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Chevalier B, Coppin L, Romanet P, Cuny T, Maiza JC, Abeillon J, Forestier J, Walter T, Gilly O, Le Bras M, Smati S, Nunes ML, Geslot A, Grunenwald S, Mouly C, Arnault G, Wagner K, Koumakis E, Cortet-Rudelli C, Merlen É, Jannin A, Espiard S, Morange I, Baudin É, Cavaille M, Tauveron I, Teissier MP, Borson-Chazot F, Mirebeau-Prunier D, Savagner F, Pasmant É, Giraud S, Vantyghem MC, Goudet P, Barlier A, Cardot-Bauters C, Odou MF. Beyond MEN1, when to think about MEN4? Retrospective study on 5600 patients in the French population & literature review. J Clin Endocrinol Metab 2024:dgae055. [PMID: 38288531 DOI: 10.1210/clinem/dgae055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 12/18/2023] [Accepted: 01/25/2024] [Indexed: 03/13/2024]
Abstract
CONTEXT Germline CDKN1B variants predispose patients to multiple endocrine neoplasia type 4 (MEN4), a rare MEN1-like syndrome, with <100 reported cases since its discovery in 2006. Although CDKN1B mutations are frequently suggested to explain cases of genetically-negative MEN1, the prevalence and phenotype of MEN4 patients is poorly known, and genetic counseling is unclear. OBJECTIVE To evaluate the prevalence of MEN4 in MEN1-suspected patients and characterize the phenotype of MEN4 patients. DESIGN Retrospective observational nationwide study. Narrative review of literature and variant class reassessment. PATIENTS We included all adult patients with class 3/4/5 CDKN1B variants identified by the laboratories from the French TENGEN network between 2015 and 2022 through germline genetic testing for MEN1 suspicion. After class reassessment, we compared the phenotype of symptomatic patients with class 4/5 CDKN1B variants, i.e. with genetically-confirmed MEN4 diagnosis, in our series and in literature with 66 matched MEN1 patients from the UMD-MEN1 database. RESULTS From 5600 MEN1-suspected patients analyzed, four patients with class 4/5 CDKN1B variant were found (0.07%). They presented with multiple duodenal NET, PHPT and adrenal nodule, isolated PHPT, PHPT and pNET. We listed 29 patients with CDKN1B class 4/5 variants from literature. Compared to matched MEN1 patients, MEN4 patients presented lower NET incidence and older age at PHPT diagnosis. CONCLUSION The prevalence of MEN4 is low. PHPT and PA represent the main associated lesions, NETs are rare. Our results suggest a milder and later phenotype than in MEN1. Our observations will help to improve genetic counseling and management of MEN4 families.
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Affiliation(s)
- Benjamin Chevalier
- Department of Endocrinology, Diabetology and Metabolism, Lille University Hospital, Lille, France
- University of Lille, Lille, France
- Department of Nuclear Medicine, Lille University Hospital, Lille, France
| | - Lucie Coppin
- University of Lille, CNRS, Inserm, CHU Lille, UMR9020-U1277 - CANTHER - Cancer - Heterogeneity Plasticity and Resistance to Therapies, Lille, France
- CHU Lille, Service de Biochimie et Biologie moléculaire « Hormonologie, Métabolisme-Nutrition, Oncologie » , Lille, France
| | - Pauline Romanet
- Aix Marseille Univ, APHM, INSERM, UMR1251 MMG, Laboratory of Molecular Biology GEnOPé, Biogénopôle, Hôpital de la Timone, Marseille, France
| | - Thomas Cuny
- Aix Marseille Univ, APHM, INSERM, UMR1251 MMG, MARMARA Institute, CRMR HYPO, Department of Endocrinology, Hôpital de la Conception, Marseille, France
| | - Jean-Christophe Maiza
- Department of Endocrinology, Diabetes, and Nutrition, GHSR, Centre Hospitalo-Universitaire de la Réunion, Saint-Pierre, La Réunion, France
| | - Juliette Abeillon
- Hospices Civils de Lyon, Fédération d'Endocrinologie, Université Claude Bernard Lyon 1, Lyon, France
| | - Julien Forestier
- Service d'Oncologie Médicale et Hépatogastroentérologie, Hospices Civil de Lyon, Lyon, France
| | - Thomas Walter
- Service d'Oncologie Médicale et Hépatogastroentérologie, Hospices Civil de Lyon, Lyon, France
- Université de Lyon, Lyon, France
| | - Olivier Gilly
- Department of Metabolic and Endocrine Disease, CHU Nîmes, Université Montpellier, Nîmes, France
| | - Maëlle Le Bras
- Nantes Université, CHU Nantes, Service d'endocrinologie, diabétologie, nutrition, l'institut du thorax, F-44000 Nantes, France
| | - Sarra Smati
- Nantes Université, CHU Nantes, Service d'endocrinologie, diabétologie, nutrition, l'institut du thorax, F-44000 Nantes, France
| | - Marie Laure Nunes
- Department of Endocrinology, Diabetes and Nutrition, University Hospital (CHU) and University of Bordeaux, Bordeaux, France
| | - Aurore Geslot
