Tumour Pathology 2 Flashcards
Properties of cancer cells: What are examples of loss of tumour suppressor genes?
- Adenomatour Polyposis
- Retinoblastoma
- BRCA1
Properties of cancer cells: What are examples of gain of function of oncogenes?
- B-raf
- Cyclin D1
- Erbb2
What are other properties of cancer cells?
- Altered cellular function
- Abnormal morphology
- Cells are capable of independent growth
How is cellular function altered in cancer cells
- Loss of cell-to-cell adhesion
- Altered cell-to-matrix adhesion
- Production of tumour-related proteins for example tumour biomarkers including Onco-foetal proteins, oncogenes, growth factors and receptors, immune checkpoint inhibitors
What are tumour biomarkers clinically used for?
Screening, diagnosis, prognosis, predictive
What are examples of currently used tumour biomarkers? 1
- Alpha fetoprotein
- Carcino-embryonic antigen (CEA)
- Oestrogen receptor
- Prostate specific antigen
What is the tumour biomarker alpha-fetoprotein used for?
- Teratoma of testis
- Hepatocellular carcinoma
What is the tumour biomarker Carcino-embryonic antigen (CEA) used for?
Colorectal cancer
What is the tumour biomarker Oestrogen receptor used for?
Breast cancer
What is the tumour biomarker Prostate specific antigen used for?
Prostate cancer
What is the morphology of cancer cells?
- Cellular and nuclear pleomorphism- marked variation in size and shape
- Mitoses are present and often abnormal
What is Angiogenesis?
New blood vessel formation by tumours
Why is angiogenesis important clinically?
- Angiogenesis is required to sustain tumour growth
- However, it provides a route for the release of tumour cells into circulation. More blood vessels in a tumour results in a poorer prognosis
What is apoptosis?
Programmed cell death which regulates tumour growth.
It is involved in response to chemotherapy and radiotherapy.
How is the spread of cancer divided?
Divided into 2 parts- invasion (local) or metastasis (spreads to other tissues/organs)
What will a secondary tumour look like?
Identical to primary tumour
How can a tumour spread be described?
Normal> Tumour> Metastasis
What does metastasis involve?
- Increased matrix degradation by proteolytic enzymes
- Altered cell-to-cell and cell-to-matrix adhesion
What are the modes of the spread of cancer?
- Local spread
- Lymphatic spread
- Blood spread
- Trans-coelomic spread
How does tumour invasion occur?
Malignant tumour
Invasion into connective tissue
Invasion into lymph/blood vessels
How does tumour invasion occur via lymphatics?
- Adherence of tumour cells to lymph vessels
- Invasion from lymphatics
- Invasion from blood vessels
- Invasion into tissue
- Formation of metastasis
- Clinical evidence of metastasis
How does tumour metastasis occur via blood?
- Adherence of tumour cells to blood vessels
- invasion from blood vessels
- invasion into tissue
- formation of metastasis
- clinical evidence of metastasis
How does trans-polemic spread occur?
It is a special form of local spread.
-Spread of tumour cells across BODY CAVITIES e.g. pleural or peritoneal cavities
What shows trans-polemic spread?
Tumours of lung, stomach, colon and ovary
What is the site of metastasis not related to?
Tissue blood flow
What does the site of tumour metastasis depend on?
Both tumour and tissue related factors
What are common site of metastasis?
Lung, liver, brain, bone, adrenal gland, peritoneum
What are uncommon site of metastasis?
Spleen, kidney, skeletal muscle, heart
What tissue do breast tumours common metastasise to?
Bone tissue
What tissue do prostate tumours common metastasise to?
Bone tissue
What tissue do colorectal tumours common metastasise to?
Liver tissue
What tissue do ovary tumours common metastasise to?
momentum/periotneum
What tumours can:
- Kras
- Braf
- EGFR
- PD-L1
- Her2 predict?
Kras- colorectal cancer
Braf- melanoma
EGFR- lung cancer
PD-L1- lung cancer
Her2- Breast cancer, gastric cancer
