Neoplasia 2 Flashcards
0
Q
How can neoplasms invade a secondary site?
A
- Motility
- Altered adhesion
- Stromal proteolysis
1
Q
How are neoplasms transported to distant sites?
A
- Blood vessels: capillaries and venules
- Lymphatic vessels
- Transcoelomic spread: fluid in body cavities
2
Q
What is meant by motility in reference to invasion?
A
- Change in actin cytoskeleton
3
Q
What is stromal proteolysis?
A
- Altered expression of proteases
- Mainly MMPs: matrix metalloproteinases
- Proteases are provided by the cancer’s niche
4
Q
What is altered adhesion?
A
- Altered adhesion between malignant and stromal proteins changes the integrin expression
- Between malignant cells reduces E Cadherin expression
5
Q
What are the required stages for a malignancy to invade a secondary site?
A
- Grow and invade at primary site
- Enter a transport system and lodge at a secondary site
- Grow at secondary site to form a new tumour - Colonisation
- Must evade destruction by immune system
6
Q
Why is malignancy spread an inefficient process?
A
- Many cells can’t operate all of the required stages
7
Q
What are micrometastases?
A
- When a metastasis invades but isn’t big enough to be detected
- Tumour dormancy
- Hostile secondary site
- Reduces angiogenesis
8
Q
Why do certain cancers grow in specific areas?
A
- Seed and soil theory
- Seed: cancer cells
- Soil: niche
9
Q
If cancers are found in the following areas where are they like to metastasise to?
Lymphatic
Transcoelomic
Blood borne
A
- Lymphatic: drains at lymph nodes
- Transcoelomic: elsewhere in coelomic space
- Blood borne: lung and liver depending on which is the first available capillary bed
10
Q
What is meant by a cancer’s personality? Give some examples
A
- Some neoplasms are more aggressive and faster spreading e.g. Small cell bronchial carcinoma
- Some never metastasise e.g. Basal cell carcinoma of skin
11
Q
What is likelihood of metastasis related to?
A
- Size of primary neoplasm
12
Q
Where do carcinomas spread to first?
A
- Lymphatics
13
Q
What types of a cancer spread to the bone first?
A
- Breast
- Bronchus
- Thyroid
- Prostate
14
Q
Where do sarcomas tend to spread to?
A
- Via bloodstream
- Lung
- Liver
- Bone
- Brain
