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MD2002 > Carcinogenesis > Flashcards

Carcinogenesis Flashcards

1
Q

What are the 4 major categories of carcinogen?

A

Chemicals
Radiation
Parisites
Viruses

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2
Q

List the stages of chemical carcinogenesis (4 stages).

A

Initiation
Promotion/Acceleration
Progression
Malignancy

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3
Q

At what point does this chain of events become irreversible?

A

When the progression stage is reached and started

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4
Q

Briefly summarise initiation.

A

Mutagenic event which involves cellular genome mutation(s) in tumour supressor genes and/or proto-oncogenes

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5
Q

Briefly summarise promotion.

A

A reversible, non-mutagenic event which involves the stimulation of proliferation and causes both mutated and normal cells to proliferate

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6
Q

Briefly summarise progression.

A

Irreversible enhancement/repression of gene expression - the selection of neoplastic cells for optimal growth

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7
Q

What is malignancy?

A

Cancer

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8
Q

Comment on the effect promotors have.

A

High dose of carcinogen = tumours develop
Low dose of carcinogen = no tumours develop
Low dose of carcinogen + promoter = tumours develop
Multiple doses of promotor = no tumours develop

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9
Q

What is a common cause of carcinogenesis associated with lifestyle?

A

Occupational exposure

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10
Q

Workers in the dye industry were common sufferers of carcinogenesis. What was the carcinogen present and what did it cause?

A

2-napthylamine (2-NPA)

Bladder cancer

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11
Q

Describe the mechanism of action of 2-NPA.

A

Liver converts 2-napthylamine to its carcinogenic metabolite, 2-amino-napthol. This is then detoxified to glucoronide which isn’t carcinogenic and is hence excreted to the kidneys. However, it then passes into the bladder (the normal pathway for excretion after leaving the kidneys) and is converted to a carcinogen due to the expression of the converting enzyme beta-glucoronidase by urothelial cells

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12
Q

What is asbestosis?

A

The formation of scar tissue in the lungs as a result of asbestos exposure

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13
Q

What medical condition can asbestosis lead to and by how much is the risk of this being brought about increased by?

A

Bronchogenic carcinomas

Risk increased by factor of 5

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14
Q

Exposure to blue asbestos fibres carry an increased risk of what?

A

Mesothelioma (rare tumour with a 25-45 year latent period)

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15
Q

What three factors does risk of these conditions depend on?

A

Intensity
Exposure
Duration

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16
Q

What lifestyle choice can increase the chance of asbestos related tumour formation by 50 times?

A

Smoking

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17
Q

What type of substance is asbestos?

A

FIBROUS SILICATE

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18
Q

Upon inhalation of needle-like asbestos fibres, what happens to them?

A

They become coated in proteins to become asbestos bodies

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19
Q

The formation of these asbestos bodies triggers an immune response; what type of leukocyte is primarily stimulated?

A

Monocytes —> Macrophages

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20
Q

What is the published increase in risk of lung cancer associated with smoking?

A

22x more likely

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21
Q

How many chemicals are there in tobacco smoke?

A

> 4000

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22
Q

What is the main active carcinogen present in tobacco smoke?

A

The polycyclic aromatic hydrocarbon: 3,4 BENZAPYRENE

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23
Q

What carcinogenic effect does 3,4 benzopyrene have?

A

GUANINE MUTATIONS IN K-Ras & p53 GENES

G-C PAIR IS REPLACED BY A-T PAIR

24
Q

What is the role of GSTM1 (glutathione S transferase)?

A

Detoxifies carcinogens

25
Q

Is the GSTM1 enzyme present in everyone?

A

The majority of people, but some individuals have a null genotype so no GSTM protein is detectable (30-50% of global population)

26
Q

What does having a homologous null genotype increase the risk of?

A

Lung cancer along with mouth, bladder and kidney cancers

27
Q

What type of chemotherapeutic agent can cause secondary carcinogenesis following cancer treatment?

