Neoplasia endocrina múltiple tipo 1 con mutación negativa y fenocopias / Multiple endocrine neoplasia type 1 with negative mutation and phenocopies

Introducción: existen 4 tipos de neoplasias endocrinas múltiples, las cuales se caracterizan por la aparición de tumores en 2 o más glándulas endocrinas. La prevalencia de neoplasia endocrina múltiple 1 es aproximadamente 2 por 100 000, y constituyen una enfermedad poco frecuente. Objetivo: descartar, ante la sospecha de una neoplasia endocrina múltiple 1 con mutación negativa, otras enfermedades para poder diagnosticarla como tal. Presentación del caso clínico: mujer de 36 años, con diagnóstico de macroprolactinoma e hiperparatiroidismo primario normocalcémico (neoplasia endocrina múltiple 1 clínica), hallazgos clínicos que justificaron el estudio genético. Inicialmente para neoplasia endocrina múltiple 1, resultó negativo. En pacientes con neoplasia endocrina múltiple 1 clínica -o alta sospecha de neoplasia endocrina múltiple 1 en los que no se identifica mutación- hay que considerar que se trate de una fenocopia y ampliar el estudio genético: CDC73, CDKN1B, CaSR y AIP. También se analizaron estos genes, y fueron negativos. Otra entidad a considerar sería el hiperparatiroidismo aislado familiar. Conclusiones: llegar al diagnóstico de neoplasia endocrina múltiple 1 a veces no es tan simple, como identificar una mutación positiva. Es importante descartar fenocopias, para poder diagnosticar correctamente al paciente, pues esto determinará el seguimiento en búsqueda de otros posibles tumores, lo que -en último término- puede condicionar el pronóstico(AU)

Introduction: there are four types of multiple endocrine neoplasias which are characterized by occurrence of tumors in two or more endocrine glands. The prevalence rate of multiple endocrine neoplasia type 1 is 2 per 100 000 patients approximately and it is a rare disease. Objective: to rule out the existence of any other disease in order to properly diagnose a suspected multiple endocrine neoplasia type 1 with negative mutation. Clinical case presentation: a 36 years-old woman diagnosed with macroprolactinoma and primary normocalcemic hyperparathyroidism (clinical multiple endocrine neoplasia type 1) and clinical findings supporting the performance of a genetic study. The study initially yielded negative results for the above-mentioned disease. However, in those patients with clinical multiple endocrine neoplasia type 1- or high suspicious of multiple endocrine neoplasia type 1 with no identified mutation- it must be considered that there is a phenocopy and the genetic study must be extended to include CDC 73, CDKN1B, CaSR and AIP. These genes were also analyzed with negative results. Another disease to be considered would be isolated family hyperparathyroidism. Conclusions: making the diagnosis of a multiple endocrine neoplasia type 1 is not sometimes as simple as identifying a positive mutation. It is important to rule out possible phenocopies to be able to adequately diagnose a patient, since this will determine the search for other probable tumors which may ultimately influence this prognosis(AU)

The clinical significance of CDK1 expression in oral squamous cell carcinoma

China OBJECTIVES: To evaluate the clinical significance of cyclin-dependent kinase 1 (CDK1) in 77 oral squamous cell carcinomas (OSCC) using immunohistochemical methods. Study DESIGN: Immunohistochemical expression of CDK1 was compared with various clinic pathological features in 77 OSCC and 60 controlled epithelia adjacent to the tumours. In addition, correlation of CDK1 expression and prognostic and the 5-year accumulative survival rate of OSCC were investigated. RESULTS: The CDK1 protein was expressed in 52 cases of 77 tumor tissues (67.5%), compared with 21 cases of 60controlled (35.0%). The expression of CDK1 was significantly correlated with the histological grade of OSCC(P<0.05). The CDK1 protein was over-expressed in recurrent tumors or in those with lymph node metastasis. Statistical analysis showed a significant reduction in the 5-year accumulative survival rate in CDK1 positive cases compared with CDK1 negative cases (P<0.05). Namely, the CDK1 positive patients had poor prognosis. CONCLUSIONS: The expression of CDK1 might serve as malignant degree and prognostic markers for the survival of OSCC