Tumour Pathology 2 Flashcards
What are the 2 groups of genes that cause cancer?
Suppresor genes
Oncogenes (promote tumour development, are normally switched of)
What are some properties of cancers?
Altered cellular function
Abnormal morphology
Cells capable of independant growth
No single feature is unique to tumour cells
Tumour biomarkers
What is the altered function in cancers?
Loss of cell to cell adhesion
Altered cell to matrix adhesion
Production of tumour related proteins (tumour biomarkers)
What are tumour biomarkers?
Ono-fetal proteins
Oncogenes
Growth factor and receptors
Immune checkpoint inhibitors
What are tumour biomarkers used clinically for?
Screening
Diagnosis
Prognostic (identifying patients with specific outcome)
Predictive (identifying patients who will response to a particular therapy)
What is the difference between diagnosis and screening?
Diagnosis is once the patient is already symptomatic whereas screening is before the symptoms are apparent
What are some examples of tumour biomarkers?
Alpha-fetoprotein
Carcino-embryonic antigen (CEA)
Oestrogen receptor
Prostate specific antigen
Kras
Braf
EGFR
PD-L1
Her2
What cancer shows alpha-fetoprotein?
Teratoma of testis
Hepatocellular carcinoma
What cancer shows carcino-embryonic antigen (CEA)?
Colorectal cancer
What cancer shows oestrogen receptors?
Breast cancer
What cancer shows prostate specific antigen?
Prostate cancer
What cancer shows Kras?
Colorectal cancer
What cancer shows Braf?
Melanoma
What cancer shows EGFR?
Lung cancer
What cancer shows PD-L1?
Lung cancer
What cancer shows Her2?
Breast cancer
Gastric cancer
What do you see in morphology of cancer?
Cellular and nuclear pleomorphism (marked variation in size and shape)
Mitosis present and often abnormal (cell division not normal as chromosomes are not structured)
What is tumour growth a balance between?
Cell growth (angiogenesis) and cell death (apoptosis)
What happens during tumour angiogenesis?
New blood vessels are formed by the tumours that provides a route for the release of tumour cells in circulation
What does greater tumour angiogenesis mean?
Poorer prognosis (outcome)
What is apoptosis?
The mechanism for programmed cell death
What is metastasis?
Spread of cancer
What are metastatic tumours?
Secondary tumours
What is a major clinical problem of cancer?
Formation of metastatic tumours
What is invasion and metastasis due to?
Increased matrix degradation by proteolytic enzymes
Altered cell to cell and cell to matrix adhesion
What is the cell to cell adhesion of tumours like throughout their lifetime?
At some point they need to be stuck together, and at other points they need to be seperate to spread
What are different modes for the spread of cancer?
Local spread (invastion of primary tumours in adjacent structures)
Lymphatic spread (to lymph nodes)
Blood spread (to other tissues and organs in the body)
Trans-coelomic spread (through cavities such as pleural)
What is the process of tumour invasion?
1) Malignant tumour
2) Invasion into connective tissue
3) Invastion into lymph/blood vessels
What is the process of tumour metastasis via lymphatics?
1) Adherance of tumour cells to lymph vessels
2) Invasion from lymphatics
3) Invastion into lymph nodes
4) Formation of metastasis in lymph node
5) Clinical evidence of metastasis
What is the process of tumour metastasis via blood?
1) Adherance of tumour cells to blood vessels
2) Invasion from blood vessels
3) Invasion into tissue
4) Formation of metastasis
5) Clinical evidence of metastasis
What is trans-coelomic spread?
Special form of local spread where tumour cells spread across body cavities such as pleural or peritoneal
What kinds of tumours show trans-coelomic spread?
Lung
Stomach
Colon
Ovary
What is the site of tumour metastasis related to?
The tumour, not the tissue blood flow
What are common sites of metastasis?
Liver
Lung
Brain
Bone (axial skeleton)
Adrenal gland
Omentum/perioneum
What are uncommon sites of metastasis?
Spleen
Kidney
Skeletal muscle
Heart
What is the spread of tumours from sites like?
Tumours from tissues often commonly metastasis to specific sites
Where do breast tumours commonly metastasis to?
Bone
Where do prostate tumours commonly metastasis to?
Bone
Where do colorectal tumours commonly metastasis to?
Liver
Where do ovary tumours commonly metastasis to?
Omentium/perioneum