A

Alkylating agents

28
Q

What facilitates the conversion of 3,4 benzopyrene into benzopyrene idol epoxide (which has the damaging effect on DNA)?

A

Aryl Hydrocarbon Hydroxylase (AHH) (which is unregulated in smokers)

29
Q

Where is a transitional cell carcinoma most frequently seen and where can it be expressed other than this site?

A

Bladder

Anywhere where there are urothelial cells present

30
Q

Increased risk of lung cancer associated with smoking is between what percentages?

A

15% - 24%

31
Q

What is sidestream smoke?

A

Smoke that passes into the surrounding air rather than into the smokers’ lungs

32
Q

How can secondary tumours be brought about following use of alkylating agents in cancer chemotherapy

A

DNA damage to surviving normal somatic cells during treatment
This can lead to DNA strand breakage and base damage

33
Q

Describe how nitrosamines (type of carcinogen) can enter the body.

A

Food additives or fertilisers that enter drinking water are ingested
GI bacteria convert the excess of nitrites and nitrates present into nitrosamines

34
Q

What can nitrosamines cause?

A

Cancers of GI tract

Cancers of the liver

35
Q

Which organ do poisoning aflatoxins target?

A

The liver

36
Q

What can aflatoxins cause?

A

Aflatoxicosis

37
Q

What two fungi are aflatoxins produced by?

A

Aspergillus flavus

A. parasiticus

38
Q

Describe how aflatoxins can contaminate food, bearing in mind that they are of fungal origin.

A

At high temperatures and high levels of humidity, moulds develop on various NUTS (especially peanuts), seeds, on cooked and stored rice and on cereals
These moulds penetrate the cells of peanuts and secrete aflatoxins that contaminate the once edible nut

39
Q

Aflatoxins and what other infection together predispose to over cancer?

A

Hepatitis B infection

40
Q

What type of aflatoxin is a potent carcinogen?

A

Aflatoxin B1

41
Q

What type of gene is p53?

A

TUMOUR SUPRESSOR GENE

42
Q

Which type of GI tumour is more common; Small intestine or Large intestine?

A

Large Intestine

43
Q

Why is this type of GI tumour so much more common?

A

Bcl2 (a GROWTH PROMOTING GENE and hence prevents cell death/apoptosis) INCREASED EXPRESSION IN LARGE INTESTINE, thus promoting cell survival and as mutations accumulate, carcinogenesis occurs

44
Q

Is Bcl2 expressed in the small intestine

A

NO

45
Q

Where is Bcl2 expressed specifically?

A

Crypts of clonic epithelium

46
Q

Bcl2 over-expression seen in other cancers such as lung cancer is due to what?

A

Gene amplification

47
Q

What does a Bcl2 knock-out mean?

A

Basically moving Bcl2 and silencing its effects (so in large intestine, %age of apoptotic cells decreases vastly)

48
Q

What two effects does UV radiation have on DNA?

A

Causes formation of pyrimidine dimers
OR
Causes breakage of DNA via indirect mechanisms

49
Q

Is UV radiation ionising?

A

No

50
Q

What is the disease that means individuals are repair deficient to UV radiation?

A

Xeroderma pigmentosum (rare autosomal recessive disease)

51
Q

What enzyme is deficient in xeroderma pigmentosum and what is the normal function of this enzyme?

A

Endonuclease - enzyme in the pathway of thymine dimer removal, hence repair of damage is defective

52
Q

What are the symptoms and signs of xeroderma pigmentosum?

A

Severe skin abnormalities - freckling, multiple squamous and basal cell carcinomas and melanomas

53
Q

What type of cancer did radium dial painters commonly contract and why were they so susceptible to it?

A

Radiation-induced bone cancer

They licked paint brushes carrying large amounts of radium salts and so ingested large amounts of radioactivity

54
Q

How does radium get into the bone in the first place?

A

It follows calcium into the bone during calcium turnover

55
Q

What type of cancer was common in children following Chernobyl associated with iodine uptake and thus gamma ray emission?

A

Thyroid cancer (radiation induced)

MD2002 (27 decks)

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