Knudson A G
Natl Cancer Inst Monogr. 1979 May(51):19-24.
The embryonal tumors of children occur in dominantly heritable and nonhereditary forms, which indicates that a dominant mutation can be on the carcinogenic pathway. A model which fits age-specific incidence hypothesizes that both forms arise as a consequence of two mutations. The background incidences of these tumors then reflect spontaneous mutation rates in germinal and somatic cells and may be increased by mutagens. The gene for one tumor (retinoblastoma) seems to be located on chromosome 13. Clues to the pathophysiology of these tumor genes come from consideration of their tissue specificity, origin from embryonal cells, and developmental effects. Childhood cancers may be manifestations of the homozygous states of a series of genes concerned with differentiation in specific embryonal tissues.
儿童胚胎性肿瘤以显性遗传和非遗传形式出现,这表明显性突变可能处于致癌途径上。一个符合年龄特异性发病率的模型假设,这两种形式都是由两个突变导致的。这些肿瘤的背景发病率反映了生殖细胞和体细胞中的自发突变率,并且可能因诱变剂而增加。一种肿瘤(视网膜母细胞瘤)的基因似乎位于13号染色体上。这些肿瘤基因病理生理学的线索来自对其组织特异性、胚胎细胞起源和发育影响的考虑。儿童癌症可能是一系列与特定胚胎组织分化有关的基因纯合状态的表现。