, ▁although ▁families ▁with ▁Li – F raum eni ▁synd rome , ▁caused ▁by ▁an ▁inherited ▁in activ ation ▁mut ation ▁in ▁T P 5 3 , ▁have ▁increased ▁risk . ▁Several ▁gen es ▁have ▁been ▁shown ▁to ▁be ▁rec urrent ly ▁mut ated , ▁including ▁T P 5 3 , ▁CT NN B 1 , ▁M EN 1 , ▁PR K AR 1 A , ▁R PL 2 2 , ▁and ▁DA XX . ▁The ▁tel omer ase ▁gene ▁T ERT ▁is ▁often ▁ampl ified ▁while ▁Z NR F 3 ▁and ▁CD K N 2 A ▁ ▁are ▁often ▁hom o zy g ously ▁deleted . ▁The ▁gen es ▁h 1 9 , ▁ins ul in - like ▁growth ▁factor ▁II ▁( IG F - II ), ▁and ▁p 5 7 k ip 2 ▁are ▁important ▁for ▁f etal ▁growth ▁and ▁development . ▁They ▁are ▁located ▁on ▁chrom os ome ▁ 1 1 p . ▁Expression ▁of ▁the ▁h 1 9 ▁gene ▁is ▁marked ly ▁reduced ▁in ▁both ▁non function ing ▁and ▁function ing ▁ad ren al ▁cort ical ▁car cin omas , ▁especially ▁in ▁tum ors ▁producing ▁cort is ol ▁and ▁al d oster one . ▁Also , ▁a ▁loss ▁occurs ▁of ▁activity ▁of ▁the ▁p 5 7 k ip 2 ▁gene ▁product ▁in ▁vir il izing ▁ad en omas ▁and ▁ad ren al ▁cort ical ▁car cin omas . ▁In ▁contrast , ▁I G F - II ▁gene ▁expression ▁has ▁been ▁shown ▁to ▁be ▁high ▁in ▁ad ren al ▁cort