part 4

Question 1

Treg cells

Answer 1

suppress tumor immunity (verzwakt afweer)
promote immune tolerance
maintain lymphocyte homeostasis
produces: TGF-B, IL-10, IL-35

a lot of Treg cells in tumor indicated bad prognosis

Question 2

Th1 cells

Answer 2

promote tumor immunity (versterkt afweer)
for intracellular pathogens
drives auto-immunity
produces TFN-G

Question 3

Th2 cells

Answer 3

for extracellular pathogens
allergy
asthma
produces: IL-4, IL-5, IL-13

Question 4

HLA-MHC I loss

Answer 4

= missing self

can cause immune escape

Question 5

PDL1 expression

Answer 5

causes immune escape
often in lung cancer
presented on cancer cells, inhibits T-cells

Question 6

immune suppressed microenvironment

Answer 6

can cause immune escape
created through production of cytokines like TGF-B
also through attraction of regulatory T-cells

Question 7

immunotherapy: IL-2 therapy

Answer 7

works in metastatic melanoma and metastatic renal cell carcinoma
high toxicity bc it stimulates all T cells

Question 8

immunotherapy: TIL therapy

Answer 8

= tumor infiltrating lymphocytes
specific
autologous cells
personalised
highly dependant on in vitro manipulation (Time/costs)

Question 9

immunotherapy: adoptive T-cell transfer

Answer 9

same as TIL but T cells are not taken from tumor but elsewhere and then cultured w/ tumors to become specific for that tumor.
Then given back to patient

Question 10

immunotherapy: antigen therapies

Answer 10

viral proteins

ex. HPV (baarmoederhals kanker)

Question 11

antigen therapies: neo-antigen targeted therapies

Answer 11

specific
personalised
highly dependant on in vitro prep.
= vaccine w/ mutated peptides

Question 12

antigen therapies: tumor-associated proteins

Answer 12

ex. GP100
not tumor specific
limited efficacy

Question 13

Tumor grades

Answer 13

GX: undetermined
G1: well-differentiated (low grade)
G2: moderately differentiated (intermediate grade)
G3: poorly differentiated (high grade)
G4: undifferentiated (high grade)

Question 14

TNM staging: T

Answer 14

size
T1: < 2cm
T2: 2-5 cm
T3: > 5 cm
T4: extension into other organs

Question 15

TNM staging: N

Answer 15

regional lymph node involvement
N0: none
N1: small amount of lymph nodes involved
N2: more

Question 16

TNM staging: M

Answer 16

distant metastasis
MX: undetermined
M0: none
M1: yes

Question 17

TNM staging; prefixes

Answer 17

c= clinical (before treatment)
p= histopathologically
yp= histopathologically after treatment
x= unclassified

Question 18

Breast cancer staging

Answer 18

0= in situ cancer
1= localised cancer
2= further local spread, usually includes spread to nearest lymphnodes
3= usually indicates more extensive lymph node spread
4= always indicates distant spread (metastasis)

Question 19

Lung cancer classification: N

Answer 19

N1: lymph nodes within lung involved
N2: lymph nodes in mediastinum involved
N3: supraclavicular lymph nodes involved

Question 20

Lung cancer staging

Answer 20

1= only small tumor in lung
2= local lymph node involvement
3= mediastinal lymph node involvement
4= distant metastasis

Question 21

Duke’s classification

Answer 21

for colon cancer

Question 22

Ann arbour classification

Answer 22

for lymphomas

Question 23

Breslow scale + Clarks level

Answer 23

for melanome

Question 24

FIGO

Answer 24

for gynaecological tumors (cervix, vulva, endometrium)