye Soo Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Daejeon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Daejeon,
Korea
| | - Je Ho Han
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Incheon,
Korea
| | - Sung-dae Moon
- Department of Biomedicine and Health Science, The Catholic University of Korea, Seoul,
Korea
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul,
Korea
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Incheon,
Korea
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Fussey JM, Smith JA, Cleaver R, Bowles C, Ellard S, Vaidya B, Owens M. Diagnostic RET genetic testing in 1,058 index patients: A UK centre perspective. Clin Endocrinol (Oxf) 2021; 95:295-302. [PMID: 33340421 DOI: 10.1111/cen.14395] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 11/23/2020] [Accepted: 11/29/2020] [Indexed: 01/14/2023]
Abstract
OBJECTIVE Diagnostic germline RET analysis is offered to all patients with a diagnosis of medullary thyroid carcinoma (MTC), or other conditions associated with multiple endocrine neoplasia type 2 (MEN2) in the United Kingdom. Here, we report the experience of a single centre's germline RET analysis over a 21-year period. DESIGN Retrospective case-note review. PATIENTS All index patients referred to the Exeter Genomics Laboratory for diagnostic germline RET analysis between 1997 and 2018, and unaffected family members, undergoing predictive testing. MEASUREMENTS The rate and nature of pathogenic variant detection were recorded, as well as the indication for testing. RESULTS 1,058 index patients and 551 unaffected family members were tested. The overall rate of pathogenic variant detection was 10.2% amongst index patients and 29% amongst unaffected family members. The commonest indication was isolated MTC, and amongst the 690 patients with isolated MTC, 68 (9.9%) were found to harbour a RET pathogenic variant. Of those with presumed sporadic MTC, 8.5% were found to harbour germline RET pathogenic variants, compared with 36.4% of those with a family history of MEN2-associated conditions. Pathogenic variants were identified in 3.6% and 0% of patients with isolated phaeochromocytoma and primary hyperparathyroidism, respectively. CONCLUSIONS Although the detection rate of RET germline pathogenic variants in patients with presumed sporadic MTC was significant, the overall detection rate in those with MTC was lower than expected in this series. Advances in RET analysis in response to reports of new variants over the last two decades are likely to have improved the pick-up rate in recent years.
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Affiliation(s)
- Jonathan Mark Fussey
- Department of Head and Neck Surgery, Royal Devon and Exeter Hospital, Exeter, UK
| | - Joel Anthony Smith
- Department of Head and Neck Surgery, Royal Devon and Exeter Hospital, Exeter, UK
| | - Ruth Cleaver
- Department of Clinical Genetics, Royal Devon and Exeter Hospital, Exeter, UK
| | | | - Sian Ellard
- Institute of Biomedical and Clinical Science, College of Medicine and Health, University of Exeter, Exeter, UK
| | - Bijay Vaidya
- Institute of Biomedical and Clinical Science, College of Medicine and Health, University of Exeter, Exeter, UK
- Department of Endocrinology, Royal Devon and Exeter Hospital, Exeter, UK
| | - Martina Owens
- Exeter Genomics Laboratory, Royal Devon and Exeter Hospital, Exeter, UK
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Amodru V, Taieb D, Guerin C, Romanet P, Paladino N, Brue T, Cuny T, Barlier A, Sebag F, Castinetti F. MEN2-related pheochromocytoma: current state of knowledge, specific characteristics in MEN2B, and perspectives. Endocrine 2020; 69:496-503. [PMID: 32388798 DOI: 10.1007/s12020-020-02332-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Accepted: 04/25/2020] [Indexed: 12/19/2022]
Abstract
Multiple endocrine neoplasia type 2 (MEN2) is a rare hereditary syndrome due to mutations of the proto-oncogene REarranged during Transfection (RET), defined by the association of medullary thyroid carcinoma (MTC) in almost 100% cases, and pheochromocytoma in roughly 50% (primary hyperparathyroidism can be seen in 10-20% of patients with MEN2A). Early thyroidectomy and the efficacy of novel tyrosine kinase inhibitors modified the natural history of MTC, with possibilities of cure or long-term control. The second main compound, pheochromocytoma, is reported with a variable penetrance, from 10 to 80% cases, depending on the mutation of RET. Pheochromocytoma constitutes the main disease to screen in patients with RET mutations. Pheochromocytoma clinical and biochemical diagnosis, as well as the way to treat it are thus crucial. This review will thus focus on the epidemiological specificities of MEN2-related pheochromocytoma, the genotype/phenotype relationship, the modern imaging modalities necessary to confirm the diagnosis in this hereditary context, as well as the optimal management and the possibilities of adrenal sparing surgery. Additional information will include the natural history of MEN2B-pheochromocytoma, the rare cases of malignant pheochromocytoma, and the factors that could modify the penetrance between individuals carrying the same mutation, especially in the same family.
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Affiliation(s)
- Vincent Amodru
- Department of Endocrinology, Aix-Marseille University, INSERM U1251, Endo-ERN Reference Center for Rare Genetic Tumor Syndromes, Assistance Publique-Hopitaux de Marseille, Marseille, France
| | - David Taieb
- Department of Nuclear Medicine, Aix-Marseille University, Endo-ERN Reference Center for Rare Genetic Tumor Syndromes, Assistance Publique-Hopitaux de Marseille, Marseille, France
| | - Carole Guerin
- Department of Endocrine Surgery, Aix-Marseille University, Endo-ERN Reference Center for Rare Genetic Tumor Syndromes, Assistance Publique-Hopitaux de Marseille, Marseille, France
| | - Pauline Romanet
- Department of Molecular Biology, Aix-Marseille University, INSERM U1251, Endo-ERN Reference Center for Rare Genetic Tumor Syndromes, Assistance Publique-Hopitaux de Marseille, Marseille, France
| | - Nunzia Paladino
- Department of Endocrine Surgery, Aix-Marseille University, Endo-ERN Reference Center for Rare Genetic Tumor Syndromes, Assistance Publique-Hopitaux de Marseille, Marseille, France
| | - Thierry Brue
- Department of Endocrinology, Aix-Marseille University, INSERM U1251, Endo-ERN Reference Center for Rare Genetic Tumor Syndromes, Assistance Publique-Hopitaux de Marseille, Marseille, France
| | - Thomas Cuny
- Department of Endocrinology, Aix-Marseille University, INSERM U1251, Endo-ERN Reference Center for Rare Genetic Tumor Syndromes, Assistance Publique-Hopitaux de Marseille, Marseille, France
| | - Anne Barlier
- Department of Molecular Biology, Aix-Marseille University, INSERM U1251, Endo-ERN Reference Center for Rare Genetic Tumor Syndromes, Assistance Publique-Hopitaux de Marseille, Marseille, France
| | - Frederic Sebag
- Department of Endocrine Surgery, Aix-Marseille University, Endo-ERN Reference Center for Rare Genetic Tumor Syndromes, Assistance Publique-Hopitaux de Marseille, Marseille, France
| | - Frederic Castinetti
- Department of Endocrinology, Aix-Marseille University, INSERM U1251, Endo-ERN Reference Center for Rare Genetic Tumor Syndromes, Assistance Publique-Hopitaux de Marseille, Marseille, France.
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6
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Larsen LV, Mirebeau-Prunier D, Imai T, Alvarez-Escola C, Hasse-Lazar K, Censi S, Castroneves LA, Sakurai A, Kihara M, Horiuchi K, Barbu VD, Borson-Chazot F, Gimenez-Roqueplo AP, Pigny P, Pinson S, Wohllk N, Eng C, Aydogan BI, Saranath D, Dvorakova S, Castinetti F, Patocs A, Bergant D, Links TP, Peczkowska M, Hoff AO, Mian C, Dwight T, Jarzab B, Neumann HPH, Robledo M, Uchino S, Barlier A, Godballe C, Mathiesen JS. Primary hyperparathyroidism as first manifestation in multiple endocrine neoplasia type 2A: an international multicenter study. Endocr Connect 2020; 9:489-497. [PMID: 32375120 PMCID: PMC7354718 DOI: 10.1530/ec-20-0163] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 05/06/2020] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Multiple endocrine neoplasia type 2A (MEN 2A) is a rare syndrome caused by RET germline mutations and has been associated with primary hyperparathyroidism (PHPT) in up to 30% of cases. Recommendations on RET screening in patients with apparently sporadic PHPT are unclear. We aimed to estimate the prevalence of cases presenting with PHPT as first manifestation among MEN 2A index cases and to characterize the former cases. DESIGN AND METHODS An international retrospective multicenter study of 1085 MEN 2A index cases. Experts from MEN 2 centers all over the world were invited to participate. A total of 19 centers in 17 different countries provided registry data of index cases followed from 1974 to 2017. RESULTS Ten cases presented with PHPT as their first manifestation of MEN 2A, yielding a prevalence of 0.9% (95% CI: 0.4-1.6). 9/10 cases were diagnosed with medullary thyroid carcinoma (MTC) in relation to parathyroid surgery and 1/10 was diagnosed 15 years after parathyroid surgery. 7/9 cases with full TNM data were node-positive at MTC diagnosis. CONCLUSIONS Our data suggest that the prevalence of MEN 2A index cases that present with PHPT as their first manifestation is very low. The majority of index cases presenting with PHPT as first manifestation have synchronous MTC and are often node-positive. Thus, our observations suggest that not performing RET mutation analysis in patients with apparently sporadic PHPT would result in an extremely low false-negative rate, if no other MEN 2A component, specifically MTC, are found during work-up or resection of PHPT.
