Molecular pathology of tumors, ie markers and mutations and what they indicate

Question 1

The three main methods of molecular pathological diagnostics

Answer 1

Immunohistyochemitry - Protein expression

In situ hybridisation - Detection of large DNA changes, translocations, amplifications, deletions

PCR methods - Detection of small DNA mutations.

Question 2

Colorectal carcinoma molecular markers

Answer 2

KRAS and NRAS mutations - resistance to anti-EGFR Bevacizumab

BRAF mutation - negative prognostic factor

MSI - mutations to the MSH genes or mutations to the micro satellite sequences. Reacts favorably to immuno therapy.

Question 3

Non small cell lung carcinoma molecular markers

Answer 3

KRAS - usually from smoking, EGFR inhib resistant

PD-L1 expression and MSI mutations indicate favorable response to immune checkpoint inhibition.

Question 4

Breast carcinoma molecular markers

Answer 4

Ki-67 indicates prognosis

ER
PR
HER2

BRCA1/2 Indicates sensitivity to platimun agents and PARP inhibitors