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2a- Pathology > Carcinogenesis > Flashcards

Carcinogenesis Flashcards

1
Q

What is carcinogenesis?

A

The transformation of normal cells to neoplastic cells though permanent genetic alterations or mutations

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2
Q

Which type tumour goes through carcinogenesis?

A

Malignant neoplasms

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3
Q

Which type of tumour goes through oncogenesis?

A

Benign and malignant tumours

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4
Q

What is a carcinogen?

A

Agents known or suspected to cause tumours

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5
Q

What is the difference between carcinogenic and oncogenic?

A
  • Carcinogenic = cancer causing
  • Oncogenic = tumour causing
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6
Q

What does mutagenic mean?

A

Acts on DNA

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7
Q

What occupational risk is bladder cancer seen in?

A
  • Incidence in aniline dye and rubber industries
  • β-naphthylamine
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8
Q

What occupational risk is scrotal cancer seen in?

A
  • Incidence in chimney sweeps
  • Polycyclic aromatic hydrocarbons
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9
Q

What is thorotrast?

A
  • Colloidal suspension of thorium
  • Irreversibly ingested by phagocytes
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10
Q

What is evidence of thyroid irradiation?

A
  • 1986: Chernobyl nuclear reactor explodes
  • Release of 125I and 131I into atmosphere
  • 1990: ↑ incidence of thyroid cancer in Ukrainian children
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11
Q

Why may testing on animals and cell/tissue cultures not be comparable to humans?

A
  • Animals / cultures may metabolise agents differently to humans
  • Bacterial mutation may not = carcinogenecity
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12
Q

What are the classes of carcinogens?

A
  • Chemical
  • Viral
  • Ionising and non-ionising radiation
  • Hormones, parasites and mycotoxins
  • Miscellaneous
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13
Q

Describe features of chemical carcinogens

A
  • No common structural features
  • Some act directly
  • Most require metabolic conversion from pro-carcinogens to ultimate carcinogens
  • Enzyme required may be ubiquitous (everywhere) or confined to certain organs
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14
Q

What are examples of chemical carcinogens?

A

Polycyclic aromatic hydrocarbons, aromatic amines, nitrosamines and alkylating agents

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15
Q

What cancer do polycyclic aromatic hydrocarbons cause and what can it be caused by?

A

Lung caner and skin cancer caused by smoking, mineral oils

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16
Q

What cancer do aromatic amines cause and what can it be caused by?

A

Bladder cancer found in rubber/dye workers

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17
Q

What cancer do nitrosamines cause and what can it be caused by?

A

Gut cancer proven in animals

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18
Q

What cancer do alkylating agents cause and what can it be caused by?

A

Leukaemia which has a small risk in humans

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19
Q

How much of all cancers are viral carcinogens responsible for?

A
  • 10-15%
  • Most oncogenic viral infections don’t result in cancer
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20
Q

What are examples of DNA viruses that can cause cancer?

A
  • Human Herpes Virus 8
  • Epstein Barr Virus
  • Hepatitis B Virus
  • Human papillomavirus
  • Merkle cell polyomavirus
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21
Q

What cancer can Human Herpes Virus 8 (HHV8) cause?

A

Kaposi sarcoma

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22
Q

What cancers can Epstein Barr Virus (EBV) cause?

A
  • Burkitt lymphoma
  • Nasopharyngeal carcinoma
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23
Q

What cancer can Hepatitis B virus (HBV) cause?

A
  • Hepatocellular carcinoma
24
Q

What cancer can Human papillomavirus (HPV) cause?

A

Squamous cell carcinomas of the cervix, penis, anus, head and neck

25
Q

What cancer can Merkle cell polyomavirus (MCV) cause?

A

Merkle cell carcinoma

26
Q

What cancer does HIV cause?

A
  • Doesn’t cause any
27
Q

What are examples of RNA viruses that can cause cancer?