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Affiliation(s)
- Louise Vølund Larsen
- Department of ORL Head & Neck Surgery and Audiology, Odense University Hospital, Odense, Denmark
| | - Delphine Mirebeau-Prunier
- Laboratoire de Biochimie et Biologie Moléculaire, CHU Angers, Université d’Angers, UMR CNRS 6015, INSERM U1083, MITOVASC, Angers, France
| | - Tsuneo Imai
- Department of Breast & Endocrine Surgery, National Hospital Organization, Higashinagoya National Hospital, Nagoya, Japan
| | | | - Kornelia Hasse-Lazar
- Department of Nuclear Medicine and Endocrine Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Gliwice, Poland
| | - Simona Censi
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Luciana A Castroneves
- Department of Endocrinology, Endocrine Oncology Unit, Instituto do Cancer do Estado de São Paulo, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Akihiro Sakurai
- Department of Medical Genetics and Genomics, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Minoru Kihara
- Department of Surgery, Kuma Hospital, Kobe, Hyogo, Japan
| | - Kiyomi Horiuchi
- Department of Breast and Endocrine Surgery, Tokyo Women’s Medical University, Tokyo, Japan
| | - Véronique Dorine Barbu
- AP-HP, Sorbonne Université, Laboratoire Commun de Biologie et Génétique Moléculaires, Hôpital St Antoine & INSERM CRSA, Paris, France
- Réseau TenGen, Marseille, France
| | - Francoise Borson-Chazot
- Réseau TenGen, Marseille, France
- Fédération d’Endocrinologie, Hospices Civils de Lyon, Université Lyon 1, France
| | - Anne-Paule Gimenez-Roqueplo
- Réseau TenGen, Marseille, France
- Service de Génétique, AP-HP, Hôpital européen Georges Pompidou, Paris, France
- Université de Paris, PARCC, INSERM, Paris, France
| | - Pascal Pigny
- Réseau TenGen, Marseille, France
- Laboratoire de Biochimie et Oncologie Moléculaire, CHU Lille, Lille, France
| | - Stephane Pinson
- Réseau TenGen, Marseille, France
- Laboratoire de Génétique Moléculaire, CHU Lyon, Lyon, France
| | - Nelson Wohllk
- Endocrine Section, Hospital del Salvador, Santiago de Chile, Department of Medicine, University of Chile, Santiago, Chile
| | - Charis Eng
- Genomic Medicine Institute, Lerner Research Institute and Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Berna Imge Aydogan
- Department of Endocrinology And Metabolic Diseases, Ankara University School of Medicine, Ankara, Turkey
| | - Dhananjaya Saranath
- Department of Research Studies & Additional Projects, Cancer Patients Aid Association, Dr. Vithaldas Parmar Research & Medical Centre, Worli, Mumbai, India
| | - Sarka Dvorakova
- Department of Molecular Endocrinology, Institute of Endocrinology, Prague, Czech Republic
| | - Frederic Castinetti
- Aix-Marseille Université, Institut National de la Santé et de la Recherche Médicale (INSERM), U1251, Marseille Medical Genetics (MMG), Marseille, France
- Department of Endocrinology, Assistance Publique-Hôpitaux de Marseille (AP-HM), Hôpital de la Conception, Centre de Référence des Maladies Rares de l’hypophyse HYPO, Marseille, France
| | - Attila Patocs
- HAS-SE Momentum Hereditary Endocrine Tumors Research Group, Semmelweis University, Budapest, Hungary
| | - Damijan Bergant
- Department of Surgical Oncology, Institute of Oncology, Ljubljana, Slovenia
| | - Thera P Links
- Department of Endocrinology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | | | - Ana O Hoff
- Department of Endocrinology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Caterina Mian
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Trisha Dwight
- Cancer Genetics, Kolling Institute, Royal North Shore Hospital and University of Sydney, Sydney, New South Wales, Australia
| | - Barbara Jarzab
- Department of Nuclear Medicine and Endocrine Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Gliwice, Poland
| | - Hartmut P H Neumann
- Section for Preventive Medicine, Medical Center-University of Freiburg, Faculty of Medicine, Albert Ludwigs-University of Freiburg, Freiburg, Germany
| | - Mercedes Robledo
- Hereditary Endocrine Cancer Group, Spanish National Cancer Research Center (CNIO), Madrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Madrid, Spain
| | - Shinya Uchino
- Department of Endocrine Surgery, Noguchi Thyroid Clinic and Hospital Foundation, Beppu, Oita, Japan
| | - Anne Barlier
- Réseau TenGen, Marseille, France
- Aix Marseille Univ, APHM, INSERM, MMG, Laboratory of Molecular Biology, Hospital La Conception, Marseille, France
| | - Christian Godballe
- Department of ORL Head & Neck Surgery and Audiology, Odense University Hospital, Odense, Denmark
| | - Jes Sloth Mathiesen
- Department of ORL Head & Neck Surgery and Audiology, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Correspondence should be addressed to J S Mathiesen:
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7
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Mathiesen JS, Nielsen SG, Rasmussen ÅK, Kiss K, Wadt K, Hermann AP, Nielsen MF, Larsen SR, Brusgaard K, Frederiksen AL, Godballe C, Rossing M. Variability in Medullary Thyroid Carcinoma in RET L790F Carriers: A Case Comparison Study of Index Patients. Front Endocrinol (Lausanne) 2020; 11:251. [PMID: 32411094 PMCID: PMC7198720 DOI: 10.3389/fendo.2020.00251] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 04/06/2020] [Indexed: 12/27/2022] Open
Abstract
Background: Previous studies have suggested that the variability in age of onset and aggressiveness of medullary thyroid carcinoma (MTC) in patients with multiple endocrine neoplasia type 2A (MEN 2A) carrying the same REarranged during Transfection (RET) mutation may be caused by additional RET germline variants or somatic variants. Methods: This study was a retrospective case comparison study of all MEN 2A index patients (n = 2) with the RET L790F germline mutation in Denmark. Whole blood and MTC tissue were analyzed for RET germline variants and other somatic variants (>500), respectively. Results: Patient 1 presented with MTC (T1aN1bM0) at age 14 years, while patient 2 presented with MTC (T1bN0M0) at age 70 years. No germline RET germline variants nor other variants were found to explain this MTC variability. Conclusions: We could not confirm the previously reported finding of a somatic RET variant as likely responsible for the early onset and aggressiveness of MTC in a RET germline mutation carrier. Also, we found no RET germline variants that could explain the MTC variability among our index patients. We did, however, identify a somatic FLT3 R387Q variant with an unknown potential as genetic modifier. Further large-scale studies are needed to investigate genetic modifiers in RET L790F carriers.
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Affiliation(s)
- Jes Sloth Mathiesen
- Department of ORL Head and Neck Surgery and Audiology, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- *Correspondence: Jes Sloth Mathiesen
| | - Søren Grønlund Nielsen
- Department of ORL Head and Neck Surgery and Audiology, Odense University Hospital, Odense, Denmark
| | - Åse Krogh Rasmussen
- Department of Medical Endocrinology, Copenhagen University Hospital, Copenhagen, Denmark
| | - Katalin Kiss
- Department of Pathology, Copenhagen University Hospital, Copenhagen, Denmark
| | - Karin Wadt
- Department of Clinical Genetics, Copenhagen University Hospital, Copenhagen, Denmark
| | | | | | | | - Klaus Brusgaard
- Department of Clinical Genetics, Odense University Hospital, Odense, Denmark
| | | | - Christian Godballe
- Department of ORL Head and Neck Surgery and Audiology, Odense University Hospital, Odense, Denmark
| | - Maria Rossing
- Center for Genomic Medicine, Copenhagen University Hospital, Copenhagen, Denmark
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8
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Maciel RMB, Camacho CP, Assumpção LVM, Bufalo NE, Carvalho AL, de Carvalho GA, Castroneves LA, de Castro FM, Ceolin L, Cerutti JM, Corbo R, Ferraz TMBL, Ferreira CV, França MIC, Galvão HCR, Germano-Neto F, Graf H, Jorge AAL, Kunii IS, Lauria MW, Leal VLG, Lindsey SC, Lourenço DM, Maciel LMZ, Magalhães PKR, Martins JRM, Martins-Costa MC, Mazeto GMFS, Impellizzeri AI, Nogueira CR, Palmero EI, Pessoa CHCN, Prada B, Siqueira DR, Sousa MSA, Toledo RA, Valente FOF, Vaisman F, Ward LS, Weber SS, Weiss RV, Yang JH, Dias-da-Silva MR, Hoff AO, Toledo SPA, Maia AL. Genotype and phenotype landscape of MEN2 in 554 medullary thyroid cancer patients: the BrasMEN study. Endocr Connect 2019; 8:289-298. [PMID: 30763276 PMCID: PMC6410763 DOI: 10.1530/ec-18-0506] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Accepted: 02/13/2019] [Indexed: 12/26/2022]
Abstract
Multiple endocrine neoplasia type 2 (MEN2) is an autosomal dominant genetic disease caused by RET gene germline mutations that is characterized by medullary thyroid carcinoma (MTC) associated with other endocrine tumors. Several reports have demonstrated that the RET mutation profile may vary according to the geographical area. In this study, we collected clinical and molecular data from 554 patients with surgically confirmed MTC from 176 families with MEN2 in 18 different Brazilian centers to compare the type and prevalence of RET mutations with those from other countries. The most frequent mutations, classified by the number of families affected, occur in codon 634, exon 11 (76 families), followed by codon 918, exon 16 (34 families: 26 with M918T and 8 with M918V) and codon 804, exon 14 (22 families: 15 with V804M and 7 with V804L). When compared with other major published series from Europe, there are several similarities and some differences. While the mutations in codons C618, C620, C630, E768 and S891 present a similar prevalence, some mutations have a lower prevalence in Brazil, and others are found mainly in Brazil (G533C and M918V). These results reflect the singular proportion of European, Amerindian and African ancestries in the Brazilian mosaic genome.
