Tumour Pathology 2 Flashcards
How can cancer cells alter genetics?
- loss of tumour suppressor genes
- gain of function of oncogenes
What are tumour-related proteins and what do they do?
- proteins found in abnormally large quantities in cancerous cells
- altered cellular function
Describe the function of oncogenes?
-normally switched off or function at very low levels in normal cells
Describe the function of tumour suppressor cells?
-genes function in normal cells to prevent abnormal cell proliferation
What are 4 properties of cancer cells?
- altered genetics
- altered cellular function
- abnormal morphology
- cells capable of independent growth
However, no single feature is unique to cancer cells
How does cancer affect cellular function? (3)
- loss of cell-to-cell adhesion
- altered cell-to-matrix adhesion
- production of tumour-related proteins such as tumour biomarkers
What are 3 examples of tumour biomarkers?
- onco-foetal proteins
- oncogenes
- growth factors and receptors
What are the clinical uses of tumour biomarkers?
- screening
- diagnosis
- prognosis (patients specific outcome)
- predictive (patients treatment plan)
What cancers can the alpha-fetoprotein be useful in?
- teratoma of the testis
- hepatocellular carcinoma
What cancer can carcino-embryonic antigen (CEA) be useful in?
colorectal cancer
What cancer can oestrogen receptor be useful in?
breast cancer
What cancer can prostate specific antigen be useful in?
prostate cancer
What type of cancer is Kras a biomarked for?
colorectal cancer
What type of cancer is EGFR a biomarker for?
lung cancer
What type of cancers is Her2 a biomarker for?
- breast cancer
- gastric cancer
What type of cancer is Braf a biomarker for?
melanoma
How do cancer cells appear?
- show cellular and nuclear pleomorphism
- marked variation in shape and size
- mitosis present and often abnormal
What is tumour growth a balance between?
- cell growth and death
- angiogenesis
- apoptosis
How does angiogenesis benefit the spread of cancer?
- New blood vessels are formed by tumours
- They are required to sustain cell growth
- They provide a route for release of tumour cells into circulation
- More blood vessels in a tumour equals poorer prognosis.
What is apoptosis?
programmed cell death
What is the role of apoptosis in cancer
- regulates tumour growth
- involved in response to chemo/radiotherapy
What does the prognosis of cancer depend on?
the extent of cancer spread
What is a major clinical problem of cancer?
the formation of metastatic tumours
What does invasion and metastasis result in?
- increased matrix degradation by proteolytic enzymes
- altered cell-to-cell and cell-to=matrix adhesion
What are the modes of spread of cancer?
- local spread
- lymphatic spread
- blood spread
- trans-coelomic spread
Describe the process of tumours cells spreading to show clinical evidence of metastasis.
- malignant tumour
- invasion into connective tissue
- invasion into lymph/blood vessels
- adherence of tumour cells to lymph vessels
- invasion from lymphatics
- invasion into lymph node
- formation of metastasis in lymph node
- clinical evidence of metastasis
What is trans-coelomic spread?
Spread of tumour cells across body cavities e.g. pleural or peritoneal cavities
Tumours of what organs show trans-coelomic spread?
- lung
- stomach
- colon
- ovary
What is tumour metastasis dependent on?
Tumour and tissue related factors
What are the common sites of metastasis?
- liver
- lung
- brain
- bone (axial skeleton)
- adrenal gland
What are uncommon sites of metastasis?
- spleen
- kidney
- skeletal muscle
- heart
Where do breast tissue commonly metastasise to?
bone
Where do colorectal tumours commonly metastasise to?
liver
