Skip to main content
Top
Published in: BMC Medical Genetics 1/2018

Open Access 01-12-2018 | Research article

The altered activity of P53 signaling pathway by STK11 gene mutations and its cancer phenotype in Peutz-Jeghers syndrome

Authors: Yu-Liang Jiang, Zi-Ye Zhao, Bai-Rong Li, Fu Yang, Jing Li, Xiao-Wei Jin, Hao Wang, En-Da Yu, Shu-Han Sun, Shou-Bin Ning

Published in: BMC Medical Genetics | Issue 1/2018

Login to get access

Abstract

Background

Peutz-Jeghers syndrome (PJS) is caused by mutations in serine/threonine kinase 11 (STK11) gene. The increased cancer risk has been connected to P53 pathway.

Methods

PJS probands with STK11 mutation were included in the function analysis. P53 activity elevated by STK11 mutants was investigated using dual-luciferase reporter assay in vitro after constructing expression vectors of STK11 wild type and mutants generated by site-directed substitution. The association between the P53 activity and clinicopathological factors was analysis, especially the cancer history.

Results

Thirteen probands with STK11 mutations were involved, and within the mutations, c.G924A was novel. P53 activity elevation caused by 6 truncating mutations were significantly lower than that of STK11 wild type (P < 0.05). Family history of cancer was observed in 5 families. Within them, P53 activity was reduced and cancer occurred before 40 in 2 families, while it was not significantly changed and cancers happened after 45 in the other 3 families.

