Cancer of the Uterus by George Coukos, Stephen C. Rubin

By George Coukos, Stephen C. Rubin

NTI/Sales replica: the one advisor to supply entire insurance of the administration of endometrial melanoma, in addition to cancers in, on, and round the uterus. experiences the influence of diagnostic instruments, imaging recommendations, and sampling techniques within the assessment and administration of assorted cancers. Discusses overdue and complex level remedies together with radiation and surgical procedure.

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Liaw D, Marsh DJ, Li J, et al. Germline mutations of the PTEN gene in Cowden disease, an inherited breast and thyroid cancer syndrome. Nature Genetics 1997; 16:64–67. Coukos01 001-034 11/18/04 1:32 PM Page 23 Molecular Genetics of Uterine Malignancies 23 42. Nelen MR, van Staveren WC, Peeters EA, et al. Germline mutations in the PTEN/MMAC1 gene in patients with Cowden disease. Hum Mol Genetics 1997; 6:1383–1387. 43. Eng C, Parsons R. Cowden Sydrome. In: Vogelstein, Kinzler, eds. The Genetic Basis of Human Cancer: McGraw-Hill, 1998:519–525.

Recent work from Gradia et al. and Fishel and colleagues provides a second explanation for why loss of DNA mismatch repair may be so frequent in some tumor types (58–60). Mismatch repair proteins theoretically function as molecular sensors that connect signaling pathways and the nucleus to direct the repair Coukos01 001-034 11/18/04 1:32 PM Page 11 Molecular Genetics of Uterine Malignancies 11 of DNA damage or to elicit cell death (61). Loss of this molecular sensor function could provide the endometrial cancer cell with a growth and/or survival advantage.

The benefits of colonic surveillance for members of HNPCC families has been documented, and colonoscopy at 18- to 24-month intervals beginning at age 25 to 30 is recommended (26). A recommendation for endometrial screening beginning between ages 25 and 30 has been made, but the optimal methods for screening and the clinical benefit of endometrial surveillance are not yet well established (26). The criteria used to diagnose HNPCC are rather stringent, and in most families the three cardinal features of inherited cancer susceptibility are present: early age-of-onset, synchronous and metachronous cancers, and multiple closely related affected family members.

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