Chromosome instability

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Chromosomal instability (CIN) is a type of genomic instability in which chromosomes are unstable, such that either whole chromosomes or parts of chromosomes are duplicated or deleted. More specifically, CIN refers to the increase in rate of addition or loss of entire chromosomes or sections of them. [1] The unequal distribution of DNA to daughter cells upon mitosis results in a failure to maintain euploidy (the correct number of chromosomes) leading to aneuploidy (incorrect number of chromosomes). In other words, the daughter cells do not have the same number of chromosomes as the cell they originated from. Chromosomal instability is the most common form of genetic instability and cause of aneuploidy. [2]

Contents

These changes have been studied in solid tumors (a tumor that usually doesn't contain liquid, pus, or air, compared to liquid tumor), [3] which may or may not be cancerous. CIN is a common occurrence in solid and haematological cancers, especially colorectal cancer. [4] Although many tumours show chromosomal abnormalities, CIN is characterised by an increased rate of these errors. [5]

Criteria for CIN definition

Classification

Numerical CIN is a high rate of either gain or loss of whole chromosomes; causing aneuploidy. Normal cells make errors in chromosome segregation in 1% of cell divisions, whereas cells with CIN make these errors approximately 20% of cell divisions. Because aneuploidy is a common feature in tumour cells, the presence of aneuploidy in cells does not necessarily mean CIN is present; a high rate of errors is definitive of CIN. [6] One way of differentiating aneuploidy without CIN and CIN-induced aneuploidy is that CIN causes widely variable (heterogeneous) chromosomal aberrations; whereas when CIN is not the causal factor, chromosomal alterations are often more clonal. [7]

Structural CIN is different in that rather than whole chromosomes, fragments of chromosomes may be duplicated or deleted. The rearrangement of parts of chromosomes (translocations) and amplifications or deletions within a chromosome may also occur in structural CIN. [6]

How Chromosome instability is generated

Defective DNA damage response

A loss in the repair systems for DNA double-stranded breaks and eroded telomeres can allow chromosomal rearrangements that generate loss, amplification and/or exchange of chromosome segments. [2]

Some inherited genetic predispositions to cancer are the result of mutations in machinery that responds to and repairs DNA double-stranded breaks. Examples include ataxia telangiectasia – which is a mutation in the damage response kinase ATM – and BRCA1 or MRN complex mutations that play a role in responding to DNA damage. When the above components are not functional, the cell can also lose the ability to induce cell-cycle arrest or apoptosis. Therefore, the cell can replicate or segregate incorrect chromosomes. [8]

Faulty rearrangements can occur when homologous recombination fails to accurately repair double-stranded breaks. Since human chromosomes contain repetitive DNA sections, broken DNA segments from one chromosome can combine with similar sequences on a non-homologous chromosome. If repair enzymes do not catch this recombination event, the cell may contain non-reciprocal translocation where parts of non-homologous chromosomes are joined together. Non-homologous end joining can also join two different chromosomes together that had broken ends. The reason non-reciprocal translocations are dangerous is the possibility of producing a dicentric chromosome – a chromosome with two centromeres. When dicentric chromosomes form, a series of events can occur called a breakage-fusion-bridge cycle : Spindle fibers attach onto both centromeres in different locations on the chromosome, thereby tearing the chromatid into two pieces during anaphase. The result is a pair of DNAs with broken ends that can attach to other broken-ended DNA segments creating additional translocation and continue the cycle of chromosome breakage and fusion. As the cycle continues, more chromosome translocations result, leading to the amplification or loss of large DNA fragments. Some of these changes will kill the cell, however, in a few rare cases, the rearrangements can lead to a viable cell without tumor suppressor genes and increased expression of proto-oncogenes that may become a tumor cell. [9]

Degenerating telomeres

Telomeres – which are a protective ‘cap’ at the end of DNA molecules – normally shorten in each replication cycle. In certain cell types, the telomerase enzyme can re-synthesize the telomere sequences, however, it is not present in all somatic cells. Once 25-50 divisions pass, the telomeres can be completely lost, inducing p53 to either permanently arrest the cell or induce apoptosis. Telomere shortening and p53 expression is a key mechanism to prevent uncontrolled replication and tumor development because even cells that excessively proliferate will eventually be inhibited. [10] [11]

