Nasal polyposis in Peutz-Jeghers syndrome: a distinct histopathological and molecular genetic entity.

Abstract:

BACKGROUND:Peutz-Jeghers syndrome (PJS) is an autosomal dominant hamartomatous polyposis syndrome of the gastrointestinal tract, caused by a germline STK11/LKB1 mutation. Nasal polyposis was described in the original report by Peutz. Recently, a molecular-genetic association between nasal polyposis and PJS has been reported. OBJECTIVE:To further explore the occurrence and pathogenesis of PJS-related nasal polyposis. METHODS:51 patients with PJS, 84 unaffected family members and 36 spouses from 18 families with PJS were questioned for the presence of nasal polyposis. 12 PJS-related nasal polyps, 1 carcinoma of the nasal cavity and 28 sporadic nasal polyps were analysed for loss of (wild type) STK11/LKB1, eosinophilia, squamous metaplasia, dysplasia and expression of cyclo-oxygenase 2 and p53. RESULTS:Nasal polyps occurred in 8 of 51 patients with PJS, and were not reported by non-affected family members (p<0.001). Germline STK11/LKB1 mutations were identified in all patients with PJS and nasal polyposis. Loss of heterozygosity was found in four of eight PJS-related nasal polyps, but not in sporadic nasal polyps (p = 0.002). PJS-related nasal polyps showed less eosinophilia than sporadic nasal polyps (p<0.001). Expression of cyclo-oxygenase 2 was found in 11 of 12 PJS-related nasal polyps and 19 of 28 sporadic nasal polyps (p>0.05). Overexpression of p53 was not found. CONCLUSIONS:Nasal polyposis occurs in a significant number of Dutch patients with PJS, one of whom developed a carcinoma in the nasal cavity. The loss of heterozygosity, and the absence of eosinophilia suggest a distinct pathogenesis compared with sporadic nasal polyposis.

journal_name

J Clin Pathol

authors

de Leng WW,Westerman AM,Weterman MA,Jansen M,van Dekken H,Giardiello FM,de Rooij FW,Paul Wilson JH,Offerhaus GJ,Keller JJ

doi

10.1136/jcp.2005.036418

subject

Has Abstract

pub_date

2007-04-01 00:00:00

pages

392-6

issue

4

eissn

0021-9746

issn

1472-4146

pii

jcp.2005.036418

journal_volume

60

pub_type

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