Behaviour of Tumours (22) Flashcards Preview

EMS - Mechanisms of Disease > Behaviour of Tumours (22) > Flashcards

Flashcards in Behaviour of Tumours (22) Deck (27)
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1
Q

Invasion (Local disease)

A

Invades adjacent normal tissue, destroys normal tissue (Increased motility, decreased adhesion, production of proteolytic enzymes)

2
Q

Metastasis (Systemic disease)

A

Spreads from site of origin to distant sites and forms new tumours in these areas

3
Q

Less adhesion/more motility

A

Mutations of E-cadehrin leads to loss of cell-cell adhesion and contact inhibition, changes to integrin expression lead to decrease cell-matrix adhesion, epithelial-mesenchymal transition

4
Q

Proteolytic enzymes

A

Matrix metalloproteinases - degrade extracellular matrix e.g. Interstitial collagenases, gelatinases, stomolysins

5
Q

Mechanical pressure

A

Uncontrolled proliferation forms mass, pressure occludes vessels, pressure atrophy, spread along lines of least resistance

6
Q

Metastasis

A

Often the presenting tumour, often worse than primary, unknown primary site, early/late relapse, increased metabolic demand (cachexia)

7
Q

Metastasis routes

A

Lymphatic, blood (liver, lungs, bone, brain), transcoelomic, implantation

8
Q

Metastasis stages

A
  1. Intravasation
  2. Detachment invasion
  3. Survival against host defences
  4. Adherence extravasation
  5. Growth
9
Q

Carcinomas and metastasis

A

(Epithelial cells) Lymphatic spread first

10
Q

Sarcomas and metastasis

A

(Mesenchymal) Blood spread first

11
Q

Patterns of metastasis

A

Bone mets - breast, prostate, lung, kidney, thyroid

Transcoelomic - ovarian

Brain and adrenal - lung

12
Q

Bone metastases

A

Lytic - spaces in bone (lung)

Sclerotic - dense (prostate)

13
Q

Seed and soil hypothesis

A

Stephen Paget, seeds only live and growth if they fall on congenial soil

14
Q

Angiogenesis

A

Derives from existing vessels, role in development - healing, essential if metastases are to grow larger than 1-2mm

15
Q

Promoters of angiogenesis

A

VEGF (tumour cells), PDGF (stromal cells), TGFB (inflammatory cells)

16
Q

Inhibitors of angiogenesis

A

ECM proteins, thrombospondin, canstatin, endostatin

17
Q

Stage

A

How advanced? How it spread and to what extent

18
Q

Grade

A

How aggressive/fast? Differentiation

19
Q

Staging TMN

A

Tumour (size and extent)
Metastases (presence and extent)
Nodes (presence and number)

20
Q

Breast cancer staging T

A

Tis in-situ disease
T1 5cm
T4 Involving skin/chest wall

21
Q

Breast cancer staging N

A

N0 No nodes
N1 Ipsilateral nodes
N2 >Node involvement

22
Q

Breast cancer staging M

A

M0 No distant mets

M1 Distant mets

23
Q

Dukes Staging is for what?

A

Colorectal cancer

24
Q

Dukes staging for colorectal cancer

A
A= invades into, not though bowel wall
B = invades through bowel wall but with no lymph node metastases
C = local lymph nodes involved
D = distant metastases
25
Q

Grading

A

Differentiation, nuclear pleomorphism and size, mitotic activity, necrosis (subjective)

26
Q

Grade 1

A

Near normal (well-differentiated)

27
Q

Grade 4

A

Far from normal (poor-differentiated)