OPMD and Oral Cancer Flashcards
What is meant by a potentially malignant lesion
Altered tissue in which cancer more likely to form
What is meant by potentially malignant disorder
Generalised state with increased cancer risk
Name some potentially malignant conditions
Lichen planus
Oral submucous fibrosis
Iron deficiency
Tertiary syphilis
Name some potential malignant lesion
Leukoplakia
-chronic hyperplastic candidosis
-proliferative verrucous leukoplakia
erythioplokia
What type of pt would have chronic hyperplastic candidosis and what it show
Smokers
Commisures
Dysplasia may be present
What is PAS
Periodic Schiff stain
What does PAS stain
To demo Candida albicans hyphae clearly
How do you treat chronic hyperplastic candidosis
Systemic anti fungal
-fluconazole capsules 14 days
Biopsy to diagnose
Stop smoking
In the UK where do most oral carcinomas arise
Clinically normal mucosa
What is more likely to progress to cancer than normal mucosa
Leukoplakia 50-100 times
What sites is leukoplakia low risk to turn cancer
Buccal
What sites is leukoplakia high risk to turn cancer
Floor of mouth
Tongue
What clinical appearance appearance of leukoplakia wousk be a good sign
Homogenous
What clinical signs of leukoplakia would be a bad sign
Non homogenous
-verrucous, ulcerated Leuko erythroplakia
What type of leukoplakia has highest chance of turning malignant
Proliferation verrucous leukoplakia
What is the criteria for diagnosis of a potentially malignant Lesion
Asses architectural changes
-abnormal maturation and stratification
Assess cytological abnormalities
-cellular atypia
How do you grade epithelial dysplasia
Hyperplasia
Mild
Moderate
Severe
Carcinoma in situ
What is basal hyperplasia and what does it look like
Increase in basal cell numbers
Regular stratification
Basal compartment is larger
No cellular atypia
What does milf dysplasia look like histologically
Changes in the lower third of the architecture
Mild atypia
What does moderate hyperplasia look like
Architecture- changes extend to middle third
Cytology- moderate atypia
What does severe dysplasia look like
Architecture- changes extend to upper third
Cytology- severe atypia and numerous mitoses, abnormally high
What are onco genes
gene that has the potential to cause cancer
What are tumour suppressor genes
They suppress the growth of cells
What is important about tp53
If it’s mutated or inactivated it results in a p53 protein that is less able to control cell proliferation. Specifically, it is unable to trigger apoptosis in cells with mutated or damaged DNA
What is meant by knudsons two got hypothesis of carcinogenesis
in order for a particular cell to become cancerous, both of the cell’s tumor suppressor genes must be mutated
What changes happen to DNA in cancer
Changes to chromosomes
-aneuploidy, translocations, amplifications
Genes
-mutations, deletions, amplifications
Epigenetic changes
What are the 6 hallmarks of cancer
Self sufficiency in growth signals
Insensitivity to anti growth signals
Tissue invasion and metastasis
Limitless reply drive potential
Sustained angiogenesis
Evading apoptosis
How can oral cancer spread
Local extension of disease
Lymphatic spread
Haematogenous spread
