MLH1, MSH2, MSH6, PMS2, CDH1,APC, MUTYH,STK11,SMAD4,PTEN, BMPR1A, BRCA1/2, and EPCAM are well studied genes in hereditary cancer syndromes, such as Lynch syndrome, hereditary diffuse gastric cancer and etc. In present study, we also looked into the above gene status in our cases by NGS approach. The gene discussed is SMAD4; the disease is Familial gastric cancer.