Diagnosis, Grading, and Staging of Neoplasms Flashcards
Grading is based on ___ of tumor cells and the number of ___ within the tumor
Grading is based on the degree of differentiation of tumor cells and the number of mitoses within the tumor
Which is a histological method? Grading or staging?
Grading
What is the prognostic value of grading?
Can speculate malignant/benign but has limited prognostic value
Grading of neoplasms ranges from ___ to ___
well differentiated (I) to anaplastic (IV)
Staging is based on…
- size of primary neoplasm
- extent of its spread to regional lymph nodes
- presence or absence of metastases
All solid tumors use which staging system (with different qualifiers)?
TNM system
What is the T in the TNM system?
Primary tumor size (0-4)
0 is in situ
2-3 is intermediate
4 is huge >7cm
What is the N in the TNM system?
Regional lymph node involvement (0-3)
0 is not in lymph nodes
1 means 1 node or 1 anatomical group of nodes is involved
2 means 2 or more lymph node groups on 1 side of the diaphragm are involved
3 means 2 or more lymph node groups on both sides of diaphragm are involved
What is the M in the TNM system?
Metastases (0-1)
0 means there is none
1 means there is metastasis
Which factor of the TNM system has the greatest prognostic value?
Metastasis
Prostate cancer uses what grading system?
Gleason score, a histological grading system
What is Gleason scoring?
Histological grading system of prostate cancer
Score derived from adding grades from several histological sites ranked accordingly based on deviation from normal prostatic architecture and relative loss of complete gland units
A higher Gleason score is ___ differentiated
poorly differentiated/anaplastic
A lower Gleason score is ___ differentiated
well differentiated
What must be seen to diagnose cancer?
Cells
What are three histological/cytological methods of diagnosing cancer?
- Excision or biopsy
- Needle aspiration
- Cytologic smears
Which histological/cytological method of diagnosing cancer is most invasive?
Excision or biopsy
Which histological/cytological method of diagnosing cancer is least invasive?
Cytologic smears
What is needle aspiration?
What is an example where this might be utilized?
Histological/cytological method of diagnosing cancer where cells are sucked out with a needle
ie. thyroid, breast
What is an example of a cytologic smear?
Pap smear
What is immunocytochemistry?
Antibody looks for mutation
If it lights up with antibody, it’s cancerous
What is flow cytometry?
Cell counting by machine
ie. WBC count (leukemia)
What are five methods of cancer diagnosis?
- Histological/cytological methods
- Immunocytochemistry
- Molecular identification
- Flow cytometry
- Tumor markers
Name five biochemical indicators of the presence of a tumor
- Estrogen receptors (HER2)
- Alpha-fetoprotein (AFP)
- Carcinoembryonic antigen (CEA)
- Prostate specific antigen (PSA)
- CA125
Estrogen receptors (HER2) are biochemical indicators of the presence of…
breast carcinoma
Alpha-fetoprotein (AFP) is a biochemical indicator of the presence of…
liver carcinoma, testicular carcinoma
Carcinoembryonic antigen (CEA) is a biochemical indicator of the presence of…
colon, pancreas, breast carcinoma
Prostate specific antigen (PSA) is a biochemical indicator of the presence of…
prostate carcinoma
CA125 is a biochemical indicator of the presence of…
ovarian carcinoma
What are three things that evaluating tumor markers accomplish?
- Help support diagnosis of cancer
- Indicates success of therapy
- May indicate “return” of cancer
Name five current treatment modalities of cancer
- Surgical excision
- Chemotherapy
- Radiation therapy
- Combined therapies/induction therapy
- Anti-hormonal/immunotherapy/stem-cell transplants
Most treatment of cancer will have which modality of treatment?
Combined therapies
What are two types of radiation therapy?
- Conformal radiotherapy
- Localized therapy
