Tumour Pathology 2

Question 1

Give 2 properties of cancer cells in terms of altered genetics.

Answer 1

 Tumour suppressor genes mutate so control of cell cycle lost

 Oncogenes formation that stimulate excessive cell division

Question 2

Give 4 properties of cancer cells relating to altered cellular function

Answer 2

 Tumour related protein formation – used in clinical practise to diagnose tumour

 Abnormal cell

 Capable of independent irreversible growth

 All cancer cells are different

Question 3

Name the 4 tumour biomarkers

Answer 3

• onco-fetal protein
• oncogenes
• Growth factors and receptors
• immune checkpoint inhibitor

Question 4

What types of cancer can the onco-fetal protein, alpha-fetoprotein be used to diagnose?

Answer 4

• teratomas of testis

- hepatocellular carcinoma

Question 5

What type of cancer can the onco-fetal protein, carcino-embryonic antegen (CEA) be used to diagnose?

Answer 5

Colonorectal cancer (CRC)

Question 6

What type of cancer can the onco-fetal protein, oestrogen receptor be used to diagnose?

Answer 6

Breast cancer

Question 7

What type of cancer can the onco-fetal protein, prostate specific antigen be used to diagnose?

Answer 7

Prostate Cancer

Question 8

What is an onco-fetal protein?

Answer 8

They are present only in fetal development but switched off after birth. In certain cancerous tumours they are produced again

Question 9

What cancer the predictive tumour biomarker KRAS used for?

Answer 9

Colorectal cancer

Question 10

What cancer the predictive tumour biomarker BRAF used for?

Answer 10

Melanoma

Question 11

What cancer the predictive tumour biomarker HER2 used for?

Answer 11

Breast cancer

Question 12

What cancer the predictive tumour biomarker EGFR used for?

Answer 12

Lung cancer

Question 13

What cancer the predictive tumour biomarker PD-L1 used for?

Answer 13

Lung cancer

Question 14

Morphology of cancer

Answer 14

 Cellular and nuclear pleomorphism (differences in shape and nucleus of cancerous cells)
 Abnormal mitoses (dark blob that contains chromosomes all lined up in metaphase for division)

Question 15

T/F there is balance in tumour growth and death

Answer 15

True

Question 16

How does the growth of cancer occur?

Answer 16

Angiogenesis

 This is the formation of new blood vessels that provide nutrients for tumour to grow
 Also allows tumour to disseminate and spread by providing pathway into circulation

Question 17

How does the death of cancer occur?

Answer 17

Apoptoses

 Active process where individual cancerous cells are induced to die
 Chemotherapy and radiotherapy cause apoptosis of tumour
 More apoptosis the more susceptible the tumour

Question 18

What is the fundamental property of cancer?

Answer 18

Spread of cancer

Question 19

What does invasion mean?

Answer 19

Spreading of cancer to nearby tissues

Question 20

What does metastasis mean?

Answer 20

Spreading of cancer into other sides of the body

Question 21

How to tumours invade and metastasise?

Answer 21

 Cancer cells produce proteolytic enzymes that can degrade connective tissue allowing passage for cancer
 Cancer stop sticking to other cells (less cell-cell adhesion)
 Cancer stop sticking to connective tissue (less cell-matrix adhesion)

Question 22

How do cancers metastasise?

Answer 22

 Local spread (invasion) – tumour invades connective tissue and can enter blood vessels
 Lymphatic spread – tumour stick to endothelium of lymph vessel and invade lymph nodes which provide good conditions for cancers to grow
 Blood spread – tumour sticks to endothelium of blood vessel and can squeeze through it to enter tissue
 Trans-coelomic spread – spread of tumours across body cavities e.g. pleural cavity and tumours that spread this way are lung, ovary, stomach

Question 23

Where does tumour metastasise to?

Answer 23

 More blood flow to a certain tissue doesn’t mean it is more susceptible to tumour spread
 Depends on the actual tumour and the conditions provided by tissue (metastatic niche)

Question 24

Common sites of tumour metastasis

Answer 24

liver, lung, brain, bone, adrenal gland

Question 25

Uncommon sites of tumour metastasis

Answer 25

spleen, heart. Skeletal muscle, kidney

Question 26

Metastasis sites for tumours:

• Breast cancer
• Prostate cancer
• Colon cancer

Answer 26

Breast cancer – bone, lung
Prostate cancer – bone
Colon cancer - liver