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Chapter 7 Part 4 Flashcards

1
Q

Steps in chemical carcinogenesis

A
  1. Initiation resulting from exposure of a cell to a significant amount of carcinogen
  2. DNA damage that is unrepairable
  3. Promotion of tumor development
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2
Q

Direct acting carcinogen

A

require no metabolic conversion to become a carcinogen, CA treatments can be direct acting carcinogens and cause development of secondary cancers

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3
Q

Indirect-Acting carcinogen

A

carcinogens that require metabolic conversion to become active

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4
Q

Initiator

A

agent that causes DNA damage and eventually leads to rapid and irreversible damage

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5
Q

Promoter

A

agent that contributes to tumor growth only after the application of an initiator

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6
Q

Most common metabolizer of carcinogens

A

cytochrome P-450-dependent mono-oxygenases

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7
Q

Why does carcinogen metabolism vary among individuals?

A

polymorphisms of CYP450 cause differences in gene product and enzyme productivity

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8
Q

What breaks down polycyclic aromatic hydrocarbons?

A

CYP1A1

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9
Q

Main target of carcinogens

A

DNA

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10
Q

Are carcinogen caused DNA mutations entirely random?

A

No, carcinogens may be more attracted to DNA sequences or bases and produce “hotspots”

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11
Q

aflatoxin B1 preferentially binds what sequence/mutation?

A

T:A transversion in codon 249 that produces an Arg to Ser substitution

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12
Q

Types of carcinogenic radiant energy

A

UV rays, ionizing electromagnetic and particulate radiation

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13
Q

CA types associated with increased UV radiation

A

squamous cell carcinoma, basal cell carcinoma, melanoma of the skin

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14
Q

Wavelength range of UVA

A

320-400 nm

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15
Q

Wavelength range of UVB and CA associated

A

280-320 nm, cutaneous CAs

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16
Q

Wavelength range of UVC

A

200-280 nm

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17
Q

What causes the carcinogenicity of UVB light

A

formation of pyrimidine dimers in DNA

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18
Q

How does dimerization effect DNA?

A

crosslinking of DNA distorts the helix and prevents proper pairing, can be fixed by repair mechanisms

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19
Q

xeroderma pigmentosum

A

nucleotide excision repair process is damaged/defective

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20
Q

Ionizing radiation examples

A

x-rays, gamma-rays, a and b particles, protons and neutrons

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21
Q

CA risk associated with CT scans

A

3 fold higher risk of leukemia development in children who receive 2 or 3 CTs, 3 fold increase in brain tumors in children that have 5-10 CTs

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22
Q

Hierarchy of tissues vulnerable to radiation induced CA

A

myeloid leukemias (granulocytes), thyroid, breast, lungs, salivary glands

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23
Q

What tissues are typically not affected by radiation?

