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55 Cards in this Set
- Front
- Back
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What is neoplasia?
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New growth
Benign or malignant |
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What does monoclonal growth tend to be?
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Uncontrolled
Single stem cell Neoplasia |
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What does polyclonal growth tend to be?
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Embryological development
Controlled Beneficial Hyperplasia |
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What must you have to make a cancer diagnosis?
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A biopsy
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Where does a teratoma originate from?
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Embryonic stem cells
Neoplasia Pluripotent growth |
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What is included in somatic development?
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Organ specific
Cell type specific Tissue type specific |
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What is dysplasia?
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Alteration in cell size and morphology with or without a disorganised growth pattern
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What are the features of malignant growth?
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Metastasis
Locally invasive Poor differentiation Lymphatic/ vascular spread Rapidly progressive |
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What are the features of a benign growth
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Not invasive
Within tissue of origin Slowly progressive Well differentiated |
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What is a precancerous lesion?
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Coexist with invasive neoplasms
Precede invasive neoplasms Hereditary/ spontaneous Risk markers - SNIPs analysis Epithelial |
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Where would growth invade?
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Adjacent fatty tissue
stroma |
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What are the 2 types of prognostic grading?
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Pre- neoplastic stage- atypical hyperplasia/ metaplasia/ dysplasia
Neoplastic stage- in situ/ locally invasive/ metastatic Differentiation? |
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What are types of growth pattern?
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Sessile- flat
Polypoid- multiple growth Papilloma Ulcerative carcinoma |
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What is sarcoma?
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Cancer of the connective tissue
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What is carcinoma
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Cancer of the epithelium
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What is adenoma?
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cancer of glandular epithelium
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What does it mean by Hormone receptor positive in breast cancer?
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Respond to hormone therapies
Growth in response to oestrogen Oestrogen/ Progesterone receptors >10% immunohistochemistry detected oestrogen receptor expression |
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What type of treatment is required for Oestrogen receptor negative?
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Early cytotoxic therapy
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How is the Her2 receptor targeted?
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Block action blocks progression
Intracellular- inhibition of tyrosine kinase phosphorylation Extraceluular- Prevents dimerisation by blocking receptor |
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What Treatment is used to block HER2?
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Herceptin
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What is adjuvant therapy?
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Examples: Anti oestrogens- Tamoxifen/ aromatase inhibitors
Herceptin |
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What drugs are used in chemotherapy?
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Anthracyclins
Taxones |
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What factors determine long term survival?
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Size of tumour
Number of lymph nodes affected Stage Grade |
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Name histopathology techniques (5)
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Biopsy
Microscopy Immunocytochemistry DNA techniques tissue diagnosis |
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What is grade 1?
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Normal nuclei
Gland formation Low mitotic count |
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Grade 2?
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Larger nuclei
Moderate gland formation Higher mitotic count |
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Garde 3?
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Very large nuclei
No gland formation Very high mitotic count |
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What are the (7) things looked at when assessing treatment options?
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Tumour size
In situ component Hormone receptor status Excision margins Lymph node stage Vascular invasion Histological type/ grade |
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Why is predictive typing via biomarkers performed?
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Specific
Responsiveness to treatment Molecular manifestation Monitor progress |
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What are the 2 types of breast cancer?
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Carcinoma in situ (ductal/ lobular)
Invasive carcinoma (ductal/ lobular) |
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What is a cancer biomarker?
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A measurable molecular characteristic of cancer tissue representative of function/ behaviour
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What are the 4 types of biomarkers used?
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Small molecule- over / under expression
mRNA- over/ under expression, selective Gene- Methylation/ point mutation/ Deletions/ Translocations/ amplifications Protein- Over/ under expression, selective |
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What is the cause of neoplasia?
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Genetic inheritance/ predisposition
Environmental mutagens/ Carcinogens (Physical/ chemical/ biological) |
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What is a physical type of environmental mutagen?
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Radiation
Radio- iodine induced Thyroid nodule- traps iodine Tumour initiated |
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What is a chemical carcinogen?
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Smoking
Causes bronchial squamous carcinoma Length of time smoking determines the reversibility promoter stopped within 40 weeks = reversible |
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What is a dietary carcinogen?
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Aflatoxin induced hepatoma
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Concerning cell cycle control, what happens in G1-S phase in terms of tumour development?
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Initiation and promotion
Oncogene activation Atypical hyperplasia |
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S-G2?
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Transformation
In situ Reversible Immortalisation (telomerase) Tumour suppressor inactivation |
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G2- M?
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Progression
Locally and distant invasive Genetic instability |
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What defines a neoplastic growth? SIT SELF!
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Sustained angiogenesis
Insensitivity to anti- grow signals Tissue invasion and metastasis Self sufficiency in growth signals Evade apoptosis Limitless replication potential Failure of immune response |
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What is required for metastasis?
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Soil and seed hypothesis
Micro- embolisation of new blood vessels Travels by blood and lymph to new sites Emigration from blood vessels Neo angiogenesis |
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What is the seed and soil hypothesis?
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Seed- Inherent potential for metastasis cells to grow in foreign tissue
Soil- Inherent capacity of the foreign tissue to support metastatic growth |
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What are the steps of tumourgenesis?
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Normal cell- DNA damage- failure to repair
Initiated cell Cell proliferation/ altered differentiation (reversible) Preneoplastic growth- proliferation and additional mutation Malignant neoplasm |
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What are the 3 components of invasion?
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Cell migration
Cell attachment Matrix degrading enzymes |
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What are the components of cell attachment?
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E- cadherin/ catenin adhesions complex = cell- cell
Integrins = cell matrix adhesions (Integrins bind to laminin, collagen, proteoglycans, vitronectin) |
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What are the components of cell migration?
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Motility promoting factors
HGF/ scattering factor Rho GTPase family (contraction of actin cells) |
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What is HGF/ scattering factor?
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Heterodimer of alpha and beta chains
Autocrine growth factor Binds c-met receptor and activates downstream Induces invasion |
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What are the different types of matrix degrading enzymes?
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Proteases:
Cysteine Aspartyl Metalloproteinase Serine (plasmin, plasminogen activators, cathespin) |
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What are the 4 subgroups of Metalloproteinases?
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Soluble/secreted groups (collagenase/ gelatinase/ stromyeslins)
Membrane type group Zinc ion in active centre- catalytic |
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How are metalloproteinases regulated?
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Controlled by increased expression on a transcriptional level
Calcium dependent proteases- activated by cleavage of a propeptide Regulated by specific inhibitors (Tissue inhibitors TIMPs) MMP2 + MMP9 cleave type IV collagen on the basement membrane |
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What does plasmin cleave?
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Fibronectin
Laminin Gelatin Activates proforms of MMPs by propeptide cleavage |
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How does an early stage growth evade the immune system?
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Evade recognition
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How does a proneoplastic growth evade the immune system?
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Immune elimination
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How does a Late stage growth evade the immune system?
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Immune escape
Development of anti- immune mechanisms |
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What are the 2 types on tumour specific immune resistance?
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Suppression of cytotoxic T cell:
Decreased expression of MHC Resistance to granzyme and perforin mediated killing T regulatory cell suppression of cytotoxic T cell prlif and function Suppression of antigen processing and presentation: Cytokine mediated suppression of APC function |
