Cancer Classification and Identification Flashcards
What is cancer staging
(5)
Cancer staging describes the extent of a person’s cancer based on:
- The site of the primary tumour
- Its size
- How far it has invaded into local tissues and structures
- Whether it has spread to regional lymph nodes
- Whether it has metastasised to other regions of the body
What is cancer staging
(5)
Cancer staging describes the extent of a person’s cancer based on:
- The site of the primary tumour
- Its size
- How far it has invaded into local tissues and structures
- Whether it has spread to regional lymph nodes
- Whether it has metastasised to other regions of the body
What is TNM
Tumour, node and metastasis
What is the T in TNM staging?
Primary tumout
What is the N in TNM
Regional lymph node
What is the M in TNM
Distant metastasis
How are tumours classed
TX
T0
T1, T2, T3, T4
What does TX mean
Main tumour cannot be measured
What does T0 mean
Main tumour cannot be found
What does T1 - T4 mean?
(3)
This refers to the size and/or extent of the main tumour
The higher the number after the T, the larger the tumour or the more it has grown into nearby tissues
T’s may be further divided to provide more detail, such as T3a and T3b
How are regional lymph nodes graded
NX
N0
N1, N2, N3
What does NX mean
Cancer in nearby lymph nodes cannot be measured
What does N0 mean
There is no cancer in nearby lymph nodes
What does N1, N2, N3 mean
This refers to the number and location of lymph nodes that contain cancer
The higher the number after the N, the more lymph nodes that contain cancer
How is metastasis graded?
MX
M0
M1
What does MX mean?
Metastasis cannot be measured
What does M0 mean?
Cancer has not spread to other parts of the body
What does M1 mean?
Cancer has spread to other parts of the body
Write about poorly differentiated cancers
(2)
These have highly abnormal call appearance and large numbers of dividing cells and tend to grow more quickly, spread to other organs more frequently, and be less responsive to therapy than cancers whose cells have a more normal appearance
Based on these differences in microscopic appearance, doctors assign a numerical ‘grade’ to most cancers
How does differentiation add to grading of tumours
A low number grade (grade I or II) refers to cancers with fewer cell abnormalities than those with higher numbers (III or IV)
What does grade 0 mean?
(3)
Abnormal cells are present but have not spread to nearby tissue.
Also called carcinoma in situ, or CIS
CIS is not cancer but it may become cancer
What does grade I-III mean
Cancer is present
The higher the number, the larger the cancer tumour and the more it has spread into nearby tissues
What does grade IV mean
The cancer has spread to distant parts of the body
What does in situ mean
Abnormal cells are present but have not spread to nearby tissue
What does localised mean
Cancer is limited to the place where it started, with no sign that it has spread
What does regional mean
Cancer has spread to nearby lymph nodes, tissues or organs
What does distant mean
Cancer has spread to distant parts of the body
What does ‘unknown’ site of tumour mean
There is not enough information to figure out the stage
Tumours are classified based on site, what are the five sites of tumours
In situ
Localised
Regional
Distant
Unknown
What is cancer
(3)
When normal cell regulation is disrupted, a chain reaction of cellular malfunction can occur which leads to disease
Cancer can be a result of this malfunction
We need to understand the differences between healthy cells and cancer cells to be able to identify them
Where should division only occur?
Should only be dividing in the basal layer
What is a slow dividing cancer?
Indolent cancer
What is a fast dividing cancer
Aggressive cancer
What should you be looking for when investigating cancer at low power
(4)
Pattern disruption
Darker areas of staining
Indistinct cell borders
Lymphocytic infiltrate
What patterns are seen in carcinoma?
Nests, packets lobules
What patterns are seen in adenocarcinoma
Tubules
Acini
What are acini
Any cluster of cells that resembles a many-lobed “berry”
What do we look for in cells when investigating cancer at high power
(5)
Irregular shape
Larger darker nuclei
Out of control growth that doesn’t follow a pattern
Immortal cells
Immature- undifferentiated cells
Write about the morphology of the cancer cell
Large nucleus
Having an irregular size and shape
Nucleoli are prominent
Cytoplasm is scarce and intensely coloured or extremely pale
Loss of specialised features
How should you investigate the nucleus?
Surface
Volume
Nucleus/cytoplasm ratio
Shape
Density
Structure and homogeneity
The number of mitoses is increases
Atypical mitosis form
What are eight examples of epithelial neoplasms
Squamous cell carcinoma
Basal cell carcinoma
Adenocarcinoma
Medullary carcinoma
Small cell carcinoma
Large cell carcinoma
Carcinoma in situ
Mucinous carcinoma
Give some examples of connective tissue neoplasm
Bone = osteosarcoma
fibrous tissue = fibrosarcoma
Cartilage = chondrosarcoma
fat = liposarcoma
Nerve = neurofibrosarcoma
What indicates Hodgkins lymphoma?
Reed Sternberg cells
What indicates Non Hodgkins lymphoma
(4)
Mature B cell neoplasms
Mature T cell and Natural killer (NK) neoplasm
Precursor lymphoid neoplasms
Immunodeficiency-associated lymphoproliferative disorders
Write about tumour infiltrating immune cells
White blood cell that leaves the blood and migrate towards a tumour
T and B cells, NK cells, macrophages, neutrophil
Implicated in killing tumour cells
Presence of lymphocytes are often associated with better-clinical outcomes important in prognosis and potentially prediction to therapy
Write about the tumour microenvironment
Tumour cells co-exist with immune cells and on immune cells
Nearly all immune cells can infiltrate cancer cells
CD8+ T lymphocytes can recognise and kill cancer cells directly but secreting cytotoxic molecules
