Chapter 31
Neoplasia of the Gastrointestinal Tract
Ofer Margalit,
Raymond N. DuBois,
Ofer Margalit
Biodesign Institute, Arizona State University, Tempe, AZ, USA
Search for more papers by this authorRaymond N. DuBois
Biodesign Institute, Arizona State University, Tempe, AZ, USA
Search for more papers by this authorOfer Margalit,
Raymond N. DuBois,
Ofer Margalit
Biodesign Institute, Arizona State University, Tempe, AZ, USA
Search for more papers by this authorRaymond N. DuBois
Biodesign Institute, Arizona State University, Tempe, AZ, USA
Search for more papers by this authorBook Editor(s):Daniel K. Podolsky MD,
Michael Camilleri MD,
J. Gregory Fitz MD FAASLD,
Anthony N. Kalloo MD,
Fergus Shanahan MD,
Timothy C. Wang MD,
Daniel K. Podolsky MD
President, University of Texas Southwestern Medical Center, Professor of Internal Medicine, Department of Internal Medicine, University of Texas Southwestern Medical School, Dallas, TX, USA
Search for more papers by this authorMichael Camilleri MD
Executive Dean for Development, Atherton and Winifred W. Bean Professor, Professor of Medicine, Physiology and Pharmacology, Distinguished Investigator, Mayo Clinic, Rochester, MN, USA
Search for more papers by this authorJ. Gregory Fitz MD FAASLD
Executive Vice President for Academic Aff airs and Provost, University of Texas Southwestern Medical Center, Dean, Professor of Internal Medicine, Department of Internal Medicine, University of Texas Southwestern Medical School, Dallas, TX, USA
Search for more papers by this authorAnthony N. Kalloo MD
Professor of Medicine, Johns Hopkins University School of Medicine, Director, Division of Gastroenterology & Hepatology, Johns Hopkins Hospital, Baltimore, MD, USA
Search for more papers by this authorFergus Shanahan MD
Professor and Chair, Department of Medicine, Director, Alimentary Pharmabiotic Centre, University College Cork, National University of Ireland, Cork, Ireland
Search for more papers by this authorTimothy C. Wang MD
Chief, Division of Digestive and Liver Diseases, Silberberg Professor of Medicine, Department of Medicine and Irving Cancer Research Center, Columbia University Medical Center, New York, NY, USA
Search for more papers by this authorFirst published: 27 November 2015
Summary
Factors that increase the rate of acquired genetic alterations in gastrointestinal (GI) malignancies are either extrinsic, including exposure to chemicals (e.g., tobacco), viruses, or bacteria, or intrinsic, such as dietary habits. Both genetic and epigenetic alterations ultimately lead to abnormal gene expression of at least three distinct types of genes, namely oncogenes, DNA repair genes, and tumor suppressor genes (TSGs), which cooperatively drive carcinogenesis. In order to sustain proliferation, apart from gaining constitutive proproliferative signaling, cancer cells must disable the counteracting programs that are aimed at inhibiting proliferation. The three main TSG pathways involved in GI malignancies are the p53, retinoblastoma (RB), and transforming growth factor-β (TGF-β) pathways. Telomeres affect two critical hallmarks of cancer, namely cell cycle control and genetic instability. Tumor cells may reactivate or overexpress telomerase through a variety of mechanisms. Intense efforts had been directed to development of therapeutic agents targeting telomerase.
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