diagnostic and lab methods

Question 1

surgical biopsy

Answer 1

incisional (removes only part of the suspicious area, enough to make a dx).
excisional (removes entire tumor with or w/out trying to take out an edge of normal tissue)

Question 2

needle biopsy

Answer 2

a very thin needle attached to a syringe is used to withdraw a small amount of tissue which is then looked at under microscope.

Question 3

endoscopic biopsy

Answer 3

instruments are used to look inside the body. some are hollow while others use fiber optics, and some have a small video camera for viewing. commonly used to look at esophagus, stomach, large intestine, lungs, throat, larynx.. if something suspicious is seen during the exam, biopsy samples may be removed and viewed under a microscope.

Question 4

frozen section

Answer 4

a tissue mass is removed surgically and biopsy given to the pathologist who freezes the tissue in a cryostat machine, cuts it w a microtome, and then stains it w various dyes so that it can be examined under the microscope. If the sample is found to be cancerous, the entire mass can be removed at that time.

Question 5

exfoliative cytology

Answer 5

microscopic examination of cells desquamated from a body surface or lesion, done to detect malignancy or microbiologic changes. the cells can be obtained by aspiration, washing, smear, or scraping.

Question 6

tumor markers (serum or tissue)

Answer 6

cellular products that are helpful in the detection, diagnosis, and therapeutic management of certain cancers. These may be normal cell components that are over-expressed by malignant cells or they may be cellular products produced by the body in response to the malignant cells. They can be found at higher than normal levels in the blood of some people with cancer. But, more than 20 tumor markers have been identified, no tumor markers are unique to cancer cells, and different tumor markers are found in different types of cancer.

Question 7

what tumor markers can tell us

Answer 7

help confirm diagnosis; provide important info about prognosis/treatment; alert to early recurrence in previously treated pts.

Question 8

what tumor markers CANNOT tell us

Answer 8

diagnose cancer; identify a specific cancer; rule out cancer.

Question 9

5 categories of tumor markers

Answer 9

• Antigens
• Enzymes
• Hormones
• Oncogenes
• Tissue Receptors – cell surface proteins that affect the rate of tumor development by binding to hormones and growth factors. ER assay, PR assay, EGFR.

Question 10

Tumor markers: antigens

Answer 10

proteins normally found in larger amounts during fetal development. 
AFP (liver)
CEA (colorectal)
PSA
CA-125 (ovarian) 
Bence Jones Proteins (mult myeloma)

Question 11

tumor markers: enzymes

Answer 11

biological catalysts that speed rate of reactions; increased levels seen in blood when there is malignant tissue present. Prostatic Acid Phosphatase, Galactosyl transferase II (ovarian).

Question 12

tumor markers: hormones

Answer 12

can be due to the tissue producing more hormone than it usually does, or a tissue producing hormone that typically doesn’t. Often associated with cancers of endocrine glands. Beta-HCG
Human Calcitonin.

Question 13

tumor markers: oncogenes

Answer 13

genes that are useful in fetal development but trigger tumor growth when activated in mature cells.
BRCA-1, BRCA-2
Philadelphia Chromosome.

Question 14

tumor markers: tissue receptors

Answer 14

cell surface proteins that affect the rate of tumor development by binding to hormones and growth factors.
ER assay (estrogen)
PR assay (progesterone)
EGFR (epidermal growth factor receptor)