Conclusions

The affected P53 activity caused by STK11 mutations in PJS patients is significantly associated with protein truncation, while cancer risk in PJS can be elevated through pathways rather than P53 pathway. P53 activity test is probably a useful supporting method to predict cancer risk in PJS, which could be helpful in clinical practice.
Appendix
Available only for authorised users
Literature
1.
go back to reference Giardiello FM, Brensinger JD, Tersmette AC, Goodman SN, Petersen GM, Booker SV, Cruz-Correa M, Offerhaus JA. Very high risk of cancer in familial Peutz-Jeghers syndrome. Gastroenterology. 2000;119(6):1447–53.CrossRefPubMed Giardiello FM, Brensinger JD, Tersmette AC, Goodman SN, Petersen GM, Booker SV, Cruz-Correa M, Offerhaus JA. Very high risk of cancer in familial Peutz-Jeghers syndrome. Gastroenterology. 2000;119(6):1447–53.CrossRefPubMed
2.
go back to reference Boardman LA, Thibodeau SN, Schaid DJ, Lindor NM, McDonnell SK, Burgart LJ, Ahlquist DA, Podratz KC, Pittelkow M, Hartmann LC. Increased risk for cancer in patients with the Peutz-Jeghers syndrome. Ann Intern Med. 1998;128(11):896–9.CrossRefPubMed Boardman LA, Thibodeau SN, Schaid DJ, Lindor NM, McDonnell SK, Burgart LJ, Ahlquist DA, Podratz KC, Pittelkow M, Hartmann LC. Increased risk for cancer in patients with the Peutz-Jeghers syndrome. Ann Intern Med. 1998;128(11):896–9.CrossRefPubMed
3.
go back to reference Giardiello FM, Trimbath JD. Peutz-Jeghers syndrome and management recommendations. Clin Gastroenterol Hepatol. 2006;4(4):408–15.CrossRefPubMed Giardiello FM, Trimbath JD. Peutz-Jeghers syndrome and management recommendations. Clin Gastroenterol Hepatol. 2006;4(4):408–15.CrossRefPubMed
4.
go back to reference Resta N, Pierannunzio D, Lenato GM, Stella A, Capocaccia R, Bagnulo R, Lastella P, Susca FC, Bozzao C, Loconte DC, et al. Cancer risk associated with STK11/LKB1 germline mutations in Peutz-Jeghers syndrome patients: results of an Italian multicenter study. Dig Liver Dis. 2013;45(7):606–11.CrossRefPubMed Resta N, Pierannunzio D, Lenato GM, Stella A, Capocaccia R, Bagnulo R, Lastella P, Susca FC, Bozzao C, Loconte DC, et al. Cancer risk associated with STK11/LKB1 germline mutations in Peutz-Jeghers syndrome patients: results of an Italian multicenter study. Dig Liver Dis. 2013;45(7):606–11.CrossRefPubMed
5.
go back to reference Jenne DE, Reimann H, Nezu J, Friedel W, Loff S, Jeschke R, Muller O, Back W, Zimmer M. Peutz-Jeghers syndrome is caused by mutations in a novel serine threonine kinase. Nat Genet. 1998;18(1):38–43.CrossRefPubMed Jenne DE, Reimann H, Nezu J, Friedel W, Loff S, Jeschke R, Muller O, Back W, Zimmer M. Peutz-Jeghers syndrome is caused by mutations in a novel serine threonine kinase. Nat Genet. 1998;18(1):38–43.CrossRefPubMed
6.
go back to reference Hemminki A, Markie D, Tomlinson I, Avizienyte E, Roth S, Loukola A, Bignell G, Warren W, Aminoff M, Hoglund P, et al. A serine/threonine kinase gene defective in Peutz-Jeghers syndrome. Nature. 1998;391(6663):184–7.CrossRefPubMed Hemminki A, Markie D, Tomlinson I, Avizienyte E, Roth S, Loukola A, Bignell G, Warren W, Aminoff M, Hoglund P, et al. A serine/threonine kinase gene defective in Peutz-Jeghers syndrome. Nature. 1998;391(6663):184–7.CrossRefPubMed
7.
go back to reference Hanks SK, Quinn AM, Hunter T. The protein kinase family: conserved features and deduced phylogeny of the catalytic domains. Science. 1988;241(4861):42–52.CrossRefPubMed Hanks SK, Quinn AM, Hunter T. The protein kinase family: conserved features and deduced phylogeny of the catalytic domains. Science. 1988;241(4861):42–52.CrossRefPubMed
