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Mutation Analysis of Glial Cell Line-Derived Neurotrophic Factor, a Ligand for an RET/Coreceptor Complex, in Multiple Endocrine Neoplasia Type 2 and Sporadic Neuroendocrine Tumors

Department of Adult Oncology (D.J.M., Z.Z., B.J.R., G.I.S., C.E.) and Human Cancer Genetics Unit (D.J.M., Z.Z., C.E.), Dana-Farber Cancer Institute, Department of Medicine (D.J.M., Z.Z., A.A., B.J.R., G.I.S., C.E.), Harvard Medical School, Boston, MA; Laboratory of Endocrine Oncology (A.A.), Massachusetts General Hospital, Boston, MA; Molecular Genetics Laboratory, Kolling Institute for Medical Research (S.D.A., D.L., B.G.R.), Royal North Shore Hospital, University of Sydney, St. Leonards, New South Wales, Australia; Department of Surgery (A.F.), Eppendorf University of Hamburg, Hamburg, Germany; Department of Pathology (P.K.), University of Zurich, Zurich, Switzerland; Division of Nephrology (H.P.H.N.), Department of Internal Medicine IV, Albert-Ludwigs University of Freiburg, Freiburg, Germany; CRC Human Cancer Genetics Research Group (B.A.J.P.), University of Cambridge, Cambridge, UK; and Departments of Pathology and Paediatrics (L.M.M.), Queen’s University, Kingston, Ontario, Canada

Address all correspondence and requests for reprints to: Charis Eng, Dana-Farber Cancer Institute, 44 Binney Street, Boston, Massachusetts 02115-6084.

Causative germline missense mutations in the RET proto-oncogene have been associated with over 92% of families with the inherited cancer syndrome multiple endocrine neoplasia type 2 (MEN 2). MEN 2A is characterized primarily by medullary thyroid carcinoma (MTC) and pheochromocytoma, both tumors of neural crest origin. Parathyroid hyperplasia or adenoma is also seen in MEN 2A, but rarely in MEN 2B, which has additional stigmata, including a marfanoid habitus, mucosal neuromas, and ganglioneuromatosis of the gastrointestinal tract. In familial MTC, MTC is the only lesion present. Somatic RET mutations have also been identified in a subset of sporadic MTCs, pheochromocytomas, and rarely, small cell lung cancer, but not in sporadic parathyroid hyperplasias/adenomas or other neuroendocrine tumors. Glial cell line-derived neurotrophic factor (GDNF) and its receptor molecule GDNFR-, have recently been identified as members of the RET ligand binding complex. Therefore, the genes encoding both GDNF and GDNFR- are excellent candidates for a role in the pathogenesis of those MEN 2 families and sporadic neuroendocrine tumors without RET mutations. No mutations were found in the coding region of GDNF in DNA samples from 9 RET mutation negative MEN 2 individuals (comprising 6 distinct families), 12 sporadic MTCs, 17 sporadic cases of parathyroid adenoma, and 10 small cell lung cancer cell lines. Therefore, we find no evidence that mutation within the coding regions of GDNF plays a role in the genesis of MEN 2 and sporadic neuroendocrine tumors.

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