[DICER1综合征:临床各种内分泌表现和诊断特征]。

E E Novokreshennih, A A Kolodkina, O B Bezlepkina
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引用次数: 0

摘要

DICER1 综合征是一种罕见的遗传性疾病,会在儿童期逐渐发展为恶性和非恶性疾病。该综合征的病因是内切核酸酶 DICER 功能障碍,DICER 在处理微核糖核酸(microRNAs)过程中发挥重要作用,随后调节控制致癌基因和抑癌基因的表达。发育不良症的临床表现非常不同,既包括内分泌表现--多结节性甲状腺肿、分化型甲状腺癌、卵巢间质瘤、垂体胚芽肿,也包括非内分泌表现--胸膜肺胚芽肿、囊性肾瘤、松果体母细胞瘤。DICER1 基因的体细胞突变是发育不良发病机制的一个结果阶段,决定了肿瘤发生的进一步路径。目前,DICER1 综合征的诊断极为罕见,这导致患者体内的疾病成分发现较晚,肿瘤诊断较晚,缺乏家庭咨询。在疾病的早期阶段进行诊断,制定筛查计划来管理这些患者,可以最大限度地降低发展为恶性、侵袭性疾病的风险。
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[DICER1 syndrome: clinical variety endocrine manifestations and features of diagnostics].

DICER1 syndrome is a rare genetic disorder with the progressive development of malignant and non-malignant diseases in childhood. The cause of this syndrome is a dusfunction of the endoribonuclease DICER, which plays an important role in the processing of microRNAs with subsequent regulation of the control of the expression of oncogenes and tumor suppressor genes. Clinical manifestations of dyseropathies is very different and may include both endocrine manifestations - multinodular goiter, differentiated thyroid cancers, ovarian stromal tumors, pituitary blastoma, and non-endocrine formations - pleuropulmonary blastoma, cystic nephroma, pineoblastoma. The presence of somatic mutations of the DICER1 gene is a resultant stage in the pathogenesis of dyseropathies, determining the further path of oncogenesis. At present, DICER1 syndrome is diagnosed extremely rarely, which leads to late detection of the components of the disease in the patient, late diagnosis of neoplasms, lack of family counseling. Diagnosis at the early stages of the disease, the development of screening programs for the management of these patients allows minimizing the risks of developing more malignant, aggressive forms of the disease.

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