However, telomere degeneration can also induce tumorigenesis in other cells. The key difference is the presence of a functional p53 damage response. When tumor cells have a mutation in p53 that results in a non-functional protein, telomeres can continue to shorten and proliferate, and the eroded segments are susceptible to chromosomal rearrangements through recombination and breakage-fusion-bridge cycles. Telomere loss can be lethal for many cells, but in the few that are able to restore the expression of telomerase can bring about a “stable” yet tumorigenic chromosome structure. Telomere degeneration thereby explains the transient period of extreme chromosomal instability observed in many emerging tumors. [11]

In experiments on mice where both telomerase and p53 were knocked out, they developed carcinomas with significant chromosomal instability similar to tumors seen in humans. [2]

Additional theories

Spindle assembly checkpoint (SAC) abnormalities: The SAC normally delays cell division until all of the chromosomes are accurately attached to the spindle fibers at the kinetochore. Merotelic attachments – when a single kinetochore is connected to microtubules from both spindle poles. Merotelic attachments are not recognized by the SAC, so the cell can attempt to proceed through anaphase. Consequently, the chromatids may lag on the mitotic spindle and not segregate, leading to aneuploidy and chromosome instability. [12]

Chromosome instability and aneuploidy

CIN often results in aneuploidy. There are three ways that aneuploidy can occur. It can occur due to loss of a whole chromosome, gain of a whole chromosome or rearrangement of partial chromosomes known as gross chromosomal rearrangements (GCR). All of these are hallmarks of some cancers. [13] Most cancer cells are aneuploid, meaning that they have an abnormal number of chromosomes which often have significant structural abnormalities such as chromosomal translocations, where sections of one chromosome are exchanged or attached onto another. Changes in ploidy can alter expression of proto-oncogenes or tumor suppressor genes. [1] [2]

Segmental aneuploidy can occur due to deletions, amplifications or translocations, which arise from breaks in DNA, [5] while loss and gain of whole chromosomes is often due to errors during mitosis.

Genome integrity

Chromosomes consist of the DNA sequence, and the proteins (such as histones) that are responsible for its packaging into chromosomes. Therefore, when referring to chromosome instability, epigenetic changes can also come into play. Genes on the other hand, refer only to the DNA sequence (hereditary unit) and it is not necessary that they will be expressed once epigenetic factors are taken into account. Disorders such as chromosome instability can be inherited via genes, or acquired later in life due to environmental exposure. One way that Chromosome Instability can be acquired is by exposure to ionizing radiation. [14] Radiation is known to cause DNA damage, which can cause errors in cell replication, which may result in chromosomal instability. Chromosomal instability can in turn cause cancer. However, chromosomal instability syndromes such as Bloom syndrome, ataxia telangiectasia and Fanconi anaemia are inherited [14] and are considered to be genetic diseases. These disorders are associated with tumor genesis, but often have a phenotype on the individuals as well. The genes that control chromosome instability are known as chromosome instability genes and they control pathways such as mitosis, DNA replication, repair and modification. [15] They also control transcription, and process nuclear transport. [15]

Chromosome instability and cancer

CIN is a more pervasive mechanism in cancer genetic instability than simple accumulation of point mutations. However, the degree of instability varies between cancer types. For example, in cancers where mismatch repair mechanisms are defective – like some colon and breast cancers – their chromosomes are relatively stable. [2]

Cancers can go through periods of extreme instability where chromosome number can vary within the population. Rapid chromosomal instability is thought to be caused by telomere erosion. However, the period of rapid change is transient as tumor cells generally reach an equilibrium abnormal chromosome content and number. [16]

The research associated with chromosomal instability is associated with solid tumors, which are tumors that refer to a solid mass of cancer cells that grow in organ systems and can occur anywhere in the body. These tumors are opposed to liquid tumors, which occur in the blood, bone marrow, and lymph nodes. [17]