8.
go back to reference Boudeau J, Baas AF, Deak M, Morrice NA, Kieloch A, Schutkowski M, Prescott AR, Clevers HC, Alessi DR. MO25alpha/beta interact with STRADalpha/beta enhancing their ability to bind, activate and localize LKB1 in the cytoplasm. EMBO J. 2003;22(19):5102–14.CrossRefPubMedPubMedCentral Boudeau J, Baas AF, Deak M, Morrice NA, Kieloch A, Schutkowski M, Prescott AR, Clevers HC, Alessi DR. MO25alpha/beta interact with STRADalpha/beta enhancing their ability to bind, activate and localize LKB1 in the cytoplasm. EMBO J. 2003;22(19):5102–14.CrossRefPubMedPubMedCentral
9.
go back to reference Tiainen M, Ylikorkala A, Makela TP. Growth suppression by Lkb1 is mediated by a G(1) cell cycle arrest. Proc Natl Acad Sci U S A. 1999;96(16):9248–51.CrossRefPubMedPubMedCentral Tiainen M, Ylikorkala A, Makela TP. Growth suppression by Lkb1 is mediated by a G(1) cell cycle arrest. Proc Natl Acad Sci U S A. 1999;96(16):9248–51.CrossRefPubMedPubMedCentral
10.
go back to reference Karuman P, Gozani O, Odze RD, Zhou XC, Zhu H, Shaw R, Brien TP, Bozzuto CD, Ooi D, Cantley LC, et al. The Peutz-Jegher gene product LKB1 is a mediator of p53-dependent cell death. Mol Cell. 2001;7(6):1307–19.CrossRefPubMed Karuman P, Gozani O, Odze RD, Zhou XC, Zhu H, Shaw R, Brien TP, Bozzuto CD, Ooi D, Cantley LC, et al. The Peutz-Jegher gene product LKB1 is a mediator of p53-dependent cell death. Mol Cell. 2001;7(6):1307–19.CrossRefPubMed
11.
go back to reference Spicer J, Rayter S, Young N, Elliott R, Ashworth A, Smith D. Regulation of the Wnt signalling component PAR1A by the Peutz-Jeghers syndrome kinase LKB1. Oncogene. 2003;22(30):4752–6.CrossRefPubMed Spicer J, Rayter S, Young N, Elliott R, Ashworth A, Smith D. Regulation of the Wnt signalling component PAR1A by the Peutz-Jeghers syndrome kinase LKB1. Oncogene. 2003;22(30):4752–6.CrossRefPubMed
12.
go back to reference Ossipova O, Bardeesy N, DePinho RA, Green JB. LKB1 (XEEK1) regulates Wnt signalling in vertebrate development. Nat Cell Biol. 2003;5(10):889–94.CrossRefPubMed Ossipova O, Bardeesy N, DePinho RA, Green JB. LKB1 (XEEK1) regulates Wnt signalling in vertebrate development. Nat Cell Biol. 2003;5(10):889–94.CrossRefPubMed
13.
go back to reference Smith DP, Rayter SI, Niederlander C, Spicer J, Jones CM, Ashworth A. LIP1, a cytoplasmic protein functionally linked to the Peutz-Jeghers syndrome kinase LKB1. Hum Mol Genet. 2001;10(25):2869–77.CrossRefPubMed Smith DP, Rayter SI, Niederlander C, Spicer J, Jones CM, Ashworth A. LIP1, a cytoplasmic protein functionally linked to the Peutz-Jeghers syndrome kinase LKB1. Hum Mol Genet. 2001;10(25):2869–77.CrossRefPubMed
14.
go back to reference Bardeesy N, Sinha M, Hezel AF, Signoretti S, Hathaway NA, Sharpless NE, Loda M, Carrasco DR, DePinho RA. Loss of the Lkb1 tumour suppressor provokes intestinal polyposis but resistance to transformation. Nat. 2002;419(6903):162–7.CrossRef Bardeesy N, Sinha M, Hezel AF, Signoretti S, Hathaway NA, Sharpless NE, Loda M, Carrasco DR, DePinho RA. Loss of the Lkb1 tumour suppressor provokes intestinal polyposis but resistance to transformation. Nat. 2002;419(6903):162–7.CrossRef
15.
go back to reference Watts JL, Morton DG, Bestman J, Kemphues KJ. The C. elegans par-4 gene encodes a putative serine-threonine kinase required for establishing embryonic asymmetry. Dev (Cambridge, England). 2000;127(7):1467–75. Watts JL, Morton DG, Bestman J, Kemphues KJ. The C. elegans par-4 gene encodes a putative serine-threonine kinase required for establishing embryonic asymmetry. Dev (Cambridge, England). 2000;127(7):1467–75.
