Cancer prevention & early detection ´ëÀå°æ Á¤¸®
1. Èí¿¬ÀÌ ¿øÀÎÀÎ ¾Ï(p2575): lung, oral cavity, larynx, esophagus, bladder, kidney,
pancreas, oral cavity, esophagus, possibly lung cancer´Â alcohol°ú synergistic effect
2. Kaposi's sarcoma, multicentric Castleman's disease, ÃÖ±Ù multiple myelomaÀÇ ¹ß»ý°ú
°ü·ÃÀÖ´Â 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 ÅðÇà À¯µµ: ¥â-carotene, î-retinoic acid
5. chemoprevention : breast cancer¿¡¼ÀÇ tamoxifen
H & N cancer¿¡¼ÀÇ retinoid
colorectal cancer¿¡¼ÀÇ NSAIDs
6. cancer screening
¸Å³â: stool OB, DRE, prostate exam, self breast exam(>40¼¼), mammography
sigmoid: 3-5³â, pelvic exam 1-3³â, pap smear ¸Å³â -3ȸÀÌÈÄ °£°Ý´Ã¸²
breast exam: 20¼¼ À̻󿡼 ¸Å¿ù
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. ¿¹ÈÄÆÇÁ¤¿¡ Áß¿äÇÑ tumor marker: CEA, PSA, LDH, ¥â2-microglobulin
<Cancer cell biology & genetics>
1. telomerase overexpression: malignant cell, embryonic cell, adult male germ cell
2. G1 checkpoint¿¡¼ S-phase·Î ÀÌÇà¿¡ ÇÊ¿äÇÑ protein: cyclin, cdk(cyclin-dependent
kinases)
cyclin/cdk complexȰ¼ºÈ: IL-2
ºÒȰ¼ºÈ: cdk inhibitor
* cdk inhibitor: p21, p25, p57, p16, p15, p18
S phase·Î ÀÌÇàÃËÁø: Rb, cyclin D, cdk4, p15, p16 alteration, E2F
3. p53ÀÇ ¿ªÇÒ i) ¼Õ»óµÈ DNA repairÀ§ÇØ cell cycleÁ¤Áö
ii) programmed cell death(apoptosis) À¯µµ
4. p53: guardian of the G1 checkpoint
chromosome 17p¿¡ Á¸ÀçÇÏ´Â tumor suppressor gene
DNA damage½Ã DNA repairÀ§ÇØ cell cycleÀ» Á¤Áö½Ã۰í damage°¡ ½ÉÇϸé apoptosis¸¦
À¯¹ßÇÑ´Ù.
aflatoxin¿¡ ÀÇÇÑ hepatoma¿¡¼µµ p53 mutationÀÌ °ü·ÃµÈ´Ù.
¸ðµç Á¾¾çÀÇ 50%¿¡¼ ¹ß°ßµÇ´Â ÈçÇÑ mutationÀÌ´Ù.
5. apoptosisÃËÁø : p53, fas
apoptosis¾ïÁ¦ : bcl-2, bcl-XL
cf. follocular lymphoma t(14:18)¿¡¼ 18¹øÀÇ bcl-2 gene
6. oncogene activationÀÇ Á¾·ù¿Í ¿¹
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 cancer¿Í °ü·ÃÇÑ genetic changes
¨ç 3 suppressor gene loss : APC, DCC gene, p53 gene
¨è ras oncogene mutation
¨é DNA hypomethylation
8. lung cancer -> 3p(-)
9. G-protein mutationÀÌ Áõ¸íµÈ endocrine tumor
pituitary somatotroph adenoma,
thyroid tumor(autonomously functioning thyroid adenoma, papillary carcinoma, follicular ca)
adrenal cortical and ovarian cancer
10. cancer cell invasion¿¡ °ü¿©ÇÏ´Â Áß¿äÇÑ µÎ°¡Áö ¹°Áú
collagenase, TIMP(tissue inhibitors of metalloproteinases)