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Affiliation(s)
- Rui M B Maciel
- Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil
- Correspondence should be addressed to R M B Maciel or S C Lindsey: or
| | - Cleber P Camacho
- Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil
| | - Lígia V M Assumpção
- Faculdade de Ciências Médicas, Universidade de Campinas, Campinas, São Paulo, Brazil
| | - Natassia E Bufalo
- Faculdade de Ciências Médicas, Universidade de Campinas, Campinas, São Paulo, Brazil
| | | | - Gisah A de Carvalho
- Faculdade de Medicina, Universidade Federal do Paraná, Curitiba, Paraná, Brazil
| | - Luciana A Castroneves
- Faculdade de Medicina da Universidade de São Paulo, São Paulo, São Paulo, Brazil
- Instituto do Câncer do Estado de São Paulo, São Paulo, São Paulo, Brazil
| | | | - Lucieli Ceolin
- Hospital de Clínicas de Porto Alegre and Faculdade de Medicina da Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Janete M Cerutti
- Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil
| | - Rossana Corbo
- Instituto Nacional do Câncer, Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Carla V Ferreira
- Hospital de Clínicas de Porto Alegre and Faculdade de Medicina da Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - M Inez C França
- Universidade Federal do Espírito Santo, Vitória, Espírito Santo, Brazil
- Hospital Santa Rita de Cássia, Vitória, Espírito Santo, Brazil
| | | | - Fausto Germano-Neto
- Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil
| | - Hans Graf
- Faculdade de Medicina, Universidade Federal do Paraná, Curitiba, Paraná, Brazil
| | - Alexander A L Jorge
- Faculdade de Medicina da Universidade de São Paulo, São Paulo, São Paulo, Brazil
| | - Ilda S Kunii
- Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil
| | - Márcio W Lauria
- Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Vera L G Leal
- Instituto Estadual de Diabetes e Endocrinologia, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Susan C Lindsey
- Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil
- Correspondence should be addressed to R M B Maciel or S C Lindsey: or
| | - Delmar M Lourenço
- Faculdade de Medicina da Universidade de São Paulo, São Paulo, São Paulo, Brazil
- Instituto do Câncer do Estado de São Paulo, São Paulo, São Paulo, Brazil
| | - Léa M Z Maciel
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Patrícia K R Magalhães
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - João R M Martins
- Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil
| | - M Cecília Martins-Costa
- Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil
- Hospital Geral de Fortaleza, Fortaleza, Ceará, Brazil
- Universidade de Fortaleza, Fortaleza, Ceará, Brazil
| | - Gláucia M F S Mazeto
- Faculdade de Medicina de Botucatu, Universidade Estadual Paulista, Botucatu, São Paulo, Brazil
| | - Anelise I Impellizzeri
- Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Célia R Nogueira
- Faculdade de Medicina de Botucatu, Universidade Estadual Paulista, Botucatu, São Paulo, Brazil
| | - Edenir I Palmero
- Hospital de Câncer de Barretos, Barretos, São Paulo, Brazil
- Faculdade de Ciências da Saúde de Barretos Dr. Paulo Prata, Barretos, São Paulo, Brazil
| | | | - Bibiana Prada
- Faculdade de Medicina de Botucatu, Universidade Estadual Paulista, Botucatu, São Paulo, Brazil
| | - Débora R Siqueira
- Hospital de Clínicas de Porto Alegre and Faculdade de Medicina da Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Maria Sharmila A Sousa
- Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil
- Escola Fiocruz de Governo, Fundação Oswaldo Cruz and Ministério da Saúde, Brasília, Distrito Federal, Brazil
| | - Rodrigo A Toledo
- Faculdade de Medicina da Universidade de São Paulo, São Paulo, São Paulo, Brazil
- Vall d’Hebron Institute of Oncology (VHIO), CIBERONC, Barcelona, Spain
| | - Flávia O F Valente
- Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil
| | - Fernanda Vaisman
- Instituto Nacional do Câncer, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Laura S Ward
- Faculdade de Ciências Médicas, Universidade de Campinas, Campinas, São Paulo, Brazil
| | - Shana S Weber
- Hospital de Clínicas de Porto Alegre and Faculdade de Medicina da Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Rita V Weiss
- Instituto Estadual de Diabetes e Endocrinologia, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Ji H Yang
- Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil
| | - Magnus R Dias-da-Silva
- Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil
| | - Ana O Hoff
- Faculdade de Medicina da Universidade de São Paulo, São Paulo, São Paulo, Brazil
- Instituto do Câncer do Estado de São Paulo, São Paulo, São Paulo, Brazil
| | - Sergio P A Toledo
- Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil
- Faculdade de Medicina da Universidade de São Paulo, São Paulo, São Paulo, Brazil
| | - Ana L Maia
- Hospital de Clínicas de Porto Alegre and Faculdade de Medicina da Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
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9
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Mathiesen JS, Kroustrup JP, Vestergaard P, Stochholm K, Poulsen PL, Rasmussen ÅK, Feldt-Rasmussen U, Schytte S, Londero SC, Pedersen HB, Hahn CH, Bentzen J, Möller S, Gaustadnes M, Rossing M, Nielsen FC, Brixen K, Frederiksen AL, Godballe C. Survival and Long-Term Biochemical Cure in Medullary Thyroid Carcinoma in Denmark 1997-2014: A Nationwide Study. Thyroid 2019; 29:368-377. [PMID: 30618340 PMCID: PMC6437622 DOI: 10.1089/thy.2018.0564] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Survival of medullary thyroid carcinoma (MTC) subgroups in relation to the general population is poorly described. Data on the factors predicting long-term biochemical cure in MTC patients are nonexistent at a population level. A nationwide retrospective cohort study of MTC in Denmark from 1997 to 2014 was conducted, aiming to detect subgroups with survival similar to that of the general population and to identify prognostic factors for disease-specific survival and long-term biochemical cure. METHODS The study included 220 patients identified from the nationwide Danish MTC cohort between 1997 and 2014. As a representative sample of the general population, a reference population matched 50:1 to the MTC cohort was used. RESULTS Patients diagnosed with hereditary MTC by screening (hazard ratio [HR] = 1.5 [confidence interval (CI) 0.5-4.3]), patients without regional metastases (HR = 1.4 [CI 0.9-2.3]), and patients with stage I (HR = 1.3 [CI 0.6-3.1]), stage II (HR = 1.1 [CI 0.6-2.3]), and III (HR = 1.3 [CI 0.4-4.2]) disease had an overall survival similar to the reference population. On multivariate analysis, the presence of distant metastases (HR = 12.3 [CI 6.0-25.0]) predicted worse disease-specific survival, while the absence of regional lymph node metastases (odds ratio = 40.1 [CI 12.0-133.7]) was the only independent prognostic factor for long-term biochemical cure. CONCLUSIONS Patients with hereditary MTC diagnosed by screening, patients without regional metastases, and patients with stages I, II, and III disease may have similar survival as the general population. The presence of distant metastases predicted worse disease-specific survival, while the absence of regional metastases predicted long-term biochemical cure.
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Affiliation(s)
- Jes Sloth Mathiesen
- Department of ORL—Head & Neck Surgery and Audiology, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Address correspondence to: Jes Sloth Mathiesen, MD, Department of ORL—Head & Neck Surgery and Audiology, Odense University Hospital, J. B. Winsløvs Vej 4, DK-5000 Odense, Denmark
| | - Jens Peter Kroustrup
- Department of Clinical Medicine and Endocrinology, Aalborg University Hospital, Aalborg, Denmark
| | - Peter Vestergaard
- Department of Clinical Medicine and Endocrinology, Aalborg University Hospital, Aalborg, Denmark
- Steno Diabetes Center North Jutland, Gentofte, Denmark
| | - Kirstine Stochholm
- Department of Internal Medicine and Endocrinology, Aalborg University Hospital, Aalborg, Denmark
- Center for Rare Diseases, Aalborg University Hospital, Aalborg, Denmark
| | - Per Løgstrup Poulsen
- Department of Internal Medicine and Endocrinology, Aalborg University Hospital, Aalborg, Denmark
| | - Åse Krogh Rasmussen
- Department of Medical Endocrinology, Copenhagen University Hospital, Copenhagen, Denmark
| | - Ulla Feldt-Rasmussen
- Department of Medical Endocrinology, Copenhagen University Hospital, Copenhagen, Denmark
| | - Sten Schytte
- Department of ORL—Head & Neck Surgery and Aarhus University Hospital, Aarhus, Denmark
| | | | | | - Christoffer Holst Hahn
- Department of ORL—Head & Neck Surgery, and Copenhagen University Hospital, Copenhagen, Denmark
| | - Jens Bentzen
- Department of Oncology, Herlev Hospital, Herlev, Denmark
| | - Sören Möller
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Odense Patient data Explorative Network (OPEN), Odense University Hospital, Odense, Denmark
| | - Mette Gaustadnes
- Department of Molecular Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Maria Rossing
- Center for Genomic Medicine, Copenhagen University Hospital, Copenhagen, Denmark
| | - Finn Cilius Nielsen
- Center for Genomic Medicine, Copenhagen University Hospital, Copenhagen, Denmark
| | - Kim Brixen
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Anja Lisbeth Frederiksen
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Clinical Genetics, Odense University Hospital, Odense, Denmark
| | - Christian Godballe
- Department of ORL—Head & Neck Surgery and Audiology, Odense University Hospital, Odense, Denmark
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10
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Høxbroe Michaelsen S, Ornstrup MJ, Poulsen MM, Bennedbaek FN, Gaustadnes M, Rossing M, Darling P, Vestergaard P, Mathiesen JS. Long-term follow-up of RET Y791F carriers in Denmark 1994-2017: A National Cohort Study. J Surg Oncol 2019; 119:687-693. [PMID: 30644554 DOI: 10.1002/jso.25371] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Accepted: 01/02/2019] [Indexed: 12/28/2022]
Abstract
BACKGROUND AND OBJECTIVES Recently, a comprehensive study presented evidence that a long-disputed REarranged during Transfection (RET) variant, RET Y791F, should be classified as nonpathogenic. In spite of this, several subsequently published papers, including the revised American Thyroid Association guidelines for medullary thyroid carcinoma, refer to the variant as pathogenic. This study presents data from a unique national Danish cohort of RET Y791F carriers who have been followed by watchful waiting instead of being subjected to early thyroidectomy, to determine if any carrier shows evidence of multiple endocrine neoplasia 2A (MEN2A) at long-term follow-up. METHODS A national cohort of all patients tested for RET mutations in Denmark from September 1994 to October 2017 was searched for carriers of RET Y791F. Medical records and laboratory reports of carriers were reviewed for signs of MEN2A at latest follow-up (medullary thyroid carcinoma, primary hyperparathyroidism, pheochromocytoma, cutaneous lichen amyloidosis, or Hirschsprung's disease). RESULTS In total, twenty RET Y791F-carriers were identified, none of whom showed any evidence of MEN2A, despite an age range from 7 to 87 years. CONCLUSIONS Our national cohort study of all Danish RET Y791F carriers substantiates the claim that the RET Y791F variant is nonpathogenic.
