Neuro-Oncology; Aetiology & Epidemiology Flashcards
What is the central nervous system made up of?
Brain
Spinal cord
What is the peripheral nervous system made up of?
Somatic (conscious thought processes e.g. touch and feeling)
Autonomic (unconscious e.g. digestion)
What do parasympathetic nerves stimulate?
Pupil constriction
Saliva stimulation
Airway constriction
Slows heartbeat
Stimulates stomach activity
Inhibits glucose release
Stimulates gallbladder
Stimulates intestine activity
Contracts bladder
Genital erection
What do sympathetic nerves stimulate?
Pupil dilation
Saliva inhibition
Airways relaxed
Increases heartbeat
Inhibits stomach activity
Stimulates glucose release
Inhibits gallbladder
Inhibits intestine activity
Relaxes bladder
Genital ejaculation and vaginal contractions
Epidemiology definition
Distribution of incidence, distribution of diseases or other factors relating to health
Application of knowledge for disease prevention and control
Epidemiology statistics - Global
308,102 diagnosed in 2020
251,329 deaths in 2020
Epidemiology statistics - Europe (EU-27)
43,567 diagnosed in 2020
Lithuania (13 cases per 100,000), Greece (11.9), Poland (11.9)
Epidemiology statistics - England 2020
4,585 diagnosed (1995 3,538)
Meninges 21:35 M:F
Brain 2586:1810 M:F
Spinal cord, cranial nerves, CNS 63:70 M:F
Incidence rates
Incidence related to age
Highest incidence in older people
23% cases diagnosed in 75+ (2018)
Most common tumour location (gliomas)
Frontal
Least common tumour location (gliomas)
Occipital
Most to least common tumour location (gliomas)
Frontal
Temporal
Parietal
Occipital
What is aetiology?
Risk factors
What are risk factors for children (adolescents)?
Single gene inherited disorders
Ionising Radiation
What are risk factors for adults?
Environment
Genetic
Syndromes/disorders
Genetic alterations
What environmental risk factors are there for adults?
High dose ionising radiation risk factor
Power-lines (low frequency magnetic fields)
What genetic risk factors are there for adults?
Inherited & sporadic brain tumour risk
What syndromes/disorders risk factors are there for adults?
Lynch Syndrome
Mismatch repair deficiency
Ollier disease (IDH1 gene)
Li-Fraumeni syndrome*
Cowden syndrome
Gorlin’s syndrome*
What genetic alteration risk factors are there for adults?
IDH
1p/19q codeletion
H3 LysMet
RELA-fusion
What is the overall main risk factor?
Radiation
What did Lynch syndrome used to be called?
Hereditary non-polyposis colorectal cancer (HNPCC)
What is Ollier disease (IDH1 gene) characterised by?
Multiple enchondromas, which are noncancerous (benign) growths of cartilage that develop within the bones. These growths most commonly occur in the limb bones, especially in the bones of the hands and feet; however, they may also occur in the skull, ribs, and bones of the spine (vertebrae). Enchondromas may result in severe bone deformities, shortening of the limbs, and fractures.
Genetic alterations (IDH, 1p/19q codeletion, RELA-fusion, H3 Lys27Met) + histology = ?
Improved diagnosis & grading
Improved management
2016 WHO Classification of CNS tumours
What did a clinical trial regarding ‘In Vivo Molecular Mapping of Adult Primary Brain Tumour Activity Using Novel Magnetic Resonance Imaging (MRI): a Pilot Study’ conclude?
Correlation of the MRI signal intensity (advanced MRI sequence 1; arbitrary units) and glioma protein concentration (g/L) in a 1 x 1 x 1 cm region of interest (R value) [Time Frame: 5 years]
