人甲状腺髓样癌TT细胞胃动素基因表达的调控

目的:研究人甲状腺髓样癌TT细胞系中胃动素基因表达调控.方法:通过人甲状腺髓样癌TT细胞体外培养,观察经cAMP,生长激素或甲状腺雌激素诱导后,胃动素表达的改变以及胃动素对TT细胞生长、侵袭和转移的影响.结果:甲状腺髓样癌TT细胞表达胃动素mRNA,胃动素可抑制TT细胞的生长.当胃动素基因沉默后,TT细胞转移和侵袭能力增加.当TT细胞分别经cAMP、胃动素、生长激素或甲状腺刺激素孵育48小时后,胃动素基因转录增加,降钙素基因相关肽与胃动素mRNA比值持续下降.环磷酸腺苷可降低TT细胞增殖和c-myc基因的表达.结论:人甲状腺髓样癌细胞生长活性可能与甲状腺C细胞(低的降钙素基因相关肽与胃动素比率)分化的表型有关.     

人甲状腺髓样癌TT细胞胃动素基因表达的调控(英文)

目的:研究人甲状腺髓样癌TT细胞系中胃动素基因表达调控。方法:通过人甲状腺髓样癌TT细胞体外培养,观察经cAMP,生长激素或甲状腺雌激素诱导后,胃动素表达的改变以及胃动素对TT细胞生长、侵袭和转移的影响。结果:甲状腺髓样癌TT细胞表达胃动素mRNA,胃动素可抑制TT细胞的生长。当胃动素基因沉默后,TT细胞转移和侵袭能力增加。当TT细胞分别经cAMP、胃动素、生长激素或甲状腺刺激素孵育48小时后,胃动素基因转录增加,降钙素基因相关肽与胃动素mRNA比值持续下降。环磷酸腺苷可降低TT细胞增殖和c-myc基因的表达。结论:人甲状腺髓样癌细胞生长活性可能与甲状腺C细胞(低的降钙素基因相关肽与胃动素比率)分化的表型有关。     

彩超检查甲状腺滤泡癌和髓样癌的表现及病理分析

目的:探讨甲状腺滤泡癌和髓样癌的彩超表现及诊断价值。方法:选取我院收治的45例甲状腺髓样癌和40例甲状腺滤泡癌患者作为研究对象,所有患者术前均行彩超检查,对85例患者的病理特征和彩超表现进行对比、分析。结果:两组患者的病灶超声表现以低回声或等回声光团居多,少数病例可有高回声光团表现,且内部回声普遍不均匀,肿瘤与周围组织多有粘连。MTC患者的肿瘤边界多不清晰,内部钙化的病灶数目较多,而FTC的肿瘤边界则较为清晰,内部钙化的病灶数目较少。两组的内部钙化灶数目、钙化形式及肿瘤边界情况比较,差异均具有统计学意义(P0.05)。MTC与FTC患者的肿瘤内部血流信号情况比较,具有显著性差异(P0.05)。结论:甲状腺髓样癌和滤泡癌的其病理改变与彩超特征联系密切,彩超检查能有效鉴别、诊断甲状腺髓样癌和滤泡癌,值得推广应用。     

降钙素和降钙素基因相关肽的选择性表达

降钙素和降钙素基因相关肽(CT/CGRP)由同一基因编码,该基因结构及其5＇端侧翼序列决定了它能够在甲状腺C细胞以及中枢和外周神经细胞生成不同的表达产物.这种选择表达调控决定多细胞生物的发育、性别分化和进化.如果表达失控将导致甲状腺髓样瘤(MTC)和骨质疏松症等疾病.文章对该基因的结构和选择性表达调控进行了综述.     