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Affiliation(s)
- Sanne Høxbroe Michaelsen
- Department of ORL, Head & Neck Surgery and Audiology, Odense University Hospital, Odense, Denmark
| | - Marie Juul Ornstrup
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Morten Møller Poulsen
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Finn Noe Bennedbaek
- Department of Endocrinology, Herlev and Gentofte University Hospital, Herlev, Denmark
| | - Mette Gaustadnes
- Department of Molecular Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Maria Rossing
- Center for Genomic Medicine, Copenhagen University Hospital, Copenhagen, Denmark
| | - Peter Darling
- Department of ORL, Head & Neck Surgery and Audiology, Odense University Hospital, Odense, Denmark
| | - Peter Vestergaard
- Department of Clinical Medicine and Endocrinology, Aalborg University Hospital, Aalborg, Denmark.,Steno Diabetes Center North Jutland, Aalborg University Hospital, Aalborg, Denmark
| | - Jes Sloth Mathiesen
- Department of ORL, Head & Neck Surgery and Audiology, Odense University Hospital, Odense, Denmark.,Department of Clinical Research, University of Southern Denmark, Odense, Denmark
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11
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Mathiesen JS, Kroustrup JP, Vestergaard P, Stochholm K, Poulsen PL, Rasmussen ÅK, Feldt-Rasmussen U, Schytte S, Londero SC, Pedersen HB, Hahn CH, Bentzen J, Möller S, Gaustadnes M, Rossing M, Nielsen FC, Brixen K, Frederiksen AL, Godballe C. Completeness of RET testing in patients with medullary thyroid carcinoma in Denmark 1997-2013: a nationwide study. Clin Epidemiol 2019; 11:93-99. [PMID: 30666164 PMCID: PMC6330966 DOI: 10.2147/clep.s183268] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Background The completeness of REarranged during Transfection (RET) testing in patients with medullary thyroid carcinoma (MTC) was recently reported as 60%. However, the completeness on a population level is unknown. Similarly, it is unknown if the first Danish guidelines from 2002, recommending RET testing in all MTC patients, improved completeness in Denmark. We conducted a nationwide retrospective cohort study aiming to evaluate the completeness of RET testing in the Danish MTC cohort. Additionally, we aimed to assess the completeness before and after publication of the first Danish guidelines and characterize MTC patients who had not been tested. Methods The study included 200 patients identified from the nationwide Danish MTC cohort 1997–2013. To identify RET tested MTC patients before December 31, 2014, the MTC cohort was cross-checked with the nationwide Danish RET cohort 1994–2014. To characterize MTC patients who had not been RET tested, we reviewed their medical records and compared them with MTC patients who had been tested. Results Completeness of RET testing in the overall MTC cohort was 87% (95% CI: 0.81–0.91; 173/200). In the adjusted MTC cohort, after excluding patients diagnosed with hereditary MTC by screening, completeness was 83% (95% CI: 0.76–0.88; 131/158). Completeness was 88% (95% CI: 0.75–0.95; 42/48) and 81% (95% CI: 0.72–0.88) (89/110) before and after publication of the first Danish guidelines, respectively. Patients not RET tested had a higher median age at diagnosis compared to those RET tested. Median time to death was shorter in those not tested relative to those tested. Conclusion The completeness of RET testing in MTC patients in Denmark seems to be higher than reported in other cohorts. No improvement in completeness was detected after publication of the first Danish guidelines. In addition, data indicate that advanced age and low life expectancy at MTC diagnosis may serve as prognostic indicators to identify patients having a higher likelihood of missing the compulsory RET test.
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Affiliation(s)
- Jes Sloth Mathiesen
- Department of ORL Head & Neck Surgery and Audiology, Odense University Hospital, Odense, Denmark, .,Department of Clinical Research, University of Southern Denmark, Odense, Denmark,
| | - Jens Peter Kroustrup
- Department of Clinical Medicine and Endocrinology, Aalborg University Hospital, Aalborg, Denmark
| | - Peter Vestergaard
- Department of Clinical Medicine and Endocrinology, Aalborg University Hospital, Aalborg, Denmark.,Steno Diabetes Center North Jutland, Aalborg, Denmark
| | - Kirstine Stochholm
- Department of Internal Medicine and Endocrinology, Aarhus University Hospital, Aarhus, Denmark.,Center for Rare Diseases, Aarhus University Hospital, Aarhus, Denmark
| | | | - Åse Krogh Rasmussen
- Department of Medical Endocrinology, Copenhagen University Hospital, Copenhagen, Denmark
| | - Ulla Feldt-Rasmussen
- Department of Medical Endocrinology, Copenhagen University Hospital, Copenhagen, Denmark
| | - Sten Schytte
- Department of ORL Head and Neck Surgery, Aarhus University Hospital, Aarhus, Denmark
| | | | | | - Christoffer Holst Hahn
- Department of ORL Head & Neck Surgery, Copenhagen University Hospital, Copenhagen, Denmark
| | - Jens Bentzen
- Department of Oncology, Herlev Hospital, Herlev, Denmark
| | - Sören Möller
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark, .,Odense Patient data Explorative Network (OPEN), Odense University Hospital, Odense, Denmark
| | - Mette Gaustadnes
- Department of Molecular Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Maria Rossing
- Center for Genomic Medicine, Copenhagen University Hospital, Copenhagen, Denmark
| | - Finn Cilius Nielsen
- Center for Genomic Medicine, Copenhagen University Hospital, Copenhagen, Denmark
| | - Kim Brixen
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark,
| | - Anja Lisbeth Frederiksen
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark, .,Department of Clinical Genetics, Odense University Hospital, Odense, Denmark
| | - Christian Godballe
- Department of ORL Head & Neck Surgery and Audiology, Odense University Hospital, Odense, Denmark,
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12
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Mathiesen JS, Kroustrup JP, Vestergaard P, Poulsen PL, Rasmussen ÅK, Feldt-Rasmussen U, Schytte S, Londero SC, Pedersen HB, Hahn CH, Bentzen J, Möller S, Gaustadnes M, Rossing M, Nielsen FC, Brixen K, Godballe C. Replication of newly proposed TNM staging system for medullary thyroid carcinoma: a nationwide study. Endocr Connect 2019; 8:1-7. [PMID: 30550378 PMCID: PMC6330714 DOI: 10.1530/ec-18-0494] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Accepted: 12/14/2018] [Indexed: 12/23/2022]
Abstract
A recent study proposed new TNM groupings for better survival discrimination among stage groups for medullary thyroid carcinoma (MTC) and validated these groupings in a population-based cohort in the United States. However, it is unknown how well the groupings perform in populations outside the United States. Consequently, we conducted the first population-based study aiming to evaluate if the recently proposed TNM groupings provide better survival discrimination than the current American Joint Committee on Cancer (AJCC) TNM staging system (seventh and eighth edition) in a nationwide MTC cohort outside the United States. This retrospective cohort study included 191 patients identified from the nationwide Danish MTC cohort between 1997 and 2014. In multivariate analysis, hazard ratios for overall survival under the current AJCC TNM staging system vs the proposed TNM groupings with stage I as reference were 1.32 (95% CI: 0.38-4.57) vs 3.04 (95% CI: 1.38-6.67) for stage II, 2.06 (95% CI: 0.45-9.39) vs 3.59 (95% CI: 1.61-8.03) for stage III and 5.87 (95% CI: 2.02-17.01) vs 59.26 (20.53-171.02) for stage IV. The newly proposed TNM groupings appear to provide better survival discrimination in the nationwide Danish MTC cohort than the current AJCC TNM staging. Adaption of the proposed TNM groupings by the current AJCC TNM staging system may potentially improve accurateness in survival discrimination. However, before such an adaption further population-based studies securing external validity are needed.
