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Chapter 7: Neoplasia

Nomenclature 266
Characteristics of Benign and Malignant Neoplasms 267
Differentiation and Anaplasia 268
Local Invasion 271
Metastasis 272
Pathways of Spread 273
Epidemiology of Cancer 275
The Global Impact of Cancer 275
Environmental Factors 276
Age 278
Acquired Predisposing Conditions 278
Genetic Predisposition and Interactions
Between Environmental and Inherited Factors 279
Molecular Basis of Cancer: Role of Genetic and Epigenetic Alterations
280
Cellular and Molecular Hallmarks of Cancer 282
Self-Suffiiency in Growth Signals: Oncogenes 283
Proto-oncogenes, Oncogenes, and Oncoproteins 284
Insensitivity to Growth Inhibition: Tumor Suppressor Genes 290
Growth-Promoting Metabolic Alterations:The Warburg Effect 300
Evasion of Programmed Cell Death (Apoptosis) 301
Limitless Replicative Potential:The Stem CellLike Properties of
Cancer Cells 303
Angiogenesis 305
Invasion and Metastasis 306
Invasion of Extracellular Matrix 306
Vascular Dissemination and Homing of Tumor Cells 308
Molecular Genetics of Metastasis Development 309
Role of Stromal Elements in Metastasis 309
Evasion of Host Defense 310
Tumor Antigens 310
Antitumor Effector Mechanisms 312
Immune Surveillance and Escape 312
Genomic Instability 314
Cancer-Enabling Inflmmation 315
Dysregulation of Cancer-Associated Genes 316
Chromosomal Changes 316
Epigenetic Changes 319
Noncoding RNAs and Cancer 320
Molecular Basis of Multistep Carcinogenesis 320
Carcinogenic Agents and Their Cellular Interactions 321

Steps Involved in Chemical Carcinogenesis 322


Direct-Acting Carcinogens 322
Indirect-Acting Carcinogens 323
Promotion of Chemical Carcinogenesis 324
Radiation Carcinogenesis 324
Ultraviolet Rays 324
Ionizing Radiation 325
Microbial Carcinogenesis 325
Oncogenic RNA Viruses 325
Oncogenic DNA Viruses 326
Helicobacter pylori 329
Clinical Aspects of Neoplasia 329
Grading and Staging of Tumors 332
Laboratory Diagnosis of Cancer 332
Molecular Profies of Tumors: The Future of Cancer Diagnostics 335
Tumor Markers 337

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