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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
What cancer can Merkle cell polyomavirus (MCV) cause?
Merkle cell carcinoma
26
What cancer does HIV cause?
- Doesn't cause any
27
What are examples of RNA viruses that can cause cancer?
- Human T-lymphotrophic virus - Hepatitis C Virus
28
What cancer can Human T-lymphotrophic virus (HTLV-1) cause?
Adult T-cell leukaemia
29
What cancer can Hepatitis C Virus (HCV) cause?
Hepatocellular carcinoma
30
Is UV light ionising or non-ionising?
Non-ionising
31
What type of cancer does UV light cause?
Exposure to UVA or UVB increases risk of BCC (basal cell carcinoma), melanoma, SCC (squamous cell carcinoma)
32
Who has increased risk from UV light?
- People with xeroderma pigmentosum - Where normal intracellular DNA damage repairing mechanism is impaired
33
What effects does ionising radiation have?
- Long term effect - Skin cancer in radiographers - Lung cancer in uranium miners - Thyroid cancer in Ukrainian children
34
What are examples of biological agents that can cause cancer?
- Hormones - Mycotoxins - Parasites
35
What hormones can cause cancer?
- Oestrogen - Anabolic steroids
36
What cancer can be caused by an increase in oestrogen?
Mammary/endometrial cancer
37
What cancer can be caused by anabolic steroids?
Hepatocellular carcinoma (liver cancer)
38
What mycotoxin can cause cancer?
Aflatoxin B1
39
What cancer does aflatoxin B1 cause?
Hepatocellular carcinoma
40
What parasites can cause cancer?
- Chlonorchis sinensis - Shistosoma
41
What cancer does Chlonorchis sinensis cause?
Cholangiocarcinoma
42
What cancer does Shistosoma cause?
Bladder cancer (particularly squamous cell carcinoma)
43
What are some other miscellaneous carcinogens?
- Asbestos - Metals (arsenic → skin cancer)
44
What are host factors that could cause cancer?
- Ethnicity - Diet / Lifestyle - Constitutional factors - age, gender etc. - Premalignant lesions - Transplacental exposure
45
How does ethnicity influence cancer?
- ↑ Oral cancer in India, SE Asia (reverse smoking, betal nut chewing) - ↓ Skin cancer in those with darker skin (melanin)
46
What are constitutional factors that influence cancer?
- Inherited predisposition - Age - Gender
47
How does inherited predisposition influence cancer?
- familial polyposis coli (chr 5) - retinoblastoma (chr 13)
48
How does age influence cancer?
- incidence increases with age - longer exposed to environment, live out latent period
49
How does gender influence cancer?
- breast cancer F:M = 200:1
50
How what lifestyle factors can influence cancer?
- Diet / Exercise - Sexual behaviour
51
How does diet/ exercise influence cancer?
- 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
How does sexual behaviour influence cancer?
- Unprotected sex increases risk of HPV-related cancer (cervix, penis, oropharyngeal)
53
What is a premalignant condition?
Identifiable local abnormality associated with increased risk of malignancy at that site
54
What are examples of premalignant conditions?
- Colonic polyps - Cervical dysplasia (CIN) - Ulcerative colitis - Undescended testis
55
What is an example of transplacental exposure?
- Diethylstilboestrol → ↑ vaginal cancer - Used to treat morning sickness, crosses placenta

2a- Pathology (16 decks)

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