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Affiliation(s)
- Jes Sloth Mathiesen
- Department of ORL Head & Neck Surgery and Audiology, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Correspondence should be addressed to J S Mathiesen:
| | - Jens Peter Kroustrup
- Department of Clinical Medicine and Endocrinology, Aalborg University Hospital, Aalborg, Denmark
| | - Peter Vestergaard
- Department of Clinical Medicine and Endocrinology, Aalborg University Hospital, Aalborg, Denmark
- Steno Diabetes Center North Jutland, Aalborg, Denmark
| | - Per Løgstrup Poulsen
- Department of Internal Medicine and Endocrinology, Aarhus University Hospital, Aarhus, Denmark
| | - Åse Krogh Rasmussen
- Department of Medical Endocrinology, Copenhagen University Hospital, Copenhagen, Denmark
| | - Ulla Feldt-Rasmussen
- Department of Medical Endocrinology, Copenhagen University Hospital, Copenhagen, Denmark
| | - Sten Schytte
- Department of ORL Head & Neck Surgery, Aarhus University Hospital, Aarhus, Denmark
| | | | | | - Christoffer Holst Hahn
- Department of ORL Head & Neck Surgery, Copenhagen University Hospital, Copenhagen, Denmark
| | - Jens Bentzen
- Department of Oncology, Herlev Hospital, Herlev, Denmark
| | - Sören Möller
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Odense Patient data Explorative Network (OPEN), Odense University Hospital, Odense, Denmark
| | - Mette Gaustadnes
- Department of Molecular Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Maria Rossing
- Center for Genomic Medicine, Copenhagen University Hospital, Copenhagen, Denmark
| | - Finn Cilius Nielsen
- Center for Genomic Medicine, Copenhagen University Hospital, Copenhagen, Denmark
| | - Kim Brixen
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Christian Godballe
- Department of ORL Head & Neck Surgery and Audiology, Odense University Hospital, Odense, Denmark
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13
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Loveday C, Josephs K, Chubb D, Gunning A, Izatt L, Tischkowitz M, Ellard S, Turnbull C. p.Val804Met, the Most Frequent Pathogenic Mutation in RET, Confers a Very Low Lifetime Risk of Medullary Thyroid Cancer. J Clin Endocrinol Metab 2018; 103:4275-4282. [PMID: 29590403 PMCID: PMC6194854 DOI: 10.1210/jc.2017-02529] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Accepted: 03/20/2018] [Indexed: 01/16/2023]
Abstract
CONTEXT To date, penetrance figures for medullary thyroid cancer (MTC) for variants in rearranged during transfection (RET) have been estimated from families ascertained because of the presence of MTC. OBJECTIVE To gain estimates of penetrance, unbiased by ascertainment, we analyzed 61 RET mutations assigned as disease causing by the American Thyroid Association (ATA) in population whole-exome sequencing data. DESIGN For the 61 RET mutations, we used analyses of the observed allele frequencies in ∼51,000 individuals from the Exome Aggregation Consortium (ExAC) database that were not contributed via The Cancer Genome Atlas (TCGA; non-TCGA ExAC), assuming lifetime penetrance for MTC of 90%, 50%, and unbounded. SETTING Population-based. RESULTS Ten of 61 ATA disease-causing RET mutations were present in the non-TCGA ExAC population with observed frequency consistent with penetrance for MTC of >90%. For p.Val804Met, the lifetime penetrance for MTC, estimated from the allele frequency observed, was 4% [95% confidence interval (CI), 0.9% to 8%]. CONCLUSIONS Based on penetrance analysis in carrier relatives of p.Val804Met-positive cases of MTC, p.Val804Met is currently understood to have high-lifetime penetrance for MTC (87% by age 70), albeit of later onset of MTC than other RET mutations. Given our unbiased estimate of penetrance for RET p.Val804Met of 4% (95% CI, 0.9% to 8%), the current recommendation by the ATA of prophylactic thyroidectomy as standard for all RET mutation carriers is likely inappropriate.
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Affiliation(s)
- Chey Loveday
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, United Kingdom
| | - Katherine Josephs
- Department of Clinical Genetics, St George’s University Hospital, London, United Kingdom
| | - Daniel Chubb
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, United Kingdom
| | - Adam Gunning
- Institute of Biomedical and Clinical Science, University of Exeter Medical School, Exeter, United Kingdom
| | - Louise Izatt
- Department of Clinical Genetics, Guy’s and St Thomas’ NHS Foundation Trust, London, United Kingdom
| | - Marc Tischkowitz
- Department of Medical Genetics, University of Cambridge, Cambridge, United Kingdom
| | - Sian Ellard
- Institute of Biomedical and Clinical Science, University of Exeter Medical School, Exeter, United Kingdom
| | - Clare Turnbull
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, United Kingdom
- Department of Clinical Genetics, Guy’s and St Thomas’ NHS Foundation Trust, London, United Kingdom
- William Harvey Research Institute, Queen Mary University, London, United Kingdom
- National Cancer Registration and Analysis Service, Public Health England, London, United Kingdom
- Correspondence and Reprint Requests: Clare Turnbull, MD, PhD, Division of Genetics and Epidemiology, The Institute of Cancer Research, 15 Cotswold Road, Sutton SM2 5NG, United Kingdom. E-mail:
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14
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Mathiesen JS, Kroustrup JP, Vestergaard P, Stochholm K, Poulsen PL, Rasmussen ÅK, Feldt-Rasmussen U, Schytte S, Pedersen HB, Hahn CH, Bentzen J, Möller S, Gaustadnes M, Rossing M, Nielsen FC, Brixen K, Frederiksen AL, Godballe C. Incidence and prevalence of multiple endocrine neoplasia 2A in Denmark 1901-2014: a nationwide study. Clin Epidemiol 2018; 10:1479-1487. [PMID: 30349395 PMCID: PMC6190626 DOI: 10.2147/clep.s174606] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Background The incidence and prevalence of multiple endocrine neoplasia 2A (MEN2A) have only been reported once in a nationwide setting. However, it is unclear whether the figures are representative of other populations, as the major component of the syndrome, hereditary medullary thyroid carcinoma (MTC), has been reported as rare in the same country. We conducted a nationwide retrospective cohort study of MEN2A in Denmark from 1901 to 2014, aiming to describe the incidence and prevalence. Methods This study included 250 unique MEN2A patients born or resident in Denmark before December 31, 2014. Patients were identified through the Danish REarranged during Transfection (RET) cohort, linkage of MEN2A pedigrees, the Danish MTC cohort, a nationwide collaboration of MEN2 centers, cross-checking of other relevant cohorts, and a systematic literature search. Results The incidence from 1971 to 2000 was 28 (95% CI: 21–37) per million live births per year. Incidence for the specific mutations or for the overall MEN2A group did not change significantly from 1901 to 2014 (P>0.05). Point prevalence at January 1, 2015, was 24 per million (95% CI: 20–28). Conclusion The incidence and prevalence of MEN2A in Denmark seem higher than those reported in other countries. This is likely explained by the Danish C611Y founder effect. Also, our data indicate no significant change in MEN2A incidence during the last century.
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Affiliation(s)
- Jes Sloth Mathiesen
- Department of ORL Head & Neck Surgery and Audiology, Odense University Hospital, Odense, Denmark, .,Department of Clinical Research, University of Southern Denmark, Odense, Denmark,
| | - Jens Peter Kroustrup
- Department of Clinical Medicine and Endocrinology, Aalborg University Hospital, Aalborg, Denmark
| | - Peter Vestergaard
- Department of Clinical Medicine and Endocrinology, Aalborg University Hospital, Aalborg, Denmark.,Steno Diabetes Center North Jutland, Aalborg, Denmark
| | - Kirstine Stochholm
- Department of Internal Medicine and Endocrinology, Aarhus University Hospital, DK-8000 Aarhus, Denmark.,Center for Rare Diseases, Aarhus University Hospital, Aarhus N, Denmark
| | - Per Løgstrup Poulsen
- Department of Internal Medicine and Endocrinology, Aarhus University Hospital, DK-8000 Aarhus, Denmark
| | - Åse Krogh Rasmussen
- Department of Medical Endocrinology, Copenhagen University Hospital, Copenhagen, Denmark
| | - Ulla Feldt-Rasmussen
- Department of Medical Endocrinology, Copenhagen University Hospital, Copenhagen, Denmark
| | - Sten Schytte
- Department of ORL Head and Neck Surgery, Aarhus University Hospital, Aarhus, Denmark
| | | | - Christoffer Holst Hahn
- Department of ORL Head and Neck Surgery, Copenhagen University Hospital, Copenhagen, Denmark
| | - Jens Bentzen
- Department of Oncology, Herlev Hospital, Herlev, Denmark
| | - Sören Möller
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark, .,Odense Patient data Explorative Network (OPEN), Odense University Hospital, Odense, Denmark
| | - Mette Gaustadnes
- Department of Molecular Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Maria Rossing
- Center for Genomic Medicine, Copenhagen University Hospital, Copenhagen, Denmark
| | - Finn Cilius Nielsen
- Center for Genomic Medicine, Copenhagen University Hospital, Copenhagen, Denmark
| | - Kim Brixen
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark,
| | - Anja Lisbeth Frederiksen
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark, .,Department of Clinical Genetics, Odense University Hospital, Odense, Denmark
| | - Christian Godballe
- Department of ORL Head & Neck Surgery and Audiology, Odense University Hospital, Odense, Denmark,
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15
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Qi XP, Peng JZ, Yang XW, Cao ZL, Yu XH, Fang XD, Zhang DH, Zhao JQ. The RET C611Y mutation causes MEN 2A and associated cutaneous. Endocr Connect 2018; 7:998-1005. [PMID: 30300539 PMCID: PMC6176283 DOI: 10.1530/ec-18-0220] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Cutaneous lichen amyloidosis (CLA) has been reported in some multiple endocrine neoplasia type 2A (MEN 2A) families affected by specific germline RET mutations C634F/G/R/W/Y or V804M, as a characteristic of the clinical manifestation in ‘MEN 2A with CLA’, one of four variants of MEN 2A, which was strictly located in the scapular region of the upper back. PATIENT FINDINGS This study reports a large south-eastern Chinese pedigree with 17 individuals carrying the MEN 2A-harboring germline C611Y (c.1832G>A) RET mutation by Sanger sequencing. One individual presented MEN 2A-related clinical features, including typical CLA in the interscapular region; another individual exhibited neurological pruritus and scratching in the upper back but lacked CLA skin lesions. Both subjects presented with CLA or pruritic symptoms several years before the onset of medullary thyroid carcinoma (MTC) and/or pheochromocytoma. The remaining 15 RET mutation carriers did not exhibit CLA; of these, one presented with MTC and pheochromocytoma, nine with MTC only, two with elevated serum calcitonin and three younger subjects with normal serum calcitonin levels. This family’s clinical data revealed a later diagnosis of MTC (mean age, 45.9 (range: 23–73) years), a lower penetrance of pheochromocytoma (2/17, 11.8%) and CLA (1/17, 5.9%). However, no hyperparathyroidism and Hirschsprung disease were reported in this family. SUMMARY AND CONCLUSIONS This is the first description of a family with MEN 2A-related CLA due to a germline RET C611Y mutation, which might exhibit a novel and diversified genotype–phenotype spectrum in MEN 2A.
