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75 Cards in this Set
- Front
- Back
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What is neoplasia?
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New growth from autonomous or uncontrolled proliferation as a result of genetic mutations.
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Do benign neoplasms or tumors invade or metastasize?
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No, they only grow in size.
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Cancer
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Malignant neoplasms. Invade tissue locally and metastasize.
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Metaplasia
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Non-neoplastic change in type of tissue at a site of injury or irritation (squamous replaces glanduar --> squamous metaplasia)
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Dysplasia
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Neoplastic mutations which result in abnormal features in some of the cells. Mix or normal and abnormal.
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Carcinoma-in-situ
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Neoplastic mutations that result in replacement of all of the normal epithelial cells by abnormal cells without invasion through BM.
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Carcinoma
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Invasion through the basement membrane and/or metastases
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What is lung cancer an example of?
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Chronic smoking has caused the squamous metaplasia but this can progress to dysplasia (neoplastic from this point on), ends with invasive squamous cell carinoma.
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Invasive squamous cell carcinoma of the cervix is due to what chronic infection?
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HPV over yaers can cause squamous metaplasia.
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Esophageal cancer etiology...
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chronic reflex of acid into distal esophagus causes glandular metaplasia. Barrett's esophagus.
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Grade/Anaplasia is determined by what features? (6)
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Pleomorphism, hyperchromatic staing, increased nuclear/cytoplasmic, prominent nucleolus or nucleoli, increased mitotic activity, disorganized growth (failure to produce structure such as gladns or keratin)
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What grows more quickly - benign or malignant neoplasm?
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A malignant neoplasm.
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How is tumor growth measured?
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Doubling time. The higher the grade, the shorter the doubling time and the faster the growth.
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Why do cancers grow so fast?
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Cell production exceeds cells loss. More cycling.
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What two processes to cancer cells avoid in order to grow so fast?
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Permanent terminal maturation and apoptosis.
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What is stage?
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The extent of spread of a neoplasm. How "Fat" it is.
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What is low stage?
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Tumor limited to site of origin, good prognosis.
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What is high stage?
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Spread beyond the site of origin to other organs, poor prognosis. Spread beyond the site of origin to other organs, poor prognosis.
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What are the 3 main steps of invasion?
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1. Less cell-to-cell adhesion, 2. Binding of malignant cells to extra-cellular matrix by activation of adhesion molecules, 3. Migration of tumor cells into degraded zone of extracellular matrix.
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What is down-regulationed for breaking adhesion?
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Epithelial (E) cadherin, which anchors adjacent cells and catenins which serve as membrane attachment sites under the plasma membrane.
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What do free catenins cause?
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They induce cellular proliferation
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Binding of malignant cells to extra-cellular matrix by activation of adhesion molecules...what are these two ways?
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1. Immunoglobulin supergene family (ICAM/VCAM)
2. Integrins are increased and initiate penetration of basement membrane by secretion of proteolytic enzymes. |
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What proteolytic enzymes are secreted that initiate penetration of basement membrane?
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Serine proteinase - activates plasmin
Caollagenases (metalloproteins) Cystein proteinase (cathespin B) |
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What is the desmoplastic reaction?
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It is when fibrocytes are turned back into fibroblasts and there is Type I collagenase produced and this breaks down collagen instead of forming...
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Walburg Effect?
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Altered glycolysis. Most tumor cells do not use mitochondria for glycolysis - but they use direct aerbic glycolysis which make only 2 ATPs/1glucose.
Use this to detect metasatitc tumors |
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What is thrombospondin-1?
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It is an anti-angiogenic factor - it promotes angiogenesis without control in the lodging of a new tumor!
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What are the two most important angiogenic factors?
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VEGF and bFGF
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What are the four malignancies that are -omas?
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lymphoma, mesothelioma, melanoma, seminoma
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What is a multiple myeloma??
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This is a kind of hemopoietic malignancie. It is malignant proliferaiton of plasma cells. It remains in the bone marrow and causes holes. The plasma cells secrete a monocolonal immunoglobulin
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Most patients that have multiple myeloma die from what?
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They die from infection because of depression of humoral immunity which leads to infection. The kidneys fail because proteins plug up renal tubules and or cause amyloidosis.
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What are the top five causes of death?
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1. Heart Dz
2. cancer 3. CV Dz 4. Chronic lower resp infections 5. accidents |
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What are the main causes of cancer-death in males and females of all ages?
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Males: 1. Lung 2. Prostate 3. Colorectal
Females: 1. lung 2. Breast 3. Colorectal |
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What are the most common causes of cancer-death in reproductive age females? (20-39 y/o)
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1. breast
2. uterine cervix 3. leukemia |
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What are the most common causes of cancer death in males and females under 20 years old?
