p53 mutation and cancer
p53 MUTATIONS IN ESOPHAGEAL CANCER
The incidence of esophageal cancer has risen in recent decades, coinciding with a shift in histologic type and primary tumor location. Adenocarcinoma of the esophagus is now more prevalent than squamous cell carcinoma in the United States and western Europe, with most tumors located in the distal esophagus. The cause for the rising incidence and demographic alterations is unknown. While risk factors for squamous cell carcinoma of the esophagus have been identified (tobacco, alcohol, diet, etc.), the risk factors associated with esophageal adenocarcinoma are less clear. The presence of Barrett's esophagus is associated with an increased risk of developing adenocarcinoma of the esophagus, and chronic reflux is considered the predominate cause of Barrett's metaplasia. The results of a population-based, case-controlled study from Sweden strongly suggest that symptomatic gastroesophageal reflux is a risk factor for esophageal adenocarcinoma. The frequency, severity, and duration of reflux symptoms were positively correlated with increased risk of esophageal adenocarcinoma. Fewer than 50% of esophageal cancers are squamous cell carcinomas. Adenocarcinomas, typically arising in Barrett's esophagus, account for at least 50% of malignant lesions, and the incidence of this histology appears to be rising. Barrett's esophagus contains glandular epithelium cephalad to the esophagogastric junction. Three different types of glandular epithelium can be seen: metaplastic columnar epithelium, metaplastic parietal cell glandular epithelium within the esophageal wall, or metaplastic intestinal epithelium with typical goblet cells. Dysplasia is particularly likely to develop in the intestinal type mucosa.
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Spectrum of p53 mutations in esophagal cancer
The frequency of p53 mutations is higher in esophageal ADC compared to SCC
The pattern of p53 mutations is diferent in the two types.