Although chromosome instability has long been proposed to promote tumor progression, recent studies suggest that chromosome instability can either promote or suppress tumor progression. [13] The difference between the two are related to the amount of chromosomal instability taking place, as a small rate of chromosomal instability leads to tumor progression, or in other words cancer, while a large rate of chromosomal instability is often lethal to cancer. [18] This is due to the fact that a large rate of chromosomal instability is detrimental to the survival mechanisms of the cell, [18] and the cancer cell cannot replicate and dies (apoptosis). [19] Therefore, the relationship between chromosomal instability and cancer can also be used to assist with diagnosis of malignant vs. benign tumors. [18]

The level of chromosome instability is influenced both by DNA damage during the cell cycle and the effectiveness of the DNA damage response in repairing damage. The DNA damage response during interphase of the cell cycle (G1, S and G2 phases) helps protect the genome against structural and numerical cancer chromosome instability. However untimely activation of the DNA damage response once cells have committed to the mitosis stage of the cell cycle appears to undermine genome integrity and induce chromosome segregation errors. [20]

A majority of human solid malignant tumors is characterized by chromosomal instability, and have gain or loss of whole chromosomes or fractions of chromosomes. [5] For example, the majority of colorectal and other solid cancers have chromosomal instability (CIN). [21] This shows that chromosomal instability can be responsible for the development of solid cancers. However, genetic alterations in a tumor do not necessarily indicate that the tumor is genetically unstable, as ‘genomic instability’ refers to various instability phenotypes, including the chromosome instability phenotype [5]

The role of CIN in carcinogenesis has been heavily debated. [22] While some argue the canonical theory of oncogene activation and tumor suppressor gene inactivation, such as Robert Weinberg, some have argued that CIN may play a major role in the origin of cancer cells, since CIN confers a mutator phenotype [23] that enables a cell to accumulate large number of mutations at the same time. Scientists active in this debate include Christoph Lengauer, Kenneth W. Kinzler, Keith R. Loeb, Lawrence A. Loeb, Bert Vogelstein and Peter Duesberg.

Chromosome instability in anticancer therapy

Hypothetically, the heterogeneous gene expression that can occur in a cell with CIN, the rapid genomic changes can drive the emergence of drug-resistant tumor cells. While some studies show that CIN is associated with poor patient outcomes and drug resistance, conversely, others studies actually find that people respond better with high CIN tumors. [24]

Some researchers believe that CIN can be stimulated and exploited to generate lethal interactions in tumor cells. ER negative breast cancer patients with the most extreme CIN have the best prognosis, with similar results for ovarian, gastric and non-small cell lung cancers. A potential therapeutic strategy therefore could be to exacerbate CIN specifically in tumor cells to induce cell death. [25] For example, BRCA1 , BRCA2 and BC-deficient cells have a sensitivity to poly(ADP-ribose) polymerase (PARP) which helps repair single-stranded breaks. When PARP is inhibited, the replication fork can collapse. Therefore, PARP tumor suppressing drugs could selectively inhibit BRCA tumors and cause catastrophic effects to breast cancer cells. Clinical trials of PARP inhibition are ongoing. [26]

There is still a worry that targeting CIN in therapy could trigger genome chaos that actually increases CIN that leads to selection of proliferative advantages. [24]

Chromosome instability and metastasis

Chromosomal instability has been identified as a genomic driver of metastasis. [27] Chromosome segregation errors during mitosis lead to the formation of structures called micronuclei. These micronuclei, which reside outside of the main nucleus have defective envelopes and often rupture exposing their genomic DNA content to the cytoplasm. [28] Exposure of double-stranded DNA to the cytosol activates anti-viral pathways, such as the cGAS-STING cytosolic DNA-sensing pathway. This pathway is normally involved in cellular immune defenses against viral infections. Tumor cells hijack chronic activation of innate immune pathways to spread to distant organs, suggesting that CIN drives metastasis through chronic inflammation stemming in a cancer cell-intrinsic manner. [27]

