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DEN 2027 - Disease Mechanisms > Cancer 2 > Flashcards

Cancer 2 Flashcards

1
Q

What is cancer?

A

Broad complex group of diseases characterised by uncontrollable growth of cells which do not die

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2
Q

Why do cancers tend to occur in older patients?

A

There is more time for accumulation of genetic changes

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3
Q

Name 6 major hallmarks of cancer

A
  1. Sustaining proliferative signalling
  2. Evading growth suppressors
  3. Activating invasion and metastasis
  4. Enabling replicative immortality
  5. Inducing angiogenesis
  6. Resisting cell death
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4
Q

Name 4 proteins in cytoplasm which have cell cycle control

A
  1. Cyclins
  2. Cyclin dependent kinases (CDKs)
  3. Cyclin dependent kinase inhibitors (CKIs)
  4. Anaphase promoting complex (APC)
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5
Q

Describe 3 cytoplasm proteins which are affected in a tumour cell

A
  • Over expression of cyclins
  • Over expression of CDKs
  • Deactivation of CKIs
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6
Q

Describe a major characteristic of tumour cells with regards to cell division but unrelated to the major cytoplasm proteins

A

Abnormality of checkpoints

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7
Q

What are 2 genes which cause sustained proliferative signalling?

A
  1. Activation of oncogene

2. Inhibition of tumour suppressor genes

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8
Q

Describe oncogenes

A
  • Dominant

- Encourage cell division

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9
Q

Name 3 types of hyper activation of genes which promote growth

A
  1. Gene fusions / translocations (BCR-Abl)
  2. Point mutations (KRAS)
  3. Amplification (HER2)
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10
Q

Describe tumour suppressor genes

A
  • Recessive
  • Keep cell growth under check
  • Can repair damage or stop cell dividing
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11
Q

Name 4 ways tumour suppressor genes can be altered

A
  1. Point mutations
  2. Deletion of regions of chromosomes
  3. Loss of heterozygosity
  4. Altered methylation of promoter
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12
Q

Describe familial cancer syndromes

A
  • Recessive at a cellular level but dominant with regard to cancer risk
  • Point mutation knocks out recessive gene
  • Only one more gene must be knocked out instead of 2
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13
Q

What is Li-Fraumeni Syndrome caused by?

A

Mutation in p53

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14
Q

Describe the familial form of retinoblastoma

A
  • Child inherits one mutant copy of Rb1 gene
  • Disease occurs earlier
  • Higher probability of disease occurring in 2 eyes
  • Tumour may be multi-focal and bilateral
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15
Q

Describe the sporadic form of retinoblastoma

A
  • Mutation has to occur in both copies of Rb1 gene
  • Unlikely for 2 mutations in more than one cell
  • Tumour occur later in life
  • Tumours are likely to be unilateral
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16
Q

Name 4 stresses on a cell which normally causes p53 activation

A
  1. DNA damage
  2. Hypoxia
  3. Heat / cold shock
  4. Mitotic spindle damage
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17
Q

Name 4 outcomes triggered in a normal cell by p53 activation

A
  1. Cell cycle arrest
  2. DNA repair
  3. Apoptosis
  4. Senescence
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18
Q

How does HPV affect p53 gene?

A

HPV encodes a protein which binds to and inactivates p53

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19
Q

How do cancers tend to activate invasion and metastasis?

A

Cell-Extracellular matrix interactions are altered

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20
Q

Name 4 ways cell-extracellular matrix interactions are altered

A
  1. Changes in structural proteins (integrins)
  2. Up regulation of enzymes for tissue break down (MMPs)
  3. Altered expression of chemokines (IL8)
  4. Altered growth factor expression (FGFs)
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21
Q

What is metastasis?

A

Process by which cancer cells spread to other parts of the body

22
Q

Name 3 routes of metastasis

A
  1. Lymphatic
  2. Haematogenous
  3. Transcoelomic
23
Q

What tumours tend to metastasise in a haematogenous fashion?

A

Sacromas

24
Q

What tumours tend to metastasise in a transcoelomic fashion?