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Affiliation(s)
- Xiao-Ping Qi
- Department of Oncologic and Urologic SurgeryThe 117th PLA Hospital, Wenzhou Medical University, Hangzhou, Zhejiang Province, China
- Correspondence should be addressed to Xiao-Ping Qi or Jian-Qiang Zhao or Da-Hong Zhang: or or
| | - Jian-Zhong Peng
- Department of DermatologyHangzhou Third People’s Hospital, Hangzhou, Zhejiang Province, China
| | - Xiao-Wei Yang
- Department of PediatricsThe First People’s Hospital of Wenling City, Wenling, Zhejiang Province, China
| | - Zhi-Lie Cao
- Department of Oncologic and Urologic SurgeryThe 117th PLA Hospital, Wenzhou Medical University, Hangzhou, Zhejiang Province, China
| | - Xiu-Hua Yu
- Department of Oncologic and Urologic SurgeryThe 117th PLA Hospital, Wenzhou Medical University, Hangzhou, Zhejiang Province, China
| | - Xu-Dong Fang
- Department of Oncologic and Urologic SurgeryThe 117th PLA Hospital, Wenzhou Medical University, Hangzhou, Zhejiang Province, China
| | - Da-Hong Zhang
- Department of Urologic SurgeryZhejiang Provincial People’s Hospital, People’s Hospital of Hangzhou Medical College, Hangzhou, Zhejiang Province, China
- Correspondence should be addressed to Xiao-Ping Qi or Jian-Qiang Zhao or Da-Hong Zhang: or or
| | - Jian-Qiang Zhao
- Department of Head and Neck SurgeryZhejiang Cancer Hospital, Hangzhou, Zhejiang Province, China
- Correspondence should be addressed to Xiao-Ping Qi or Jian-Qiang Zhao or Da-Hong Zhang: or or
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16
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Mathiesen JS, Kroustrup JP, Vestergaard P, Stochholm K, Poulsen PL, Rasmussen ÅK, Feldt-Rasmussen U, Schytte S, Londero SC, Pedersen HB, Hahn CH, Djurhuus BD, Bentzen J, Möller S, Gaustadnes M, Rossing M, Nielsen FC, Brixen K, Frederiksen AL, Godballe C. Incidence and prevalence of sporadic and hereditary MTC in Denmark 1960-2014: a nationwide study. Endocr Connect 2018; 7:829-839. [PMID: 29760189 PMCID: PMC6000757 DOI: 10.1530/ec-18-0157] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Accepted: 05/14/2018] [Indexed: 12/20/2022]
Abstract
Recent studies have shown a significant increase in the temporal trend of medullary thyroid carcinoma (MTC) incidence. However, it remains unknown to which extent sporadic medullary thyroid carcinoma (SMTC) and hereditary MTC (HMTC) affect the MTC incidence over time. We conducted a nationwide retrospective study using previously described RET and MTC cohorts combined with review of medical records, pedigree comparison and relevant nationwide registries. The study included 474 MTC patients diagnosed in Denmark between 1960 and 2014. In the nationwide period from 1997 to 2014, we recorded a mean age-standardized incidence of all MTC, SMTC and HMTC of 0.19, 0.13 and 0.06 per 100,000 per year, respectively. The average annual percentage change in incidence for all MTC, SMTC and HMTC were 1.0 (P = 0.542), 2.8 (P = 0.125) and -3.1 (P = 0.324), respectively. The corresponding figures for point prevalence at January 1, 2015 were 3.8, 2.5 and 1.3 per 100,000, respectively. The average annual percentage change in prevalence from 1998 to 2015 for all MTC, SMTC and HMTC was 2.8 (P < 0.001), 3.8 (P < 0.001) and 1.5 (P = 0.010), respectively. We found no significant change in the incidence of all MTC, SMTC and HMTC possibly due to our small sample size. However, due to an increasing trend in the incidence of all MTC and opposing trends of SMTC (increasing) and HMTC (decreasing) incidence, it seems plausible that an increase for all MTC seen by others may be driven by the SMTC group rather than the HMTC group.
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Affiliation(s)
- Jes Sloth Mathiesen
- Department of ORL Head & Neck SurgeryOdense University Hospital, Odense, Denmark
- Department of Clinical ResearchUniversity of Southern Denmark, Odense, Denmark
| | - Jens Peter Kroustrup
- Department of Clinical Medicine and EndocrinologyAalborg University Hospital, Aalborg, Denmark
| | - Peter Vestergaard
- Department of Clinical Medicine and EndocrinologyAalborg University Hospital, Aalborg, Denmark
| | - Kirstine Stochholm
- Department of Internal Medicine and EndocrinologyAarhus University Hospital, Aarhus, Denmark
- Center for Rare DiseasesAarhus University Hospital, Aarhus N, Denmark
| | - Per Løgstrup Poulsen
- Department of Internal Medicine and EndocrinologyAarhus University Hospital, Aarhus, Denmark
| | - Åse Krogh Rasmussen
- Department of Medical EndocrinologyCopenhagen University Hospital, Copenhagen, Denmark
| | - Ulla Feldt-Rasmussen
- Department of Medical EndocrinologyCopenhagen University Hospital, Copenhagen, Denmark
| | - Sten Schytte
- Department of ORL Head & Neck SurgeryAarhus University Hospital, Aarhus, Denmark
| | | | | | - Christoffer Holst Hahn
- Department of ORL Head & Neck SurgeryCopenhagen University Hospital, Copenhagen, Denmark
| | | | - Jens Bentzen
- Department of OncologyHerlev Hospital, Herlev, Denmark
| | - Sören Möller
- Department of Clinical ResearchUniversity of Southern Denmark, Odense, Denmark
- Odense Patient data Explorative Network (OPEN)Odense University Hospital, Odense, Denmark
| | - Mette Gaustadnes
- Department of Molecular MedicineAarhus University Hospital, Aarhus, Denmark
| | - Maria Rossing
- Center for Genomic MedicineCopenhagen University Hospital, Copenhagen, Denmark
| | - Finn Cilius Nielsen
- Center for Genomic MedicineCopenhagen University Hospital, Copenhagen, Denmark
| | - Kim Brixen
- Department of Clinical ResearchUniversity of Southern Denmark, Odense, Denmark
| | - Anja Lisbeth Frederiksen
- Department of Clinical ResearchUniversity of Southern Denmark, Odense, Denmark
- Department of Clinical GeneticsOdense University Hospital, Odense, Denmark
| | - Christian Godballe
- Department of ORL Head & Neck SurgeryOdense University Hospital, Odense, Denmark
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17
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Guilmette J, Nosé V. Hereditary and familial thyroid tumours. Histopathology 2017; 72:70-81. [DOI: 10.1111/his.13373] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Revised: 08/22/2017] [Accepted: 08/24/2017] [Indexed: 01/16/2023]
Affiliation(s)
| | - Vania Nosé
- Massachusetts General Hospital; Boston MA USA
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18
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Mathiesen JS, Kroustrup JP, Vestergaard P, Stochholm K, Poulsen PL, Rasmussen ÅK, Feldt-Rasmussen U, Gaustadnes M, Ørntoft TF, Rossing M, Nielsen FC, Albrechtsen A, Brixen K, Godballe C, Frederiksen AL. Founder Effect of the RET C611Y Mutation in Multiple Endocrine Neoplasia 2A in Denmark: A Nationwide Study. Thyroid 2017; 27:1505-1510. [PMID: 29020875 DOI: 10.1089/thy.2017.0404] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Multiple endocrine neoplasia (MEN) 2A and 2B are caused by REarranged during Transfection (RET) germline mutations. In a recent nationwide study, an unusually high prevalence (33%) of families with the C611Y mutation was reported, and it was hypothesized that this might be due to a founder effect. The first nationwide study of haplotypes in MEN2A families was conducted, with the aim of investigating the relatedness and occurrence of de novo mutations among Danish families carrying similar mutations. METHODS The study included 21 apparently unrelated MEN2A families identified from a nationwide Danish RET cohort from 1994 to 2014. Twelve, two, two, three, and two families carried the C611Y, C618F, C618Y, C620R, and C634R mutations, respectively. Single nucleotide polymorphism chip data and identity by descent analysis were used to assess relatedness. RESULTS A common founder mutation was found among all 12 C611Y families and between both C618Y families. No relatedness was identified in the remaining families. CONCLUSION The data suggest that all families with the C611Y germline mutation in Denmark originate from a recent common ancestor, probably explaining the unusually high prevalence of this mutation. Additionally, the results indicate that the C611Y mutation rarely arises de novo, thus underlining the need for thorough multigenerational genetic work up in carriers of this mutation.