Diagnostic methods

Chromosomal instability can be diagnosed using analytical techniques at the cellular level. Often used to diagnose CIN is cytogenetics flow cytometry, Comparative genomic hybridization and Polymerase Chain Reaction. [5] Karyotyping, and fluorescence in situ hybridization (FISH) are other techniques that can be used. [29] In Comparative genomic hybridization, since the DNA is extracted from large cell populations it is likely that several gains and losses will be identified. [5] Karyotyping is used for Fanconi Anemia, based on 73-hour whole-blood cultures, which are then stained with Giemsa. Following staining they are observed for microscopically visible chromatid-type aberrations [30]

See also

Related Research Articles

<span class="mw-page-title-main">Centromere</span> Specialized DNA sequence of a chromosome that links a pair of sister chromatids

The centromere links a pair of sister chromatids together during cell division. This constricted region of chromosome connects the sister chromatids, creating a short arm (p) and a long arm (q) on the chromatids. During mitosis, spindle fibers attach to the centromere via the kinetochore.

<span class="mw-page-title-main">Aneuploidy</span> Presence of an abnormal number of chromosomes in a cell

Aneuploidy is the presence of an abnormal number of chromosomes in a cell, for example a human cell having 45 or 47 chromosomes instead of the usual 46. It does not include a difference of one or more complete sets of chromosomes. A cell with any number of complete chromosome sets is called a euploid cell.

<span class="mw-page-title-main">Werner syndrome</span> Medical condition

Werner syndrome (WS) or Werner's syndrome, also known as "adult progeria", is a rare, autosomal recessive disorder which is characterized by the appearance of premature aging.

<span class="mw-page-title-main">Chromosomal translocation</span> Phenomenon that results in unusual rearrangement of chromosomes

In genetics, chromosome translocation is a phenomenon that results in unusual rearrangement of chromosomes. This includes balanced and unbalanced translocation, with two main types: reciprocal, and Robertsonian translocation. Reciprocal translocation is a chromosome abnormality caused by exchange of parts between non-homologous chromosomes. Two detached fragments of two different chromosomes are switched. Robertsonian translocation occurs when two non-homologous chromosomes get attached, meaning that given two healthy pairs of chromosomes, one of each pair "sticks" and blends together homogeneously.

<span class="mw-page-title-main">Spindle checkpoint</span> Cell cycle checkpoint

The spindle checkpoint, also known as the metaphase-to-anaphase transition, the spindle assembly checkpoint (SAC), the metaphase checkpoint, or the mitotic checkpoint, is a cell cycle checkpoint during metaphase of mitosis or meiosis that prevents the separation of the duplicated chromosomes (anaphase) until each chromosome is properly attached to the spindle. To achieve proper segregation, the two kinetochores on the sister chromatids must be attached to opposite spindle poles. Only this pattern of attachment will ensure that each daughter cell receives one copy of the chromosome. The defining biochemical feature of this checkpoint is the stimulation of the anaphase-promoting complex by M-phase cyclin-CDK complexes, which in turn causes the proteolytic destruction of cyclins and proteins that hold the sister chromatids together.

Double minutes (DMs)are small fragments of extrachromosomal DNA, which have been observed in a large number of human tumors including breast, lung, ovary, colon, and most notably, neuroblastoma. They are a manifestation of gene amplification as a result of chromothripsis, during the development of tumors, which give the cells selective advantages for growth and survival. This selective advantage is as a result of double minutes frequently harboring amplified oncogenes and genes involved in drug resistance. DMs, like actual chromosomes, are composed of chromatin and replicate in the nucleus of the cell during cell division. Unlike typical chromosomes, they are composed of circular fragments of DNA, up to only a few million base pairs in size, and contain no centromere or telomere. Further to this, they often lack key regulatory elements, allowing genes to be constitutively expressed. The term ecDNA may be used to refer to DMs in a more general manner. The term Double Minute originates from the visualization of these features under microscope; double because the dots were found in pairs, and minute because they were minuscule.

