cancer diagnoses (pathology based) Flashcards
Why is molecular profiling important in cancer diagnosis?
Whilst traditional methods of diagnosis, such as histology are still paramount for achieving diagnoses, molecular profiling allows visualisation of prognostic and predictive markers to treatment response. For example, a patient may have specific TP53 mutation which is associated with worse prognosis, as a result this patient may be given a more powerful combination of drugs to try and attack this tumour intensely to prevent its recurrence. There are numerous devices available to do this now, e.g. Oncotype DX. It allows production of a recurrence risk score, to allow us to individualise treatments and incorporate the use of personalised medicine and increased treatment response.
What are the events required for metastasis to occur?
Detachment Invasion Intravasation Evasion of host defences Adherence to endothelium at remote location Extravasation Growth and angiogenesis
What effects the outcome of cancer?
The tumour type, the tumour stage, the tumour grade, and the presence of tumour cells in lymph/blood vessels, and the correct excision of the specimen, etc.
How is tumour grade defined?
Tumour grade refers to how well the tumour resembles the tissue of origin, e.g. how much the tumour has differentiated. This can be determined by histology.
How is tumour stage defined?
This refers to the size of the primary tumour and the presence and location of metastases, e.g. the extent of the spread. This can be determine by histology, and imaging.
What is the system used to categorise tumour size, metastases and lymph node involvement?
This is the TNM staging. The T is tumour size, the N is lymph node involvement, and the M is distant metastases. Each section is given a number 1-4 based on the extent/presence of the factors.
