mechanisms of oncogenesis Flashcards

1
Q

cancer statistics

A

incidence = someone is diagnosed every 2 mins in UK
990 cases diagnosed everyday

mortality = every 4 mins someone dies from cancer

risk = 1 in 2 people in Uk will be diagnosed with some form of cancer during their lifetime

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2
Q

cancer survival and prevention

A

survival = half of diagnosed survive for 10 years

prevention= 4 in 10 cases linked to lifestyle

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3
Q

prevention and reducing risks

A
smoking
hormones
obesity and weight 
alcohol 
workplace causes of cancer 
sun and UV
infections and HPV 
physical activity 
diet and healthy eating 
inherited genes 
air pollution and radon
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4
Q

what is cancer

A

name for a group of diseases characterised by:

abnormal cell proliferation
tumour formation
invasion of neighbouring normal tissue
metastasis to form new tumours at distant sites

over 200 diff types of cancers

approx 85% occur in epithelial cells = carcinomas

cancers derived from mesoderm cells = sarcomas

cancers found in glandular tissue = adenocarcinomas

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5
Q

hallmarks of cancers (6)

A

two enabling characteristics = genome instability and tumour inflammation

two emerging hallmarks = avoiding immune destruction and reprogramming energy metabolism

  1. resisting cell death
  2. deregulating cellular energetics
  3. sustaining proliferative signalling
  4. evading growth suppressors
  5. genome instability and mutation
  6. inducing angiogenesis
  7. activating invasion and metastasis
  8. tumour promoting inflammation
  9. enabling replicative immortality
  10. avoiding immune destruction.
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6
Q

evidence suggesting cancer is a disease of the genome at cellular level

A
  • carcinogens cause alterations to DNA
  • DNA from tumours contain many alterations from point mutations to deletions
  • many mutations over time = multi step process underlying carcinogens
  • accumulation occurs openly after cells defence mechanism of DNA repair been evaded
  • in cases if severe damage cell apoptosis induced
  • mechanisms exist for blocking carcinogenesis but over burdening system increases possibility that cells will escape surveillance

longer we live = more time for DNA to accumulate mutations that may lead to cancer

cancer is more prevalent as lifespan has increased

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7
Q

evidence that cancer is a disease of the genome at the cellular level

A

tumour cells:

somatic mutations constitute all mutations in tumour cells

all cells in primary tumour arise from single cell, initiation of development of cancer is clonal

only one of the 10^14 cells in body need to be transformed to create a tumour

continued accumulation of mutations

tumour cells can evolve sub clonal selection allowing growth advantage and explain and heterogeneity of cells in tumour

dependent on interaction with other tumour cells and tumour clonal cells microenvironment

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8
Q

conversion of a normal cell to tumour cell

A

proliferation and control = control of cell division within a tissue is important in rapidly self renewing tissues when proliferation must balance cell loss

signals = messages, growth factors, EGF, PDGF,

cytokines: growth hormone, interleukins
hormones: oestrogen

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9
Q

oncogenes and tumour suppressor genes

A
  • normal genes regulate growth
  • normal genes can be activated to be oncogenic are called proto-oncogenes
  • oncogene = protooncogene that has mutated in a way that leads to signals that cause uncontrolled growth, cancer.

tumour suppressor genes = inhibit both growth and tumour formation. act as braking signals during phase G1 of cell cycle, stop or slow cell cycle before S phase
- if tumour suppressor genes are mutated, normal brake mechanisms disables = uncontrolled growth

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10
Q

multistage carcinogenesis

A

3 assumptions:

  1. malignant transformation of single cell is sufficient to give rise to a tumour
  2. any cell in a tissue is as likely to be transformed as any other of the same type
  3. once a malignant cell is generated the mean time to tumour detection is generally constant
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11
Q

chemical carcinogens

A

cancer = 3 steps = initiation, promotion, progression

chemical carcinogens can alter these processes to induce their carcinogenic effects

presence of multiple mutations in critical genes is a distinctive feature of cancer cells and supports that cancer arises through accumulation of irreversible DNA damage

in majority of instances chemical carcinogens can induce this DNA damage and act in genotoxic manner

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12
Q

several classes of carcinogens

A

chemical = 10 groups: polycyclic aromatic hydrocarbons, aromatic amines, azo dyes, nitrosamines, carbamates, halogenated compounds, alkylating agents

physical = radiation and asbestos

heritable = predisposition

viral = hepatits B and epstein Barr

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13
Q

cancer causing chemicals in tobacco and cig smoke have other uses too…

A

Benzene – an industrial solvent, refined from crude oil

Arsenic – a poison, used in wood preservatives

Cadmium and lead – used in batteries

Formaldehyde – used in mortuaries and paint manufacturing

Polonium-210 – a highly radioactive element

Chromium – used to manufacture dye, paints and alloys
1,3-Butadiene – used in rubber manufacturing

Nickel – used to protect metals from corrosion

Vinyl chloride – used to produce plastic and vinyl products

Beryllium – used in nuclear reactors

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14
Q

chemical carcinogens

A

Four of the major groups polycyclic aromatic hydrocarbons, aromatic amines, nitrosamines and alkylating agents
exert their effects by adding functional groups to DNA bases called DNA adducts

One example is coal tar, which contains benzo[a]pyrene, a polycyclic hydrocarbon

Benzo[a]pyrene is commonly found in cigarette smoke (together with 81 other carcinogens)!

