Invasion And Metastasis 07.11.23

Question 1

Do cancerous cells have a growth advantage over normal cells?

Answer 1

Yes

Question 2

Carcinoma in situ meaning

Answer 2

Means it hasn’t reached the basement membrane so it can’t spread anywhere (lymphatics or blood vessels)

Question 3

How can you easily cure carcinoma in situ?

Answer 3

Removal of cancerous tissue

Question 4

Invasive carcinoma meaning

Answer 4

Cancerous cells which have invaded the basement membrane, so will be able to metastasise

Question 5

Micro-invasive carcinoma meaning

Answer 5

Has only partially invaded the basement membrane, so lower risk of wide spread

Question 6

Which proteases do cancer cells have to contain to get through the basement membrane?

Answer 6

Collagenase

Cathepsin D

Urokinase-type plasminogen activator

Question 7

After cancer cells have penetrated the basement membrane, what do they next invade?

Answer 7

Extracellular matrix

Question 8

To spread, where do cancer cells need to reach?

Answer 8

A vessel! - blood vessel (usually venous) or lymphatic vessels

Question 9

Process of metastasis

Answer 9

Tumour growths through basement membrane —> then into stroma —> into a vessel (lymphatic or blood) —> travels via vessel (must resist immune response in vessel) —> exits vessel into stroma —> metastasis formed

Question 10

How big can a metastasis get without a blood supply?

Answer 10

About 2mm

Question 11

How does the cancer cells go through intravasation (into vessel)?

Answer 11

Collagenases and cell motility

Question 12

How does the cancer cells go through extravasation (into vessel)?

Answer 12

Adhesion receptors, collagenases and cell motility

Question 13

What causes growth at the metastatic site?

Answer 13

Growth factors

Question 14

What are angiogenesis promoters?

Answer 14

Vascular endothelial growth factor

Basic fibroblast growth factor

Question 15

What are angiogenesis inhibitors?

Answer 15

Angiostatin

Endostatin

Vasculostatin

Question 16

Avastin medication - what does it do?

Answer 16

Inhibits angiogenesis by stopping VEGF-A from binding to membrane and therefore no vessels can grow

Question 17

Describe route of metastasis from vena cava…

Answer 17

Vena cava —> heart —> lung —> gets stuck in lungs due to size of metastasis

Question 18

Which tumours more commonly metastasise into the lungs?

Answer 18

Sarcomas and any common cancers

Question 19

Define sarcoma

Answer 19

A malignant tumour of connective or other non-epithelial tissue

Question 20

If a metastasis goes down towards the liver (e.g. a gut tumour will travel towards the liver) where does it then go?

Answer 20

In the liver, then through the portal vein

Question 21

Which tumours more commonly metastasise to the liver?

Answer 21

Colon, stomach, pancreas, carcinoid tumours of the intestine

Question 22

In which, liver or lungs, are you more likely to get a single metastasis? What treatment could you do?

Answer 22

Liver (if this was the case you could potentially remove the single metastasis)

Question 23

Which tumours are commonly metastasise to bone?

Answer 23

Prostate (via lower spine), breast, thyroid, lung, kidney