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Flashcards in Behaviour of tumours Deck (48)
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31

How is organ selectivity for metastasis explained?

Tissue environment is important in the development of metastases

32

What role does angiogenesis have in metastasis?

Essential if metastases are to grow larger than 1-2 mm

33

Factors promoting angiogenesis are produced by what 3 types of cells?

Tumour cells, stromal cells and inflammatory cells

34

Name 3 factors which promote angiogenesis?

VEGF
PDGF
TGF-beta

35

Name 4 inhibitors of angiogenesis?

ECM proteins
Thrombospondin
Canstatin
Endostatin

36

How does the balance between promotors and inhibitors of angiogenesis change in metastasis and why?

Promotor expression increases and outnumber inhibitor expression, not only are promotors produced by tumour cells, the tumour cells illicit an inflammatory response which leads to the stromal and inflammatory cells produced these promotors which further contributes to the formation of new blood vessels

37

Give 3 reasons to stage and grade a tumour?

1) Determine prognosis - survival time, quality of life
2) Decide how to treat a tumour
3) Research - compare therapies or prognostic factors

38

What is meant by stage of a tumour?

How advanced the tumour is. Has the cancer spread and if so what is the extent of the spread.
If you had an arrow depicting cancer disease course from pre-invasive to death stage would tell you how far along the arrow the tumour is

39

What is meant by the grade of a tumour?

How aggressive is the tumour and how different does it look from the tissue of origin
If you had an arrow depicting cancer disease course from pre-invasive to death grade would tell you how fast the tumour is moving along the arrow

40

Tumours are staged using TMN what does this stand for?

T=tumour
M=metastases
N=nodes
Each organ has an individual TMN system, stage can be clinical, pathological or radiological

41

How does TMN staging basically work?

T = size and extend of primary tumour
M = presence and extent of distant metastases
N = presence and number of lymph node metastases
TMN can be combined to give and overall stage for the tumour from 1-4

42

How does the stage of a breast cancer affect the treatment?

1 - surgery only
2 - surgery and radiotherapy
3 - surgery and chemo
4 - chemo

43

What is Duke's staging for colorectal cancer?

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

44

How does Duke's staging for colorectal cancer correlate with survival?

A = >90% 5 year survival
B = 70% 5 year survival
C = 30% 5 year survival
D = 5-10% 5 year survival

45

Grading is performed by which specialists?

Histopathologists

46

What is grading based on?

Differentiation - how much does the tumour resemble the tissue it originates from
Nuclear pleomorphism and size
Mitotic activity
Necrosis

47

How do grade and stage correlate with outcome?

Both correlate well with outcome

48

What 3 things lead to systemic malignant disease?

1) Invasion
2) Metastasis
3) Angiogenesis