16.
go back to reference Boudeau J, Sapkota G, Alessi DR. LKB1, a protein kinase regulating cell proliferation and polarity. FEBS Lett. 2003;546(1):159–65.CrossRefPubMed Boudeau J, Sapkota G, Alessi DR. LKB1, a protein kinase regulating cell proliferation and polarity. FEBS Lett. 2003;546(1):159–65.CrossRefPubMed
17.
go back to reference Martin SG, St Johnston D. A role for Drosophila LKB1 in anterior-posterior axis formation and epithelial polarity. Nature. 2003;421(6921):379–84.CrossRefPubMed Martin SG, St Johnston D. A role for Drosophila LKB1 in anterior-posterior axis formation and epithelial polarity. Nature. 2003;421(6921):379–84.CrossRefPubMed
18.
go back to reference Baas AF, Kuipers J, van der Wel NN, Batlle E, Koerten HK, Peters PJ, Clevers HC. Complete polarization of single intestinal epithelial cells upon activation of LKB1 by STRAD. Cell. 2004;116(3):457–66.CrossRefPubMed Baas AF, Kuipers J, van der Wel NN, Batlle E, Koerten HK, Peters PJ, Clevers HC. Complete polarization of single intestinal epithelial cells upon activation of LKB1 by STRAD. Cell. 2004;116(3):457–66.CrossRefPubMed
19.
go back to reference Vogelstein B, Lane D, Levine AJ. Surfing the p53 network. Nat. 2000;408(6810):307–10.CrossRef Vogelstein B, Lane D, Levine AJ. Surfing the p53 network. Nat. 2000;408(6810):307–10.CrossRef
20.
go back to reference Donehower LA, Harvey M, Slagle BL, McArthur MJ, Montgomery CA Jr, Butel JS, Bradley A. Mice deficient for p53 are developmentally normal but susceptible to spontaneous tumours. Nat. 1992;356(6366):215–21.CrossRef Donehower LA, Harvey M, Slagle BL, McArthur MJ, Montgomery CA Jr, Butel JS, Bradley A. Mice deficient for p53 are developmentally normal but susceptible to spontaneous tumours. Nat. 1992;356(6366):215–21.CrossRef
21.
go back to reference Wei C, Amos CI, Stephens LC, Campos I, Deng JM, Behringer RR, Rashid A, Frazier ML. Mutation of Lkb1 and p53 genes exert a cooperative effect on tumorigenesis. Cancer Res. 2005;65(24):11297–303.CrossRefPubMed Wei C, Amos CI, Stephens LC, Campos I, Deng JM, Behringer RR, Rashid A, Frazier ML. Mutation of Lkb1 and p53 genes exert a cooperative effect on tumorigenesis. Cancer Res. 2005;65(24):11297–303.CrossRefPubMed
22.
go back to reference Aaltonen LA, Hamilton SR. Pathology and genetics of Tumours of the digestive system. Lyon: IARC Press; 2010. Aaltonen LA, Hamilton SR. Pathology and genetics of Tumours of the digestive system. Lyon: IARC Press; 2010.
23.
go back to reference Zhao ZY, Jiang YL, Li BR, Yang F, Li J, Jin XW, Ning SB, Sun SH. A 23-nucleotide deletion in STK11 gene causes Peutz-Jeghers syndrome and malignancy in a Chinese patient without a positive family history. Dig Dis Sci. 2017;62(11):3014–20.CrossRefPubMed Zhao ZY, Jiang YL, Li BR, Yang F, Li J, Jin XW, Ning SB, Sun SH. A 23-nucleotide deletion in STK11 gene causes Peutz-Jeghers syndrome and malignancy in a Chinese patient without a positive family history. Dig Dis Sci. 2017;62(11):3014–20.CrossRefPubMed
24.
go back to reference Lek M, Karczewski KJ, Minikel EV, Samocha KE, Banks E, Fennell T, O’Donnell-Luria AH, Ware JS, Hill AJ, Cummings BB, et al. Analysis of protein-coding genetic variation in 60,706 humans. Nat. 2016;536(7616):285–91.CrossRef Lek M, Karczewski KJ, Minikel EV, Samocha KE, Banks E, Fennell T, O’Donnell-Luria AH, Ware JS, Hill AJ, Cummings BB, et al. Analysis of protein-coding genetic variation in 60,706 humans. Nat. 2016;536(7616):285–91.CrossRef
