Cancer prevention & early detection 대장경 정리

1. 흡연이 원인인 암(p2575): lung, oral cavity, larynx, esophagus, bladder, kidney,

pancreas, oral cavity, esophagus, possibly lung cancer는 alcohol과 synergistic effect

2. Kaposi's sarcoma, multicentric Castleman's disease, 최근 multiple myeloma의 발생과

관련있는 virus : HHV-8 or KSHV(Kasposi's sarcoma-associated herpes virus)

3. EBV -> Burkitt's lymphoma, nasal T-cell lymphoma

HTLV-I -> adult T-cell leukemia/lymphoma

HIV -> NHL, Kaposi's sarcoma, squamous cell ca

human papilloma virus -> cervical cancer

<Tab 112-4>

EBV: Burkitt's lymphoma, post-organ transplant lymphoma

primary CNS lymphoma(diffuse large B cell), Hodgkin's disease

HIV : diffuse large B cell lymphoma

Burkitt's lymphoma

HCV : lymphoplasmacytic lymphoma

H.pylori : gastric MALT lymphoma

HHV-8 : primary effusion lymphoma, multicentric Castleman's disease

4. leukoplakia 퇴행 유도: β-carotene, 챤-retinoic acid

5. chemoprevention : breast cancer에서의 tamoxifen

H & N cancer에서의 retinoid

colorectal cancer에서의 NSAIDs

6. cancer screening

매년: stool OB, DRE, prostate exam, self breast exam(>40세), mammography

sigmoid: 3-5년, pelvic exam 1-3년, pap smear 매년 -3회이후 간격늘림

breast exam: 20세 이상에서 매월

7-1) CEA: colon, pancreas, lung, breast, ovary cancer

inflammatory bowel disease, pancreatitis, smoking, hepatitis

2) AFP : HCC, gonadal germ cell tumor(nonseminoma), cirrhosis, hepatitis

3) NSE(neuron specific enolase): small cell lung cancer, neuroblastoma

4) CA 19-9: colon, pancreas, breast cancer, pancreatitis, UC

5) CD30: Hodgkin's disease, anaplastic large cell lymphoma

6) CD25: Hariy cell leukemia, adult T-cell leukemia/lymphoma

8. 예후판정에 중요한 tumor marker: CEA, PSA, LDH, β2-microglobulin

<Cancer cell biology & genetics>

1. telomerase overexpression: malignant cell, embryonic cell, adult male germ cell

2. G1 checkpoint에서 S-phase로 이행에 필요한 protein: cyclin, cdk(cyclin-dependent

kinases)

cyclin/cdk complex활성화: IL-2

불활성화: cdk inhibitor

* cdk inhibitor: p21, p25, p57, p16, p15, p18

S phase로 이행촉진: Rb, cyclin D, cdk4, p15, p16 alteration, E2F

3. p53의 역할 i) 손상된 DNA repair위해 cell cycle정지

ii) programmed cell death(apoptosis) 유도

4. p53: guardian of the G1 checkpoint

chromosome 17p에 존재하는 tumor suppressor gene

DNA damage시 DNA repair위해 cell cycle을 정지시키고 damage가 심하면 apoptosis를

유발한다.

aflatoxin에 의한 hepatoma에서도 p53 mutation이 관련된다.

모든 종양의 50%에서 발견되는 흔한 mutation이다.

5. apoptosis촉진 : p53, fas

apoptosis억제 : bcl-2, bcl-XL

cf. follocular lymphoma t(14:18)에서 18번의 bcl-2 gene

6. oncogene activation의 종류와 예

1) point mutation: lung cancer, colon cancer, pancreas cancer ras family

2) DNA amplification or overexpression

: N-myc(neuroblastoma), erb-B2(breast cancer)

3) chromosomal alterations: t(9:22) CML, t(15:17) AML M3, t(8:14) Burkitt's lymphoma

7. colon cancer와 관련한 genetic changes

① 3 suppressor gene loss : APC, DCC gene, p53 gene

② ras oncogene mutation

③ DNA hypomethylation

8. lung cancer -> 3p(-)

9. G-protein mutation이 증명된 endocrine tumor

pituitary somatotroph adenoma,

thyroid tumor(autonomously functioning thyroid adenoma, papillary carcinoma, follicular ca)

adrenal cortical and ovarian cancer

10. cancer cell invasion에 관여하는 중요한 두가지 물질

collagenase, TIMP(tissue inhibitors of metalloproteinases)