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Males. 1: Leukemia, 2: Brain and ONS, 3: Bones and joints
Females. 1: Leukemia, 2: Brain and ONS, and 3: Other endocrine systems |
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What are the main causes of cancer death in males and females that are 60-79 years old?
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Males: Lung, Colorectal, Prostate
Females: Lung, Breast, Colorectal |
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What tumors affect females more than males?
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Thyroid tumors, salivary glands, and gallbladder
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What are the cancers that are increasing?
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Lymphomas, prostate, and lungs
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What cancers are decreasing?
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Stomach, uterus, liver, and colon/rectum
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Is cancer increasing? What about the actual incidence for females?
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Overall incidenc eof cancer is increasing, but the actual incidence of female cancers continues to decrease.
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What kind of cancer is most common for Japanese immigrants?
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gastric and hepatic - it is INTERMEDIATE of native Japanese populations and US population.
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In what race is Burkitt's lymphoma greatest in?
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increases with immigration to high risk areas such as Africa - associated with Epstein-Barr virus.
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What is uncommon in Japan and Eastern Europeans but common in US women?
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Breast, endometrium, and ovarian. Risk increases with immigraiton.
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In who is cervical cancer most rare?
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Jewish women and women married to circumcised male.
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A promoter must be what in relation to the initiator?
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It must be continuous but can happen right after, or a long time after the initiation.
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What is an initiation event?
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Exposure of cells to an appropriate agent - it is permanent. It binds highly electrophillic intermediates to DNA.
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What forms between the carcinogen and the nucleotide in DNA?
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A non-enzymatic, rapid formation of covalent adducts (addition products)
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What are covalent adducts?
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Irreversible and become the basis of the memory for future replication.
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What are direct initiators and what are some examples?
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Direct inititors do not require metabolic activation and are uncommon. They include: Divalent metals (nickel), chemotherapy drugs, benzyl chloride
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What are indirect initiators and what are some examples?
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Indirect initiators require metabolic activation before becoming carcinogenic. They are much more common. Aromatic amines - amides, azo dyes, beta naphthylamine, aflatoxin, vinyl chloride, aromatic hydrocarbons.
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Describe aflatoxin and its effects.
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Aflatoxin is a fungal metabolite that is from contaminated beans and grains. It is metabolically activated by hepatocytes and greatly increases the risk of liver cancer.
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Describe what occurs in people with the P450 variant.
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About 10% of the population has a variant on the P450 which has a much greater ability to activate the aromatic hydrocarbons in tobacco smoke and are at much greater risk of lung cancer.
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Describe beta-naphthylamine.
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It is activated in the liver and is quickly detoxed by congujation with glucuronic acid but is unconjugated by the urinary bladder's glucuronisdase which leads to bladder cancer.
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Promotion is what?
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Promotion supports tumor growth in initiated cells but itself is not carcinogenic. Its effects are irreversible.
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What are common promoters?
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Phenolic compounds, hormones, chronic inflammation and or antigen stimulation.
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Direct-Acting Alkylating agains lead to what kind of cancer?
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lymphona and leukemia
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Polycyclic aromatic hydrocarbons of tobacco --> cx?
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oral, pharyngeal, lung, esophageal, bladder (LEBO)
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Aniline dyes -->
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urinary bladder cancers
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Aflatoxin B1 -->
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hepatocellular cx
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Asbestos -->
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pleural mesothelioma, lung carcinoma (car brakes, shipyard and insulation workers)
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Vinyl chloride -->
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Angiosarcoma of liver
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Arsenic -->
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skin cancers
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Alcohol --> cx?
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Oral and pharyngeal cancers.
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What is the cause of most skin tumors?
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UVB 280-320 nm
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What is the direct effect of UVB on DNA?
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Forms pyrimidine dimers and melanomas and skin cancers.
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Ionizing radiation forms what, which causes what kind of cancer in kids?
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It forms free radicals (OH-) and it causes papillary thyroid cancer in kids.
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In adults what do OH- radicals from ionizing radiation?
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Leukemias
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What areas resistant to radiation carciogenesis?
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Skin, bone, gut
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What exceeds cancer as a cause of death in children?
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Accidents
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What are the most common neoplasms in children?
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Leukemias, neuroblastoma, Wilm's tumor of kidney
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What can cirrhosis of the liver lead to? (cx?)
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Hepatocellular carcinoma
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Atrophic gastritis (including pernicious anemia) causes what kind of cx?
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Adenocarcinoma of the stomach
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Heliobactor pylori gastritis causes what kind of cancer?
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Adenocarcinoma of the stomack and lymphoma.
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Ulcerative colitis causes what kind of cancer?
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Adenocarcinoma of the colon.
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Certain acquired conditions make cancer more viable because of what conditions?
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The non-growth factors promote cellular proliferation, which make mutations more likely or to support growth of mutated cells.
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What is a nevus?
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benign cancerous mole
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