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Affiliation(s)
- Jes Sloth Mathiesen
- 1 Department of ORL Head and Neck Surgery, Odense University Hospital , Odense, Denmark
- 2 Department of Clinical Research, University of Southern Denmark , Odense, Denmark
| | - Jens Peter Kroustrup
- 3 Department of Clinical Medicine and Endocrinology, Aalborg University Hospital , Aalborg, Denmark
| | - Peter Vestergaard
- 3 Department of Clinical Medicine and Endocrinology, Aalborg University Hospital , Aalborg, Denmark
| | - Kirstine Stochholm
- 4 Department of Internal Medicine and Endocrinology, Aarhus University Hospital , Aarhus, Denmark
| | - Per Løgstrup Poulsen
- 4 Department of Internal Medicine and Endocrinology, Aarhus University Hospital , Aarhus, Denmark
| | - Åse Krogh Rasmussen
- 5 Department of Medical Endocrinology, Copenhagen University Hospital , Copenhagen, Denmark
| | - Ulla Feldt-Rasmussen
- 5 Department of Medical Endocrinology, Copenhagen University Hospital , Copenhagen, Denmark
| | - Mette Gaustadnes
- 6 Department of Molecular Medicine, Aarhus University Hospital , Aarhus, Denmark
| | - Torben Falck Ørntoft
- 6 Department of Molecular Medicine, Aarhus University Hospital , Aarhus, Denmark
| | - Maria Rossing
- 7 Center for Genomic Medicine, Copenhagen University Hospital , Copenhagen, Denmark
| | - Finn Cilius Nielsen
- 7 Center for Genomic Medicine, Copenhagen University Hospital , Copenhagen, Denmark
| | - Anders Albrechtsen
- 8 Bioinformatics Center, Department of Biology, University of Copenhagen , Copenhagen, Denmark
| | - Kim Brixen
- 2 Department of Clinical Research, University of Southern Denmark , Odense, Denmark
| | - Christian Godballe
- 1 Department of ORL Head and Neck Surgery, Odense University Hospital , Odense, Denmark
| | - Anja Lisbeth Frederiksen
- 2 Department of Clinical Research, University of Southern Denmark , Odense, Denmark
- 9 Department of Clinical Genetics, Odense University Hospital , Odense, Denmark
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19
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Lebeault M, Pinson S, Guillaud-Bataille M, Gimenez-Roqueplo AP, Carrie A, Barbu V, Pigny P, Bezieau S, Rey JM, Delvincourt C, Giraud S, Veyrat-Durebex C, Saulnier P, Bouzamondo N, Chabbert M, Blin J, Mohamed A, Romanet P, Borson-Chazot F, Rohmer V, Barlier A, Mirebeau-Prunier D. Nationwide French Study of RET Variants Detected from 2003 to 2013 Suggests a Possible Influence of Polymorphisms as Modifiers. Thyroid 2017; 27:1511-1522. [PMID: 28946813 DOI: 10.1089/thy.2016.0399] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND The presence of single nucleotide polymorphisms (SNPs) in the REarranged during Transfection (RET) gene has been investigated with regard to their potential role in the development or progression of medullary thyroid cancer or pheochromocytomas (PHEO) in patients with the multiple endocrine neoplasia type 2 (MEN2) syndrome. The aim of this study was to evaluate the spectrum of RET variants in France between 2003 and 2013, and to evaluate the impact of SNPs on the MEN2 A phenotype. METHODS In this retrospective cohort study, RET variants were screened in 5109 index cases, and RET pathogenic variants were screened in 2214 relatives. Exons 5, 8, 10, 11, 13, 14, 15, and 16 were characterized by Sanger sequencing. RET pathogenic variants, RET variants with unknown functional significance (VUS), and four RET SNP variants-G691S (rs1799939), L769L (rs1800861), S836S (rs1800862), and S904S (rs1800863)-were characterized and are reported in index cases. In silico analysis and classification following the recommendation of the American College of Medical Genetics and Genomics was performed for RET VUS. Each patient's age at the time of diagnosis, sex, and the endocrine neoplasias present at molecular diagnosis were recorded. RESULTS Twenty-six single VUS in RET without any well-defined risk profiles were found in 33 patients. Nine of these were considered probably pathogenic, 11 of uncertain significance, and six as probably benign. Three double pathogenic variants found in three patients were classified as pathogenic. A study of the entire cohort showed that patients carrying pathogenic variants or VUS in RET together with PHEO were diagnosed earlier than the others. The presence of the G691S SNP, or a combination of SNPs, increased the risk of developing PHEO but did not modify the date of the diagnosis. No association was found between SNPs and medullary thyroid cancer or hyperparathyroidism. CONCLUSIONS The findings propose a classification of 15 of the 26 VUS in RET without any well-defined risk profiles and suggest that the G691S SNP, or a combination of SNPs, may be associated with the development of PHEO.
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Affiliation(s)
| | - Stéphane Pinson
- 2 Laboratoire de Génétique Moléculaire , CHU Lyon, Lyon France
- 3 Réseau TenGen , France
| | - Marine Guillaud-Bataille
- 3 Réseau TenGen , France
- 4 Département de Biologie et Pathologie Médicale, Gustave Roussy, Université de Paris-Saclay, Villejuif, France
| | - Anne-Paule Gimenez-Roqueplo
- 3 Réseau TenGen , France
- 5 Service de Génétique, Assistance Publique Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France
| | - Alain Carrie
- 3 Réseau TenGen , France
- 6 Centre de Génétique Moléculaire Chromosomique, Assistance Publique Hôpitaux de Paris , Paris, France
| | - Véronique Barbu
- 3 Réseau TenGen , France
- 7 Laboratoire Commun de Biologie et Génétique Moléculaires , HUEP, SAT, AP-HP Paris, France
| | - Pascal Pigny
- 3 Réseau TenGen , France
- 8 Laboratoire de Biochimie et Oncologie Moléculaire , CHU Lille, Lille, France
| | - Stéphane Bezieau
- 3 Réseau TenGen , France
- 9 Laboratoire de Génétique Moléculaire , CHU Nantes, Nantes, France
| | - Jean-Marc Rey
- 3 Réseau TenGen , France
- 10 Laboratoire de Biopathologie Cellulaire et Tissulaire des Tumeurs , CHU Montpellier, Montpellier, France
| | - Chantal Delvincourt
- 3 Réseau TenGen , France
- 11 Laboratoire de Biologie Oncologique , CHU Reims, Reims, France
| | - Sophie Giraud
- 2 Laboratoire de Génétique Moléculaire , CHU Lyon, Lyon France
- 3 Réseau TenGen , France
| | - Charlotte Veyrat-Durebex
- 3 Réseau TenGen , France
- 12 UMR CNRS 6015-INSERMU1083, Laboratoire MITOVASC, Université d'Angers, Angers, France
- 13 Département de Biochimie et Génétique, CHU Angers , Angers, France
| | - Patrick Saulnier
- 14 Cellule de Méthodologie et Biostatistiques, Délégation à la Recherche Clinique et l'Innovation-DRCI, CHU Angers , Angers, France
| | - Nathalie Bouzamondo
- 3 Réseau TenGen , France
- 13 Département de Biochimie et Génétique, CHU Angers , Angers, France
| | - Marie Chabbert
- 12 UMR CNRS 6015-INSERMU1083, Laboratoire MITOVASC, Université d'Angers, Angers, France
| | - Julien Blin
- 15 Institut National du Cancer-INCa , Paris, France
| | - Amira Mohamed
- 3 Réseau TenGen , France
- 16 Aix Marseille Univ, CNRS, CRN2M, UMR 7286, and APHM La Conception Hospital, Molecular Biology Laboratory, Marseille, France
| | - Pauline Romanet
- 3 Réseau TenGen , France
- 16 Aix Marseille Univ, CNRS, CRN2M, UMR 7286, and APHM La Conception Hospital, Molecular Biology Laboratory, Marseille, France
| | - Francoise Borson-Chazot
- 3 Réseau TenGen , France
- 17 Hospices Civils de Lyon, Pôle IMER; Université Claude Bernard Lyon 1, HESPER EA 7425 Lyon, France
| | - Vincent Rohmer
- 1 Service d'Endocrinologie, CHU Angers , Angers, France
- 3 Réseau TenGen , France
| | - Anne Barlier
- 3 Réseau TenGen , France
- 16 Aix Marseille Univ, CNRS, CRN2M, UMR 7286, and APHM La Conception Hospital, Molecular Biology Laboratory, Marseille, France
| | - Delphine Mirebeau-Prunier
- 3 Réseau TenGen , France
- 12 UMR CNRS 6015-INSERMU1083, Laboratoire MITOVASC, Université d'Angers, Angers, France
- 13 Département de Biochimie et Génétique, CHU Angers , Angers, France
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20
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Saltiki K, Anagnostou E, Simeakis G, Kouki S, Angelopoulou A, Sarika L, Papathoma A, Alevizaki M. Familial MTC with RET exon 8 Gly533Cys mutation: origin and prevalence of second malignancy. Endocr Connect 2017; 6:676-684. [PMID: 28951487 PMCID: PMC5655672 DOI: 10.1530/ec-17-0147] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Accepted: 09/26/2017] [Indexed: 01/04/2023]
Abstract
INTRODUCTION High prevalence of RET p.Gly533Cys (c.1597G > T) has been found in familial MTC in Greece (exon 8 fMTC). We studied their origin and compared clinical characteristics with non-exon 8 fMTC. METHODS 102 fMTC (FMTC and MEN2A) patients (31.4% males) were followed for 2.9-37 years (median 6 years). Fifty-one carried the RET exon 8 mutation; the remaining were non-exon 8 fMTC (exons 10, 11, 13, 14). Pre-, post-operative calcitonin, disease extent at diagnosis and follow-up and families' place of origin were recorded. RESULTS Exon 8 fMTC were older (42.3 ± 13.3 vs 30.8 ± 17.8 years, P < 0.001), including index cases (P = 0.016). In index cases, the stage at diagnosis was more favorable in exon 8 fMTC compared to non-exon 8 fMTC (stage I and II: 65% vs 23.8%, stage III: 25% vs 57.1%, stage IV: 10% vs 19%, P = 0.025). More favorable outcome was noted in exon 8 fMTCs (remission: 72.5% vs 45.8%, stable disease: 27.5% vs 41.7%, progression: 0.0% vs 12.5%, P = 0.001). Exon 8 fMTC patients carried more frequently a second malignancy (25.5% vs 6.3%, P = 0.009); 69% of these were PTCs. Exon 8 fMTC patients were significantly older at diagnosis compared to non-exon 8 moderate-risk RET carriers and presented more favorable clinical outcome (remission: 72.5% vs 50%, stable disease: 27.5% vs 41.7%, progression: 0.0% vs 8.3%, P = 0.021). This difference remained when only index cases were analyzed. 'Hot spots' in the origin of exon 8 fMTCs families were recognized. No phenotype or outcome differences were found between the exon 8 families from the various regions. CONCLUSIONS In exon 8 fMTCs' older age, favorable disease stage at diagnosis and favorable outcome suggest slow disease progression compared to non-exon 8 fMTC. Compared with moderate-risk RET mutation carriers, exon 8 fMTC patients have a more favorable clinical outcome. The higher prevalence of second malignancies, especially PTC, not previously reported, merits further investigation. Increased awareness for inherited disease is required for patients with apparently sporadic MTC originating from recognized 'hot spots', as the age at presentation is usually delayed.