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15
Q

describe ames test

A

a test to determine the mutagenic activity of chemicals by observing whether they cause mutations in sample bacteria

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16
Q

physical carcinogens

A

imparting energy into biological material
radiation is the primary physical agent

several types of radiation can act as carcinogens

17
Q

heritable carcinogens - syndromes predisposing to cancer

A

Accounts for 5% of all cancers

An inherited germline mutation, has an increased risk of developing certain tumours but are rarely involved in causing cancer immediately

In most known hereditary malignant syndromes the elevated cancer risk is due to a mutation of a single gene (monogenic hereditary diseases)

The affected genes concerned usually have a controlling function on the cell cycle or the repair of DNA damage

18
Q

syndromes predisposing to cancer

A
DNA repair defects = ataxia telangiectasia
Bloom’s syndrome
Fanconi’s anaemia
Li-Fraumeni syndrome
Lynch type II
xeroderma pigmentosum

chromosomal abnormalaties=

downs syndrome
klinefelters syndrome

19
Q

DNA repair defects

A

Ataxia telangiectasia- neuromotor dysfunction, dilation of blood vessels,
telangiectasia = spider veins
Mutation in ATM gene, codes for a serine/threonine kinase that is recruited and activated by
dsDNA breaks leading to cell cycle arrest, DNA repair and apoptosis -cell cycle arrest
Cancer predisposition: lymphoma, leukaemia and breast cancer
Bloom’s Syndrome -short stature, rarely exceed 5 feet tall, skin rash that develops
after exposure to the sun
Mutation in BLM gene that provides instructions for coding a member of the RecQ helicase family
that help maintain the structure and integrity of DNA
Cancer predisposition: skin cancer. basal cell carcinoma and squamous cell carcinoma.

Lynch type- LS doesn’t cause any symptoms. Sometimes the first sign that a person has LS is when the symptoms of bowel and womb cancer develop.
Mutations in DNA mismatch repair (MMR) genes, notably MLH1, MSH2, MSH6 and PMS2.
Cancer predisposition: colorectal cancer

20
Q

identifying infectious agents as carcinogens

A

viruses capable of causing wide range of human disease from small pox to cold

most harm caused when viruses multiply inside infected cell, kill cell and release progeny to further infect other cells

21
Q

properties required of tumourigenic viruses

A

stable association with cells = chromosomal integration , episome

must not kill cells = non permissive host, suppression of viral lytic cycle, viral release by budding

must evade immune surveillance of infected cells
immune suppression
viral antigens not expressed at cell surface

22
Q

viruses associated with human cancer

A

DNA viruses -Epstein-Barr virus Burkitt’s lymphoma, nasopharyngeal carcinoma
papilloma viruses cervical carcinoma, warts
hepatitis B and C hepatoma

RNA retroviruses

HTLV-I Adult T-cell leukaemia, lymphoma

23
Q

forces driving carcinogenesis

A

two methods - somatic mutation theory and tissue organization field theory

SMT
cancer is derived from a single somatic cell that has successively accumulated multiple DNA mutations
those mutations damage the genes which control cell proliferation and cell cycle
Thus, according to SMT, neoplastic lesions are the results of DNA-level events

TOFT
Carcinogenesis is primarily a problem of tissue
organization
carcinogenic agents destroy the normal tissue architecture thus disrupting cell-to-cell signaling and compromising genomic integrity
the DNA mutations are randon and the effect, not the cause, of the tissue-level events.

24
Q

immune response in cancer

A

protect from virus-induced tumours

eliminate pathogens

identify and eliminate tumour cells

immune surveillance

despite this tumours can still arise- concept of cancer immunoediting

25
Q

cancer immunoediting - three Es

A

Elimination
The immune system is able to
eradicate developing tumours

Equilibrium
When incomplete removal is present
tumour cells remain dormant and 
enter equilibrium. The immune system 
exerts a potent and relentless pressure 
that contains the tumour. During this 
phase some of the tumour may mutate 
or give rise to genetic variants that 
survive, grow and enter the next phase
(Longest of the phases, around 20 years)

Escape
The expanding tumour populations becomes
clinically detectable