25.
go back to reference Zhao ZY, Jiang YL, Li BR, Yang F, Li J, Jin XW, Ning SB, Sun SH. Sanger sequencing in exonic regions of STK11 gene uncovers a novel de-novo germline mutation (c.962_963delCC) associated with Peutz-Jeghers syndrome and elevated cancer risk: case report of a Chinese patient. BMC Med Genet. 2017;18(1):130.CrossRefPubMedPubMedCentral Zhao ZY, Jiang YL, Li BR, Yang F, Li J, Jin XW, Ning SB, Sun SH. Sanger sequencing in exonic regions of STK11 gene uncovers a novel de-novo germline mutation (c.962_963delCC) associated with Peutz-Jeghers syndrome and elevated cancer risk: case report of a Chinese patient. BMC Med Genet. 2017;18(1):130.CrossRefPubMedPubMedCentral
26.
go back to reference Yu J, Xu QG, Wang ZG, Yang Y, Zhang L, Ma JZ, Sun SH, Yang F, Zhou WP. Circular RNA cSMARCA5 inhibits growth and metastasis in hepatocellular carcinoma. J Hepatol. 2018;68(6):1214–27.CrossRefPubMed Yu J, Xu QG, Wang ZG, Yang Y, Zhang L, Ma JZ, Sun SH, Yang F, Zhou WP. Circular RNA cSMARCA5 inhibits growth and metastasis in hepatocellular carcinoma. J Hepatol. 2018;68(6):1214–27.CrossRefPubMed
27.
go back to reference Mao X, Zhang Y, Wang H, Mao G, Ning S. Mutations of the STK11 and FHIT genes among patients with Peutz-Jeghers syndrome. Zhonghua Yi Xue Yi Chuan Xue Za Zhi. 2016;33(2):186–90.PubMed Mao X, Zhang Y, Wang H, Mao G, Ning S. Mutations of the STK11 and FHIT genes among patients with Peutz-Jeghers syndrome. Zhonghua Yi Xue Yi Chuan Xue Za Zhi. 2016;33(2):186–90.PubMed
28.
go back to reference Mao X, Zhang Y, Mao G, Wang H, Ning S. STK11 gene mutations in patients with Peutz-Jeghers syndrom. World Chin J Digestol. 2015;23(2):332.CrossRef Mao X, Zhang Y, Mao G, Wang H, Ning S. STK11 gene mutations in patients with Peutz-Jeghers syndrom. World Chin J Digestol. 2015;23(2):332.CrossRef
29.
go back to reference Zhao ZY, Jiang YL, Li BR, Yu ED, Ning SB. A novel mutation (c.855delG) in STK11 gene is associated with Peutz-Jeghers syndrome in a Chinese family. Dig Liver Dis. 2018;50(3):312–4.CrossRefPubMed Zhao ZY, Jiang YL, Li BR, Yu ED, Ning SB. A novel mutation (c.855delG) in STK11 gene is associated with Peutz-Jeghers syndrome in a Chinese family. Dig Liver Dis. 2018;50(3):312–4.CrossRefPubMed
30.
go back to reference Rufener SL, Koujok K, McKenna BJ, Walsh M. Small bowel intussusception secondary to Peutz-Jeghers polyp. Radiographics. 2008;28(1):284–8.CrossRefPubMed Rufener SL, Koujok K, McKenna BJ, Walsh M. Small bowel intussusception secondary to Peutz-Jeghers polyp. Radiographics. 2008;28(1):284–8.CrossRefPubMed
31.
go back to reference Harned RK, Buck JL, Sobin LH. The hamartomatous polyposis syndromes: clinical and radiologic features. AJR Am J Roentgenol. 1995;164(3):565–71.CrossRefPubMed Harned RK, Buck JL, Sobin LH. The hamartomatous polyposis syndromes: clinical and radiologic features. AJR Am J Roentgenol. 1995;164(3):565–71.CrossRefPubMed
32.
go back to reference Latchford A, Greenhalf W, Vitone LJ, Neoptolemos JP, Lancaster GA, Phillips RK. Peutz-Jeghers syndrome and screening for pancreatic cancer. Br J Surg. 2006;93(12):1446–55.CrossRefPubMed Latchford A, Greenhalf W, Vitone LJ, Neoptolemos JP, Lancaster GA, Phillips RK. Peutz-Jeghers syndrome and screening for pancreatic cancer. Br J Surg. 2006;93(12):1446–55.CrossRefPubMed
33.
