Skip to main content
Top
Published in: BMC Gastroenterology 1/2015

Open Access 01-12-2015 | Research article

Clinical characteristics and STK11 gene mutations in Chinese children with Peutz-Jeghers syndrome

Authors: Zhiheng Huang, Shijian Miao, Lin Wang, Ping Zhang, Bingbing Wu, Jie Wu, Ying Huang

Published in: BMC Gastroenterology | Issue 1/2015

Login to get access

Abstract

Background

Peutz-Jeghers syndrome (PJS) is a rare autosomal dominant inherited disease characterized by gastrointestinal hamartomatous polyps and mucocutaneous melanin spots. Germline mutation of the serine/threonine kinase 11 (STK11) gene are responsible for PJS. In this study, we investigated the clinical characteristics and molecular basis of the disease in Chinese children with PJS.

Methods

Thirteen children diagnosed with PJS in our hospital were enrolled in this study from 2011 to 2015, and their clinical data on polyp characteristics, intussusceptions events, family histories, etc. were described. Genomic DNA was extracted from whole-blood samples from each subject, and the entire coding sequence of the STK11 gene was amplified by polymerase chain reaction and analyzed by direct sequencing.

Results

The median age at the onset of symptoms was 2 years and 4 months. To date, these children have undergone 40 endoscopy screenings, 17 laparotomies and 9 intussusceptions. Polyps were found in the stomach, duodenum, small bowel, colon and rectum, with large polyps found in 7 children. Mutations were found in eleven children, including seven novel mutations (c.481het_dupA, c.943_944het_delCCinsG, c.397het_delG, c.862 + 1G > G/A, c.348_349het_delGT, and c.803_804het_delGGinsC and c.121_139de l19insTT) and four previously reported mutations (c.658C > C/T, c.890G > G/A, c.1062 C > C/G, and c.290 + 1G > G/A). One PJS patient did not have any STK11 mutations.