- Service d'endocrinologie, maladies métaboliques et nutrition, pôle cardio-vasculaire et métabolique, CHU Larrey, 24, chemin de Pouvourville, TSA 30030, 31059 Toulouse cedex, France
| | - Solange Grunenwald
- Service d'endocrinologie, maladies métaboliques et nutrition, pôle cardio-vasculaire et métabolique, CHU Larrey, 24, chemin de Pouvourville, TSA 30030, 31059 Toulouse cedex, France
| | - Céline Mouly
- Service d'endocrinologie, maladies métaboliques et nutrition, pôle cardio-vasculaire et métabolique, CHU Larrey, 24, chemin de Pouvourville, TSA 30030, 31059 Toulouse cedex, France
| | - Gwenaelle Arnault
- Endocrinologie-Diabétologie-Nutrition, CHBA, 20 boulevard Maurice Guillaudot, 56000 Vannes, France
| | - Kathy Wagner
- Department of Pediatrics, CHU-Lenval, Nice, France
| | - Eugénie Koumakis
- Reference Center for Rare Disorders of Calcium and Phosphate Metabolism, Reference Center for Rare Genetic Bone Disorders, OSCAR Filière, Rheumatology Department, Cochin Hospital, AP-HP Centre-Paris University, 27 Rue du Faubourg Saint-Jacques, 75014, Paris, France, INSERM U1160, Institut Imagine
| | - Christine Cortet-Rudelli
- Department of Endocrinology, Diabetology and Metabolism, Lille University Hospital, Lille, France
| | - Émilie Merlen
- Department of Endocrinology, Diabetology and Metabolism, Lille University Hospital, Lille, France
| | - Arnaud Jannin
- Department of Endocrinology, Diabetology and Metabolism, Lille University Hospital, Lille, France
- University of Lille, Lille, France
- University of Lille, CNRS, Inserm, CHU Lille, UMR9020-U1277 - CANTHER - Cancer - Heterogeneity Plasticity and Resistance to Therapies, Lille, France
| | - Stéphanie Espiard
- Department of Endocrinology, Diabetology and Metabolism, Lille University Hospital, Lille, France
- University of Lille, Lille, France
| | - Isabelle Morange
- Aix Marseille Univ, APHM, INSERM, UMR1251 MMG, MARMARA Institute, CRMR HYPO, Department of Endocrinology, Hôpital de la Conception, Marseille, France
| | - Éric Baudin
- Department of Endocrine Oncology and Imaging, Gustave Roussy Cancer Campus Grand Paris, France
| | - Mathias Cavaille
- INSERM, U1240 Imagerie Moléculaire et Stratégies Théranostiques, Université Clermont Auvergne, Clermont-Ferrand France; Département d'Oncogénétique, Centre Jean Perrin, Clermont Ferrand, France
| | - Igor Tauveron
- Service d'Endocrinologie, Diabétologie et Maladies Métaboliques, CHU Clermont-Ferrand, Clermont-Ferrand, France
- Laboratoire GReD, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Marie-Pierre Teissier
- Université de Limoges, Unité INSERM 1094 & IRD, 2 rue Marcland 87025 Limoges, France et Service d'Endocrinologie-Diabétologie et Maladies métaboliques, Centre hospitalier universitaire Dupuytren 2, 16 rue B. Descottes. 87042, Limoges, France
| | - Françoise Borson-Chazot
- Hospices Civils de Lyon, Fédération d'Endocrinologie, Université Claude Bernard Lyon 1, Lyon, France
| | - Delphine Mirebeau-Prunier
- Unité Mixte de Recherche (UMR) MITOVASC, INSERM U1083, CNRS 6015, Université d'Angers, Laboratoire de Biochimie et Biologie Moléculaire, Centre Hospitalier Universitaire d'Angers, Angers 49933, France
| | | | - Éric Pasmant
- Service de Génétique et Biologie Moléculaires, Hôpital Cochin, DMU BioPhyGen, Assistance Publique-Hôpitaux de Paris, AP-HP, Centre-Université de Paris, Paris, France
- Institut Cochin, Inserm U1016, CNRS UMR8104, Université de Paris, CARPEM, Paris, France
| | - Sophie Giraud
- Genetics Department, Hospices Civils de LYON (HCL), University Hospital, East Pathology Center, Bron Cedex, France
| | - Marie-Christine Vantyghem
- Department of Endocrinology, Diabetology and Metabolism, Lille University Hospital, Lille, France
- University of Lille, Lille, France
- Institut National de la Santé et de la Recherche Médicale (INSERM), European Genomic Institute for Diabetes (EGID), CHU Lille, Lille, France
| | - Pierre Goudet
- Service de Chirurgie Viscérale et Endocrinienne, Centre Hospitalier Universitaire François Mitterand, Dijon, France
| | - Anne Barlier
- Aix Marseille Univ, APHM, INSERM, UMR1251 MMG, Laboratory of Molecular Biology GEnOPé, Biogénopôle, Hôpital de la Timone, Marseille, France
| | - Catherine Cardot-Bauters
- Department of Endocrinology, Diabetology and Metabolism, Lille University Hospital, Lille, France
| | - Marie Françoise Odou
- CHU Lille, Service de Biochimie et Biologie moléculaire « Hormonologie, Métabolisme-Nutrition, Oncologie , Lille, France
- University of Lille, Inserm, CHU Lille, U1286 - Infinite - Institute for Translational Research in Inflammation, Lille, France
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