Les tumeurs corticosurrénaliennes unilatérales sont fréquentes (prévalence de 2 à 9% de la population). Il s’agit le plus souvent d’adénomes. Le cancer de la corticosurrénale, ou corticosurrénalome, a un pronostic sombre, la survie ne dépassant pas 40 % à cinq ans. Le diagnostic de malignité de ces tumeurs, actuellement basé sur l’histologie, peut être difficile. Le pronostic des corticosurrénalomes est hétérogène et peu prévisible. Enfin, la prise en charge thérapeutique est encore limitée. Ces difficultés diagnostiques, pronostiques et thérapeutiques s’expliquent entre autres par la connaissance limitée de la physiopathologie de ce cancer. Le génome a un rôle central dans le développement des cancers en général. La survenue d’altérations génomiques (mutations, anomalies de nombre de copies, pertes d’hétérozygotie, translocations, anomalies de méthylation) va aboutir à la surexpression d’oncogènes et à la répression de gènes suppresseurs de tumeurs. La génomique, en ouvrant la voie à la caractérisation moléculaire à l’échelle du génome entier des tumeurs, est devenue incontournable pour étudier la physiopathologie des cancers. Les études de transcriptome des tumeurs corticosurrénaliennes ont montré que le profil d’expression génique discrimine adénomes et corticosurrénalomes, et identifie deux groupes distincts de corticosurrénalomes avec des pronostics différents. Dans le sillage de ces travaux précédemment réalisés par l’équipe, je me suis intéressée pendant ma thèse aux anomalies de nombres de copies d'ADN et aux anomalies de méthylation des corticosurrénalomes. Dans une première partie j’ai étudié le génome de 38 adénomes et 21 corticosurrénalomes par puce d’hybridation génomique comparative (puces CGH). Le transcriptome de 54 de ces tumeurs était déjà disponible. Le génome des corticosurrénalomes est très altéré contrairement à celui des adénomes (44% du génome est perdu ou gagné, versus 10% pour les adénomes, p=2.10-10). Dans les adénomes, la région 9q34 (locus de SF-1) est fréquemment gagnée et ce gain est associé à une surexpression de SF-1. Pour les corticosurrénalomes, les évènements récurrents concernent les gains des chromosomes 5, 7, 12, 16, 19, 20 et les pertes des chromosomes 13 et 22. Les gènes situés dans les régions minimales communes gagnées ou perdues ont été filtrés en fonction de leur expression. La liste des gènes à la fois gagnés et surexprimés inclut des oncogènes comme FGFR4, CDK4, CCNE1 ; et la liste des gènes avec perte de matériel et sous-expression inclut des gènes suppresseurs de tumeurs (LATS2, ST13). Un outil diagnostique basé sur la mesure en PCR quantitative de 6 loci permet de séparer les corticosurrénalomes des adénomes dans une cohorte de validation indépendante de 79 tumeurs, avec une sensibilité de 100% et une spécificité de 83%. Le nombre d’altérations chromosomiques n’a pas de valeur pronostique, mais une technique de classification hiérarchique non supervisée permet de séparer les corticosurrénalomes en deux groupes de pronostic différent, et a été validée sur une cohorte indépendante de 25 tumeurs. Dans une deuxième partie, j’ai étudié les anomalies de méthylation des promoteurs des gènes de 51 corticosurrénalomes et 81 adénomes par puce Infinium HumanMethylation27 (Illumina). Les données d’expression étaient disponibles pour 87 tumeurs. Les corticosurrénalomes sont globalement hyperméthylés par rapport aux adénomes. La classification hiérarchique non supervisée sépare les corticosurrénalomes en 3 groupes : un groupe non-hyperméthylé, un groupe modérément hyperméthylé, et un autre très hyperméthylé. Cette classification a été confirmée par MS-MLPA. L’hyperméthylation est associée à un mauvais pronostic (p=0,02 en modèle de Cox). La corrélation entre niveau de méthylation et expression identifie 1741 gènes (sur les 12250 étudiés) corrélés négativement (…) / Unilateral adrenocortical tumors are common (prevalence : 2 to 9% of the population). Most of these tumors are adenomas. Adrenocortical cancer (ACC) has a poor prognosis, with a 5-yr survival rate not exceeding 40% in most series. Pathological diagnosis of these tumors relies on several histological features and can be difficult. The prognosis of adrenocortical carcinomas is heterogeneous and unpredictable. Knowledge of the pathophysiology of these tumors is also limited. The genome has a central role in the development of cancers in general. The occurrence of genomic alterations (mutations, abnormal copy number, loss of heterozygosity, translocations, abnormal methylation) will lead to the overexpression of oncogenes and repression of tumor suppressor genes. Genomic approaches became essential to study the pathophysiology of cancer. Transcriptome studies of adrenocortical tumors have shown that the gene expression profile discriminate ACC and adenomas, and identified two distinct groups of ACC with different prognoses. In addition to gene expression, genomics now covers a large spectrum of alterations, including chromosomal alterations, DNA sequence modifications, and epigenetic alterations. I studied chromosomal alterations and DNA methylation abnormalities in ACC during my thesis.In the first part the genome of 38 adrenocortical adenomas and 21 ACC were identified by comparative genomic hybridization arrays. The transcriptome of 54 of these tumors was already available. A larger proportion of the genome is altered in carcinomas compared with adenomas (44 % of the genome is lost or gained, versus 10% for adenomas , p = 2.10-10 ) . In adenomas, the 9q34 region, which includes the steroidogenic factor 1locus, is commonly gained and associated with an overexpression of steroidogenic factor 1 (SF-1).In carcinomas, recurrent gains include chromosomes 5, 7, 12, 16, 19, and 20 and recurrent losses chromosomes 13 and 22. Filtering the genes from these regions according to their expression profile identified genes potentially relevant to adrenocortical tumorigenesis. A diagnostic tool was built by combining DNA copy number estimates at six loci (5q, 7p, 11p, 13q, 16q, and 22q). This tool discriminates carcinomas from adenomas in an independent validation cohort (sensitivity 100%, specificity 83%). In carcinomas, the number of chromosomal alterations was not associated with survival (Cox p=0.84). A prognostic tool based on tumor DNA was designed with a clustering strategy and validated in an independent cohort. In the second part, methylation patterns of CpG islands in promoter regions of 51 adrenocortical carcinomas and 84 adenomas were studied by the Infinium HumanMethylation27 Beadchip (Illumina) . Gene expression data were available for 87 tumors. Methylation was higher in carcinomas than in adenomas (t test : p=3.1x10-9). Unsupervised clustering of DNA methylation profiles identified two groups of carcinomas, one with an elevated methylation level, evoking a CpG island methylator phenotype (CIMP). The subgroup of hypermethylated carcinomas was further divided in two subgroups, with different levels of methylation (CIMP-high and CIMP-low). This classification could be confirmed by methylation-specific multiplex ligation-dependent probe amplification. Hypermethylation was associated with a poor survival (Cox model p= 0.02). The transcriptome/methylation correlation showed 1741 genes (of 12250) negatively correlated; among the top genes were H19 and other tumor suppressors (PLAGL-1, G0S2, and NDRG2). The subgroups identified by the transcriptome adrenocortical have different levels of methylation. In conclusion, genomic alterations discriminate carcinomas from adenomas and contain prognostic information. The subgroups identified by the adrenocortical transcriptome profiles of different genomic alterations. Chromosomal alterations and abnormal methylation alter the expression of genes important for tumorigenesis.