Carcinogenesis, also called oncogenesis or tumorigenesis, is the formation of a cancer, whereby normal cells are transformed into cancer cells. The process is characterized by changes at the cellular, genetic, and epigenetic levels and abnormal cell division. Cell division is a physiological process that occurs in almost all tissues and under a variety of circumstances. Normally, the balance between proliferation and programmed cell death, in the form of apoptosis, is maintained to ensure the integrity of tissues and organs. According to the prevailing accepted theory of carcinogenesis, the somatic mutation theory, mutations in DNA and epimutations that lead to cancer disrupt these orderly processes by interfering with the programming regulating the processes, upsetting the normal balance between proliferation and cell death. This results in uncontrolled cell division and the evolution of those cells by natural selection in the body. Only certain mutations lead to cancer whereas the majority of mutations do not.

A chromosomal abnormality, chromosomal anomaly, chromosomal aberration, chromosomal mutation, or chromosomal disorder is a missing, extra, or irregular portion of chromosomal DNA. These can occur in the form of numerical abnormalities, where there is an atypical number of chromosomes, or as structural abnormalities, where one or more individual chromosomes are altered. Chromosome mutation was formerly used in a strict sense to mean a change in a chromosomal segment, involving more than one gene. Chromosome anomalies usually occur when there is an error in cell division following meiosis or mitosis. Chromosome abnormalities may be detected or confirmed by comparing an individual's karyotype, or full set of chromosomes, to a typical karyotype for the species via genetic testing.

Anaphase lag is a consequence of an event during cell division where sister chromatids do not properly separate from each other because of improper spindle formation. The chromosome or chromatid does not properly migrate during anaphase and the daughter cells will lose some genetic information. It is one of many causes of aneuploidy. This event can occur during both meiosis and mitosis with unique repercussions. In either case, anaphase lag will cause one daughter cell to receive a complete set of chromosomes while the other lacks one paired set of chromosomes, creating a form of monosomy. Whether the cell survives depends on which sister chromatid was lost and the background genomic state of the cell. The passage of abnormal numbers of chromosomes will have unique consequences with regards to mosaicism and development as well as the progression and heterogeneity of cancers.

Caretaker genes encode products that stabilize the genome. Fundamentally, mutations in caretaker genes lead to genomic instability. Tumor cells arise from two distinct classes of genomic instability: mutational instability arising from changes in the nucleotide sequence of DNA and chromosomal instability arising from improper rearrangement of chromosomes.

<span class="mw-page-title-main">CHEK1</span> Protein-coding gene in humans

Checkpoint kinase 1, commonly referred to as Chk1, is a serine/threonine-specific protein kinase that, in humans, is encoded by the CHEK1 gene. Chk1 coordinates the DNA damage response (DDR) and cell cycle checkpoint response. Activation of Chk1 results in the initiation of cell cycle checkpoints, cell cycle arrest, DNA repair and cell death to prevent damaged cells from progressing through the cell cycle.

<span class="mw-page-title-main">BUB1</span> Protein-coding gene in the species Homo sapiens

Mitotic checkpoint serine/threonine-protein kinase BUB1 also known as BUB1 is an enzyme that in humans is encoded by the BUB1 gene.

<span class="mw-page-title-main">STIL</span> Protein-coding gene in the species Homo sapiens

SCL-interrupting locus protein is a protein that in humans is encoded by the STIL gene. STIL is present in many different cell types and is essential for centriole biogenesis. This gene encodes a cytoplasmic protein implicated in regulation of the mitotic spindle checkpoint, a regulatory pathway that monitors chromosome segregation during cell division to ensure the proper distribution of chromosomes to daughter cells. The protein is phosphorylated in mitosis and in response to activation of the spindle checkpoint, and disappears when cells transition to G1 phase. It interacts with a mitotic regulator, and its expression is required to efficiently activate the spindle checkpoint.

