title: Predicting the risk of multiple endocrine neoplasia type 1 for patients with commonly occurring endocrine tumors.
abstract: OBJECTIVE
  Endocrine diseases that can be part of the rare inheritable syndrome multiple endocrine neoplasia type 1 (MEN1) commonly occur in the general population. Patients at risk for MEN1, and consequently their families, must be identified to prevent morbidity through periodic screening for the detection and treatment of manifestations in an early stage. The aim of the study was to develop a model for predicting MEN1 in individual patients with sporadically occurring endocrine tumors.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  In a nationwide study in The Netherlands, patients with sporadically occurring endocrine tumors in whom the referring physician suspected the MEN1 syndrome were identified between 1998 and 2011 (n=365). Logistic regression analysis with internal validation using bootstrapping and external validation with a cohort from Sweden was used.
  
  
  RESULTS
  A MEN1 mutation was found in 15.9% of 365 patients. Recurrent primary hyperparathyroidism (pHPT; odds ratio (OR) 162.40); nonrecurrent pHPT (OR 25.78); pancreatic neuroendocrine tumors (pNETs) and duodenal NETs (OR 17.94); pituitary tumor (OR 4.71); NET of stomach, thymus, or bronchus (OR 25.84); positive family history of NET (OR 4.53); and age (OR 0.96) predicted MEN1. The c-statistic of the prediction model was 0.86 (95% confidence interval (95% CI) 0.81-0.90) in the derivation cohort and 0.77 (95% CI 0.66-0.88) in the validation cohort.
  
  
  CONCLUSIONS
  With the prediction model, the risk of MEN1 can be calculated in patients suspected for MEN1 with sporadically occurring endocrine tumors.
authors.affiliation: Department of Internal Medicine, L00.408, University Medical Center Utrecht, PO Box 85500, 3508 GA Utrecht, The Netherlands.
authors.forename: Joanne M
authors.initials: JM
authors.lastname: de Laat
authors.forename: Emma
authors.initials: E
authors.lastname: Tham
authors.forename: Carolina R C
authors.initials: CR
authors.lastname: Pieterman
authors.forename: Menno R
authors.initials: MR
authors.lastname: Vriens
authors.forename: Johannes A N
authors.initials: JA
authors.lastname: Dorresteijn
authors.forename: Michiel L
authors.initials: ML
authors.lastname: Bots
authors.forename: Magnus
authors.initials: M
authors.lastname: Nordenskjöld
authors.forename: Rob B
authors.initials: RB
authors.lastname: van der Luijt
authors.forename: Gerlof D
authors.initials: GD
authors.lastname: Valk
mesh_terms: D000236:Adenoma / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology; D000328:Adult; D000465:Algorithms; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D003718:Denmark / Q000453:epidemiology; D004701:Endocrine Gland Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D018761:Multiple Endocrine Neoplasia Type 1 / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D018358:Neuroendocrine Tumors / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology; D011379:Prognosis; D012307:Risk Factors; D013548:Sweden / Q000453:epidemiology; D054928:Validation Studies as Topic