Abstract

BackgroundDifferent pathogenic germline mutations in the RET oncogene are identified in MEN 2, a hereditary syndrome characterized by medullary thyroid carcinoma (MTC) and other endocrine tumors. Although genetic predisposition is recognized, not all RET mutation carriers will develop the disease during their lifetime or, likewise, RET mutation carriers belonging to the same family may present clinical heterogeneity. It has been suggested that a single germline mutation might not be sufficient for development of MEN 2-associated tumors and a somatic bi-allelic alteration might be required. Here we investigated the presence of somatic second hit mutation in the RET gene in MTC.MethodsWe integrated Multiplex Ligation-dependent Probe Amplification (MLPA) and whole exome sequencing (WES) to search for copy number alteration (CNA) in the RET gene in MTC samples and medullary thyroid cell lines (TT and MZ-CR-1). We next found reads spanning exon-exon boundaries on RET, an indicative of retrocopy. We subsequently searched for RET retrocopies in the human reference genome (GRCh37) and in the 1000 Genomes Project data, by looking for reads reporting joined exons in the RET locus or distinct genomic regions. To determine RET retrocopy specificity and recurrence, DNA isolated from sporadic and MEN 2-associated MTC (n = 37), peripheral blood (n = 3) and papillary thyroid carcinomas with RET fusion (n = 10) samples were tested using PCR-sequencing methodology.ResultsThrough MLPA we have found evidence of CNA in the RET gene in MTC samples and MTC cell lines. WES analysis reinforced the presence of the CNA and hinted for a retroposed copy of RET not found in the human reference genome and 1.000 Genomes Project. Extended analysis confirmed the presence of a somatic MTC-related retrocopy of RET in both sporadic and hereditary tumors. We further unveiled a recurrent (28%) novel point mutation (p.G548 V) found exclusively in the retrocopy of RET. The mutation was also found in cDNA of mutated samples, suggesting it might be functional.ConclusionWe here report a somatic specific RET retroposed copy in MTC samples and cell lines. Our results support the idea that generation of retrocopies in somatic cells is likely to contribute to MTC genesis and progression.

Highlights

  • Different pathogenic germline mutations in the REarranged during Transfection (RET) oncogene are identified in multiple endocrine neoplasia type 2 (MEN 2), a hereditary syndrome characterized by medullary thyroid carcinoma (MTC) and other endocrine tumors

  • Our analysis showed the presence of a higher number of copies of the RET gene and hinted for a retrocopy insertion in MTC carcinoma cell lines and MTC tumor tissues, which are lacking in patient-matched blood and normal thyroid samples

  • Assessing somatic RET amplification through MLPA-based analysis In search of duplication events in the RET gene that could be related to MTC pathogenesis, we performed a Multiplex ligation-dependent probe amplification analysis

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Summary

Introduction

Different pathogenic germline mutations in the RET oncogene are identified in MEN 2, a hereditary syndrome characterized by medullary thyroid carcinoma (MTC) and other endocrine tumors. It has been suggested that a single germline mutation might not be sufficient for development of MEN 2-associated tumors and a somatic biallelic alteration might be required. We investigated the presence of somatic second hit mutation in the RET gene in MTC. MTC can occur in sporadic or hereditary forms. Sporadic MTCs are usually unilateral, characterized by the absence of familial history and not associated with other endocrinopathies [1, 2]. The hereditary form occurs as a part of the multiple endocrine neoplasia type 2 (MEN 2), an autosomal dominantly inherited cancer syndrome. MEN 2A and MEN 2B are characterized by the presence MTC, pheochromocytoma (PHEO) and additional endocrinopathies [1]

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