Orientador: Danilo Moretti-Ferreira / Resumo: As ACs são alterações visíveis nos cromossomos, classificadas como numéricas e estruturais. Atualmente o grande desafio da genética clínica é classificar e associar a relevância clínica dos desequilíbrios genéticos ao fenótipo dos portadores. O trabalho tem como objetivo principal caracterizar desequilíbrio genômico sem diagnóstico sindrômico previamente descritos pelas técnicas de citogenética clássica, molecular visando apurar os pontos de quebras e genes inseridos na região cromossômica alterada por meio da citogenômica em estudos de casos. Foram feitas análises por citogenética (bandamento GTG), citogenética molecular (FISH) e citogenômica (array-CGH) em três pacientes com malformações congênitas não-sindrômicas para definição diagnóstica e maior conhecimento sobre a correlação genótipo-fenótipo. Foram redigidos estudos de casos de três pacientes portadores de MCs, atraso do desenvolvimento e deficiência intelectual. O primeiro copilado de caso trata-se de paciente do sexo feminino com anomalias esqueléticas, deficiência intelectual e atraso do desenvolvimento. O cariótipo da paciente é 46,XX[11]/47,XX,+mar[9]. A análise de array-CGH revelou dois ganhos/duplicações nas bandas cromossômicas 6p11.2q12 (10.335 Mb de tamanho) e 6q14.1q14.3 (10.765 Mb de tamanho). Por meio da técnica da FISH e os resultados do array-CGH a região duplicada 6q14.1q14.3 encontra-se inserida em um cromossomo marcador, oriundo do cromossomo 6. Os sinais clínicos descritos na paciente foram semelhan... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: The ACs are visible changes in the chromosomes, classified as numerical and structural. Currently the great challenge of clinical genetics is to classify and associate the clinical relevance of genetic imbalances with the phenotype of the carriers. The main objective of this work is to characterize genomic imbalance without syndromic diagnosis previously described by the classical and molecular cytogenetic techniques, in order to determine the breakpoints and genes inserted in the chromosomal region altered by cytogenetics in case studies. Cytogenetics (GTG banding), molecular cytogenetics (FISH) and cytogenetics (array-CGH) were performed in three patients with non-syndromic congenital malformations for diagnostic definition and greater knowledge on genotype-phenotype correlation. Case studies of three patients with MCs, developmental delay and intellectual disability were written. The first case file is a female patient with skeletal anomalies, intellectual disability and developmental delay. The patient's karyotype is 46, XX [11] / 47, XX, + sea [9]. The array-CGH analysis revealed two gains / doublings in the chromosomal bands 6p11.2q12 (10,335 Mb in size) and 6q14.1q14.3 (10,765 Mb in size). Through the FISH technique and the results of the array-CGH the duplicate region 6q14.1q14.3 is inserted in a chromosome marker, coming from chromosome 6. The clinical signs described in the patient were similar to other patients with duplication of the region 6q14. The genes PGM3, M... (Complete abstract click electronic access below) / Mestre

Orientador: Lucilene Arilho Ribeiro-Bicudo / Resumo: As cardiopatias congênitas (CCs) podem ser definidas como qualquer anormalidade na estrutura e/ou na função cardiocirculatória presente ao nascimento. Constituem as malformações congênitas mais comuns entre recém-nascidos vivos, podendo se apresentar de duas formas: isoladas (ou não sindrômicas) e sindrômicas. De caráter multifatorial, o surgimento de CCs envolve fatores ambientais, genéticos e epigenéticos. A etiologia genética de CCs ainda é pouco conhecida. Entre as causas genéticas conhecidas, podemos destacar: aneuploidias, alterações na estrutura dos cromossomos, desequilíbrios citogenômicos (perdas e ganhos genômicos ou variações no número de cópias genômicas – CNVs), mutações pontuais, variações em um único nucleotídeo, entre outras. Dentre essas, as CNVs contribuem com aproximadamente 10% na etiologia genética de CCs não sindrômicas, e cerca de 20% entre as sindrômicas. O objetivo deste trabalho foi investigar possíveis desequilíbrios citogenômicos em pacientes diagnosticados com CCs sindrômicas e não sindrômicas idiopáticas. Foram recrutados 31 pacientes, sendo 13 sindrômicos e 18 não sindrômicos. Todos foram submetidos à avaliação genético-clínica. As amostras foram coletadas a partir do sangue periférico, e realizou-se o cariótipo convencional para todos os sindrômicos. A análise por MLPA foi realizada em 27 pacientes. O DNA genômico dos pacientes sindrômicos selecionados foi submetido a duas plataformas de CMA (array-CGH/SNP arrays): SNP-array 850K HumanCytoSNP (... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Congenital heart defects (CHD) can be defined as any abnormality in the structure and /or cardiocirculatory function present at birth. Congenital malformations are more common among live newborns. CHD can be presented at two forms: isolated (or non syndromic) and syndromic ones. Of multifactorial spectrum, the emergence of CHD involves environmental, genetic and epigenetic factors. The genetic etiology of CHD is still poorly understood. Among the known genetic causes, we can highlight: aneuploidies, changes in chromosome structure, cytogenetic imbalances (losses and genomic gains, can be also called copy number variations - CNVs), point mutations, variants in a single nucleotide, among others. Among these, CNVs contribute to approximately 10% in the genetic etiology of non-syndromic CHD, and about 20% among syndromic ones. The aim of this study was to investigate possible cytogenetic imbalances in patients diagnosed with idiopathic syndromic and non-syndromic CHD. Thirty one patients were recruited, of which 13 syndromic and 18 non-syndromic. Each patient were submitted to genetic-clinical evaluation. Only patients with an undefined syndromic condition were included in cytogenetic investigations. Samples were collected from the peripheral blood, and the conventional karyotype was performed for all syndromic patients. MLPA analysis was performed in 27 patients. The genomic DNA of the selected patients was analyzed into two CMA (array-CGH / SNP arrays) platforms: SNP-array 850K... (Complete abstract click electronic access below) / Mestre

Submitted by Edineia Teixeira (edineia.teixeira@unioeste.br) on 2018-04-24T14:44:00Z No. of bitstreams: 2 Marcos_Cochak2017.pdf: 1598683 bytes, checksum: e921541055d1b3f686918cb26de4db2d (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Made available in DSpace on 2018-04-24T14:44:00Z (GMT). No. of bitstreams: 2 Marcos_Cochak2017.pdf: 1598683 bytes, checksum: e921541055d1b3f686918cb26de4db2d (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Previous issue date: 2017-07-28 / population, responsible for spontaneous abortions, problems related to infertility, and a large number of congenital anomalies that cause psychosocial and economic impact in families and also in the health system. They are present in about 1% of the liveborn, 2% of the conceptions known in women over the age of 35 years and almost all the abortions occurred in the first trimester of gestation. These anomalies involve changes in the set or structure of the chromosomes and are referred to as syndromes, such as Down syndrome or trisomy 21 is the best known, corresponding to the fourth most frequent cause of congenital anomalies. Chromosomal changes may be inherited or de novo originated, having biological influence or associated with environmental factors such as exposure to physical and chemical agents such as industrial wastes and agrochemicals. Diagnosis is made through karyotype analysis, and their knowledge is the basis for subsequent clinical treatment, prognosis, and risk-of-recurrence data for genetic counseling. Thus, the objective of this research was to analyze, through a retrospective study, human chromosomal disorders from regions of Brazil in the period of ten years (2005 to 2015), and correlates them with the use and occupation of soil through MaxEnt (maximum entropy) a predictive model for evaluation of association of occurrence of cases of chromosomal alterations as a function of soil use and occupation. In order to do so, a documentary study was carried out in the karyotype database of samples sent to the cytogenetic study of a national clinical laboratory. Of the 43,672 karyotype results, 83% (n= 36,435) were normal, 52% (n= 18,946) female and 48% (n= 17,489) male. Karyotypes with chromosomal abnormalities were found in 17% (n= 7,237), where 52% (n= 3763) female and 48% (n= 34740) male, were the most frequent aneuploidies (77% 5.558), structural changes totaled 16% (n = 1,163) and concomitant numerical and structural changes 7% (n= 516). 