The MRN complex is a protein complex consisting of Mre11, Rad50 and Nbs1. In eukaryotes, the MRN/X complex plays an important role in the initial processing of double-strand DNA breaks prior to repair by homologous recombination or non-homologous end joining. The MRN complex binds avidly to double-strand breaks both in vitro and in vivo and may serve to tether broken ends prior to repair by non-homologous end joining or to initiate DNA end resection prior to repair by homologous recombination. The MRN complex also participates in activating the checkpoint kinase ATM in response to DNA damage. Production of short single-strand oligonucleotides by Mre11 endonuclease activity has been implicated in ATM activation by the MRN complex.

<span class="mw-page-title-main">Mitotic catastrophe</span>

Mitotic catastrophe has been defined as either a cellular mechanism to prevent potentially cancerous cells from proliferating or as a mode of cellular death that occurs following improper cell cycle progression or entrance. Mitotic catastrophe can be induced by prolonged activation of the spindle assembly checkpoint, errors in mitosis, or DNA damage and operates to prevent genomic instability. It is a mechanism that is being researched as a potential therapeutic target in cancers, and numerous approved therapeutics induce mitotic catastrophe.

<span class="mw-page-title-main">Chromothripsis</span> Massive chromosomal rearrangement process linked to cancer

Chromothripsis is a mutational process by which up to thousands of clustered chromosomal rearrangements occur in a single event in localised and confined genomic regions in one or a few chromosomes, and is known to be involved in both cancer and congenital diseases. It occurs through one massive genomic rearrangement during a single catastrophic event in the cell's history. It is believed that for the cell to be able to withstand such a destructive event, the occurrence of such an event must be the upper limit of what a cell can tolerate and survive. The chromothripsis phenomenon opposes the conventional theory that cancer is the gradual acquisition of genomic rearrangements and somatic mutations over time.

Genome instability refers to a high frequency of mutations within the genome of a cellular lineage. These mutations can include changes in nucleic acid sequences, chromosomal rearrangements or aneuploidy. Genome instability does occur in bacteria. In multicellular organisms genome instability is central to carcinogenesis, and in humans it is also a factor in some neurodegenerative diseases such as amyotrophic lateral sclerosis or the neuromuscular disease myotonic dystrophy.

<span class="mw-page-title-main">Breakage-fusion-bridge cycle</span>

Breakage-fusion-bridge (BFB) cycle is a mechanism of chromosomal instability, discovered by Barbara McClintock in the late 1930s.

<span class="mw-page-title-main">Cruciform DNA</span>

Cruciform DNA is a form of non-B DNA, or an alternative DNA structure. The formation of cruciform DNA requires the presence of palindromes called inverted repeat sequences. These inverted repeats contain a sequence of DNA in one strand that is repeated in the opposite direction on the other strand. As a result, inverted repeats are self-complementary and can give rise to structures such as hairpins and cruciforms. Cruciform DNA structures require at least a six nucleotide sequence of inverted repeats to form a structure consisting of a stem, branch point and loop in the shape of a cruciform, stabilized by negative DNA supercoiling.

Human somatic variations are somatic mutations both at early stages of development and in adult cells. These variations can lead either to pathogenic phenotypes or not, even if their function in healthy conditions is not completely clear yet.