RET原癌基因在甲状腺癌中的研究进展

原癌基因RET(rearranged during transfection)在1985年被鉴定,随后,在甲状腺乳头状癌（papillary thyroid carcinoma,PTC）中发现了不同类型的RET/PTC染色体重排。在遗传性和散发性的甲状腺髓样癌（medullary thyroid carcinoma, MTC）中发现RET点突变基因。与PTC中RET的变化存在不同,MTC中RET的活化主要通过激活点突变。RET不同类型的重排活化与甲状腺癌的高发密切相关,RET不同的活化机制需对应不同的治疗对策。讨论了RET原癌基因在甲状腺乳头状癌和甲状腺髓样癌中的致病、诊断和预后的作用,以期为RET活化引起的甲状腺癌的治疗提供理论依据。     

甲状腺髓样癌的临床相关特征及病理分析

目的探讨甲状腺髓样癌(medullary thyroid carcinoma,MTC)的临床相关特征及病理特点。方法回顾性分析我院2014年1月至2019年6月经手术和病理证实的24例MTC患者的临床病理资料。结果 MTC常伴血清学癌胚抗原(carcinoembryonic antigen,CEA)与降钙素(calcitonin, CT)升高;超声主要表现为低回声、边界欠清、形态不规则、伴钙化、血供丰富、部分伴淋巴结肿大;甲状腺细针穿刺对诊断MTC有一定局限性,RET基因检测有助于MTC的诊断,MTC以散发性甲状腺髓样癌为主;MTC典型的镜下特征:肿瘤细胞呈巢状、片状、岛状及器官样排列,细胞质丰富、淡染或略嗜碱,核圆形或卵圆形,大小一致,染色质粗颗粒,隐约可见小核仁,核分裂象罕见,间质可见多少不等的淀粉样物质沉积,术后病理显示淋巴结转移多见;MTC较可靠的免疫组化标记物为Syn、CgA、CEA、 TTF-1、CT、CD56与Ki-67,特殊染色常用刚果红染色等。结论 MTC的临床特征、实验室检查、影像学改变有助于病变的早期发现,但最终还需依靠病理形态、免疫组织化学及特殊染色明确诊断,而RET基因突变的检测可以实现MTC早期基因诊断。     

存活素反义寡核苷酸在人甲状腺髓样癌裸鼠模型中的抑瘤作用

目的探讨存活素(survivin)反义寡核苷酸(antisense oligodeoxyribonucleotide,ASODN)在人甲状腺髓样癌裸鼠模型中的抑瘤作用。方法构建12只人甲状腺髓样癌裸鼠模型,随机分配到正常组,SODN(sense oligodeoxyribonucleotide,正义寡核苷酸)组和ASODN组,每组4只。各组每日一次瘤内注射相应处理液,连续7d。治疗结束后1周,杀死全部瘤鼠,切取瘤体,测算瘤重和抑瘤率以评价肿瘤生长情况,瘤组织石腊切片分别行HE、免疫组化(IHC)和DNA末端原位标记法(TUNEL法)染色以评价组织病理构造、survivin与VEGF蛋白表达和细胞凋亡的变化。结果HE染色显示ASODN组具有明显减低的血管新生特点。此外,相对于正常组和SODN组,ASODN组具有显著的survivin和VEGF低表达、高凋亡、低瘤重和高抑瘤率特点(各P<0.01),而正常组与SODN组间未见上述各特点的统计学差异。结论本研究证实针对人甲状腺髓样癌survivin基因沉默治疗能够达到明显抑瘤效果,此效果至少部分通过促进肿瘤调亡和抑制肿瘤血管新生而实现。这提示survivin基因在人甲状腺髓样癌中具有重要意义和其可成为人甲状腺髓样癌基因靶向沉默治疗的重要候选基因之一。     

甲状腺髓样癌超声弹性成像定量参数与病灶组织中降钙素原的相关性研究

摘要 目的：探讨甲状腺髓样癌（MTC）超声弹性成像定量参数与病灶组织中降钙素原（PCT）的相关性。方法：回顾性选取2017年2月-2021年8月于我院行甲状腺癌手术且术后病理诊断为MTC的患者32例作为研究组,随机选择同期于我院行甲状腺良性肿瘤手术的患者40例作为对照组,所有患者均进行超声弹性成像检查。收集所有患者术后MTC和甲状腺良性肿瘤组织,采用免疫组化法检测MTC和甲状腺良性肿瘤组织中PCT的阳性表达率。采用受试者工作特征（ROC）曲线分析应变率比值对MTC和甲状腺良性肿瘤的鉴别诊断价值。采用Pearson相关分析应变率比值与病灶组织中PCT阳性表达率的相关性。结果：研究组应变率比值明显高于对照组,差异有统计学意义（P<0.05）。MTC组织中PCT阳性表达率为71.88%（23/32）高于甲状腺良性肿瘤组织中的35.00%（14/40）,差异有统计学意义（P<0.05）。经ROC曲线分析发现应变率比值鉴别诊断MTC和甲状腺良性肿瘤的最佳截断值为3.30,曲线下面积为0.761。Pearson相关分析显示应变率比值与MTC组织中PCT阳性表达率呈正相关（P<0.05）。结论：MTC超声弹性成像应变率比值与病灶组织中PCT阳性表达率呈正相关,且应变率比值对MTC具有一定的诊断价值。     

