A) Tumor DNA sequencing can detect a history of smoking in a patient with lung cancer. Smoking-
related mutations, such as those caused by exposure to tobacco carcinogens, leave specific DNA
signatures or mutational patterns that can be identified through sequencing.
B) For the detection of DNA adducts, a method such as mass spectrometry or immunohistochemistry
can be used. These techniques can identify chemical modifications or adducts formed when certain
carcinogens bind to DNA.
Alternatively, you could use antibodies (less common) or use mass spectrometry directly.
C) Tumor types commonly caused by germline mutations include Lynch syndrome (associated with
colon cancer) and hereditary breast and ovarian cancer.
D) A case-control study can show the relation between exposure to AF-containing dust and lung
cancer risk. This type of observational study compares individuals with lung cancer (cases) to those
without (controls) and assesses their past exposure to AF-containing dust.
Disadvantages: not every participant is always honest / can remember.
Cohort study. Prospective: select population and at that moment you don’t know whether they get
the disease yes or no. You start with a healthy population and then look over time if they are
exposed or not.
E) Metabolic activation of a chemical carcinogen involves the conversion of a pro-carcinogen into its
active form by cellular enzymes or other factors such as pH. This activation is often necessary for the
carcinogen to exert its genotoxic effects.
F) Phase 1 enzymes are involved in the initial metabolism of xenobiotics (adding groups like oxygen),
making them more reactive and amenable to conjugation by phase 2 enzymes (adder bigger groups
to make it more water soluble (hydrophilic)). An example of a phase 1 enzyme is cytochrome P450,
and an example of a phase 2 enzyme is glutathione S-transferase.
G) C: clinic, T: spreading but not that much, N: lymph nodes involved, M: metastasis. Likely sites
for distant metastases in lung cancer include the brain, bones, liver, and adrenal glands.
H) The steps for the initial spread of tumor cells involve local invasion, intravasation into blood or
lymph vessels, survival in circulation, extravasation at distant sites, and colonization and growth at
those sites.
For integration:
Changes in Cell Adhesion: Normal cells are tightly held together by adhesive molecules. Cancer cells
undergo changes that weaken these adhesions, making it easier for them to detach from the primary
tumor.
Degrading Extracellular Matrix (ECM): Cancer cells produce enzymes, particularly
metalloproteinases, that break down the extracellular matrix (ECM) surrounding the tumor. ECM
degradation creates openings for cancer cells to move into nearby tissues.
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