Peutz-Jeghers综合征的诊治进展和预防性治疗

Pathogenesis, diagnosis, and treatment of Peutz-Jeghers syndrome

Peutz-Jeghers syndrome (PJS), an autosomal dominant inherited disease, is caused by germinal mutations of the STK11. It is characterized by gastrointestinal hamartomas, mucocutaneous pigmentation and increased cancer risk. Germline mutations in STK11 cause a harmful effect on cell apoptosis, G1 arrest, and cell polarization, which leads to polyp formation and cancer occurrence. Balloon-assisted enteroscopy is widely used in removal of PJS polyps in the small bowel and it is proved to be safe and effective. We suggest to screen polyps and cancer in PJS patients, which seems to benefit these patients in the long run.

mTOR signaling pathway and Peutz-Jeghers syndrome

The mammalian target of rapamycin (mTOR) signaling pathway is one of the most important intracellular signal transduction pathways and is involved in a series of biological activities, such as gene transcription, protein translation, ribosome synthesis, and cell apoptosis. The abnormal activation of the mTOR signaling pathway has a close relationship with the development of some hereditary diseases, tumors and diabetes. Intervention with biological processes of these diseases by influencing the mTOR signalling pathway with all kinds of biological means has become a hot area of research for several years. This article reviews the recent advances in understanding the composition and function of the mTOR signaling pathway and its role in the pathogenesis of Peutz-Jeghers syndrome. It is expected that molecular therapy targeting the mTOR signalling pathway can be used for preventive therapy of Peutz-Jeghers syndrome.

Protein expression and gene mutation of Brg1 in Peutz-Jeghers syndrome

AIM: To investigate the protein expression and gene mutation of Brahma-related gene 1 (Brg1) in Peutz-Jeghers syndrome (PJS), and to analyze their relation with tumor development.

METHODS: The expression of Brg1 protein in 72 cases of PJS polyps was detected by immunohistochemistry. Mutations in exons 4 and 10 of the Brg1 gene was detected by means of polymerase chain reaction-direct sequencing (PCR-DNA) in 39 cases of PJS polyps and 2 cases of carcinoma.

RESULTS: The positive rate of Brg1 protein expression in PJS (54.17%) was lower than that in adenocarcinoma (76.67%) but higher than that in normal tissue (16.67%). There was a significant difference in the positive rate of Brg1 protein expression among the three groups (P < 0.05). No Brg1 gene mutations were detected in 39 cases of PJS polyps and 2 cases of carcinoma.

CONCLUSION: Increased expression of Brg1 protein in PJS may be associated with the development of this disease. Brg1 gene mutations might be rare in PJS. Brg1 expression can be used as an important parameter for differentiating malignancy and evaluating prognosis of PJS.