AG490对甲状腺髓样癌TT细胞放射敏感性的影响

为了研究AG490对甲状腺髓样癌TT细胞放射敏感性,本研究选择甲状腺髓样癌TT细胞作为研究对象,并采用不同浓度AG490 (0, 25μmol/L, 50μmol/L, 100μmol/L)处理细胞,利用MTT法、流式细胞术和克隆形成实验分别对细胞增殖、凋亡及放射敏感性进行检测,并采用Western blotting法检测各组JAK2、p-STAT3、Bcl-2、Bax蛋白表达。结果表明,与A组相比,B、C、D组的抑制增殖作用增强,呈浓度和时间依赖性;随着AG490药物浓度的增加凋亡率逐渐增加;与A组相比,C组细胞存活分数显著降低;JAK2、p-STAT3和Bcl-2的蛋白表达量随着药物浓度的升高而逐渐降低,Bax蛋白表达量随着药物浓度的升高而逐渐增加。AG490对甲状腺髓样癌TT细胞增殖有抑制作用,可促进细胞凋亡,提高放射敏感性。     

APL的发病分子机制和治疗进展

急性前髓细胞性白血病(APL)是急性髓细胞样白血病(AML)的一个亚型,它的分子生物学特征为95%的患者有15号染色体前髓细胞性白血病基因(PML)与17号染色体视黄酸受体(RARα)基因的融合易位表达.维甲酸(ATRA)单药治疗能使APL患者达90%的缓解率,化疗药物与ATRA的联合应用更能降低患者复发率,改善生存;三氧化二砷(ATO)能使复发患者缓解率达到90%.这篇文章主要综述APL的发病分子机制和治疗进展.     

Molecular mechanisms of medullary thyroid carcinoma: current approaches in diagnosis and treatment

Medullary thyroid carcinoma is the most common cause of death among patients with multiple endocrine neoplasia (MEN) 2. Dominant-activating mutations in the RET proto-oncogene have been shown to have a central role in the development of MEN 2 and sporadic medullary thyroid cancer (MTC): about half of sporadic MTCs are caused by somatic genetic changes of the RET oncogene. Inactivating mutations of the same gene lead to Hirschprung disease and other developmental defects. Thus, RET genetic changes lead to phenotypes that largely depend on their location in the gene and the function and timing of developmental expression of the RET protein. The reproducibility of the phenotype caused by each RET genotype led to MEN 2/MTC being among the first conditions in Medicine where a drastic measure is applied to prevent cancer, following genetic testing: thyroidectomy is currently routinely done in young children that are carriers of MTC-predisposing RET mutations. RET inhibitors have been also developed recently and are used in various types of thyroid and other cancers. This report reviews the RET involvement in the etiology of MEN 2 and MTC and updates the therapeutic approach in preclinical and clinical studies.     