Conclusions

The polyps caused significant clinical consequences in children with PJS, and mutations of the STK11 gene are generally the cause of PJS in Chinese children. This study expands the spectrum of known STK11 gene mutations.
Literature
1.
go back to reference Jeghers H, McKusick VA, Katz KH. Generalized intestinal polyposis and melanin spots of the oral mucosa, lips and digits; a syndrome of diagnostic significance. N Engl J Med. 1949;241(25):993. illust; passim.CrossRefPubMed Jeghers H, McKusick VA, Katz KH. Generalized intestinal polyposis and melanin spots of the oral mucosa, lips and digits; a syndrome of diagnostic significance. N Engl J Med. 1949;241(25):993. illust; passim.CrossRefPubMed
2.
go back to reference Beggs AD, Latchford AR, Vasen HF, Moslein G, Alonso A, Aretz S, 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, et al. Peutz-Jeghers syndrome: a systematic review and recommendations for management. Gut. 2010;59(7):975–86.CrossRefPubMed
3.
go back to reference Resta N, Pierannunzio D, Lenato GM, Stella A, Capocaccia R, Bagnulo R, 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, 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
4.
go back to reference Zheng B, Pan J, Wang Y, Li M, Lian M, Zheng Y, et al. Analysis of STK11 gene variant in five Chinese patients with Peutz-Jeghers syndrome. Dig Dis Sci. 2013;58(10):2868–72.CrossRefPubMed Zheng B, Pan J, Wang Y, Li M, Lian M, Zheng Y, et al. Analysis of STK11 gene variant in five Chinese patients with Peutz-Jeghers syndrome. Dig Dis Sci. 2013;58(10):2868–72.CrossRefPubMed
5.
go back to reference Riegert-Johnson D, Roberts M, Gleeson FC, Krishna M, Boardman L. Case studies in the diagnosis and management of Peutz-Jeghers syndrome. Fam Cancer. 2011;10(3):463–8.CrossRefPubMed Riegert-Johnson D, Roberts M, Gleeson FC, Krishna M, Boardman L. Case studies in the diagnosis and management of Peutz-Jeghers syndrome. Fam Cancer. 2011;10(3):463–8.CrossRefPubMed
6.
go back to reference Goldstein SA, Hoffenberg EJ. Peutz-Jegher syndrome in childhood: need for updated recommendations? J Pediatr Gastroenterol Nutr. 2013;56(2):191–5.CrossRefPubMed Goldstein SA, Hoffenberg EJ. Peutz-Jegher syndrome in childhood: need for updated recommendations? J Pediatr Gastroenterol Nutr. 2013;56(2):191–5.CrossRefPubMed
7.
go back to reference Church JM. Laparoscopic vs. colonoscopic removal of a large polyp. Am J Gastroenterol. 2009;104(10):2633–4.CrossRefPubMed Church JM. Laparoscopic vs. colonoscopic removal of a large polyp. Am J Gastroenterol. 2009;104(10):2633–4.CrossRefPubMed
8.
go back to reference Caputi Iambrenghi O, Ugenti I, Martines G, Marino F, Francesco Altomare D, Memeo V. Endoscopic management of large colorectal polyps. Int J Colorectal Dis. 2009;24(7):749–53.CrossRefPubMed Caputi Iambrenghi O, Ugenti I, Martines G, Marino F, Francesco Altomare D, Memeo V. Endoscopic management of large colorectal polyps. Int J Colorectal Dis. 2009;24(7):749–53.CrossRefPubMed
9.
go back to reference Choi YS, Lee JB, Lee EJ, Lee SH, Suh JP, Lee DH, et al. Can endoscopic submucosal dissection technique be an alternative treatment option for a difficult giant (>/= 30 mm) pedunculated colorectal polyp? Dis Colon Rectum. 2013;56(5):660–6.CrossRefPubMed Choi YS, Lee JB, Lee EJ, Lee SH, Suh JP, Lee DH, et al. Can endoscopic submucosal dissection technique be an alternative treatment option for a difficult giant (>/= 30 mm) pedunculated colorectal polyp? Dis Colon Rectum. 2013;56(5):660–6.CrossRefPubMed
10.
go back to reference van Lier MG, Mathus-Vliegen EM, Wagner A, van Leerdam ME, Kuipers EJ. High cumulative risk of intussusception in patients with Peutz-Jeghers syndrome: time to update surveillance guidelines? Am J Gastroenterol. 2011;106(5):940–5.CrossRefPubMed van Lier MG, Mathus-Vliegen EM, Wagner A, van Leerdam ME, Kuipers EJ. High cumulative risk of intussusception in patients with Peutz-Jeghers syndrome: time to update surveillance guidelines? Am J Gastroenterol. 2011;106(5):940–5.CrossRefPubMed
