Molecular Pathogenesis of Human Cancer

Abstract

Cancer represents a significant health problem worldwide. The successful curative treatment of almost every form of this disease depends on early diagnosis and, in the case of solid tumors, surgical resection with or without adjuvant therapy. Intensive research efforts during the last several decades have increased our understanding of carcinogenesis and have identified a genetic basis for the multistep process of cancer development (1 –3). In several human tumor systems, specific genetic alterations have been shown to correlate with well-defined histopatho-logic stages of tumor development and progression (4,5). Although the significance of mutations to the etiological mechanisms of tumor development has been debated, a causal role for such genetic lesions is now commonly accepted for many human tumors. Thus, genetic lesions represent an integral part of the processes of neoplastic transformation, tumorigenesis, and tumor progression, and as such, they represent potentially valuable markers for cancer detection and staging (6,7). Through the application of specific and sensitive molecular methodologies, the clinical laboratory of the future will be able to effectively screen populations at high risk for the development of cancer, potentially impacting the early detection and diagnosis of human cancers. In addition, development of new molecular diagnostic assays will expand the ability of clinicians to accurately stage tumor development, monitor progression of metastatic disease, and evaluate therapeutic outcome, facilitating the application of effective intervention strategies in the treatment of human tumors.