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Research on the molecular etiology of vulvar cancer has increased in the past years, not only regarding genetic alterations, but also epigenetic changes.

Gene regulation by extracellular stimuli involves not only transcription factors binding to their cognate DNA binding sites but also epigenetic changes in chromatin without alterations in DNA sequence.

Notably, it is increasingly evident that environmental agents may exert their carcinogenic effects through many diverse pathways, not only through somatic mutation but also epigenetic changes such as methylation, histone modification, miRNA etc [ 8].

Moreover, the results do not provide evidence of the driving forces of these downregulations, which could be changes in transcription factor activities but also epigenetic changes on DNA promoter or intron sequences.

Transcriptional changes during T cell stimulation are tightly regulated by a variety of mechanisms involving not only interactions between a complex network of transcription factors and cis-regulatory DNA regions, but also epigenetic changes in chromatin structure including acetylation, phosphorylation, methylation and ubiquitylation [ 4].

Among them, two cases with kidney MRT showed heterozygous deletions of the 22q11.2 locus and complete methylation of the promoter region of SMARCB1, suggesting that not only genetic events, but also epigenetic changes contributed to biallelic inactivation of SMARCB1 in MRT.

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Also epigenetic changes, like binding of microRNAs or promoter hypermethylation might inhibit gene transcription and thus protein expression.

Meanwhile, also epigenetic changes, such as cytosine methylation in DNA or various kinds of posttranslational modifications of histones, can be detected via 'epigenomics'epigenomics

Later, it was found that CRC results not only from the progressive accumulation of genetic alterations but also from epigenetic changes.

Later, it was found that CRC results not only from the progressive accumulation of genetic alteration, but also from epigenetic changes (Lengauer et al. 1997).

The idea that susceptibility to breast cancer is determined not only through inherited germline mutations but also by epigenetic changes induced by alterations in hormonal environment during fetal development is gaining increasing support.

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