TERT-Promotor-Mutation (C228T / C250T)
Deterministische Ansicht der Quelle YAML Entität. Klinische Autorität bleibt mit den zitierten Quell-IDs und Rezensenten Sign-off Zustand.
| ID | BIO-TERT |
|---|---|
| Art | Biomarker |
| Aliase | TERT-Promotor-MutationМутація промотора TERT (C228T / C250T) |
| Status | reviewed 2026-05-04 | pending_clinical_signoff |
| Erkrankungen | DIS-GBM DIS-THYROID-PAPILLARY |
| Quellen | SRC-ATA-THYROID-2015 SRC-NCCN-CNS-2025 SRC-NCCN-THYROID-2025 |
Biomarker-Fakten
| Biomarker-Typ | gene_mutation |
|---|---|
| Angaben zur Mutation | {"exon": "promoter region (non-coding; chr5:1,295,228 C>T and chr5:1,295,250 C>T)", "functional_impact": "activating", "gene": "TERT", "variant_type": "promoter gain-of-function mutation (creates de novo ETS transcription factor binding sites)"} |
| Messung | VerfahrenTumor-NGS (muss TERT-Promotor abdecken — nicht in allen Standard-Exome-Panels enthalten; erfordert spezifisches Design) oder spezielle Sanger/ddPCR-Test |
| Nachschlagewerk für die Aktionsfähigkeit | {"gene": "TERT", "variant": "promoter_mutation"} |
| Verwandte Biomarker | BIO-BRAF-V600E BIO-CDKN2A |
Anmerkungen
TERT (Telomerase Reverse Transcriptase) is the catalytic subunit of telomerase. TERT promoter mutations (C228T or C250T, by chr5 coordinates) create de novo ETS family transcription factor binding sites, increasing TERT transcription and telomerase activity, extending cellular lifespan and enabling replicative immortality. Key clinical contexts: (1) Papillary thyroid cancer (PTC): TERT promoter mutations (~10–15% of PTC) are adverse prognostic markers, particularly when co-occurring with BRAF V600E (~8–12% of PTC). BRAF V600E + TERT promoter → mortality risk ~40× vs wild-type (Xing et al. NEJM 2014); this combination stratifies high-risk PTC requiring aggressive RAI and surveillance. (2) Follicular thyroid cancer: TERT mutations in ~15–20%. (3) GBM: TERT promoter mutations in ~70–80% (often co-occurring with EGFR amplification or IDH wild-type — defines molecular IDH-wild-type GBM). TERT mutation in IDH-wild-type astrocytoma with EGFR amplification or +7/-10 → WHO grade 4 GBM (CNS WHO 2021). (4) Oligodendroglioma: IDH mutation + 1p/19q codeletion + TERT mutation = canonical molecular definition of oligodendroglioma (WHO CNS 5th ed). (5) Bladder cancer: TERT promoter mutations in ~...
Verwendet von
Therapeutische Relevanz
BMA-TERT-GLIOMA- TERT-Promotormutationen stehen im Mittelpunkt der Tumorklassifikation des WHO-ZNS (2021 5. Auflage): (...BMA-TERT-THYROID- TERT-Promotor-Mutationen (C228T oder C250T) treten bei ~10–15% des papillaren Schilddrüsenkrebses (PT...
Biomarker
BIO-1P19Q-CODELETION- 1p/19q CodeletionBIO-ATRX-MUTATION- ATRX-Mutation / ATRX-Verlust (IHC)