Brainscape's Knowledge GenomeTM

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


See full index

Year 2 EMS MoD > Behaviour of tumours > Flashcards

Behaviour of tumours Flashcards

1
Q

What is the difference between invasion and metastasis?

A

Invasion if of local tissues and destroys normal tissue, at this point the cancer is still a local disease
Metastasis is the spreading from the site of origin to distant sites and forming new tumours in these areas
At this point the cancer has become a systemic disease

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

How many cancer patients are killed by metastatic disease?

A

Half

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

What proportion of breast cancer patients are killed by metastatic disease?

A

1/3

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

What proportion of lung cancer patients are killed by metastatic disease?

A

Majority

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

What proportion of patients with basal cell carcinoma are killed by metastatic disease?

A

Essentially none

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

By what basic mechanisms do tumour cells start to invade local tissues?

A

1) Increased motility
2) Decreased adhesion
3) Mechanical pressure
4) Production of proteolytic enzymes

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

What are the 2 classes of adhesion molecule which are lost in malignant cells?

A

Cell to cell adhesion molecules - cadherins

Cell to matrix adhesion molecules - integrins

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

What changes occur leading to a reduction in adhesion of malignant cells?

A

Mutation of E-cadherin in malignant cells leads to loss of cell-cell adhesion and contact inhibition
Changes in integrin expression in malignant cells lead to decreased cell-matrix adhesion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is meant by the epithelial-mesenchymal transition?

A

Occurs in malignancy epithelial cells gain mesenchymal properties and can invade and migrate. Eg. epithelial cells are tightly connected polarised and tethered whereas mesenchymal cells are loosely connected and able to migrate

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

What is the role or proteolytic enzymes in invasion?

A

They are matrix metalloproteinases produced by the malignant cells which degrade the extracellular matrix

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

Interstitial collagenases are produced by malignant cells, what do they degrade?

A

Collagen types I, II, III

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

Gelatinases are produced by malignant cells, what do they degrade?

A

Collagen type IV, gelatin

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

Stomolysins are produced by malignant cells, what do they degrade?

A

Collagen type IV, proteoglycans

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

What is the main constituent of extracellular space?

A

Collagen

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

Are metalloproteinases produced by healthy cells?

A

Yes, they play a role in normal tissue regulation and are balanced by tissue inhibitors of metalloproteinases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How does the balance between metalloproteinases and inhibitors change in malignancy?

A

Increase in metalloproteinases and decrease in tissue inhibitors of metalloproteinases so they are no longer balanced, this favours tissue breakdown

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

What is the role of metalloproteinases in normal tissue regulation?

A

Needed to mop up collagen and remodel tissues etc.

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

How does mechanical pressure contribute to invasion?

A

Uncontrolled proliferation forms a mass
Pressure occludes vessels
Get pressure atrophy
Tumour spreads along the line of least resistance

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

Name the 4 routes of metastasis?

A

1) Lymphatic
2) Blood
3) Transcoloemic
4) Implantation - spillage of tumour during biopsy/surgery etc.

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

Give 4 cancers which commonly metastasize by the blood route?

A

1) Liver
2) Lungs
3) Bone
4) Brain

21
Q

What is meant by the transcoloemic route of metastasis?

A

Across peritoneal, pleural, pericardial cavities or in CSF

22
Q

Name the 5 stages of metastasis?

A

1) Detachment invasion
2) Intravasation (invasion of cancer cells through the basement membrane into blood vessels or lymphatics)
3) Survival against host defences
4) Adherence extravasation (from the lymph or blood vessels into surrounding tissues)
5) Growth (involving angiogenesis)

23
Q

Carcinomas commonly spread by which route?

A

Lymphatic

24
Q

Sarcomas commonly spread by which route?

A

Blood

25
Q

Bone metastases are common in what 5 cancers?

A

1) Breast
2) Prostate
3) Lung
4) Kidney
5) Thyroid

26
Q

Ovarian cancer commonly spreads by which route?

A

Transcoloemic

27
Q

Brain and adrenal metastases commonly come from which cancer?

A

lung cancer

28
Q

What 2 types of bone metastases can occur?

A

Bone metastases can by:
Lytic (lung)
Sclerotic (prostate)

29
Q

What are the 2 different theories about patterns of metastasis?

A

1) Mechanical hypothesis - pattern in dictated by anatomy eg. lymphatic drainage
2) Seed and soil hypothesis - malignant cells can travel anywhere, but ‘seeds’ are more likely to grow on good soil - ie organs with a good tissue environment for malignant cells

30
Q

Why can people recover from a cancer and then present years later with metastases?

A

Metastatic cells can remain dormant for years

31
Q

How is organ selectivity for metastasis explained?

A

Tissue environment is important in the development of metastases

32
Q

What role does angiogenesis have in metastasis?

A

Essential if metastases are to grow larger than 1-2 mm

33
Q

Factors promoting angiogenesis are produced by what 3 types of cells?

A

Tumour cells, stromal cells and inflammatory cells

34
Q

Name 3 factors which promote angiogenesis?

A

VEGF
PDGF
TGF-beta

35
Q

Name 4 inhibitors of angiogenesis?

A

ECM proteins
Thrombospondin
Canstatin
Endostatin

36
Q

How does the balance between promotors and inhibitors of angiogenesis change in metastasis and why?

A

Promotor expression increases and outnumber inhibitor expression, not only are promotors produced by tumour cells, the tumour cells illicit an inflammatory response which leads to the stromal and inflammatory cells produced these promotors which further contributes to the formation of new blood vessels

37
Q

Give 3 reasons to stage and grade a tumour?

A

1) Determine prognosis - survival time, quality of life
2) Decide how to treat a tumour
3) Research - compare therapies or prognostic factors

38
Q

What is meant by stage of a tumour?

A

How advanced the tumour is. Has the cancer spread and if so what is the extent of the spread.
If you had an arrow depicting cancer disease course from pre-invasive to death stage would tell you how far along the arrow the tumour is

39
Q

What is meant by the grade of a tumour?

A

How aggressive is the tumour and how different does it look from the tissue of origin
If you had an arrow depicting cancer disease course from pre-invasive to death grade would tell you how fast the tumour is moving along the arrow

40
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, stage can be clinical, pathological or radiological

41
Q

How does TMN staging basically work?

A

T = size and extend of primary tumour
M = presence and extent of distant metastases
N = presence and number of lymph node metastases
TMN can be combined to give and overall stage for the tumour from 1-4

42
Q

How does the stage of a breast cancer affect the treatment?

A

1 - surgery only
2 - surgery and radiotherapy
3 - surgery and chemo
4 - chemo

43
Q

What is Duke’s staging for colorectal cancer?

A 
A = invades into, but not through bowel wall
B = invades through the bowel wall but with no lymph node metastases
C = local lymph nodes involved
D = distant metastases
44
Q

How does Duke’s staging for colorectal cancer correlate with survival?

A 
A = >90% 5 year survival
B = 70% 5 year survival
C = 30% 5 year survival
D = 5-10% 5 year survival
45
Q

Grading is performed by which specialists?

A

Histopathologists

46
Q

What is grading based on?

A

Differentiation - how much does the tumour resemble the tissue it originates from
Nuclear pleomorphism and size
Mitotic activity
Necrosis

47
Q

How do grade and stage correlate with outcome?

A

Both correlate well with outcome

48
Q

What 3 things lead to systemic malignant disease?

A

1) Invasion
2) Metastasis
3) Angiogenesis

Year 2 EMS MoD (16 decks)

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