SMAD4变异及其基因型-表型与青少年多重症综合征的相关性
Kimberley Cao1,2, John-Paul Plazzer3, Finlay Macrae3,4
1Department of Colorectal Medicine and Genetics, The Royal Melbourne Hospital, Parkville, VIC, Australia. kimberley.cao@mh.org.au.
Hereditary cancer in clinical practice
|December 9, 2023
概括
与SMAD4基因变异相关的青少年多发症综合征 (JPS),特别是在MH2区域,表明胃肠癌和结肠外表现的风险更高. 早期和频繁的内镜查对受影响的个体至关重要.
科学领域:
- 遗传学 遗传学 是一个
- 在瘤学瘤学.
- 胃肠病学 胃肠病学
背景情况:
- 青少年多发症综合征 (JPS) 是一种罕见的自体主导性疾病,具有显著的终身癌症风险.
- 在SMAD4或BMPR1A基因中引起疾病的变异 (DCV) 占JPS病例的40-60%,SMAD4变异存在于20-30%.
研究的目的:
- 在JPS中对SMAD4变异的基因型-表型相关性进行表征.
- 为SMAD4变异的JPS患者提供诊断,查和管理策略的信息.
主要方法:
- 在线数据库的系统文献审查 (Ovid MEDLINE,Embase,PubMed).
- 包括110篇文章,对291个SMAD4变体的数据进行整理.
- 对变异部位和类型的分析,以与JPS表型相关联.
主要成果:
- 在JPS患者中,大多数SMAD4变异都位于MH2域内或周围.
- SMAD4变异与结肠外参与,巨大的胃多重症和侵略性表型有关,增加了肠道癌症的风险.
- 诸如遗传性出血端膜炎 (HHT) 和迈尔综合征等等位基性疾病共享SMAD4 MH2变异;心脏病理与MH1域变异有关.
结论:
- 在SMAD4 MH2区域中,截断和误解变异是常见的和致病的,需要保持警的监测.
- 由于胃肠道癌症风险较高和结肠外多症,SMAD4+ JPS 患者需要更早,更频繁的内镜查.
- 建议SMAD4+ JPS患者考虑Ménétrier病并评估HHT和其他肠外表现.
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