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We were therefore interested in learning if expression of one of the Notch targets, Hes1, could by-pass the need for mutations of Notch receptors.
It thus appears that homotypic adhesion molecules with their self-binding external domains can effect this by clustering without the need for mutations, either in themselves or in other elements.
Possibly this reflects the need for mutations to generate a high level of transcription, but it is also consistent with the fact that regulation of many DGC-containing proteins is post-translational (Goymer et al., 2006; Jenal and Malone, 2006).
Notably, NFKBIA silencing is also found far more frequently in patients with NSCLC who lack EGFR mutations than in those with EGFR-mutant NSCLC, which suggests that such downstream activation of the PI3K/AKT pathway can bypass the need for mutations in upstream driver proteins during carcinogenesis [ 85].
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This case suggested the need for mutation screening of other tumor suppressor genes, such as TP53, or screening for other genetic alterations, such as deletion, in familial diffuse gastric cancer lacking CDH1 germline mutations [ 51].
Finally, in the context of genetic counselling, specific tumour characteristics may help evaluate the possibility of a BRCA1 or BRCA2 mutation and the need for mutation testing in a family with a history of breast cancer.
Mutation can be no less a directional force if a certain class of mutation (G-to-A, small genomic deletions, intron loss, etc). is more frequent than its reverse (A-to-G, small insertions, intron gain, etc).. Thus, all that is needed for mutation-driven recurrent evolution is that multiple lineages are experiencing similar mutational biases in parallel.
We subsequently determined the lowest concentration of mutant DNA in a background of normal DNA needed for mutation detection.
The ColoCarta panel provides a more specific panel for colon cancer mutation detection and greatly reduces the amount of DNA needed for mutation profiling.
Whereas a reliable method with a high sensitivity is needed for mutation detection, it can also be argued that there is a clinical as well as a subclinical detection level.
According to the proposed perigenetic mechanism, inflammation-associated signaling molecules, such as TNF-α, can alter gastric epithelial cell adhesion and lead to the dispersion and migration of mutated epithelial cells without the need for additional mutations in tumor suppressor genes, such as genes that code for cell adhesion proteins.
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