F00574 022 f062
Normal
Key gene
Chromosome
Normal
function
Alteration
Effect
Early adenoma
Intermediate
adenoma
Late adenoma
Carcinoma
APC
(adenomatous polyposis coli)
5q
'Gatekeeper'
Truncating
mutations
K-ras
DCC
(deleted in colon cancer)
p53
12p
18q
17p
Transmembrane GTP-binding protein mediating mitogenic signals <p21)
Multiple: role in apoptosis, tumour suppressor gene
arrest celi cycle and allow DNA repair or apoptosis to occur
Further mutations
• Anchorage independence
• Protease synthesis
• Telomerase synthesis
• Multidrug resistance
• Evasion of immune system
Gain in function mutations
Allelic deleiion
Allelic deletion; gain in function mutations
Progression to Celi
early adenoma proliferation
development
? Role in invasion Celi proliferation; and metastasis impaired apoptosis
© Elsevier. Boon et al.: Davidson's Principles and Practice of Medicine 20e - www.studentconsult.com
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