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检测和分析黑斑息肉病综合征中的常见致病种系突变。

Detection and analysis of common pathogenic germline mutations in Peutz-Jeghers syndrome.

机构信息

Department of General Surgery, Air Force Medical Center, Chinese People's Liberation Army, Beijing 100142, China.

Department of Medical Oncology, Cancer Institute, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang Province, China.

出版信息

World J Gastroenterol. 2021 Oct 21;27(39):6631-6646. doi: 10.3748/wjg.v27.i39.6631.

Abstract

BACKGROUND

Different types of pathogenic mutations may produce different clinical phenotypes, but a correlation between Peutz-Jeghers syndrome (PJS) genotype and clinical phenotype has not been found. Not all patients with PJS have detectable mutations of the gene, what is the genetic basis of clinical phenotypic heterogeneity of PJS? Do PJS cases without mutations have other pathogenic genes? Those are clinical problems that perplex doctors.

AIM

The aim was to investigate the specific gene mutation of PJS, and the correlation between the genotype and clinical phenotype of PJS.

METHODS

A total of 24 patients with PJS admitted to the Air Force Medical Center, PLA (formerly the Air Force General Hospital, PLA) from November 1994 to January 2020 were randomly selected for inclusion in the study. One hundred thirty-nine common hereditary tumor-related genes including were screened and analyzed for pathogenic germline mutations by high-throughput next-generation sequencing (NGS). The mutation status of the genes and their relationship with clinical phenotypes of PJS were explored.

RESULTS

Twenty of the 24 PJS patients in this group (83.3%) had gene mutations, 90% of which were pathogenic mutations, and ten had new mutation sites. Pathogenic mutations in exon 7 of gene were significantly lower than in other exons. Truncation mutations are more common in exons 1 and 4 of , and their pathogenicity was significantly higher than that of missense mutations. We also found gene mutations in PJS patients.

CONCLUSION

PJS has a relatively complicated genetic background. Changes in the sites responsible for coding functional proteins in exon 1 and exon 4 of may be one of the main causes of PJS. Mutation of the gene may be a cause of genetic heterogeneity in PJS.

摘要

背景

不同类型的致病突变可能产生不同的临床表型,但尚未发现 Peutz-Jeghers 综合征(PJS)基因型与临床表型之间的相关性。并非所有 PJS 患者都可检测到 基因的突变,PJS 临床表型异质性的遗传基础是什么?没有 突变的 PJS 病例是否存在其他致病基因?这些都是困扰医生的临床问题。

目的

旨在探讨 PJS 的特定基因突变,以及 PJS 的基因型与临床表型之间的关系。

方法

随机选择 1994 年 11 月至 2020 年 1 月期间空军军医大学西京医院(原解放军空军总医院)收治的 24 例 PJS 患者纳入研究。通过高通量下一代测序(NGS)对包括 在内的 139 种常见遗传性肿瘤相关基因进行了致病性种系突变的筛选和分析。探讨了基因的突变状态及其与 PJS 临床表型的关系。

结果

该组 24 例 PJS 患者中有 20 例(83.3%)携带 基因的突变,其中 90%为致病性突变,并有 10 个新的突变位点。 基因外显子 7 中的致病性突变明显低于其他外显子。 基因外显子 1 和 4 的截断突变更为常见,其致病性明显高于错义突变。我们还在 PJS 患者中发现了 基因的突变。

结论

PJS 具有较为复杂的遗传背景。 基因外显子 1 和外显子 4 中负责编码功能蛋白的位点发生变化,可能是 PJS 的主要原因之一。 基因的突变可能是 PJS 遗传异质性的原因之一。

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