[The trends in early precision diagnosis and treatment strategies of multiple endocrine neoplasia type 2]

Zhonghua Wai Ke Za Zhi. 2022 Nov 1;60(11):973-980. doi: 10.3760/cma.j.cn112139-20220714-00312.
[Article in Chinese]

Abstract

Multiple endocrine neoplasia type 2 (MEN2) is an autosomal dominant hereditary neuroendocrine cancer syndrome characterized by medullary thyroid carcinoma, in combination or not with pheochromocytoma, hyperparathyroidism and extra-endocrine features, and two forms subtyped as MEN2A and MEN2B. Based on the correlation between RET proto-oncogene mutation and MEN2 phenotype, MEN2 could be prevented through prenatal diagnosis and preimplantation genetic testing. Integrating the detection of RET mutation with measurement of serum calcitonin, plasma or urinary metanephrine/normetanephrine, and serum parathyroid hormone levels could accurately predict the progression of MEN2, and then facilitating implementation of personalized precision treatment. In addition, increased awareness of MEN2 is needed, which requires participation of physicians, patients/family members, and relevant organizations, supplemented by psychological support, which could promote the comprehensive management of MEN2. The "5P" strategies for MEN2 represents a paradigm of precision medicine, which could effectively avoid or reduce the clinical adverse outcomes, improve the prognosis and quality of life of MEN2 patients.

多发性内分泌肿瘤2型(MEN2)是一种常染色体显性遗传的神经内分泌癌症综合征,临床特征性表现为甲状腺髓样癌,伴或不伴嗜铬细胞瘤、甲状旁腺功能亢进和内分泌腺外表型;有2种亚型MEN2A和MEN2B。基于RET突变与MEN2表型的相关性,通过产前诊断和植入前基因检测,可预防(preventive)MEN2发生;整合RET突变和血清降钙素等检测,可准确预测(predictive)MEN2进展,进而实施MEN2的个性化(personalized)精准治疗。此外,着力提高对MEN2的认识,需医务人员、患者和家属,以及相关组织机构的共同参与(participation),并辅以心理支持(psychological support),可促进MEN2的综合诊治水平的全面提高。MEN2的“5P诊治策略”是精确医学的范例代表,可有效避免或减少MEN2的临床危害,改善MEN2患者预后及其生活质量。.

Publication types

  • English Abstract

MeSH terms

  • Adrenal Gland Neoplasms* / diagnosis
  • Adrenal Gland Neoplasms* / genetics
  • Adrenal Gland Neoplasms* / therapy
  • Early Detection of Cancer
  • Humans
  • Multiple Endocrine Neoplasia Type 2a* / diagnosis
  • Multiple Endocrine Neoplasia Type 2a* / genetics
  • Multiple Endocrine Neoplasia Type 2a* / therapy
  • Proto-Oncogene Proteins c-ret / genetics
  • Quality of Life
  • Thyroid Neoplasms* / diagnosis
  • Thyroid Neoplasms* / genetics
  • Thyroid Neoplasms* / therapy

Substances

  • Proto-Oncogene Proteins c-ret