5.10 Grading of cancer

Question 1

Cancer grade

Answer 1

a histologic parameter which is based on the degree of differentiation of the cancer cells which correlates with tumor behaviour

Question 2

if you know it’s a neoplasm ask

Answer 2

benign or malignant

Question 3

if you know its malignat ask

Answer 3

how bad, type, how far has it spread, how dedifferentiate/aggressive it is

Question 4

differentiation

Answer 4

the extent to which neoplastic cells resemble comparable normal cells both morphologically and functionally

Question 5

well differentiatied tumors resemble

Answer 5

mature nromal cells of the tissue of origin

Question 6

poorly differentiated tumors show

Answer 6

little resemblance to the tissue of origin

Question 7

example of well differentiated carcinoma

Answer 7

hepatocellular carcinoma

Question 8

differentiation of benign tumors

Answer 8

well differentiated

Question 9

malignant neoplasms range from

Answer 9

well differentiated to undifferentiated

Question 10

neoplasmns and function

Answer 10

neoplasms can continue to express function of the tissue of origin

Question 11

what typically elaborates hormones characteristic of the cell type from which they originate

Answer 11

adenomas and well-differentiated carcinomas of endocrine glands

Question 12

well differentiated squamous cell carcinomas express

Answer 12

keratins

Question 13

melanomas express

Answer 13

melanin pigment

Question 14

breast and gyn cancers have

Answer 14

estrogen receptors

Question 15

many tumors are graded according to

Answer 15

3 tiered scheme 1. well differentiated, 2. moderately differentiatd, 3. poorly differentiated

Question 16

limitations of grading

Answer 16

many tumors are of intermediate differentiation, there is sampling error with small biopsies, grading is based on subjective light microscopic interpretation

Question 17

staging of cancer is based on

Answer 17

the size of the primary tumor, the extent of spread in original tissue, spread to regional lymphnodes, presence or absence of distant metastases

Question 18

staging is different from grading bc

Answer 18

staging is done on a biopsy or surgical sample by pathologists in conjunction with clinical imaging studies and is more important

Question 19

why is staging so important

Answer 19

if you get the cancer before it goes to the nodes and excise it you can cure it, but cant always do that clinically bc of the risk of the type of surgery

Question 20

what do we use to identify how far it has gotten

Answer 20

look for anatomical land marks like basement membrane muscularis

Question 21

can you do surgery on small cell carcinoma of the lung

Answer 21

no

Question 22

what is good to cut out

Answer 22

a squamous cell carcinoma because it usually gets big before getting to the LN so often you can cut it out

Question 23

two staging systmes

Answer 23

UICC, AJC

Question 24

UICC

Answer 24

union internationale contre cancer

Question 25

AJC

Answer 25

american joint committee on cancer staging

Question 26

what system does the UICC use

Answer 26

TNM

Question 27

TMN - T

Answer 27

primary tumor size ranging form T0 (in situ, hasn_t invaded) to T4 (huge)

Question 28

TMN - N

Answer 28

lymphnode involvment, ranging form N0 (no nodal involvment) to N3, based on number and location of involved nodes

Question 29

TMN - M

Answer 29

distant metastases, ranging form M0 (no distant metastases) to M1 and M2

Question 30

AJC System combines TNM inot

Answer 30

Stage 0 to 4

Question 31

Stage 1

Answer 31

smallest tumors

Question 32

Stage 2 and 3

Answer 32

larger tumors, more local spread

Question 33

Stage 4

Answer 33

metastases

Question 34

depending on the cancer the staging

Answer 34

differs and will be more detailed usually if screening is accessible like in breast cancer

Question 35

breast cancer screenin

Answer 35

dye injected into tumor site and hope that the firs draining sentinal node are identified and taken out. If they are clean, then the other nodes are clean and don't have to excise more nodes, sparing the woman from more axilary dissection and a chronically swollen arm.

Question 36

is grading or staging more important

Answer 36

staging is most important for determining prognosis and therapy