79.2% of the alterations involved autosomal chromosomes and 20.3% sex chromosomes, and 0.48% involved both autosomal and sexual. Among the altered cases, 9% (n= 668) were detected in mosaic. Characterizing chromosomal diseases by regions of Brazil, the highest proportion was in the South region, with 6 cases changed/100,000 inhabitants, followed by the Midwest and North regions, with 4 cases/100,000 inhabitants. The Northeast and Southeast regions presented the lowest proportions (3 cases changed/100,000 inhabitants and 2 altered cases/100,000 inhabitants respectively). When characterizing chromosomal diseases by regions of Brazil, it was possible to observe that in absolute numbers the highest frequencies occurred in the North and Northeast regions. Structural autosomal alterations were more frequent in the Southeast region, and numerical and structural concomitants were more frequent in the Northern region. Changes in mosaics were more frequent in the South, Northeast and Center-West regions, and those of single lineage were significantly more frequent in the Southeast region. Regarding land use and occupation, urbanized areas had a higher probability of occurrence of chromosomal diseases (50 to 90%), followed by areas using permanent crops (40 to 50%). This research demonstrates the prevalence of chromosomal diseases and their geographic distributions in Brazil being of great value, since studies of this genre are scarce in Brazil and, can serve as a tool to identify the incidence and recurrence risk of chromosomal diseases, enabling genetic counseling and information for the elaboration of public policies that improve the patients quality of life. / As alterações cromossômicas são doenças genéticas representativas na população, responsáveis por abortamentos espontâneos, problemas relacionados à infertilidade e grande número de anomalias congênitas, que causam impacto psicossocial e econômico nas famílias e no sistema de saúde. Estão presentes em cerca de 1% dos nativivos, 2% das concepções conhecidas em mulheres com idade acima de 35 anos e quase a totalidade dos abortos ocorridos no primeiro trimestre de gestação. Estas anomalias envolvem alterações no conjunto ou estrutura dos cromossomos e são denominadas como síndromes, dentre elas a de Down, ou trissomia do 21, é a mais conhecida, correspondendo à quarta causa mais frequente de anomalias congênitas. As alterações cromossômicas podem ser herdadas ou originadas de novo, tendo influência biológica ou associadas a fatores ambientais, como a exposição a agentes físicos e químicos, como os resíduos industriais e agrotóxicos. O diagnóstico é feito através da análise do cariótipo, e o seu conhecimento é a base para o tratamento clínico subsequente, prognóstico e dados sobre o risco de recorrência para o aconselhamento genético. Assim, o objetivo desta pesquisa foi analisar através de estudo retrospectivo as cromossomopatias humanas oriundas de regiões brasileiras no período de dez anos (2005 a 2015), e correlacioná-las com o uso e ocupação de solo através do programa MaxEnt (máxima entropia), um modelo preditivo para avaliação de associação de ocorrência de casos em função do uso e ocupação do solo. Para tanto, foi realizado um estudo documental, no banco de dados dos resultados de cariótipos, de amostras enviadas para o estudo citogenético de um laboratório clínico de abrangência nacional. Dos 43.672 resultados de cariótipo, 83% (n=36.435) foi normal, sendo 52% (n=18.946) do sexo feminino e 48% (n=17.489) masculino. Cariótipos com alterações cromossômicas foram encontradas em 17% (n=7.237), onde 52% (n=3763) do sexo feminino e 48% (n=3474) do sexo masculino, sendo as aneuploidias as mais frequentes (77%; n=5.558). As alterações estruturais somaram 16% (n=1.163) e alterações numéricas e estruturais concomitantes, 7% (n=516). Das alterações, 79.2% envolvia cromossomos autossômicos, 20,3% cromossomos sexuais e 0,48% envolvia ambos autossômicos e sexuais. Dentre os casos alterados, 9% (n=663) foi detectado em mosaico. Caracterizando as cromossomopatias por regiões do Brasil, a maior proporção de alterações por habitantes foi na região Sul, com 6/100.000, seguida pelas regiões Centro-Oeste e Norte, com 4/100.000. As regiões Nordeste e Sudeste apresentaram as menores proporções, 3/100.000 e 2/100.000, respectivamente. Ao caracterizar as frequências por regiões do Brasil, foi possível observar que em número absoluto, as maiores ocorreram nas regiões Norte e Nordeste. As alterações autossômicas estruturais na região Sudeste, e numéricas e estruturais concomitantes na região Norte. Alterações em mosaicos foram mais frequentes nas regiões Sul, Nordeste e Centro-Oeste e as de linhagem única foram mais significativamente na região Sudeste. Em relação ao uso e ocupação de solo, as áreas urbanizadas apresentaram uma maior probabilidade de ocorrência de cromossomopatias (50 a 90%), e seguida por áreas de lavouras permanentes (40 a 50%). Esta pesquisa demonstra as prevalências das alterações cromossômicas e suas distribuições geográficas no Brasil sendo de grande valia, pois estudos deste gênero são escassos no País e, poderão servir de ferramenta para identificar o risco de incidência e recorrência de doenças cromossômicas, possibilitando o aconselhamento genético e informações para a elaboração de políticas públicas que melhorem a qualidade de vida dos pacientes.

