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Primary Tumor

  1. Urinary bladder - Adrenal
    1. (Note that sec. from liver usually go to lung & those from lung; to liver)
    2. Overall, most common site of metastasis:
      1. Lymph nodes
      2. Liver
  1. Bone Secondaries:
    1. They are the commonest bone malignancy.
    2. Most common route – hematogenous.
    3. Most common primary tumour giving bone secondaries:
      Female - Breast
  1. Genetic basis of carcinogenesis: Q
    Friends, we strongly recommend to remember the following high yield information:
    Genes involved in carcinogenesis: 
    Govern production of oncoproteins.
    Examples of oncoproteins are:
    1. Growth factors –
      are products of oncogenes, and do not govern them. e.g.- PDGF, FGF
    2. Growth factor receptors –
      overexpression of er b B – 1 Gliomas
      amplification of – er b B – 2 (Her-2 neu) CA Breast, ovary, stomach  
    3. Signal transduction proteins –
      Mech. of action Gene Cause
      GTP binding protein Ras Point mutation (mnomic; Grass pointed)
      Tyrosine kinase Abl Translocation  CML, ALL
    4. Nuclear regulating proteins –
      act as transcription activators, e.g.-
      c-myc/myc - Translocation  (8-14) Burkitt’s lymphoma
      N-myc - Amplification  Neuroblastoma
      L-myc - Amplification  Lung carcinoma (small cell)
      C-myc - Amplified in any quiescent  Cell division
Cellular Oncogenes in Retroviruses
Oncogene Virus Name Protein Product
abl Abelson murine leukemia virus Tyrosine kinase
fes ST feline sarcoma virus Tyrosine kinase
fps Fujinami sarcoma virus Tyrosine kinase
src Rous sarcoma virus Tyrosine kinase
erbB Avian erythroblastosis virus Epidermal growth factor receptor
fms McDonough feline sarcoma virus Colony-stimulating factor receptor
kit Hardy-Zuckerman 4 feline sarcoma virus Stem cell factor receptor
mil Avian myelocytoma virus Serine/threonine kinase
mos Moloney murine sarcoma virus Serine/threonine kinase
raf Murine sarcoma virus 3611 Serine/threonine kinase
sis Simian sarcoma virus Platelet-derived growth factor
H-ras Harvey murine sarcoma virus GDP/GTP binding
K-ras Kirsten murine sarcoma virus GDP/GTP binding
erbA Avian erythroblastosis virus Transcription factor (thyroid hormone receptor)
ets Avian myeloblastosis virus E26 Transcription factor
fos FBJ osteosarcoma virus Transcription factor (AP1 component)
jun Avian sarcoma virus 17 Transcription factor (AP1 component)
myb Avian myeloblastosis virus Transcription factor
myc MC29 myelocytoma virus Transcription factor (NF-κ B family)
    Their damage leads to carcinogenesis.
    1. Rb  Retinoblastoma
    2. BRCa  Breast Carcinoma
    3. P53  Called ‘Guardian of genome’
    4. APC  Familial Adenomatous Polyposis Coli
Their amplification leads to carcinongenesis:
  1. Bcl – 2
  2. Akt
  3. IAP
  4. Bil – xl
Their damage cause carcinogenesis:
  1. Caspases
  2. CytC
  3. Bax
  4. B_ _ (many other three – lettered genes, beginning with B)
Chromosomal translocation, causing malignancies:-
t(8,14)  Burrkitt’s lymphoma
t(14,18)  Follicular lymphoma
t(15,17)  Acute promyelocytic leukaemia (M3)
t(9,22)  CML

Occupational cancers
  • Lung
  • Liver
  • Skin
  • Paranasal sinuses
  • Lung (squamous cell carcinoma)
  • Paranasal sinuses
  • Lung
  • Larynx
  • Lung
  • Pleura
  • Peritoneum
  • Paranasal sinuses (adenocarcinoma)
Aniline dyes:
  • Urinary bladder
Selected IARC Group 1 Chemical Carcinogens
Aflatoxins Liver cancer
Benzene Leukemia
Benzidine Bladder cancer
Beryllium Lung cancer
Cadmium Lung cancer
Chinese-style salted fish Nasopharyngeal carcinoma
Chlorambucil Leukemia
Coal tar Skin cancer, scrotal cancer
Cyclophosphamide Bladder cancer, leukemia
Diethylstilbestrol (DES) Vaginal and cervical clear cell adenocarcinomas
Ethylene oxide Leukemia, lymphoma
Estrogen replacement therapy Endometrial cancer, breast cancer
Tamoxifenc Endometrial cancer
Vinyl chloride Angiosarcoma of the liver, hepatocellular carcinoma, brain tumors, lung cancer, malignancies of lymphatic and hematopoietic system
TCDD (2,3,7,8-tetrachlorodibenzo-para-dioxin) Soft tissue sarcoma
Tobacco products, smokeless Oral cancer
Tobacco smoke Lung cancer, oral cancer, pharyngeal cancer, laryngeal cancer, esophageal cancer (squamous cell), pancreatic cancer, bladder cancer, liver cancer, renal cell carcinoma, cervical cancer, leukemia

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