RESUMO
The most important goals of tumour aftercare are increasing the cure and overall survival rates and improving the quality of life. Additional responsibilities of the physician are psychosocial support of the patient and monitoring the late effects of therapy. If examinations are performed with diagnostic instruments, a therapeutic consequence for the patient that is commensurate with the finding must be forthcoming. This is because the diagnosis of an untreatable relapse or a relapse that does not need to be immediately treated is an additional burden for the patient.
Assuntos
Assistência ao Convalescente , Neoplasias/terapia , Papel do Médico , Qualidade de Vida , Neoplasias da Mama/diagnóstico por imagem , Neoplasias do Colo/diagnóstico , Ensaios Clínicos Controlados como Assunto , Feminino , Seguimentos , Humanos , Linfoma/diagnóstico , Masculino , Metanálise como Assunto , Recidiva Local de Neoplasia/diagnóstico , Neoplasias/mortalidade , Neoplasias/psicologia , Guias de Prática Clínica como Assunto , Prognóstico , Qualidade de Vida/psicologia , Radiografia , Fatores de TempoRESUMO
Hypermethylation of CpG islands near gene promoter regions is associated with transcriptional inactivation and represents an important mechanism of gene silencing in carcinogenesis. Such epigenetic phenomena can act alongside DNA mutations and deletions to disrupt tumor-suppressor gene function. The methylation status of the promoter-associated CpG islands from 11 well-characterized cancer-related genes was analyzed by methylation-specific polymerase chain reaction in 60 adult patients with acute myelogenous leukemia (AML) at diagnosis. The frequency of aberrant methylation among the patient samples was 45.0% (27/60) for suppressor of cytokine signaling-1, 31.7% (19/60) for p15, 20.0% (12/60) for retinoic acid receptor beta2, 13.3% (8/60) for p73 and E-cadherin, 5.0% (3/60) for O(6)-methylguanine DNA methyltransferase, 3.3% (2/60) for death-associated protein kinase 1 and hMLH1, 1.7% (1/60) for p16, and 0% (0/60) for the tissue inhibitor of matrix metalloproteinases-3 and Ras association domain family 1A. Aberrant DNA methylation was found in AML of all French-American-British subtypes and throughout all cytogenetic risk groups. There appeared to be a trend towards a higher methylation frequency in AML patients with an unfavorable karyotype, but this difference was not statistically significant. Our data indicate that hypermethylation of multiple genes involving fundamental cellular pathways is a common event in AML, which varies greatly in frequency among the genes examined. The accumulation of epigenetic events affecting genes which are involved in regulating cell cycle inhibition, cell adhesion, growth factor signaling, and apoptosis may contribute to the malignant AML phenotype. The growing knowledge of the role of epigenetics in the aberrant silencing of cancer-related genes provides a rationale and molecular basis for targeted therapeutic approaches with demethylating agents in AML.