A

skin, bone, GI tract

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24
Q

CA associated with HTLV-1

A

adult T-cell leukemia/lymphoma

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25
In what areas of the world is adult T-cell leukemia/lymphoma most commonly seen?
Japan, Caribbean basin, South America, and Africa
26
Major target of HTLV-1
CD4 T cells
27
Infection of HTLV-1 occurs via
blood exposure, sexual intercourse, breastfeeding
28
Genes in HTLV-1
gag, pol, env, tax
29
What is Tax responsible for
essential for viral replication, alters host genome to increased pro-growth signal via PI3/AKT, and increases genomic instability
30
CA associated with HPV
squamous cell carcinomas of cervix, anogenital region, head and neck
31
HPV genital warts are associated with which strains?
HPV-6 and -11
32
Where is HPV DNA inserted?
E1/E2 reading frame
33
What two viral genes are most responsible for HPV's oncogenic potential?
E6 and E7
34
Actions of E6
stimulates TERT (catalytic portion of telomerase), degrades p53,
35
Actions of E7
speed cells through G1/S checkpoint, inactivates p21 and p27, activate cyclins A and E
36
tumors associated with EBV
Burkitt lymphoma, B-cell lymphomas in immunosuppressed individuals, subset of Hodgkin lymphoma, nasopharyngeal and gastric carcinomas, rare T and NK cell lymphomas
37
Most common EBV associated tumors
B-cells and nasopharyngeal carcinoma
38
EBV complement receptor
CD21
39
LMP-1 gene EBV
oncogene, acts like CD40 receptor, activates NF-kB and JAK/STATE to promote B-cell survival and proliferation, also prevents apoptosis by activating BCL-2
40
EBNA-2 gene EBV
transactivates cyclin D and SRC genes in host, encodes viralIL-10 which prevents macrophages and monocytes from attacking T cells
41
Burkitt Lymphoma
neoplasm of B lymphocytes, commonly in central Africa and New Guinea
42
How does EBV contribute to Burkitt lymphoma?
weakens the immune system to set the state for an 8;`14 translocation and other mutations
43
Populations in which nasopharyngeal carcinomas are endemic
southern China, parts of Africa, Inuit people of arctic, all due to EBV
44
Estimated percent of hepatocellular carcinomas caused by hepatitis?
70-80%
45
Dominant effect of HBV and HCV
chronic inflammation, hepatocyte death, genomic damage, hepatocyte proliferation
46
Dominant mechanism of HPV associated cancer
activation of NF-kB pathway to prevent apoptosis
47
CA associated with H. pylori
gastric adenocarcinoma, MALT lymphoma
48
Pathogenesis of H. pylori induced gastric CA
multifactorial; involved chronic inflammation and reparative gastric cell proliferation
49
H. pylori pathogenecity gene
CagA
50
H.pylori in MALT lymphomas
B cell proliferation and inflammation promotors
51
Cancer cachexia
equal loss of fat and lean muscle, elevated BMR, evidence of systemic inflammation
52
Leading cytokine contributing to cachexia
TNFa
53
Can a benign tumor be deadly?
Yes, it may cause compression of other surrounding structures that will eventually lead to the death of the patient
54
Possible complications of GI tumors
obstruction, intussusception,
55
Benign tumors in endocrine glands...
can become functional and cause a greater release of hormone
56
Erosiveness of tumors may cause...
ulceration, infections, bleeding, hemoptysis, melena
57
Paraneoplastic syndrome
signs and symptoms that can not readily be explained by the presence of a tumor, may be the earliest manifestation of cancer
58
Hypercalcemia as a paraneoplastic syndrome
most common, occurs due to calcemic humoral substance production
59
CA associated with hypercalcemia
squamous cell carcinoma of lung, breast and renal carcinoma, adult t-cell leukemia/lymphoma
60
Molecules associated with hypercalcemia
PTHRP, TGF-a TNF, IL-1
61
Most common endocrinopathy
Cushing syndrome
62
CA associated with Cushing syndrome
small-cell carcinoma of the lung, pancreatic carcinoma, neural tumors
63
Neuromyopahtic neoplastic syndromes
take diverse forms possibly caused by self reactive antibodies; mechanisms are not entirely known
64
Acanthosis nigricans
disorder characterized by gray-black patches of thickened and hyperkeratotic skin with a velvety appearance
65
CA associated with acanthosis nigricans
gastric, lung, uterine carcinomas
66
Hypertrophic osteoarhthropathy
periosteal new bone formation at distal ends of long bones, arthritis of adjacent joints, clubbing of digits
67
CA associated with hypertrophic osteoarthropathy
lung carcinoma
68
Why grade tumors?
allows the ability to quantify the probable clinical aggressiveness of a given neoplasm and its extent and spread
69
Grading cancers is based on...
degree of differentiation and number of mitoses/architectural features
70
Staging of cancers is based on...
size of primary lesion, extent of spread to lymph nodes, presence or absence of blood borne metastases
71
TNM staging
primary Tumor, Node involvement, Metastases
72
Methods of tissue sampling
needle aspiration, excision or biopsy, cytologic smears
73
Fine needle aspiration
aspirating cells from tumor, often rapid and reliable
74
Cytologic smears
often used for bladder, lung, endometrium, cervix to identify tumor cells
75
Cytologic features evaluated in a smear
anaplasia, dysplasia, cellular changes
76
Immunohistochemistry
identifying cell products or markers using antibodies
77
How can immunohistochem be used to categorize tumors?
Abs specific to cytoskeletal proteins in different cells, ags can be used to determine the location of origin, used to determine prognosis
78
Flow cytometry
quantitatively measures cell characteristics, especially cellular antigens expressed by liquid tumors
79
Circulating tumor cell assessment
permits detection, quantification and characterization of solid tumors circulating in the blood
80
Diagnosis of malignant neoplasms
PCR-based evaluation, DNA microarrays
81
Prognosis of malignant neoplasms
evaluation of genetic alterations; NMYC gene amplification and 1p deletions
82
Detection of minimal residual disease
assessed by PCR amplification of sequences unique to the clone
83
Diagnosis of hereditary predisposition to CA
detection of germline mutations to consider prophylactic surgery and counseling
84
Guiding therapy with oncoprotein-directed drugs
identification of genetic lesions, treatments that can be directed against the effects of oncoproteins
85
Difficulties of NextGen sequencing
expensive and lengthy process
86
Major impacts of cancer genome sequencing
ID of new mutations that underlie cancers, description of genetic lesions, greater appreciation of genetic heterogeneity
87
Diagnostic path that will most likely evolve...
morphologic and molecular techniques
88
Genetic complexity of tumors
chromothripsis is a likely culprit of cancer cell development - single catastrophic event that lead to formation of multiple breaks, results in many gene rearrangements
89
Tumor markers for diagnosis
can be used for detection of cancers and effectiveness of therapy
90
Sensitivity/specificity of tumor markers
low; may come from nonneoplastic conditions
91
Tumor associated with HCG
trophoblastic tumors, testicular tumors
92
Tumor associated with calcitonin
medullary carcinoma of thyroid
93
Tumor associated with catecholamines and metabolites
pheochromocytoma
94
Tumor associated with alpha-fetoprotein
liver cell cancer
95
Tumor associated with carcinoembryonic antigen
carcinoma of colon, pancreas, lung, stomach heart
96
tumor associated with prostatic acid phosphatase
prostate CA
97
Tumors associated with neuron-specific enolase
small-cell CA of lung, neuroblastoma
98
Tumor associated with immunoglobulins
multiple myeloma
99
Tumor associated with prostate-specific antigen
prostate CA
100
Tumor associated with CA-125
Ovarian CA
101
Tumor associated with CA-19-9
Colon cancer, pancreatic cancer
102
Tumor associated with CA 15-3
Breast CA
103
Tumor associated with TP53, APC, RAS mutants
colon CA
104
Tumor associated with TP53 and RAS mutants in stool and serum
pancreatic CA
105
Tumor associated with TP53, RAS mutants in sputum and serum
lung CA
106
Tumor associated with TP53 mutants in urine
Bladder CA

MOD (34 decks)

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