References

  1. 1 2 Rajagopalan H, Nowak MA, Vogelstein B, Lengauer C (September 2003). "The significance of unstable chromosomes in colorectal cancer". Nature Reviews. Cancer. 3 (9): 695–701. doi:10.1038/nrc1165. ISSN   1474-175X. PMID   12951588. S2CID   1714321.
  2. 1 2 3 4 5 Morgan D (2006). Cell Cycle: Principles of Control. London: New Science Press. ISBN   978-0-87893-508-6.
  3. "Solid Tumor Research - US". www.thermofisher.com. Retrieved 2022-02-10.
  4. Lengauer C, Kinzler KW, Vogelstein B (April 1997). "Genetic instability in colorectal cancers". Nature. 386 (6625): 623–7. Bibcode:1997Natur.386..623L. doi:10.1038/386623a0. PMID   9121588. S2CID   4309037.
  5. 1 2 3 4 5 6 7 8 9 10 11 12 Geigl JB, Obenauf AC, Schwarzbraun T, Speicher MR (February 2008). "Defining 'chromosomal instability'". Trends in Genetics. 24 (2): 64–9. doi:10.1016/j.tig.2007.11.006. PMID   18192061.
  6. 1 2 McGranahan N, Burrell RA, Endesfelder D, Novelli MR, Swanton C (June 2012). "Cancer chromosomal instability: therapeutic and diagnostic challenges". EMBO Reports. 13 (6): 528–38. doi:10.1038/embor.2012.61. PMC   3367245 . PMID   22595889.
  7. Bakhoum SF, Compton DA (April 2012). "Chromosomal instability and cancer: a complex relationship with therapeutic potential". The Journal of Clinical Investigation. 122 (4): 1138–43. doi:10.1172/JCI59954. PMC   3314464 . PMID   22466654.
  8. Hoeijmakers JH (2001-05-17). "Genome maintenance mechanisms for preventing cancer". Nature. 411 (6835): 366–374. doi:10.1038/35077232. ISSN   0028-0836. PMID   11357144. S2CID   4337913.
  9. Storchova Z, Pellman D (January 2004). "From polyploidy to aneuploidy, genome instability and cancer". Nature Reviews Molecular Cell Biology. 5 (1): 45–54. doi:10.1038/nrm1276. ISSN   1471-0072. PMID   14708009. S2CID   11985415.
  10. Cheung AL, Deng W (2008-01-01). "Telomere dysfunction, genome instability and cancer". Frontiers in Bioscience: A Journal and Virtual Library. 13 (13): 2075–2090. doi: 10.2741/2825 . ISSN   1093-9946. PMID   17981693. S2CID   13470047.
  11. 1 2 Sharpless NE, DePinho RA (2004-01-15). "Telomeres, stem cells, senescence, and cancer". Journal of Clinical Investigation. 113 (2): 160–168. doi:10.1172/JCI200420761. ISSN   0021-9738. PMC   311439 . PMID   14722605.
  12. Gregan J, Polakova S, Zhang L, Tolić-Nørrelykke IM, Cimini D (June 2011). "Merotelic kinetochore attachment: causes and effects". Trends in Cell Biology. 21 (6): 374–381. doi:10.1016/j.tcb.2011.01.003. ISSN   0962-8924. PMC   3117139 . PMID   21306900.
  13. 1 2 Yuen K, Wing Yee (2010). "Chromosome Instability (CIN), Aneuploidy and Cancer". Encyclopedia of Life Sciences. doi:10.1002/9780470015902.a0022413. ISBN   978-0-470-01617-6.
  14. 1 2 Wright EG (1 January 1999). "Inherited and inducible chromosomal instability: a fragile bridge between genome integrity mechanisms and tumourigenesis". The Journal of Pathology. 187 (1): 19–27. doi: 10.1002/(SICI)1096-9896(199901)187:1<19::AID-PATH233>3.0.CO;2-1 . PMID   10341703.
  15. 1 2 Stirling PC, Bloom MS, Solanki-Patil T, Smith S, Sipahimalani P, Li Z, Kofoed M, Ben-Aroya S, Myung K, Hieter P (April 2011). "The complete spectrum of yeast chromosome instability genes identifies candidate CIN cancer genes and functional roles for ASTRA complex components". PLOS Genetics. 7 (4): e1002057. doi: 10.1371/journal.pgen.1002057 . PMC   3084213 . PMID   21552543.