Gene expression profile of medullary thyroid carcinoma--preliminary results

INTRODUCTION: Medullary thyroid carcinoma occurs both as a sporadic and a familial disease. Inherited MTC (iMTC) patients usually exhibit better prognosis than patients with sporadic form of MTC (sMTC), however, in both subtypes the outcome is unpredictable. No molecular markers contributing to the prognosis or predicting the type of therapy have been introduced to clinical practice until now. The aim of this study was to analyze gene expression pattern of MTC by high density oligonucleotide microarray. MATERIAL AND METHODS: 24 samples were studied: 12 MTC and 12 corresponding normal tissues, (Affymetrix HG-U 133A). Among MTC patients there were half inherited cases and half sporadic ones. RESULTS: First, the differences between MTC and thyroid tissue were analyzed by Singular Value Decomposition (SVD) which indicated three main modes determining the variability of gene expression profile: the first two were related to the tumor/normal tissue difference and the third one was related to the immune response. The characteristic expression pattern, beside of numerous changes within cancer- related genes, included many up-regulated genes specific for thyroid C cells. Further analysis of the second component revealed two subgroups of MTC, but the subdivision was not related to the iMTC/sMTC difference. Recursive Feature Replacement (RFR) confirmed the very similar expression profile in both forms of MTC. With subsequent ANOVA analysis some genes with differential expression could be specified, among them monoamine oxidase B (MAOB) and gamma-aminobutyric acid receptor (GABRR1) which were consistently up-regulated in sMTC. In contrary, some genes involved in regulation of cell proliferation: opioid growth factor receptor(OGFR) and synaptotagmin V (SYT 5) were up-regulated in iMTC. CONCLUSIONS: The obtained data indicate a very similar gene expression pattern in inherited and sporadic MTC. Minor differences in their molecular profile require further analysis.     

Discovery of targeting peptides for selective therapy of medullary thyroid carcinoma

BACKGROUND: Adenovirus efficiently infects a broad range of target cells, thereby preventing selective gene transfer. Moreover, several cell types and tissues including primary tumors are refractory to adenoviral infection, mainly because of low expression levels of coxsackie-adenovirus receptor (CAR). Thus, identification of cancer-selective ligands which yield gene transfer to neoplastic cells by minimizing transduction of normal cells is a key issue for successful cancer therapy. METHODS: We initially analyzed adenoviral receptor expression in human medullary thyroid carcinoma (MTC) cells. MTC cell-specific peptides were isolated by biopanning a phage display peptide library on cultured cancer cells and on tumors in vivo and further characterized. RESULTS: We found significant differences in CAR and alphav-integrin protein levels between MTC-derived TT cells in vitro and established xenograft tumors in mice, indicating a lack of alphav-integrin expression on growing tumors. MTC-specific candidates were identified by performing three rounds of subtraction. Selected phages showed up to 22-fold higher binding efficiency for TT cells when compared with wild-type M13 phage or other human cell lines and tumor tissue in vivo. Homing to TT cells of the best binding phage was clearly blocked in the presence of specific peptide, whereas no phage competition was observed with an unspecific peptide. The best binding peptide mediated efficient internalization of the phage. Importantly, specific binding and internalization was also mediated by the identified peptide within the adenoviral context. CONCLUSIONS: Our results indicate that the identified ligand should be suitable to improve selectivity of adenoviral gene transfer to medullary thyroid tumors in vivo.     

Genetic alterations in medullary thyroid cancer: diagnostic and prognostic markers

Medullary thyroid carcinoma (MTC) is a rare calcitonin producing neuroendocrine tumour that originates from the parafollicular C-cells of the thyroid gland. The RET proto-oncogene encodes the RET receptor tyrosine kinase, with consequently essential roles in cell survival, differentiation and proliferation. Somatic or germline mutations of the RET gene play an important role in this neoplasm in development of sporadic and familial forms, respectively. Genetic diagnosis has an important role in differentiating sporadic from familiar MTC. Furthermore, depending on the location of the mutation, patients can be classified into risk classes. Therefore, genetic screening of the RET gene plays a critical role not only in diagnosis but also in assessing the prognosis and course of MTC.     

Analysis of Mutations of the RET Proto-oncogene in Patients with Medullary Thyroid Carcinoma

The spectrum of mutations of the RET proto-oncogene was analyzed in Russian patients with inherited or sporadic medullary thyroid carcinoma (MTC). Four RET exons (11, 13, 15, and 16) were subjected to molecular analysis, and mutations were revealed and identified in 47.4% (9/19) patients with sporadic MTC. In total, six different mutations (including three new ones) were observed. The most common mutation affected codon 918 to cause substitution of methionine with threonine and accounted for 31.6% alleles. Analysis of exons 11 and 16 revealed four types of mutations in patients with inherited multiple endocrine neoplasia type 2 (MEN 2). Mutations were found in each patient. Thyroidectomy was performed in four asymptomatic carriers of RET mutations from three MEN 2A families (in two families, affected relatives had bilateral pheochromocytoma). In two patients, analysis of the surgery material revealed MTC microfoci in both lobes of the thyroid gland. The results provide the ground for constructing a bank of genetic information on Russian MTC patients with the clinically verified diagnosis.     