11.
go back to reference Vidal I, Podevin G, Piloquet H, Le Rhun M, Fremond B, Aubert D, et al. Follow-up and surgical management of Peutz-Jeghers syndrome in children. J Pediatr Gastroenterol Nutr. 2009;48(4):419–25.CrossRefPubMed Vidal I, Podevin G, Piloquet H, Le Rhun M, Fremond B, Aubert D, et al. Follow-up and surgical management of Peutz-Jeghers syndrome in children. J Pediatr Gastroenterol Nutr. 2009;48(4):419–25.CrossRefPubMed
12.
go back to reference Aziz Aadam A, Wani S, Kahi C, Kaltenbach T, Oh Y, Edmundowicz S, et al. Physician assessment and management of complex colon polyps: a multicenter video-based survey study. Am J Gastroenterol. 2014;109(9):1312–24.CrossRefPubMed Aziz Aadam A, Wani S, Kahi C, Kaltenbach T, Oh Y, Edmundowicz S, et al. Physician assessment and management of complex colon polyps: a multicenter video-based survey study. Am J Gastroenterol. 2014;109(9):1312–24.CrossRefPubMed
13.
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
14.
go back to reference Boudeau J, Baas AF, Deak M, Morrice NA, Kieloch A, Schutkowski M, et al. 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.PubMedCentralCrossRefPubMed Boudeau J, Baas AF, Deak M, Morrice NA, Kieloch A, Schutkowski M, et al. 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.PubMedCentralCrossRefPubMed
15.
go back to reference Salloch H, Reinacher-Schick A, Schulmann K, Pox C, Willert J, Tannapfel A, et al. Truncating mutations in Peutz-Jeghers syndrome are associated with more polyps, surgical interventions and cancers. Int J Colorectal Dis. 2010;25(1):97–107.CrossRefPubMed Salloch H, Reinacher-Schick A, Schulmann K, Pox C, Willert J, Tannapfel A, et al. Truncating mutations in Peutz-Jeghers syndrome are associated with more polyps, surgical interventions and cancers. Int J Colorectal Dis. 2010;25(1):97–107.CrossRefPubMed
16.
go back to reference Schumacher V, Vogel T, Leube B, Driemel C, Goecke T, Moslein G, et al. STK11 genotyping and cancer risk in Peutz-Jeghers syndrome. J Med Genet. 2005;42(5):428–35.PubMedCentralCrossRefPubMed Schumacher V, Vogel T, Leube B, Driemel C, Goecke T, Moslein G, et al. STK11 genotyping and cancer risk in Peutz-Jeghers syndrome. J Med Genet. 2005;42(5):428–35.PubMedCentralCrossRefPubMed
17.
go back to reference Wang Z, Wu B, Mosig RA, Chen Y, Ye F, Zhang Y, et al. STK11 Domain XI Mutations: Candidate Genetic Drivers Leading to the Development of Dysplastic Polyps in Peutz-Jeghers Syndrome. Hum Mutat. 2014;35(7):851–8.CrossRefPubMed Wang Z, Wu B, Mosig RA, Chen Y, Ye F, Zhang Y, et al. STK11 Domain XI Mutations: Candidate Genetic Drivers Leading to the Development of Dysplastic Polyps in Peutz-Jeghers Syndrome. Hum Mutat. 2014;35(7):851–8.CrossRefPubMed
18.
go back to reference Lim W, Olschwang S, Keller JJ, Westerman AM, Menko FH, Boardman LA, et al. Relative frequency and morphology of cancers in STK11 mutation carriers. Gastroenterology. 2004;126(7):1788–94.CrossRefPubMed Lim W, Olschwang S, Keller JJ, Westerman AM, Menko FH, Boardman LA, et al. Relative frequency and morphology of cancers in STK11 mutation carriers. Gastroenterology. 2004;126(7):1788–94.CrossRefPubMed
20.
go back to reference Le Meur N, Martin C, Saugier-Veber P, Joly G, Lemoine F, Moirot H, et al. Complete germline deletion of the STK11 gene in a family with Peutz-Jeghers syndrome. Eur J Hum Genet. 2004;12(5):415–8.CrossRefPubMed Le Meur N, Martin C, Saugier-Veber P, Joly G, Lemoine F, Moirot H, et al. Complete germline deletion of the STK11 gene in a family with Peutz-Jeghers syndrome. Eur J Hum Genet. 2004;12(5):415–8.CrossRefPubMed
21.
go back to reference Archer HL, Gupta S, Enoch S, Thompson P, Rowbottom A, Chua I, et al. Distinct phenotype associated with a cryptic subtelomeric deletion of 19p13.3-pter. Am J Med Genet A. 2005;136(1):38–44.CrossRefPubMed Archer HL, Gupta S, Enoch S, Thompson P, Rowbottom A, Chua I, et al. Distinct phenotype associated with a cryptic subtelomeric deletion of 19p13.3-pter. Am J Med Genet A. 2005;136(1):38–44.CrossRefPubMed
