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EMS > Lecture 40 - Behaviour of tumours > Flashcards

Lecture 40 - Behaviour of tumours Flashcards

1
Q

How many new cases of cancers occur every year in the UK?

A

350,000

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2
Q

True or false: Cancer causes more than 1 in 4 deaths in the UK

A

True

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3
Q

How do malignant tumours behave?

A
  1. Invasion
  2. Metastasis
  3. Angiogenesis
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4
Q

What is invasion of malignant tissue?

A

Invades adjacent normal tissue
Destroys normal tissue

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5
Q

What is metastasis of malignant tissue?

A

Spreads from site of origin to a distant site establishes a new tumour there

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6
Q

What is the name of the mechanisms used my cancerous cells allowing them to become more mobile and free moving?

A

epithelial-mesenchymal transition

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7
Q

what is require for a tumour to metastasise?

A

Invasion

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8
Q

Describe the typical arrangement of epithelial cells:

A

tightly connected, polarised and tethered to one another

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9
Q

Describe the typical arrangement of mesenchymal cells:

A

loosely connected (meaning they are able to migrate)

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10
Q

What are the two stages of the epithelial-mesenchymal transition?

A

1) reducing adhesion

2) producing proteolytic enzymes

3) Increased motility

4) Mechanical pressure

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11
Q

How does cancer spread using epithelial - mesenchymal transition?

A

In cancer, epithelial cells gain mesenchymal properties and can invade and migrate

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12
Q

Give an example of a cell-to-cell adhesion molecule:

A

cadherins
A mutation in E-cadherin in the tumour  reduced cell-cell adhesion.

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13
Q

Give an example of a cell to matrix adhesion molecule:

A

integrin
Changes in integrin expression leads to decreased cell-matrix adhesion

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14
Q

What is the most important proteolytic enzyme in neoplastic invasion?

A

Matrix metalloproteinases

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15
Q

What cells secrete matrix metalloproteinases?

A

malignant neoplastic cells

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16
Q

Give three examples of matrix metalloproteinases:

A

1) interstitial collagenases

2) gelatinases

3) stromelysins

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17
Q

What proteins does interstitial collagenase break down?

A

type I, II and III collagen

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18
Q

What proteins does gelatinase break down?

A

type IV collagen and gelatine

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19
Q

What proteins does stromelysin break down?

A

type IV collagen and proteoglycans

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20
Q

Describe the balance between matrix metalloproteinases and tissue inhibitors of metalloproteinases in cancer?

A

the tissue favours extracellular matrix breakdown

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21
Q

What path do malignant neoplasms invade along?

A

the path of least resistance

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22
Q

Give two examples of ‘paths of least resistance’ used my malignant neoplasms when invading?

A

1) blood vessels

2) nerves

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23
Q

What is metastasis?

A

where a tumour spreads from the site of origin (primary) to a distant site to establish a tumour there (secondary)

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24
Q

True or false: the tumour mass of the secondary tumour exceeds that of the primary lesion

A

true

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25
Q

What two things are extremely resistance to neoplastic invasion?

A

1) Cartilage
2) Bone

26
Q

Give three easily identifiable clinical presentations of metastasis:

A

1) palpable lymph nodes

2) ascites

3) bone lesions

27
Q

What is the first step in the metastatic sequence?

A

detachment invasion

28
Q

What is detatchement invasion?

A

where cells of a primary tumour break away

29
Q

What is the name given to the process of malignant tumour cells entering blood vessels?

A

intravasation

30
Q

Give an example of a method used by tumour cells to evade the host immune system when travelling in the blood:

A

tumour cells remove their MHC I expression to reduce detection

31
Q

What is the name of the process whereby tumour cells anchor to the wall of the endothelium and exit blood vessels?

A

adherence extravasation

32
Q

Give the four main routes of metastasis:

A

1) lymphatics

2) haematogenous

3) transcoelomic

4) implantation

33
Q

Where do secondary tumours from when cancers spread through lymphatics?

A

lymph nodes

34
Q

What is the most common route of metastasis used by carcinomas?

A

lymphatic route

35
Q

What is the most common route of metastasis used by sarcomas?

A

haematogenous route

36
Q

What organs are common sites of secondary tumours when cancers spread through the blood? (4)

A

1) liver

2) lungs

3) bone

4) brain

37
Q

Where do bone metastases most frequently come from?

A

1) Lung
2) Breast
3) Kidney
4) Thyroid
5) Prostate

38
Q

What is the transcoelomic route of metastasis?

A

spread across the peritoneum or pleural cavity leading to an effusion containing neoplastic cells

39
Q

What is the implantation route of metastasis?

A

the spillage of tumour cells in surgery

40
Q

Fill in the gap: tumours cannot grow more than _-_mm without a blood supply

A

2-3mm

41
Q

What is angiogenesis?

A

Growth of blood vessels on existing vasculature
Normal part of growth and healing

42
Q

What molecule do tumour cells express to promote the sprouting of new vessels?

A

vascular endothelial growth factor (VEGF)

43
Q

What is meant by ‘stage’ in relation to cancer?

A

the extent of tumour spread/ how far along the tumour is (has it metastasised?)

44
Q

What is meant by ‘grade’ in relation to cancer?

A

the extent of aggressiveness of a tumour/ how quickly it is progressing

45
Q

What system is used to assess the stage of a cancer?

A

The TNM staging system

46
Q

What does TNM stand for?

A

tumor-node-metastasis

47
Q

What does the TNM scale assess?

A

the extent of tumour and nodal spread and metastasis

48
Q

What staging system is used for colorectal cancer?

A

Dukes staging system

49
Q

What is meant by the A-D scale used in Dukes staging system for colorectal cancer?

A

A- no invasion through the bowel wall

D- distant metastasis

50
Q

What staging system is used for lymphomas?

A

Ann Arbor system

51
Q

What is stage 1 Lymphoma?

A

Lymphoma in one group of lymph nodes

52
Q

What is stage 2 Lymphoma?

A

Lymphoma in 2 or more groups of lymph nodes

53
Q

What is stage 3 Lymphoma?

A

Lymphoma both sides of diaphragm

54
Q

What is stage 4 Lymphoma?

A

Lymphoma in organ not part of lymphatics / lymphoma in bone marrow, liver or lung

55
Q

What are the two grades of cancer?

A

low and high grade

56
Q

What things do we consider when we are determine the grade of the cancer?

A
  1. How much do the cancer cells resemble the normal tissue = differentiation
  2. The variation in size and shape of the cancer cells = pleomorphism
  3. How many cells are actively dividing, can count mitotic figures = proliferation
57
Q

How does well differentiated tumours present?

A

Cells closely resemble those of normal tissue = low grade

58
Q

How does a poorly differentiated tumour differentiated?

A

Cells hardly resemble those of normal tissue = high grade

59
Q

Does mitoses only indicated malignancy?

A

mitoses can be seen in normal tissue  do not indicate malignancy

60
Q

What type of mitotic figures are seen during malignancy?

A

Tripolar
Quadripolar
Multipolar spindles

EMS (54 decks)

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