Chapter 18- Tumor Immunology Flashcards

0
Q

Composed of cell that is similar with the normal cells they are from but difference is that they have accelerated or dysregulated growth

A

Tumor

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1
Q

“Swelling”

A

Tumor

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2
Q

Cannot be eradicated because they are similar to tissue

A

Tumor

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3
Q

Tumor that doesn’t spread

A

Benign tumor

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4
Q

Dissemination of tumor, not normal function and death occurs

A

Metastasis

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5
Q

State the 4 stages/process of normal to malignant cell

A

1) induction phase / exposure
2) in situ phase / abnormal growth
3) invasion phase / malignancy
4) dissemination

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6
Q

In induction phase, there is exposure to?

A

Carcinogens
Oncogenic viruses
Radiation

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7
Q

Enlargement of organ

A

Dysplasia

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8
Q

Abnormal growth of tissue

A

Neoplasia

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9
Q

Where neoplasia happens BUT does not metastasize yet

A

In situ phase

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10
Q

Stage where cancer develops due to exposure

A

Induction phase

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11
Q

Phase where cell becomes malignant

A

Invasion phase

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12
Q

Best phase to detect tumor

A

Invasion phase

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13
Q

Phase where tumor is spread throughout the body

A

Dissemination

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14
Q

Dissemination throughout the body is done through the ____ and _____

A

Blood

Lymphatics

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15
Q

Classification of rumors

A

1) poorly differentiated tumors / anaplastic tumors

2) well differentiated tumors

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16
Q

Tumors similar to fetal or embryonic tissue

A

Poorly differentiated tumors

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17
Q

Another term for poorly differentiated tumors

A

Anaplastic tumors

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18
Q

Tumors similar to normal tissue

A

Well-differentiated tumors

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19
Q

the more aggressive type of tumor based on classification

A

Poorly differentiated tumor / anaplastic tumor

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20
Q

This is used to classify tumors by size, involvement, and detection

A

TNM system

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21
Q

What does the TNM system stand for?

A

T=Tumor Size
N= Node (lymph) involvement
M= Metastasis detection

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22
Q

Immune system monitoring tumor

A

Immunosurveillance

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23
Q

Immune system helps monitor tumor by the following:

A

1) NK cells, T cells, and macrophages infiltrated by the tumor
2) poor antigen presentation allow tumor cells to escape from T cells
3) medicines aimed in immune system to fight cancer is a success

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24
Q

Why can tumors be poorly immunogenic?

A

Because they are the same as body

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25
Q

Cytokines that stop tumors

A

Transforming Growth Factor-B

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26
Q

Mutations of cancer cells that are less immunogenic so they escape & mutate so that they won’t be controlled by the immune system anymore

A

Immunoediting

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27
Q

Antigens present in tumors and more in number compared to normal tissues

A

TAA (Tumor Associated Antigens)

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28
Q

Tumor Associated Antigens are from

A

Mutated genes
Viruses
Aberrant (wrong) expression of normal age

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29
Q

Fetal tissue and cancer is the same

A

Oncofetal Tumor Antigens

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30
Q

What are the principles of lab tests?

A

screening test

Diagnostic test

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31
Q

This detects undetectable / asymptomatic cancer

A

Screening test

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32
Q

This is done to know the differential diagnosis (stage, prognosis, therapy selection)

A

Diagnostic test

33
Q

Probability calculation

A

Baye’s Theorem

34
Q

A good cancer test is?

A

99% sensitivity (with disease)

95% specificity (without disease)

35
Q

If population cancer is 0.1%?

A

98% of POSITIVE is False positive

36
Q

If population cancer is 1%?

A

83% of POSITIVE is false positive

37
Q

Is identified by clinician 75% of the time

A

Syndrome

38
Q

If syndrome is identified by clinician 75% of the time and done again…

A

1.7% is False positive

39
Q

High cancer prevalence being tested

A

Differential diagnosis

40
Q

Low cancer prevalence being tested

A

Screening test

41
Q

Has a high number of false positive

A

Screening test

42
Q

Instances on when to use screening tests? Name 4

A

1) cancer has a large impact on society, therefore a need to screen people arises
2) if there is a marker with high sensitivity and specificity for use in screening
3) if tumor can be cured at an early stage
4) if cost and benefits suit the society

43
Q

Name 2 benefits of screening test

A

Improves survival time

Less radical treatment for tumors detected earlier

44
Q

Differential diagnosis of tumor type is done by?

A

Tissue morphology / cell morphology

Detection of tumor markers

45
Q

Uses labeled antibody to detect antigen

A

Immunohistochemistry

46
Q

Detects abnormal gene expression

A

FISH (Fluorescent In Situ Hybridization)

47
Q

Uses nucleic acid probe

A

FISH

48
Q

What does FISH use?

A

Nucleic acid probe

49
Q

Is specific for prostate gland of men

A

PSA (Prostate Specific Antigen )

50
Q

Increased in all prostate cancer

A

PSA prostate specific antigen

51
Q

Give common tests for Tumor Marker Detection

A

1) stool occult blood
2) colonoscopy (for COLORECTAL CARCINOMA)
3) papanicolaou smear (CERVICAL CANCER)
4) x-Ray mammography (BREAST CANCER)
5) digital rectal exam (PROSTATE CANCER)

52
Q

3 types of lab methods for cancer screening & diagnosis

A

1) gross and microscopic morphology of tumors
2) detection of antigen or protein tumor markers
3) DNA/RNA molecular diagnostics

53
Q

Lab methods for cancer screening and diagnosis is chosen based on?

A

Convenience
Cost
Sensitivity
Specificity

54
Q

What are used for final diagnosis?

A

1) cytogenetic studies
2) nucleic acid amplification techniques
3) fluorescent in situ hybridization (FISH)

55
Q

Tests gene defects in various cancers

A

Cytogenetic studies

56
Q

Detects small populations of cancer cells

A

Nucleic acid amplification techniques

57
Q

Detects MUTATION, DELETION, and TRANSLOCATION

A

Nucleic acid amplification techniques

58
Q

What is detected by Nucleic acid amplification techniques ? MDT

A

Mutation
Deletion
Translocation

59
Q

Probes with flurophors that can bind to sequence of interest and apply it to cells

A

FISH

60
Q

Marker for CHRONIC MYELOGENOUS LEUKEMIA

A

BCR-ABL

61
Q

Present in MULTIPLE MYELOMA / other LYMPHOID MALIGNANCY

A

Monoclonal expression of B-Cell DNA rearrangement

62
Q

Used for multiple testing of a sample for multiple genes

A

Microarray tests

63
Q

A single chip with multiple nucleic acid tests

A

Microarray tests

64
Q

Susceptible for breast, ovarian and prostate cancer

A

BRCA-1 & BRCA-2 Mutations

65
Q

4 characteristics of an ideal tumor marker

A

1) produced by tumor / secreted into some biological fluid
2) long circulating half-life
3) elevated levels while disease is being treated & few false (+)
4) antigen is not present in people without disease so that there is decreased false (+)

66
Q

what are the non-nucleic acid tumor markers?

A
Cell surface markers
Proteins
Oncofetal Antigen
Carbohydrate antigen 
Blood group antigen
Enzymes and Isoenzymes
Hormones
67
Q

Not really from the tumor; can also be a product of normal tissue

A

Tumor markers

68
Q

Tumors are mostly detected using ____ due to its ____ BUT it may _____ due to its ____

A

ANTIBODY
SPECIFICITY
Cross react
Similarities

69
Q

Antigen saturation of antibody inhibits cross linkage needed to view reaction

A

Prozone effect

70
Q

Causes false decreased measurement;
Due to antigen excess can saturate antibody;
No sandwich configurations cannot form

A

High-Dose Hook Effect

71
Q

False increase
False (+)
Already like a tumor

A

Heterophile antibody

72
Q

Type of immunotherapy

A

Passive immunotherapy

73
Q

Involves transfer of antibody, cytokines, cells to patients without it

A

Passive immunotherapy

74
Q

Immunity comes from others

A

Passive immunotherapy

75
Q

Allogenic transfer of cells

A

Graft vs. Leukemia

76
Q

Cells from donors which can be immunized against tumors

A

T cells

77
Q

Manipulates allogenic T cell to be vulnerable to a drug that will kill them before GVHD happens

A

Suicide switch

78
Q

These are Harvested and expanded in vitro using IL-2 then give it to the patient

A

Autologous T-Cells

79
Q

Antibody that can kill cancer cells without destroying adjacent cells

A

Antibody conjugates / IMMUNOTOXINS