22.
go back to reference Hearle N, Lucassen A, Wang R, Lim W, Ross F, Wheeler R, et al. Mapping of a translocation breakpoint in a Peutz-Jeghers hamartoma to the putative PJS locus at 19q13.4 and mutation analysis of candidate genes in polyp and STK11-negative PJS cases. Genes Chromosomes Cancer. 2004;41(2):163–9.CrossRefPubMed Hearle N, Lucassen A, Wang R, Lim W, Ross F, Wheeler R, et al. Mapping of a translocation breakpoint in a Peutz-Jeghers hamartoma to the putative PJS locus at 19q13.4 and mutation analysis of candidate genes in polyp and STK11-negative PJS cases. Genes Chromosomes Cancer. 2004;41(2):163–9.CrossRefPubMed
23.
go back to reference Wang HH, Xie NN, Li QY, Hu YQ, Ren JL, Guleng B. Exome sequencing revealed novel germline mutations in Chinese Peutz-Jeghers syndrome patients. Dig Dis Sci. 2014;59(1):64–71.CrossRefPubMed Wang HH, Xie NN, Li QY, Hu YQ, Ren JL, Guleng B. Exome sequencing revealed novel germline mutations in Chinese Peutz-Jeghers syndrome patients. Dig Dis Sci. 2014;59(1):64–71.CrossRefPubMed
24.
go back to reference Yajima H, Isomoto H, Nishioka H, Yamaguchi N, Ohnita K, Ichikawa T, et al. Novel serine/threonine kinase 11 gene mutations in Peutz-Jeghers syndrome patients and endoscopic management. World J Gastrointest Endosc. 2013;5(3):102–10.PubMedCentralCrossRefPubMed Yajima H, Isomoto H, Nishioka H, Yamaguchi N, Ohnita K, Ichikawa T, et al. Novel serine/threonine kinase 11 gene mutations in Peutz-Jeghers syndrome patients and endoscopic management. World J Gastrointest Endosc. 2013;5(3):102–10.PubMedCentralCrossRefPubMed
25.
go back to reference Westerman AM, Entius MM, Boor PP, Koole R, de Baar E, Offerhaus GJ, et al. Novel mutations in the LKB1/STK11 gene in Dutch Peutz-Jeghers families. Hum Mutat. 1999;13(6):476–81.CrossRefPubMed Westerman AM, Entius MM, Boor PP, Koole R, de Baar E, Offerhaus GJ, et al. Novel mutations in the LKB1/STK11 gene in Dutch Peutz-Jeghers families. Hum Mutat. 1999;13(6):476–81.CrossRefPubMed
26.
go back to reference Zhao X, Huang Y, Yang B, Zhao Y. Mutation analysis of STK11 gene in a Chinese family with Peutz-Jeghers syndrome. Zhonghua Yi Xue Yi Chuan Xue Za Zhi. 2014;31(3):294–7.PubMed Zhao X, Huang Y, Yang B, Zhao Y. Mutation analysis of STK11 gene in a Chinese family with Peutz-Jeghers syndrome. Zhonghua Yi Xue Yi Chuan Xue Za Zhi. 2014;31(3):294–7.PubMed
27.
go back to reference Forcet C, Etienne-Manneville S, Gaude H, Fournier L, Debilly S, Salmi M, et al. Functional analysis of Peutz-Jeghers mutations reveals that the LKB1 C-terminal region exerts a crucial role in regulating both the AMPK pathway and the cell polarity. Hum Mol Genet. 2005;14(10):1283–92.CrossRefPubMed Forcet C, Etienne-Manneville S, Gaude H, Fournier L, Debilly S, Salmi M, et al. Functional analysis of Peutz-Jeghers mutations reveals that the LKB1 C-terminal region exerts a crucial role in regulating both the AMPK pathway and the cell polarity. Hum Mol Genet. 2005;14(10):1283–92.CrossRefPubMed
28.
go back to reference Olschwang S, Boisson C, Thomas G. Peutz-Jeghers families unlinked to STK11/LKB1 gene mutations are highly predisposed to primitive biliary adenocarcinoma. J Med Genet. 2001;38(6):356–60.PubMedCentralCrossRefPubMed Olschwang S, Boisson C, Thomas G. Peutz-Jeghers families unlinked to STK11/LKB1 gene mutations are highly predisposed to primitive biliary adenocarcinoma. J Med Genet. 2001;38(6):356–60.PubMedCentralCrossRefPubMed
Metadata
Title
Clinical characteristics and STK11 gene mutations in Chinese children with Peutz-Jeghers syndrome
Authors
Zhiheng Huang
Shijian Miao
Lin Wang
Ping Zhang
Bingbing Wu
Jie Wu
Ying Huang
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Gastroenterology / Issue 1/2015
Electronic ISSN: 1471-230X
DOI
https://doi.org/10.1186/s12876-015-0397-9

Other articles of this Issue 1/2015

BMC Gastroenterology 1/2015 Go to the issue
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discuss last year's major advances in heart failure and cardiomyopathies.