Identification and characterization of two novel germline RET variants associated with medullary thyroid carcinoma

Endocrine. 2015 Jun;49(2):366-72. doi: 10.1007/s12020-015-0559-0. Epub 2015 Mar 1.

Abstract

Activating germline mutations in the RET proto-oncogene are responsible for about 98 % of the familial forms of medullary thyroid carcinoma (MTC), which represent 25 % of all MTC cases. The search for germline mutations in this gene is important for the recognition of hereditary forms of MTC and further identification of at-risk relatives who may benefit from early clinical intervention. Genotype-phenotype correlations are well established for most disease-causing RET mutations, allowing risk stratification. The association of a new RET variant with the MTC phenotype and familial predisposition requires the assessment of its functional and clinical significance. The aim of this study was to evaluate the oncogenic potential of two newly identified RET germline variants associated with late-onset MTC. In vitro functional assays were designed to address the transforming potential of novel RET variants, through their expression in non-transformed cells, and comparing their effect with wild-type RET. The new variants were identified in codons 515 (p.C515W) and 636 (p.T636M) located, respectively, in exons 8 and 11, thus resulting in amino acid substitutions in the extracellular region of the tyrosine kinase receptor RET. Through functional assays, we observed increased cell growth and proliferation, loss of contact inhibition, and a stimulation of cell migration, suggesting that these new RET variants hold some relevant transforming potential. The transforming potential of these novel RET variants was of low-grade, when compared to that of RET MEN2A-causing mutation p.C634R, probably explaining the mild phenotype characterized by late onset and low clinical aggressiveness.

Publication types

  • Case Reports

MeSH terms

  • Age of Onset
  • Aged
  • Carcinoma, Neuroendocrine / genetics*
  • Carcinoma, Neuroendocrine / physiopathology
  • Female
  • Genetic Predisposition to Disease
  • Germ-Line Mutation / genetics*
  • Humans
  • Middle Aged
  • Multiple Endocrine Neoplasia Type 2a / genetics
  • Phenotype
  • Proto-Oncogene Mas
  • Proto-Oncogene Proteins c-ret / genetics*
  • Thyroid Neoplasms / genetics*
  • Thyroid Neoplasms / physiopathology

Substances

  • MAS1 protein, human
  • Proto-Oncogene Mas
  • Proto-Oncogene Proteins c-ret
  • RET protein, human

Supplementary concepts

  • Thyroid cancer, medullary