¼±Åà - È­»ìǥŰ/¿£ÅÍŰ ´Ý±â - ESC

 

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)