Henry Ford Hospital Medical Journal


Progress in understanding the single gene, cytogenetic, and multifactorial traits that predispose to human cancer suggests possible new directions for research in the multiple endocrine neoplasia (MEN) syndromes. Among the other 200 or so monogenic disorders associated with human neoplasia, advances have come from further delineation of syndromes by various clinical specialists, the recognition of subtypes of syndromes previously thought to be homogeneous, the search for in vitro manifestations of the mutant gene in fibroblasts, and the establishment of cell, tissue and patient registries and of voluntary lay organizations to serve as advocates for the disease. With regard to cytogenetics, the findings of 20p- and chromosomal fragility demand clarification. Because the age at tumor development varies in MEN, the influence of environment on the mutant gene (ecogenetics) deserves emphasis in future studies. There is a need to achieve a consensus on clinical care, especially the indications and timing of surgery, and to measure the frequency of the disease in the general population.