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Nationwide French Study of RET Variants Detected from 2003 to 2013 Suggests a Possible Influence of Polymorphisms as Modifiers

Maylis Lebeault 1 Stéphane Pinson 2 Marine Guillaud-Bataille 3 Anne Gimenez-Roqueplo 4 Alain Carrié 5 Véronique Barbu 6 Pascal Pigny 7 Stéphane Bézieau 8 Jean-Marc Rey 9 Chantal Delvincourt 10 Sophie Giraud 11 Charlotte Veyrat-Durebex 12, 1 Patrick Saulnier 13 Nathalie Bouzamondo 1 Marie Chabbert 12 Julien Blin 14 Amira Mohamed 15 Pauline Romanet 15 Françoise Borson-Chazot 16 Vincent Rohmer 17, 1 Anne Barlier 15 Delphine Mirebeau-Prunier 12, 1
Abstract : Background: The presence of single nucleotide polymorphisms (SNPs) in the REarranged during Transfection (RET) gene has been investigated with regard to their potential role in the development or progression of medullary thyroid cancer or pheochromocytomas (PHEO) in patients with the multiple endocrine neoplasia type 2 (MEN2) syndrome. The aim of this study was to evaluate the spectrum of RET variants in France between 2003 and 2013, and to evaluate the impact of SNPs on the MEN2 A phenotype. Methods: In this retrospective cohort study, RET variants were screened in 5109 index cases, and RET pathogenic variants were screened in 2214 relatives. Exons 5, 8, 10, 11, 13, 14, 15, and 16 were characterized by Sanger sequencing. RET pathogenic variants, RET variants with unknown functional significance (VUS), and four RET SNP variants—G691S (rs1799939), L769L (rs1800861), S836S (rs1800862), and S904S (rs1800863)—were characterized and are reported in index cases. In silico analysis and classification following the recommendation of the American College of Medical Genetics and Genomics was performed for RET VUS. Each patient's age at the time of diagnosis, sex, and the endocrine neoplasias present at molecular diagnosis were recorded. Results: Twenty-six single VUS in RET without any well-defined risk profiles were found in 33 patients. Nine of these were considered probably pathogenic, 11 of uncertain significance, and six as probably benign. Three double pathogenic variants found in three patients were classified as pathogenic. A study of the entire cohort showed that patients carrying pathogenic variants or VUS in RET together with PHEO were diagnosed earlier than the others. The presence of the G691S SNP, or a combination of SNPs, increased the risk of developing PHEO but did not modify the date of the diagnosis. No association was found between SNPs and medullary thyroid cancer or hyperparathyroidism. Conclusions: The findings propose a classification of 15 of the 26 VUS in RET without any well-defined risk profiles and suggest that the G691S SNP, or a combination of SNPs, may be associated with the development of PHEO.
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Maylis Lebeault, Stéphane Pinson, Marine Guillaud-Bataille, Anne Gimenez-Roqueplo, Alain Carrié, et al.. Nationwide French Study of RET Variants Detected from 2003 to 2013 Suggests a Possible Influence of Polymorphisms as Modifiers. Thyroid, Mary Ann Liebert, 2017, 27 (12), pp.1511-1522. ⟨10.1089/thy.2016.0399⟩. ⟨hal-01731580⟩

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