go back to reference van Lier MG, Wagner A, Mathus-Vliegen EM, Kuipers EJ, Steyerberg EW, van Leerdam ME. High cancer risk in Peutz-Jeghers syndrome: a systematic review and surveillance recommendations. Am J Gastroenterol. 2010;105(6):1258–64. author reply 1265CrossRefPubMed van Lier MG, Wagner A, Mathus-Vliegen EM, Kuipers EJ, Steyerberg EW, van Leerdam ME. High cancer risk in Peutz-Jeghers syndrome: a systematic review and surveillance recommendations. Am J Gastroenterol. 2010;105(6):1258–64. author reply 1265CrossRefPubMed
34.
go back to reference Zeng PY, Berger SL. LKB1 is recruited to the p21/WAF1 promoter by p53 to mediate transcriptional activation. Cancer Res. 2006;66(22):10701–8.CrossRefPubMed Zeng PY, Berger SL. LKB1 is recruited to the p21/WAF1 promoter by p53 to mediate transcriptional activation. Cancer Res. 2006;66(22):10701–8.CrossRefPubMed
35.
go back to reference Tiainen M, Vaahtomeri K, Ylikorkala A, Makela TP. Growth arrest by the LKB1 tumor suppressor: induction of p21(WAF1/CIP1). Hum Mol Genet. 2002;11(13):1497–504.CrossRefPubMed Tiainen M, Vaahtomeri K, Ylikorkala A, Makela TP. Growth arrest by the LKB1 tumor suppressor: induction of p21(WAF1/CIP1). Hum Mol Genet. 2002;11(13):1497–504.CrossRefPubMed
36.
go back to reference Gurumurthy S, Hezel AF, Sahin E, Berger JH, Bosenberg MW, Bardeesy N. LKB1 deficiency sensitizes mice to carcinogen-induced tumorigenesis. Cancer Res. 2008;68(1):55–63.CrossRefPubMedPubMedCentral Gurumurthy S, Hezel AF, Sahin E, Berger JH, Bosenberg MW, Bardeesy N. LKB1 deficiency sensitizes mice to carcinogen-induced tumorigenesis. Cancer Res. 2008;68(1):55–63.CrossRefPubMedPubMedCentral
37.
go back to reference Scott KD, Nath-Sain S, Agnew MD, Marignani PA. LKB1 catalytically deficient mutants enhance cyclin D1 expression. Cancer Res. 2007;67(12):5622–7.CrossRefPubMed Scott KD, Nath-Sain S, Agnew MD, Marignani PA. LKB1 catalytically deficient mutants enhance cyclin D1 expression. Cancer Res. 2007;67(12):5622–7.CrossRefPubMed
38.
go back to reference Setogawa T, Shinozaki-Yabana S, Masuda T, Matsuura K, Akiyama T. The tumor suppressor LKB1 induces p21 expression in collaboration with LMO4, GATA-6, and Ldb1. Biochem Biophys Res Commun. 2006;343(4):1186–90.CrossRefPubMed Setogawa T, Shinozaki-Yabana S, Masuda T, Matsuura K, Akiyama T. The tumor suppressor LKB1 induces p21 expression in collaboration with LMO4, GATA-6, and Ldb1. Biochem Biophys Res Commun. 2006;343(4):1186–90.CrossRefPubMed
39.
go back to reference Liang J, Shao SH, Xu ZX, Hennessy B, Ding Z, Larrea M, Kondo S, Dumont DJ, Gutterman JU, Walker CL, et al. The energy sensing LKB1-AMPK pathway regulates p27(kip1) phosphorylation mediating the decision to enter autophagy or apoptosis. Nat Cell Biol. 2007;9(2):218–24.CrossRefPubMed Liang J, Shao SH, Xu ZX, Hennessy B, Ding Z, Larrea M, Kondo S, Dumont DJ, Gutterman JU, Walker CL, et al. The energy sensing LKB1-AMPK pathway regulates p27(kip1) phosphorylation mediating the decision to enter autophagy or apoptosis. Nat Cell Biol. 2007;9(2):218–24.CrossRefPubMed
40.
go back to reference Cheng H, Liu P, Wang ZC, Zou L, Santiago S, Garbitt V, Gjoerup OV, Iglehart JD, Miron A, Richardson AL, et al. SIK1 couples LKB1 to p53-dependent anoikis and suppresses metastasis. Sci Signal. 2009;2(80):ra35.CrossRefPubMedPubMedCentral Cheng H, Liu P, Wang ZC, Zou L, Santiago S, Garbitt V, Gjoerup OV, Iglehart JD, Miron A, Richardson AL, et al. SIK1 couples LKB1 to p53-dependent anoikis and suppresses metastasis. Sci Signal. 2009;2(80):ra35.CrossRefPubMedPubMedCentral
41.