Expression of the first calcitonin/CGRP gene in spontaneous and transplanted rat medullary thyroid carcinoma: a comparison of dot-blot analysis, in situ hybridization, and immunohistochemistry.

Calcitonin (CT) and calcitonin gene-related peptide (CGRP) are encoded by a single gene, the CALC-I gene. They are expressed in the thyroid and in the nervous system by alternative splicing of the pre-messenger RNA derived from the CALC-I gene. In medullary thyroid carcinoma (MTC), a malignancy derived from the calcitonin-producing C-cells in the thyroid, production of calcitonin and CGRP is a common feature. We investigated the CT and CGRP production of four spontaneous MTCs transplanted three to four times and 14 MTC lines transplanted for several years in WAG/Rij rats, a strain with hereditary MTC. The expression of CT and CGRP in the spontaneous and in the transplanted tumors was studied by means of RNA in situ hybridization (RISH), dot-blot analysis, and immunohistochemistry. A down-regulation of CT production in transplanted compared with spontaneous tumors was observed, but an inverse relation between CT and CGRP mRNA content in both spontaneous and transplanted tumors was not observed. In this study, RISH proved to be as sensitive as dot-blot analysis to detect gene expression in tissue samples. The different approaches of analyzing the gene expression in tissue samples (the cellular localization of gene expression by ISH vs the analysis of an extract of a total tissue sample with dot-blot analysis) showed that each technique is equal in value and that they are complementary to each other.     

Mice conditionally expressing RET(C618F) mutation display C cell hyperplasia and hyperganglionosis of the enteric nervous system

Medullary thyroid carcinoma (MTC) develops from hyperplasia of thyroid C cells and represents one of the major causes of thyroid cancer mortality. Mutations in the cysteine‐rich domain (CRD) of the RET gene are the most prevalent genetic cause of MTC. The current consensus holds that such cysteine mutations cause ligand‐independent dimerization and constitutive activation of RET. However, given the number of the CRD mutations left uncharacterized, our understanding of the pathogenetic mechanisms by which CRD mutations lead to MTC remains incomplete. We report here that RET(C618F), a mutation identified in MTC patients, displays moderately high basal activity and requires the ligand for its full activation. To assess the biological significance of RET(C618F) in organogenesis, we generated a knock‐in mouse line conditionally expressing RET(C618F) cDNA by the Ret promoter. The RET(C618F) allele can be made to be Ret‐null and express mCherry by Cre‐loxP recombination, which allows the assessment of the biological influence of RET(C618F) in vivo. Mice expressing RET(C618F) display mild C cell hyperplasia and increased numbers of enteric neurons, indicating that RET(C618F) confers gain‐of‐function phenotypes. This mouse line serves as a novel biological platform for investigating pathogenetic mechanisms involved in MTC and enteric hyperganglionosis.     

Polyclonal origin of medullary carcinoma of the thyroid in multiple endocrine neoplasia type 2

Multiple endocrine neoplasia type 2 (MEN 2) is a dominantly inherited cancer syndrome characterized by medullary thyroid carcinoma (MTC) and other tumors. Since MTC can also occur in a sporadic form and as familial medullary thyroid carcinoma, this neoplasm offers a unique opportunity to investigate the difference of origin, if any, between the sporadic and the hereditary forms of a tumor. While sporadic malignancies have usually been found to result from a mutational event occurring at the single-cell level and are therefore monoclonal, studies on hereditary neoplasms have been scarce and often produced conflicting results. In order to determine the clonal origin of sporadic MTCs and of those occurring in MEN 2 syndromes we used a clonality assay based on a polymorphic trinucleotide repeat of the X-linked human androgen-receptor gene. We found that 10 out of 11 MTCs expressed a polyclonal pattern of X inactivation, including a significant percentage of the cases clinically defined as sporadic. Received: 21 May 1996 / Revised: 14 August 1996