Neoplasia Flashcards
Metastasis
- Cancer spreads to a region other than where it originated
- Commonly develop when cancer cells break away from main tumour and enter bloodstream or lymphatic system
- Can also develop when breaking away from main tumour (in belly, abdominal cavity) and grow in nearby areas (liver, lungs or bones)
Dysplasia
- Abnormal development of cells within tissues or organs
- Can lead to a wide range of conditions involving enlarged tissue or pre-cancerous cells
- Reversible –> can undergo apoptosis and repair
Neoplasia
- Uncontrolled, abnormal growth of cells or tissues that is not under physiologic control
o Abnormality = neoplasm or tumour - Irreversible –> can no longer go under apoptosis or cell repair
In Situ
- Tumour confined to its site of origin and has not invaded neighbouring tissue or gone elsewhere in the body
Carcinoma
- Abnormal cells that divide without control
- Originates in epithelial cells lining the skin or the tissue lining organs, such as the liver or kidneys
8 Behavioural changes that occur in cancer cells
- Limitless Replicative Potential
- Evasion of Apoptosis
- Ability to Invade and Metastasise
- Insensitivity to Antigrowth Signals
- Sustained Angiogenesis
- Self-Sufficiency in Growth Signals (Proliferation without external stimuli)
- Warburg Effect
- Defects in DNA Repair
Limitless Replicative Potential
- Tumour cells can inactivate senescence signals and activate telomerase
- Telomerase replaces telomeres with base pairs and allows unlimited replication
- Three Cell Types that may show unlimited replication
o Germ Cell (normal)
o Stem Cell (normal)
o Tumour Cells (abnormal)
Evasion of Apoptosis
- P53 (guardian of the genome) is responsible for detecting DNA damage, chromosome abnormalities and arresting the cell cycle to initiate repair
o If not possible, apoptosis is induced - More than half of cancers have mutated or missing gene P53
o Therefore, it is damaged or missing - Cancer cells than either increase the activity of inhibitors of P53 or silence the activators of P53
Ability to Invade and Metastasise
- Primary tumour masses spawn pioneer cells that invade adjacent tissue
- Allows the tumour to colonise a new region of the body in which nutrients and spacer are not limiting
- Successfulness is dependent on the other hallmarks of cancer
Insensitivity to Antigrowth Signals
- Antigrowth signals are proteins that inhibit growth
- At a molecular level, nearly all antigrowth signals are funnelled through the Retinoblastoma protein (Tumour Suppressor protein)
o Can be lost through mutation of its gene
o Cancer-promoting proteins (oncoproteins) can block the function of Retinoblastoma - Another antigrowth signal (TGF-Beta) blocks the advancement of cell division when present
o Therefore, cancer cells can reduce the number of TGF-Beta receptors to be irresponsive to its presence
Sustained Angiogenesis
- Creating leaky and unstable blood vessels
Self-Sufficiency in Growth Signals (Proliferation without external stimuli)
- Protooncogenes regulate cell proliferation
- Protooncogenes mutate forming oncogenes which promote autonomous growth via the creation of oncoproteins
o Inactivate internal regulator pathways and result in abnormal cell function and transformation - Many cancer cells acquire the ability to synthesise and secrete their own growth factors (creates positive feedback loop)
- Cancer cells can tweak growth factor receptor
o Increases number of receptors on cell surface lower level of growth factor is required to trigger cell division
Warburg Effect
- Form of modified cellular metabolism found in cancer cell
o Tend to favour a specialised fermentation over the aerobic respiration pathway - Cancer cells predominantly produce energy by a high rate of glycolysis followed by lactic acid fermentation in the cytosol
o Rather than glycolysis, followed by the oxidation of pyruvate - Aerobic glycolysis produces ATP synthesis promotes cell proliferation by reprogramming metabolism to increase glucose uptake and stimulate lactate production
o High proliferating cancer cells use increased fatty acid synthesis to support the rate of cell division
Defects in DNA Repair
- Enable cancer cells to accumulate genomic alterations that contribute to their aggressive phenotype
- When erroneous DNA repair leads to mutations/chromosomal aberrations affecting oncogenes and tumour suppressor genes
o Cells undergo malignant transformation resulting in cancerous growth
Benign tumour characteristics
- Never metastasizes
- Well- differentiated
- Encapsulated
- Homogenous
Malignant characteristics
- Can potentially metastasize
- Well differentiated or undifferentiated
- Heterogenous
- Infiltrative growth
Nomenclature: Benign Tumours of Connective Tissue
- Connective Tissue + Cell Type = Benign Tumour of Connective Tissue
- Fibrous Tissue + Fibrocyte = Fibroma
- Muscle + Myocyte = Leiomyoma
- Cartilage + Chondrocytes = Chondroma
- Bone + Osteocyte = Osteoma
- Others include:
o Lipoma
o Haemangioma
Name of Malignant Tumours of Connective Tissue
- Sarcomas
o Name (Sarc = Malignant + CT cells of origin)
Fibrosarcoma
Leiomyosarcoma
Epithelial Benign Tumours naming
- Papil- (finger like projection)
- Adeno- (relating to glands)
- Cystadena- (cyst like)
- -oma- (denoting tumour and other abnormal growths)
Examples of Malignant Epithelial Tumours
o Squamous Cell Carcinoma
o Renal Cell Carcinoma
o Adenocarcinoma
Name of malignant tumours
- Carcinomas
- Sarcomas
- Testicular Tumours
- Mesothelioma
- Melanoma
- Gliomas
- Lymphomas
- Leukaemias
o Blastomas
Pathogenesis
1) Normal Cell –> Multiple Mutations –> Cancer
2) Normal Cell –> Multiple Mutations –> Benign Tumor OR Normal Cell –> Multiple Mutations –> Benign Tumor –> Further Mutations –> Cancer
3) Normal Cell –> Sustained Stress –> Metaplasia –> Multiple Mutations –> Dysplasia –> Further Mutations –> Cancer
3 main routes of metastasis
- Blood (haematogenous)
o Bone and Soft Tissue Tumours - Lymphatics (vessels and nodes)
o Melanoma, Breast, Lung and Gastrointestinal Tumours - Direct Seeding (through/within body cavities)
o Certain tumour cells can only successfully colonise selective organs that have suitable growth environments
Importance of Early Detection
- If it is found early, it may be easier to treat
- If cancer has begun to spread, alternative treatment must be utilised
- If cancer has not spread, tumour may have the ability to be removed without further treatment required