go back to reference Dai L, Fu L, Liu D, Zhang K, Wu Y, Meng H, Zhang B, Guan X, Guo H, Bai Y. Novel and recurrent mutations of STK11 gene in six Chinese cases with Peutz-Jeghers syndrome. Dig Dis Sci. 2014;59(8):1856–61.CrossRefPubMed Dai L, Fu L, Liu D, Zhang K, Wu Y, Meng H, Zhang B, Guan X, Guo H, Bai Y. Novel and recurrent mutations of STK11 gene in six Chinese cases with Peutz-Jeghers syndrome. Dig Dis Sci. 2014;59(8):1856–61.CrossRefPubMed
42.
go back to reference Hampel H, Bennett RL, Buchanan A, Pearlman R, Wiesner GL. A practice guideline from the American College of Medical Genetics and Genomics and the National Society of genetic counselors: referral indications for cancer predisposition assessment. Genet Med. 2015;17(1):70–87.CrossRefPubMed Hampel H, Bennett RL, Buchanan A, Pearlman R, Wiesner GL. A practice guideline from the American College of Medical Genetics and Genomics and the National Society of genetic counselors: referral indications for cancer predisposition assessment. Genet Med. 2015;17(1):70–87.CrossRefPubMed
43.
go back to reference Tan H, Wei X, Yang P, Huang Y, Li H, Liang D, Wu L. A lesson from a reported pathogenic variant in Peutz-Jeghers syndrome: a case report. Familial Cancer. 2017;16(3):417–22.CrossRefPubMed Tan H, Wei X, Yang P, Huang Y, Li H, Liang D, Wu L. A lesson from a reported pathogenic variant in Peutz-Jeghers syndrome: a case report. Familial Cancer. 2017;16(3):417–22.CrossRefPubMed
44.
go back to reference Beggs AD, Latchford AR, Vasen HF, Moslein G, Alonso A, Aretz S, Bertario L, Blanco I, Bulow S, Burn J, et al. Peutz-Jeghers syndrome: a systematic review and recommendations for management. Gut. 2010;59(7):975–86.CrossRefPubMed Beggs AD, Latchford AR, Vasen HF, Moslein G, Alonso A, Aretz S, Bertario L, Blanco I, Bulow S, Burn J, et al. Peutz-Jeghers syndrome: a systematic review and recommendations for management. Gut. 2010;59(7):975–86.CrossRefPubMed
45.
go back to reference Syngal S, Brand RE, Church JM, Giardiello FM, Hampel HL, Burt RW, American College of G. ACG clinical guideline: genetic testing and management of hereditary gastrointestinal cancer syndromes. Am J Gastroenterol. 2015;110(2):223–62. quiz 263CrossRefPubMedPubMedCentral Syngal S, Brand RE, Church JM, Giardiello FM, Hampel HL, Burt RW, American College of G. ACG clinical guideline: genetic testing and management of hereditary gastrointestinal cancer syndromes. Am J Gastroenterol. 2015;110(2):223–62. quiz 263CrossRefPubMedPubMedCentral
46.
go back to reference Biasini M, Bienert S, Waterhouse A, Arnold K, Studer G, Schmidt T, Kiefer F, Gallo Cassarino T, Bertoni M, Bordoli L, et al. SWISS-MODEL: modelling protein tertiary and quaternary structure using evolutionary information. Nucleic Acids Res. 2014;42(Web Server issue):W252–8.CrossRefPubMedPubMedCentral Biasini M, Bienert S, Waterhouse A, Arnold K, Studer G, Schmidt T, Kiefer F, Gallo Cassarino T, Bertoni M, Bordoli L, et al. SWISS-MODEL: modelling protein tertiary and quaternary structure using evolutionary information. Nucleic Acids Res. 2014;42(Web Server issue):W252–8.CrossRefPubMedPubMedCentral
Metadata
Title
The altered activity of P53 signaling pathway by STK11 gene mutations and its cancer phenotype in Peutz-Jeghers syndrome
Authors
Yu-Liang Jiang
Zi-Ye Zhao
Bai-Rong Li
Fu Yang
Jing Li
Xiao-Wei Jin
Hao Wang
En-Da Yu
Shu-Han Sun
Shou-Bin Ning
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Medical Genetics / Issue 1/2018
Electronic ISSN: 1471-2350
DOI
https://doi.org/10.1186/s12881-018-0626-5

Other articles of this Issue 1/2018

BMC Medical Genetics 1/2018 Go to the issue