Juvenile polyposis syndrome (review)

T. A. Vlasko, A. Likutov, V. Veselov, A. A. Ponomarenko, A. S. Tsukanov
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Abstract

Juvenile polyposis syndrome (JPS), a rare disease with an autosomal dominant mode of inheritance, which is characterized with the presence of multiple polyps in various parts of the gastrointestinal tract, mainly in the colon. The detection of adenomatous polyps in patients with JPS, in addition to juvenile ones, significantly complicates the differential diagnosis with familial adenomatous polyposis, in which it is necessary to perform a radical surgery — proctocolectomy. Only in 40-60% of cases, pathogenic variants of the SMAD4 and BMPR1A genes can be identified, each of which is characterized with its own clinical manifestations. Treatment options for patients with JPS include endoscopic and surgical; however, the decision-making algorithm, as well as the timing of postoperative follow-up, are not evaluated in Russian clinical guidelines. The rare occurrence of this syndrome, difficulties in endoscopic diagnosis and morphological verification, as well as limitations in determining the molecular genetics cause of the disease demonstrate the need for further research.
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幼年息肉病综合征(回顾)
幼年息肉病综合征(JPS)是一种罕见的常染色体显性遗传病,其特征是在胃肠道的不同部位(主要是结肠)出现多发性息肉。在 JPS 患者中,除了幼年息肉外,还发现了腺瘤性息肉,这使得与家族性腺瘤性息肉病的鉴别诊断变得非常复杂,在这种情况下,有必要进行根治性手术--直肠结肠切除术。只有在 40-60% 的病例中,才能发现 SMAD4 和 BMPR1A 基因的致病变体,每种变体都有自己的临床表现。JPS 患者的治疗方案包括内窥镜手术和外科手术;然而,俄罗斯的临床指南并未对决策算法和术后随访时间进行评估。这种综合征很少发生,内窥镜诊断和形态学验证困难重重,在确定该病的分子遗传学病因方面也存在局限性,因此有必要开展进一步的研究。
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