Cancer Flashcards
where in the cervix does cervical cancer arise
in the transformation zone - this is where there is natural metaplasia of glandular epithelia from the endocervix to squamous epithelia found in the exocervix
how does HPV cause cervical cancer
expresses the viral protein E6 and E7 which inhibit the tumour suppressor gene p53 and pRB - this means theres increased cell proliferation and less DNA repair
which HPV strains are high risk for cervical cancer
16 and 18
what are risk factors for cervical cancer
HPV immunodeficiency smoking multiple births multiple partners oral contraceptive pill
what is a Pap test
where cells from the transformation zone of the cervix are scraped off, stained and examined
what is colposcopy
where the is a visual examination of the cervix
when does cervical screening start and how often is it repeated
at 25 and repeated every 5 years
what are the advantages of the HPV vaccination to boys
prevents penile cancer
acts as herd immunity as penile cancer can also cause cervical cancer
what is CIN
cervical intraepithelial neoplasm - where there is dysplasia of the squamous cells but it has not breached the basement membrane
what levels of CIN may regress on its own
I and II
what is CIN III
carcinoma in situ - lots of squamous dysplasia but just not breached the basement membrane yet
what is the most common types of cervical carcinomas
80% = squamous cell carcinomas 20% = adenocarcinomas
what type of cancer are vulval tumours usually
squamous cell carcinomas
what is the most common cause of vulval cancer in pre-menopausal women
HPV
what are the most common causes of vulval cancer in post-menopausal women
vulval irritation/inflammation:
- squamous hyperplasia
- Lichen sclerosis
what is Lichen sclerosis
fibrosis of the superficial dermis causing chronic irritation giving squamous abnormalities
what is VIN
vulval intraepithelial neoplasm - abnormal squamous cells which havent invaded through the basement membrane - precursor to squamous cell carcinoma
where do vulval carcinomas spread
inguinal, pelvic, iliac and para-aortic lymph nodes
what are the risk factors of endometrial cancer
high oestrogen exposure causing hyperplasia:
- obesity
- exogenous oestrogen
- annovulation
why can obesity increase the risk of endometrial hyperplasia
adipose tissue contains the enzyme aromatase which converts androgens to oestrogen so theres an increase in circulating oestrogen
what type of cancer is endometrial cancer
adenocarcinomas
what are the 2 types of endometrial adenocarcinomas
- endometrioid endometrial adenocarcinomas
2. serous adenocarcinoma
which type of endometrial adenocarcinoma gives a worse prognosis
serous adenocarcinoma - spreads more easily
what type of cancer is found in the myometrium
leiomyomas (fibroids) - bengin, smooth muscle tumours
what symptoms are seen with myometrial tumours
heavy/painful periods, urinary frequency, infertility
what tumour markers are seen with testicular cancer
alpha fetoprotein and HCG
what type of germ cell tumours are seen in males
seminomas or non-seminomatous
what are non-seminomatous tumours usually made up of
a mixture of yolk sac tumour, choriocarcinomas, teratomas and embryonal tumours
in what ages are teratomas in males benign/malignant
bengin in pre-puberty
malignant in post-puberty
what are the most common types of sperm cord-stomal tumours in males
sertoli or leydig cell tumours
what tumour marker is seen in ovarian cancer
CA-125
how is the contraceptive pill protective of ovarian cancer
reduces ovulation so means theres less trauma and scarring/healing of the ovaries
what are the 4 classifications of ovarian cancers
mullerian epithelium tumours
germ cell tumours
sperm cord-stroma tumours
metasises
what are the 3 types of mullerian epithelia tumours
serous
mucinous
endometrioid
what are the types of germ cell cancer in the ovaries
teratomas, yolk sac tumour, embryonal, choriocarcinomas
what are the 3 types of teratomas in females
bengin, malignant or monodermal
what are monodermal teratomas
tumours composed of thyroid tissue so can cause hyperthyroidism if functional
what are teratomas
tumours containing hair, sebaceous glands, teeth and a range of other tissue
what are mucinous tumour like
cystic, benign and glandular
where do serous tumour spread
to peritoneal surfaces causing ascites
what are endometrioid tumours
tumours which resemble endometrial glandular tissue
what is a kruckenberg tumour
tumour from the stomach which spreads to the ovaries
what 2 types of sex cord-stroma tumours are seen in females
feminising - made up of granulose/theca cells
masculinising - made up of sertoli/Leydig cells