Le carcinome médullaire de la thyroïde (CMT) est une tumeur neuroendocrine rare, se développant à partir des cellules sécrétant la calcitonine. Cette tumeur survient dans un contexte familial dans un tiers des cas. Toutes les formes germinales et près de 40% des formes sporadiques sont causées par une mutation ponctuelle activatrice de l’oncogène RET, codant pour un récepteur membranaire à activité tyrosine kinase. Les événements oncogéniques à l’origine des formes sporadiques non mutées RET restent mal définis, à l’exception de mutations activatrices des oncogènes RAS découvertes récemment.Le pronostic péjoratif du CMT est essentiellement lié à un envahissement ganglionnaire précoce. A ce titre, la chirurgie initiale est souvent insuffisante et les formes métastatiques ont longtemps été considérées en impasse thérapeutique. L’avènement récent des inhibiteurs séléctifs de tyrosine kinases (ITK) a apporté un nouvel élan à la prise en charge des tumeurs réfractaires, certains d’entre eux incluant dans leur spectre d’action le récepteur RET. Mais l’optimisation de ces traitements requiert une connaissance préalable des mécanismes moléculaires sous-jacents au développement tumoral.Dans ce contexte et en nous appuyant sur une collection importante de prélèvements humains, nous avons cherché à approfondir la decription du ‘paysage génomique’ du CMT.Dans un premier temps, nous avons évalué les anomalies structurales ponctuelles et chromosomiques présentées par les CMT. Nous avons montré, par optimisation de méthodes de séquençage, que les mutations des gènes RET et RAS interviennent dans plus de 96% des cas et que ces évènements sont mutuellement exclusifs. Ces mutations permettent de distinguer plusieurs groupes d’agressivité et de réponse aux traitements par ITK. Nous avons également observé - par technique d’hybridation génomique comparative - des anomalies de grande ampleur récurrentes dans cette pathologie : les délétions du bras court du chromosome 1 et des chromosomes entiers 4 et 22 apparaissent comme étant des évènements précoces et indépendants de la tumorigenèse du CMT.Dans un second temps, nous avons déterminé - par approche de type biopuce - les profils d’expression de microARN dans les CMT. Certains de ces régulateurs post-transcriptionnels majeurs semblent liés au caractère invasif de la tumeur, et notamment les miR-21, miR-199 et miR-129. Nous avons également démontré le potentiel d’utilisation des microARN miR-21 et miR-199 en tant que biomarqueurs circulants du CMT. L’impact fonctionnel des formes précurseurs mir-21 et mir-129 a ensuite été évalué par transfection dans les modèles cellulaires TT et MZ-CRC1.Les observations ainsi obtenues offrent de nombreuses perspectives d’études. Elles permettent la définition de marqueurs tissulaires distinguant a priori les tumeurs métastatiques et/ou réfractaires aux thérapies. Enfin, elles mettent en lumière de nouvelles pistes pour la découverte de cibles thérapeutiques additionnelles dans cette pathologie. / Medullary thyroid carcinoma (MTC) is a rare neuroendocrine tumor, arising from calcitonin-secreting cells. This cancer occurs in a family context in a third of cases. All inherited forms and nearly 40% of sporadic forms are caused by activating point-mutations in the RET oncogene, coding for a tyrosine-kinase receptor. Other oncogenic events causing sporadic cases remain unclear, but activating mutations of RAS oncogenes have been discovered recently.Prognosis of MTC is essentially linked to early lymph node occurrence. Initial surgery of metastatic forms is often insufficient and patients are considered in therapeutic dead-end. The recent advent of selective tyrosine-kinase inhibitors (TKIs) has brought a new impetus to the management of refractory tumors, some of them targeting the RET receptor. Optimization of these treatments require improving knowledge of the underlying molecular mechanisms of tumor development.In this context and helped by a large collection of human specimens, we have sought to deepen the description of genomic landscape of MTC.At first, we evaluated the structural and chromosomal abnormalities presented by MTC. We showed, by optimizing sequencing methods, that RET and RAS mutations are involved in over 96% of the cases, these events are mutually exclusives. These mutations can distinguish several groups of aggressiveness and of response to TKI treatments. We also observed, by comparative genomic hybridization techniques, recurrent abnormalities such as deletion of the short arm of chromosome 1 and loss of entire chromosomes 4 and 22. These losses appear to be early events of tumorigenesis MTC.In a second step, we determined - by a microarray approach – the microRNA expression profile of MTC. Some of these post-transcriptional regulators seem related to tumor invasiveness, such as miR-21, miR-199 and miR-129. We demonstrated the potential of microRNAs miR-21 and miR-199 as circulating diagnosis biomarkers of MTC. The functional impact of the precursor forms mir-21 and mir-129 was then evaluated by transfection in TT and MZ- CRC1 cellular models.Observations obtained pave the way for a lot of new potential studies. They allow the definition of tissue biomarkers distinguishing metastatic forms or refractory patients. Finally, they highlight new pathways for the discovery of additional therapeutic targets in this disease.