  16. Pihan G, Doxsey SJ (August 2003). "Mutations and aneuploidy: co-conspirators in cancer?". Cancer Cell. 4 (2): 89–94. doi: 10.1016/s1535-6108(03)00195-8 . ISSN   1535-6108. PMID   12957283.
  17. National Cancer Institute. "Definition of Solid Tumors" . Retrieved April 1, 2013.
  18. 1 2 3 Dabas N, Byrnes DM, Rosa AM, Eller MS, Grichnik JM (1 January 2012). "Diagnostic role of chromosomal instability in melanoma". Journal of Skin Cancer. 2012: 914267. doi: 10.1155/2012/914267 . PMC   3483783 . PMID   23125934.
  19. Mohapatra S, Winkle M, Ton AN, Nguyen D, Calin GA (September 2022). "The role of noncoding RNAs in chromosomal instability in cancer". J Pharmacol Exp Ther. 384 (1): 10–19. doi: 10.1124/jpet.122.001357 . PMC   9827503 . PMID   36167417.
  20. Bakhoum SF, Kabeche L, Compton DA, Powell SN, Bastians H (2017). "Mitotic DNA Damage Response: At the Crossroads of Structural and Numerical Cancer Chromosome Instabilities". Trends in Cancer. 3 (3): 225–234. doi:10.1016/j.trecan.2017.02.001. PMC   5518619 . PMID   28718433.
  21. Michor F, Iwasa Y, Vogelstein B, Lengauer C, Nowak MA (February 2005). "Can chromosomal instability initiate tumorigenesis?". Seminars in Cancer Biology. 15 (1): 43–9. doi:10.1016/j.semcancer.2004.09.007. PMID   15613287.
  22. Gibbs WW (July 2008). "Untangling the Roots of Cancer". Scientific American. 18 (3): 30–39. doi:10.1038/scientificamerican0708-30sp.
  23. Loeb LA (2001). "A Mutator Phenotype in Cancer". Cancer Research. 61 (8): 3230–3239. PMID   11309271 . Retrieved 3 December 2014.
  24. 1 2 Vargas-Rondón N, Villegas VE, Rondón-Lagos M (2017-12-28). "The Role of Chromosomal Instability in Cancer and Therapeutic Responses". Cancers. 10 (1): 4. doi: 10.3390/cancers10010004 . ISSN   2072-6694. PMC   5789354 . PMID   29283387.
  25. Thompson SL, Bakhoum SF, Compton DA (2010-03-23). "Mechanisms of chromosomal instability". Current Biology. 20 (6): R285–295. Bibcode:2010CBio...20.R285T. doi:10.1016/j.cub.2010.01.034. ISSN   1879-0445. PMC   3781365 . PMID   20334839.
  26. Kwei KA, Kung Y, Salari K, Holcomb IN, Pollack JR (June 2010). "Genomic instability in breast cancer: pathogenesis and clinical implications". Molecular Oncology. 4 (3): 255–266. doi:10.1016/j.molonc.2010.04.001. ISSN   1878-0261. PMC   2904860 . PMID   20434415.
  27. 1 2 Bakhoum SF, Ngo B, Laughney AM, Cavallo JA, Murphy CJ, Ly P, et al. (January 2018). "Chromosomal instability drives metastasis through a cytosolic DNA response". Nature. 553 (7689): 467–472. Bibcode:2018Natur.553..467B. doi:10.1038/nature25432. PMC   5785464 . PMID   29342134.
  28. Hatch EM, Fischer AH, Deerinck TJ, Hetzer MW (July 2013). "Catastrophic nuclear envelope collapse in cancer cell micronuclei". Cell. 154 (1): 47–60. doi:10.1016/j.cell.2013.06.007. PMC   3749778 . PMID   23827674.
  29. Sakamoto Hojo ET, van Diemen PC, Darroudi F, Natarajan AT (1995). "Spontaneous chromosomal aberrations in Fanconi anaemia, ataxia telangiectasia fibroblast and Bloom's syndrome lymphoblastoid cell lines as detected by conventional cytogenetic analysis and fluorescence in situ hybridisation (FISH) technique". Mutation Research. 334 (1): 59–69. doi:10.1016/0165-1161(95)90031-4. PMID   7799980.
  30. Oostra AB, Nieuwint AW, Joenje H, de Winter JP (1 January 2012). "Diagnosis of fanconi anemia: chromosomal breakage analysis". Anemia. 2012: 238731. doi: 10.1155/2012/238731 . PMC   3368163 . PMID   22693659.