Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

EMS - MoD > 22. Behaviour of Tumours > Flashcards

22. Behaviour of Tumours Flashcards

1
Q

In what ways do tumours behave in local disease?

A

Invasion

  • invades adjacent normal tissue
  • destroys normal tissue
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

In what way do tumours behave in systemic disease?

A

Metastasis

- spreads from site of origin to distant sites and forms new tumours in these new areas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is invasion associated with?

A
  • increased motility
  • decreased adhesion
  • production of proteolytic enzymes
  • mechanical pressure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the cell to cell adhesion molecules?

A

Cadherins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the cell to matrix adhesion molecules?

A

Integrins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What does mutation of E-cadherin lead to?

A

Loss of cell-cell adhesion and contact inhibition

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What do changes in integrin expression?

A

Decreased cell-matrix adhesion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What 3 things are involved in less adhesion/more motility?

A
  • cadherins changes
  • integrins changes
  • epithelial-mesenchymal transition
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the difference between epithelial cells and mesenchymal cells?

A

Epithelial cells - tightly connected, polarised and tethered

Mesenchymal cells - loosely connected, able to migrate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What happens to the epithelial cells in cancer?

A

Epithelial cells gain mesenchymal properties allowing them to invade and migrate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are matrix metalloproteinases?

A

Enzymes responsible for the degradation of most extracellular matrix proteins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What do interstitial collagenases degrade?

A

Collagen types I, II and III

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What degrades collagen type IV and gelatin?

A

Gelatinases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What degrades collagen type IV and proteoglycans?

A

Stomolysins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Name 3 matrix metalloproteinases

A
  • interstitial collagenases
  • gelatinases
  • stomolysins
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What do stomolysins degrade?

A

Collage type IV, proteoglycans

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is in balance in normal tissue regulation? (concerning proteolytic enzymes)

A

Matrix metalloproteinases and tissue inhibitors of metalloproteinases are in balance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

In cancer, what is out of balance concerning proteolytic enzymes?

A

More matrix metalloproteinases than tissue inhibitors of metalloproteinases - favours ECM breakdown

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What causes increased mechanical pressure in cancer?

A

Uncontrolled proliferation forms mass = increased pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the consequence of increased mechanical pressure in cancer?

A
  • pressure from mass occludes vessels
  • pressure atrophy
  • spread along lines of least resistance
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Secondary tumour burden is often what?

A

Secondary tumour burden is often greater than that of the primary site

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Give some features of metastasis

A
  • metastasis is often the presenting tumour
  • primary site might be unknown
  • occurs at different stages in natural history in different tumours
  • may be early or more commonly, a late relapse
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Give 4 potential metastasis routes

A
  • lymphatic
  • blood
  • transcoelomic
  • implantation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What does the transcoelomic route of metastasis mean?

A

Across peritoneal, pleural, pericardial cavities or in CSF

25
Q

What does implantation route of metastasis mean?

A

Spillage of tumour during biopsy/surgery

26
Q

Metastasis by blood occurs in which cancers?

A
  • liver
  • lungs
  • bone
  • brain
27
Q

What are the stages in metastasis?

A
  • detachment
  • invasion
  • intravasation
  • survival against host defences
  • adherence
  • extravasation
  • growth
  • angiogenesis
28
Q

What is intravasation?

A

The invasion of cancer cells through the basal membrane into a blood or lymphatic vessel

29
Q

What is extravasation?

A

Cancer cells exiting the capillaries and entering organs

30
Q

What is the typical pattern of metastasis in carcinomas?

A

Lymphatic spread first

31
Q

What is the typical pattern of metastasis in sarcomas?

A

Blood spread first

32
Q

What are the 2 types of bone metastases?

A
  • lytic (bone)

- sclerotic (prostate)

33
Q

What are the 2 hypotheses concerning patterns of metastasis?

A
  • mechanical hypothesis (dictated by anatomy)

- seed and soil hypothesis (“seeds carried in all directions but can only live and grow if they fall on congenial soil”)

34
Q

Why is tissue environment important in patterns of metastasis?

A

Influences organ selectivity for metastases

35
Q

Are metastatic cells always active?

A

Metastatic cell can remain dormant for years

36
Q

What is angiogenesis?

A

New vessel formation (derives from existing vessels)

37
Q

What is the role of angiogenesis?

A
  • role in development and healing
  • role of bone marrow derived endothelial stem cells uncertain
  • essential if metastases are to grow larger than 1-2mm
38
Q

What are the promoters of angiogenesis?

A
  • VGEF
  • PDGF
  • TGFb
39
Q

What are inhibitors of angiogenesis?

A
  • ECM proteins
  • thrombospondin
  • canstatin
  • endostatin
40
Q

Why is staging and grading of cancer important?

A
  • determine prognosis (survival time and quality of life)
  • decide how to treat the tumour
  • research (compare therapies or prognostic factors)
41
Q

What is the stage of cancer?

A

How advanced is the tumour? Has the cancer spread and if so, what is the extent of spread?

42
Q

What is the grade of cancer?

A

How aggressive is the tumour? How different does it look from tissue of origin?

43
Q

What are stage and grade in terms of the arrow from pre-inavsive to metastasis and death?

A

Stage = how far along the arrow the tumour is

Grade = how quickly the tumour progresses along the arrow

44
Q

Tumours are staged using TMN. What does this stand for?

A 
T = tumour
M = metastases
N = nodes

Each organ has an individual TMN system and stage can be clinical, pathological or radiological

45
Q

What is T in TMN staging?

A

Size and extent of primary tumour

46
Q

What is M in TMN staging?

A

Presence and extent of distant metastases

47
Q

What is N in TMN staging?

A

Presence and number of lymph nodes metastases

48
Q

TMN can be combined to give what?

A

An overall stage for the tumour (I to IV)

49
Q

What are the different T stages in breast cancer staging?

A 
Tis = in situ disease
T1 = less than 2cm
T2 = 2-5cm
T3 = over 5cm
T4 = involving skin or chest wall
50
Q

What are the different N stages in breast cancer staging?

A 
N0 = no nodes
N1 = ipsilateral nodes
N2 = more node involvement
51
Q

What are the different M stages in breast cancer staging?

A 
M0 = no distant mets
M1 = distant mets
52
Q

What do the overall stages mean?

A 
0 = Tis
I = T1, N0, M0
II = T1/2, N1 or T3
III = T(any), N2 or T4
IV = T(any), N(any), M1
53
Q

How does stage of breast cancer indicate treatment?

A

Surgery, surgery and radiotherapy, surgery can chemotherapy, just chemotherapy… as stage progresses

54
Q

How does stage correlate with outcome?

A

Decreased survival at all years with increased stage

55
Q

Describe Dukes staging for colorectal cancer

A

A = invades into, but not through bowel wall

B = invades through bowel wall but with no lymph node metastases

C = local lymph nodes involved

D = distant metastases

56
Q

How does Dukes staging correlate with survival?

A

A = over 90% 5yr survival

B = 70% 5yr survival

C = 30% 5yr survival

D = 5-10% 5yr survival

57
Q

What is grading based on?

A
  • differentiation (how much tumour resembles tissue it originates from)
  • nuclear polymorphism and size
  • mitotic activity
  • necrosis
58
Q

Describe basic grading

A 
G1 = near normal (well differentiated) 
G2 = moderately differentiated
G3 = poorly differentiated
G4 = undifferentiated
59
Q

How does marked nuclear atypia affect grade?

A

Increases grade by one

EMS - MoD (17 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions