colon cancer Flashcards

1
Q

DIAGRAM colorectal crypts of lieberkuhn

A

stem cells at the bottom are proliferating, and at top there’s differentiaition eg goblet cells

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2
Q

cell turnover+ significance

A

very high in colon, so vulnerable to mutations

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3
Q

polyps vs adenomas

A

projection of mucosal surface vs benign neoplasm of mucosal epithelial cells (type of polyps)

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4
Q

types of polyps

A

adenomas, hyperplastic, lipomas

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5
Q

hyperplastic polyps

A

most polyps, no chance of malignancy

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6
Q

DIAGRAM types of adenomas

A

either tubular (has lots of tubules) or villous- tubular is adenoma of columnar vs mucinous cells- form tubules vs finger-like extensions

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7
Q

adenomatous polyposis coli- what is it, significance, and treatment

A

thousands of polyps- almost certain to get carcinoma, so must be removed

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8
Q

microsatellite instability and cause

A

microsatellites are repeat sequences that often mutate, and if there’s mismatch repair genes (problem with repair genes), it leads to microsatellite instability- this occurs due to something called HNPCC/lynch syndrome

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9
Q

adenoma-carcinoma sequence

A

initially, there is mutation in APC gene (TMS gene)- adenoma then forms due to K-ras mutation (oncogene)- p53 mutation then occurs (TMS), leading to carcinoma

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10
Q

genetic influences to colon cancer

A

either FAP/APC mutation (adenoma to carcinoma) or HNPCC/lynch syndrome (microsatellite instability)

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11
Q

how APC mutation may cause cancer

A

beta catenin normally in cytoplasm- if APC mutation occurs, beta catenin moves into nucleus and more proliferation occurs

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12
Q

p53 mutation paradox

A

cells with more P53 more vulnerable to cancer, as body tries to respond to increased proliferation by producing more P53, but it’s defective

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13
Q

link between fat consumption and colon cancer

A

theres a positive correlation

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14
Q

dietary deficiency and signficance

A

lack folates in diet can lead to deficiency in MTHFR gene

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15
Q

link between age and colon cancer

A

incidence increases with age

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16
Q

presentation

A

constipation/diarhhoea, bleeding, IRON DEFICIENCY ANEMIA

17
Q

where most carcinomas occur

A

mostly in sigmoid/rectum, but some in caecum/ascending colon too

18
Q

dukes classification

A

dukes A goes into mucosa, dukes B into mucularis propria, and dukes C where it’s gone into nodes

19
Q

features affecting prognosis

A

rectal bleeding improves prognosis, high CEA levels and lower age reduces prognosis

20
Q

treatment

A

dependent on stage- 1 involves just surgery, 2-3 involves surgery 5FU, 4 involves chemo as well

21
Q

screening for colon cancer- features

A

previous adenomas, whether relatives affected, IBD

22
Q

how screening works

A

use a FOB kit, and if positive, go for colonoscopy