A

Ovarian tumours can spread transperitoneally to liver

25
Q

Describe the multi step process of metastasis

A
  • Primary tumour proliferation
  • Invasion of neovasculature
  • Embolism and transport
  • Adherence to vessel wall
  • Extravasation
  • Establishment of a microenvironment
  • Metastasis
26
Q

Name 4 common sites of metastasis for breast cancer

A
  1. Bone
  2. Brain
  3. Liver
  4. Lung
27
Q

Name 3 common sites of metastasis for colorectal cancer

A
  1. Liver
  2. Lung
  3. Peritoneum
28
Q

Name 5 common sites of metastasis for lung cancer

A
  1. Adrenal gland
  2. Bone
  3. Brain
  4. Liver
  5. Other lung
29
Q

Name 4 common sites of metastasis for prostate cancer

A
  1. Adrenal gland
  2. Bone
  3. Liver
  4. Lung
30
Q

Describe normal replicative senescence

A
  • Cells have finite lifespan and limited ability to replicate
  • Due to telomere shortening
31
Q

Describe how cancerous cells enable replicative immortality

A
  • Inactivation of pRb / p53 extends lifespan 30 doublings
  • Rare mutations lead to immortalization
  • Activation of telomerase
32
Q

Describe induction of angiogenesis by cancerous cells

A
  • Pro-angiogenic factors activated in tumours
  • Signal endothelial cell proliferation
  • Growth of blood vessels
33
Q

Name 3 pro angiogenic factors

A
  1. VEGF
  2. FGF1
  3. FGF2
34
Q

What is apoptosis?

A

Programmed cell death

35
Q

Name 2 pro survival factors activated in tumours

A
  1. Bcl-2

2. Cflip

36
Q

Name 5 causes of cancer

A
  1. Lifestyle (tobacco / alcohol / diet)
  2. Infections
  3. Radiation exposure
  4. Age
  5. Genetics
37
Q

Name 4 molecular mechanisms driving carcinogenesis

A
  1. Mutations
  2. Chromosomal abnormalities
  3. Gene amplifications
  4. Altered gene expression
38
Q

Name 3 types of point mutations

A
  1. Silent
  2. Nonsense
  3. Missense
39
Q

What is a point mutation?

A

Single change in a base

40
Q

What is a silent point mutation?

A

Single change in the base but the protein is unchanged

41
Q

What is a nonsense mutation?

A

Single change in the base where there is no coded protein for the new sequence

42
Q

What is a missense mutation?

A

Single change in the base where the protein produced is different

43
Q

Describe 2 examples of point mutations

A
  1. Ras family (codes a small GTPase involved in transmitting signals)
  2. KIT gene (codes a transmembrane tyrosine kinase)
44
Q

Name 2 ways deletions can occur

A
  1. Loss of single base

2. Loss of large regions of chromosome

45
Q

Describe 2 ways translocation can affect the body

A
  1. Production of novel fusion proteins (Bcr-Abl)

2. Juxtaposition to strong promoter upstream (cMyc)

46
Q

Describe the Philadelphia chromosome

A
  • Chronic Myeloid Leukaemia is characterised by Philadelphia chromosome
  • Translocation of portion of q arm of chromosome 22 to q arm of chromosome 9
  • Creates fusion gene juxtapositioning the Abl1 gene on chromosome 9 to part of BCR gene on chromosome 22
47
Q

What is gene amplification?

A

Increased copy number of genes which may be amplified multiple times (HER2 in breast cancer)

48
Q

Name 2 epigenetic changes which alter gene expression

A
  1. DNA methylation

2. Histone modification

49
Q

Describe an example of DNA methylation leading to altered gene expression

A
  • p16 methylation
  • Acetylation opens up chromatin
  • Methylation of chromatin can cause transcriptional activation or repression
50
Q

Name 4 emerging hall marks of cancer

A
  1. Avoiding immune destruction
  2. Tumour promoting inflammation
  3. Genome instability and mutation
  4. Deregulating cellular energetics
51
Q

Name 3 “E’s” of immunoediting

A
  1. Elimination
  2. Escape
  3. Equilibrium

DEN 2027 - Disease Mechanisms (20 decks)

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