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Affiliation(s)
- Katerina Saltiki
- Endocrine UnitDepartment of Medical Therapeutics, National and Kapodistrian University of Athens, Alexandra Hospital, Athens, Greece
| | - Elli Anagnostou
- Endocrine UnitDepartment of Medical Therapeutics, National and Kapodistrian University of Athens, Alexandra Hospital, Athens, Greece
| | - George Simeakis
- Endocrine UnitDepartment of Medical Therapeutics, National and Kapodistrian University of Athens, Alexandra Hospital, Athens, Greece
| | - Sofia Kouki
- Endocrine UnitDepartment of Medical Therapeutics, National and Kapodistrian University of Athens, Alexandra Hospital, Athens, Greece
| | - Anastasia Angelopoulou
- Endocrine UnitDepartment of Medical Therapeutics, National and Kapodistrian University of Athens, Alexandra Hospital, Athens, Greece
| | - Leda Sarika
- Endocrine UnitDepartment of Medical Therapeutics, National and Kapodistrian University of Athens, Alexandra Hospital, Athens, Greece
| | - Alexandra Papathoma
- Endocrine UnitDepartment of Medical Therapeutics, National and Kapodistrian University of Athens, Alexandra Hospital, Athens, Greece
| | - Maria Alevizaki
- Endocrine UnitDepartment of Medical Therapeutics, National and Kapodistrian University of Athens, Alexandra Hospital, Athens, Greece
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21
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Mathiesen JS, van Overeem Hansen T, Rasmussen ÅK, Hjortshøj TD, Kiss K, Larsen SR, Krogh LN, Frederiksen AL, Hermann AP, Godballe C. Novel Somatic RET Mutation Questioning the Causality of the RET I852M Germline Sequence Variant in Multiple Endocrine Neoplasia 2A. Thyroid 2017; 27:1103-1104. [PMID: 28578594 DOI: 10.1089/thy.2017.0131] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Affiliation(s)
- Jes Sloth Mathiesen
- 1 Department of ORL Head and Neck Surgery, Odense University Hospital , Odense, Denmark
- 2 Institute of Clinical Research, University of Southern Denmark , Odense, Denmark
| | | | - Åse Krogh Rasmussen
- 4 Department of Medical Endocrinology, Copenhagen University Hospital , Copenhagen, Denmark
| | | | - Katalin Kiss
- 6 Department of Pathology, Copenhagen University Hospital , Copenhagen, Denmark
| | | | | | | | | | - Christian Godballe
- 1 Department of ORL Head and Neck Surgery, Odense University Hospital , Odense, Denmark
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22
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Mathiesen JS, Kroustrup JP, Vestergaard P, Madsen M, Stochholm K, Poulsen PL, Krogh Rasmussen Å, Feldt-Rasmussen U, Schytte S, Pedersen HB, Hahn CH, Bentzen J, Gaustadnes M, Ørntoft TF, Hansen TVO, Nielsen FC, Brixen K, Frederiksen AL, Godballe C. Incidence and prevalence of multiple endocrine neoplasia 2B in Denmark: a nationwide study. Endocr Relat Cancer 2017; 24:L39-L42. [PMID: 28438782 DOI: 10.1530/erc-17-0122] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Accepted: 04/24/2017] [Indexed: 01/11/2023]
Affiliation(s)
- Jes Sloth Mathiesen
- Department of ORL Head & Neck SurgeryOdense University Hospital, Odense, Denmark
- Institute of Clinical ResearchUniversity of Southern Denmark, Odense, Denmark
| | - Jens Peter Kroustrup
- Department of Clinical Medicine and EndocrinologyAalborg University Hospital, Aalborg, Denmark
| | - Peter Vestergaard
- Department of Clinical Medicine and EndocrinologyAalborg University Hospital, Aalborg, Denmark
| | - Mette Madsen
- Department of PediatricsAalborg University Hospital, Aalborg, Denmark
| | - Kirstine Stochholm
- Department of Internal Medicine and EndocrinologyAarhus University Hospital, Aarhus, Denmark
| | - Per Løgstrup Poulsen
- Department of Internal Medicine and EndocrinologyAarhus University Hospital, Aarhus, Denmark
| | - Åse Krogh Rasmussen
- Department of Medical EndocrinologyCopenhagen University Hospital, Copenhagen, Denmark
| | - Ulla Feldt-Rasmussen
- Department of Medical EndocrinologyCopenhagen University Hospital, Copenhagen, Denmark
| | - Sten Schytte
- Department of ORL Head & Neck SurgeryAarhus University Hospital, Aarhus, Denmark
| | | | - Christoffer Holst Hahn
- Department of ORL Head & Neck SurgeryCopenhagen University Hospital, Copenhagen, Denmark
| | - Jens Bentzen
- Department of OncologyHerlev Hospital, Herlev, Denmark
| | - Mette Gaustadnes
- Department of Molecular MedicineAarhus University Hospital, Aarhus, Denmark
| | | | | | - Finn Cilius Nielsen
- Center for Genomic MedicineCopenhagen University Hospital, Copenhagen, Denmark
| | - Kim Brixen
- Institute of Clinical ResearchUniversity of Southern Denmark, Odense, Denmark
| | - Anja Lisbeth Frederiksen
- Institute of Clinical ResearchUniversity of Southern Denmark, Odense, Denmark
- Department of Clinical GeneticsOdense University Hospital, Odense, Denmark
| | - Christian Godballe
- Department of ORL Head & Neck SurgeryOdense University Hospital, Odense, Denmark
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23
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Mathiesen JS, Habra MA, Bassett JHD, Choudhury SM, Balasubramanian SP, Howlett TA, Robinson BG, Gimenez-Roqueplo AP, Castinetti F, Vestergaard P, Frank-Raue K. Risk Profile of the RET A883F Germline Mutation: An International Collaborative Study. J Clin Endocrinol Metab 2017; 102:2069-2074. [PMID: 28323957 DOI: 10.1210/jc.2016-3640] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Accepted: 03/13/2017] [Indexed: 01/10/2023]
Abstract
CONTEXT The A883F germline mutation of the rearranged during transfection (RET) proto-oncogene causes multiple endocrine neoplasia 2B. In the revised American Thyroid Association (ATA) guidelines for the management of medullary thyroid carcinoma (MTC), the A883F mutation has been reclassified from the highest to the high-risk level, although no well-defined risk profile for this mutation exists. OBJECTIVE To create a risk profile for the A883F mutation for appropriate classification among the ATA risk levels. DESIGN Retrospective analysis. SETTING International collaboration. PATIENTS Included were 13 A883F carriers. INTERVENTION The intervention was thyroidectomy. MAIN OUTCOME MEASURES Earliest age of MTC, regional lymph node metastases, distant metastases, age-related penetrance of MTC and pheochromocytoma (PHEO), overall and disease-specific survival, and biochemical cure rate. RESULTS One and three carriers were diagnosed at age 7 to 9 years (median, 7.5 years) with a normal thyroid and C-cell hyperplasia, respectively. Nine carriers were diagnosed with MTC at age 10 to 39 years (median, 19 years). The earliest age of MTC, regional lymph node metastasis, and distant metastasis was 10, 20, and 20 years, respectively. Fifty percent penetrance of MTC and PHEO was achieved by age 19 and 34 years, respectively. Five- and 10-year survival rates (both overall and disease specific) were 88% and 88%, respectively. Biochemical cure for MTC at latest follow-up was achieved in 63% (five of eight carriers) with pertinent data. CONCLUSIONS MTC of A883F carriers seems to have a more indolent natural course compared with that of M918T carriers. Our results support the classification of the A883F mutation in the ATA high-risk level.
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Affiliation(s)
- Jes Sloth Mathiesen
- Department of Otorhinolaryngology Head and Neck Surgery, Odense University Hospital, DK-5000 Odense, Denmark
- Institute of Clinical Research, University of Southern Denmark, DK-5000 Odense, Denmark
| | - Mouhammed Amir Habra
- Division of Internal Medicine, Department of Endocrine Neoplasia and Hormonal Disorders, University of Texas MD Anderson Cancer Center, Houston, Texas 77030
| | - John Howard Duncan Bassett
- Division of Diabetes, Endocrinology and Metabolism, Department of Molecular Medicine, Imperial College London, London W12 0NN, United Kingdom
| | - Sirazum Mubin Choudhury
- Molecular Endocrinology Laboratory, Department of Medicine, Imperial College London, London W12 0NN, United Kingdom
| | - Sabapathy Prakash Balasubramanian
- Department of Oncology and Metabolism and Endocrine Surgical Unit, University of Sheffield and Sheffield Teaching Hospitals National Health Service Foundation Trust, Royal Hallamshire Hospital, Sheffield S10 2JF, United Kingdom
| | - Trevor A Howlett
- Department of Diabetes and Endocrinology, Leicester Royal Infirmary, University Hospitals of Leicester National Health Service Trust, Leicester LE1 5WW, United Kingdom
| | - Bruce G Robinson
- Cancer Genetics Kolling Institute, Royal North Shore Hospital, University of Sydney, St. Leonards, New South Wales 2065, Australia
| | - Anne-Paule Gimenez-Roqueplo
- Department of Genetics, Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, F-75015 Paris, France
- INSERM, Unité Mixte de Recherche 970, Paris-Cardiovascular Research Center, F-75015 Paris, France
- Paris Descartes University, Faculty of Medicine, F-75006 Paris, France
| | - Frederic Castinetti
- Department of Endocrinology, La Timone Hospital, Hôpitaux de Marseille, Aix-Marseille University, 13385 Marseille, France
| | - Peter Vestergaard
- Department of Clinical Medicine and Endocrinology, Aalborg University Hospital, DK-9000 Aalborg, Denmark
| | - Karin Frank-Raue
- Endocrine Practice, Moleculargenetic Laboratory, 69120 Heidelberg, Germany
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