临床外科杂志 ›› 2026, Vol. 34 ›› Issue (2): 165-170.doi: 10.3969/j.issn.1005-6483.20250106

• 论著 • 上一篇    下一篇

幼年性息肉综合征家系SMAD4基因致病机制研究

  

  1. 350001  福建福州,中国人民解放军联勤保障部队第九○○医院/福建医科大学福总临床医学院普通外科(康荣彬、吴俊鸿、王烈、林承志);福建医科大学附属漳州市医院胃小肠软组织肉瘤外科(徐乾辉)
  • 收稿日期:2025-02-07 接受日期:2025-02-07 出版日期:2026-02-25 发布日期:2026-02-25
  • 通讯作者: 林承志,Email:469872103@qq.com
  • 基金资助:
    福建医科大学启航基金项目(2021QH1322);福建省卫健委科技创新计划项目(2023QNA087)

Pathogenic mechanisms of SMAD4 gene in familial juvenile polyposis syndrome:a molecular and clinical study

  1. Department of General Surgery,the 900th Hospital of Joint Logistics Support Force of Chinese People's Liberation Army/Fujian Medical University Fuzong Clinical Medical College,Fuzhou 350001,China
  • Received:2025-02-07 Accepted:2025-02-07 Online:2026-02-25 Published:2026-02-25

摘要: 目的 探讨幼年性息肉综合征(juvenile polyposis syndrome,JPS)家系发病的分子机制。方法 收集1例JPS家系8位成员息肉组织标本行HE染色及免疫组化分析。结果 SMAD4突变导致蛋白表达显著下调,下游TGF-β信号通路关键分子磷酸化SMAD3的活性显著减弱,引发腺体结构紊乱、炎症细胞浸润和腺上皮异型性。突变组织与对照组中Bax均表达上调,Bcl-2在突变组均表达上调,而对照组表达正常或下调:Caspase3在突变组表达下调,对照组表达正常。结论 SMAD4突变通过TGF-β信号通路阻断和凋亡调控失衡,促进JPS病变形成的分子机制,并为疾病的早期诊断和靶向治疗提供了新思路。

关键词: 幼年性息肉综合征家系, SMAD4, 转化生长因子-β

Abstract: Objective To investigate the molecular mechanisms underlying the pathogenesis of juvenile polyposis syndrome (JPS) in a family.Methods Eight family members of a JPS family were enrolled,and polyp tissue samples were collected for HE staining and immunohistochemical analysis.Results SMAD4 mutation led to a significant reduction in protein expression,and the activity of phosphorylated SMAD3,a key molecule in the downstream TGF-β signaling pathway,was significantly weakened,resulting in glandular structural disorder,infiltration of inflammatory cells,and epithelial atypia.Moreover,Bax expression was upregulated in both the mutated tissue and the control group.Bcl-2 showed consistently elevated expression in the mutant group,while maintaining normal or decreased expression in the control group.Caspase3 exhibited reduced expression in the mutant group,with normal expression levels observed in the control group.Conclusion The SMAD4 mutation promotes the formation of JPS lesions through disruption of the TGF-β signaling pathway and apoptosis regulation imbalance.These findings provide new insights for the early diagnosis and targeted therapy of the disease.

Key words: juvenile polyposis syndrome family, SMAD4, transforming growth factor-β

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[2] 林有智 陈孝平 陆玉蕾等. Smad4在TGF-β诱导人胆管癌细胞上皮间质转化中的作用 [J]. 临床外科杂志, 2013, 21(5): 340-342.
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