Solomon E, Voss R, Hall V, Bodmer W F, Jass J R, Jeffreys A J, Lucibello F C, Patel I, Rider S H
Nature. 1987;328(6131):616-9. doi: 10.1038/328616a0.
That the sporadic and inherited forms of a particular cancer could both result from mutations in the same gene was first proposed by Knudson. He further proposed that these mutations act recessively at the cellular level, and that both copies of the gene must be lost for the cancer to develop. In sporadic cases both events occur somatically whereas in dominant familial cases susceptibility is inherited through a germline mutation and the cancer develops after a somatic change in the homologous allele. This model has since been substantiated in the case of retinoblastoma, Wilms tumour, acoustic neuroma and several other tumours, in which loss of heterozygosity was shown in tumour material compared to normal tissue from the same patient. The dominantly inherited disorder, familial adenomatous polyposis (FAP, also called familial polyposis coli), which gives rise to multiple adenomatous polyps in the colon that have a relatively high probability of progressing to a malignant adenocarcinoma, provides a basis for studying recessive genes in the far more common colorectal carcinomas using this approach. Following a clue as to the location of the FAP gene given by a case report of an individual with an interstitial deletion of chromosome 5q, who had FAP and multiple developmental abnormalities, we have examined sporadic colorectal adenocarcinomas for loss of alleles on chromosome 5. Using a highly polymorphic 'minisatellite' probe which maps to chromosome 5q we have shown that at least 20% of this highly heterogeneous set of tumours lose one of the alleles present in matched normal tissue. This parallels the assignment of the FAP gene to chromosome 5 (see accompanying paper) and suggests that becoming recessive for this gene may be a critical step in the progression of a relatively high proportion of colorectal cancers.
特定癌症的散发性和遗传性形式都可能由同一基因的突变引起,这一观点最早由克努森提出。他进一步提出,这些突变在细胞水平上呈隐性作用,并且该基因的两个拷贝都必须缺失,癌症才会发生。在散发性病例中,这两个事件都发生在体细胞中,而在显性家族性病例中,易感性是通过种系突变遗传的,癌症在同源等位基因发生体细胞变化后发展。此后,该模型在视网膜母细胞瘤、肾母细胞瘤、听神经瘤和其他几种肿瘤的病例中得到了证实,与同一患者的正常组织相比,肿瘤组织中显示出杂合性缺失。显性遗传疾病家族性腺瘤性息肉病(FAP,也称为家族性结肠息肉病)会导致结肠中出现多个腺瘤性息肉,这些息肉发展为恶性腺癌的概率相对较高,这为使用这种方法研究更为常见的结直肠癌中的隐性基因提供了基础。根据一份病例报告给出的关于FAP基因位置的线索,该报告中的一名个体患有5号染色体间质缺失,患有FAP并伴有多种发育异常,我们检查了散发性结直肠癌中5号染色体上等位基因的缺失情况。使用一个高度多态的“微卫星”探针,该探针定位于5号染色体长臂,我们发现,在这组高度异质性的肿瘤中,至少20%的肿瘤丢失了匹配的正常组织中存在的一个等位基因。这与FAP基因定位于5号染色体的结果相符(见随附论文),并表明该基因变为隐性可能是相当一部分结直肠癌进展中的关键步骤。