A
  • Human T-lymphotrophic virus
  • Hepatitis C Virus
28
Q

What cancer can Human T-lymphotrophic virus (HTLV-1) cause?

A

Adult T-cell leukaemia

29
Q

What cancer can Hepatitis C Virus (HCV) cause?

A

Hepatocellular carcinoma

30
Q

Is UV light ionising or non-ionising?

A

Non-ionising

31
Q

What type of cancer does UV light cause?

A

Exposure to UVA or UVB increases risk of BCC (basal cell carcinoma), melanoma, SCC (squamous cell carcinoma)

32
Q

Who has increased risk from UV light?

A
  • People with xeroderma pigmentosum
  • Where normal intracellular DNA damage repairing mechanism is impaired
33
Q

What effects does ionising radiation have?

A
  • Long term effect
  • Skin cancer in radiographers
  • Lung cancer in uranium miners
  • Thyroid cancer in Ukrainian children
34
Q

What are examples of biological agents that can cause cancer?

A
  • Hormones
  • Mycotoxins
  • Parasites
35
Q

What hormones can cause cancer?

A
  • Oestrogen
  • Anabolic steroids
36
Q

What cancer can be caused by an increase in oestrogen?

A

Mammary/endometrial cancer

37
Q

What cancer can be caused by anabolic steroids?

A

Hepatocellular carcinoma (liver cancer)

38
Q

What mycotoxin can cause cancer?

A

Aflatoxin B1

39
Q

What cancer does aflatoxin B1 cause?

A

Hepatocellular carcinoma

40
Q

What parasites can cause cancer?

A
  • Chlonorchis sinensis
  • Shistosoma
41
Q

What cancer does Chlonorchis sinensis cause?

A

Cholangiocarcinoma

42
Q

What cancer does Shistosoma cause?

A

Bladder cancer (particularly squamous cell carcinoma)

43
Q

What are some other miscellaneous carcinogens?

A
  • Asbestos
  • Metals (arsenic → skin cancer)
44
Q

What are host factors that could cause cancer?

A
  • Ethnicity
  • Diet / Lifestyle
  • Constitutional factors - age, gender etc.
  • Premalignant lesions
  • Transplacental exposure
45
Q

How does ethnicity influence cancer?

A
  • ↑ Oral cancer in India, SE Asia (reverse smoking, betal nut chewing)
  • ↓ Skin cancer in those with darker skin (melanin)
46
Q

What are constitutional factors that influence cancer?

A
  • Inherited predisposition
  • Age
  • Gender
47
Q

How does inherited predisposition influence cancer?

A
  • familial polyposis coli (chr 5)
  • retinoblastoma (chr 13)
48
Q

How does age influence cancer?

A
  • incidence increases with age
  • longer exposed to environment, live out latent period
49
Q

How does gender influence cancer?

A
  • breast cancer F:M = 200:1
50
Q

How what lifestyle factors can influence cancer?

A
  • Diet / Exercise
  • Sexual behaviour
51
Q

How does diet/ exercise influence cancer?

A
  • Excess alcohol use increases risk of cancers of the mouth, oesophagus, liver, colon and breast
  • Obesity increases risk of breast, oesophagus, colon and kidney cancer
  • Exercise reduces risk of colon and breast cancer
52
Q

How does sexual behaviour influence cancer?

A
  • Unprotected sex increases risk of HPV-related cancer (cervix, penis, oropharyngeal)
53
Q

What is a premalignant condition?

A

Identifiable local abnormality associated with increased risk of malignancy at that site

54
Q

What are examples of premalignant conditions?

A
  • Colonic polyps
  • Cervical dysplasia (CIN)
  • Ulcerative colitis
  • Undescended testis
55
Q

What is an example of transplacental exposure?

A
  • Diethylstilboestrol → ↑ vaginal cancer
    • Used to treat morning sickness, crosses placenta

2a- Pathology (16 decks)

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