Tumour Pathology 2 Flashcards
How are the genetics of a cancer cell altered?
Loss of tumour suppressor genes and gain of function of oncogenes.
What are other properties of cancer cells?
Altered cellular function (tumour-related proteins) and abnormal morphology.
Cells capable of independent growth.
No single feature is unique to cancer cells.
How does the cellular function of cancer cells differ from normal cells?
Loss of cell-to-cell adhesion
Altered cell-to-matrix adhesion
Production of tumour-related proteins (tumour biomarkers)
Name 3 tumour biomarkers examples.
Onco-fetal proteins, oncogenes, growth factors and receptors.
What are onco-fetal proteins?
Made when prenatal and genes for this switched off once born.
What are oncogenes?
A change in DNA sequence of a proto-oncogene gives rise to an oncogene which produces a different protein and interfere with normal cell regulation.
What can tumour biomarkers be used for?
Screening
Diagnosis
Prognostic
Predictive (what therapy would be best)
What would detection of alpha-fetoprotein biomarker indicate?
Teratoma of testis
Hepatocellular carcinoma
What would detection of Caarcino-embryonic antigen (CEA) biomarker indicate?
Colorectal cancer
What would detection of oestrogen receptor biomarker indicate?
Breast cancer
What would detection of prostate specific antigen biomarker indicate?
Prostate cancer
What is a useful predictive tumour marker for colorectal cancer?
Kras
What is a useful predictive tumour marker for lung cancer?
EGFR
What is a useful predictive tumour marker for breast and gastric cancer?
Her2
What is a useful predictive tumour marker for melanoma cancer?
Braf
How does the appearance of cancer cells differ from normal cells?
Cellular and nuclear pleomorphism (marked variation in size and shape)
Mitoses present and often abnormal
Tumour growth is balance between what?
Angiogenesis and apoptosis
What is angiogenesis and apoptosis?
Angiogenesis - new blood vessel formation
apoptosis - programmed cell death
Why do tumours undergo angiogenesis?
When tumours are very small can get their nutrients from circulation. Required to sustain tumour growth
Provides route for release of tumour cells into circulation.
Why do more blood vessels in a tumour result in poorer prognosis?
The more BVs the more nutrients going to a tumour so the more it will grow and the higher chances of metastasis.
In tumours, what is the apoptosis/angiogenesis balance like?
A lot more angiogenesis than apoptosis
How do tumours degrade the matrix?
They produce proteolytic enzymes which degrade the matrix
What are the four modes of spread of cancer?
Local spread
Lymphatic spread
Blood spread
Trans-coelomic spread
Malignant tumour that invades into connective tissue then has the potential to invade into where?
Lymph/blood vessels
What is trans-coelomic spread?
Spread of tumour cells across body cavities, e.g. pleural or peritoneal cavity.
What tumours shown trans-coelomic spread?
Lung, stomach, colon and ovary.
What are the sites of metastasis related to?
NOT tissue blood flow.
Depends on both tumour and tissue related factors.
Name the 5 common sites of metastasis.
Liver Lung Brain Bone (axial skeleton) Adrenal gland
Name 4 uncommon sites of metastasis.
Spleen
Kidney
Skeletal muscle
Heart
What are common sites of metastasise in the breast?
Bone
What are common sites of metastasise in the prostate?
Bone
What are common sites of metastasise in the colorectal?
Liver
