Colon Caner Flashcards Preview

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Flashcards in Colon Caner Deck (11)
1

What the second most important molecular pathways associated with colon cancer?

Microsattalite instability
MS: repeating sequences in DNA that are copied in cell division; mutation in DNA repair enzyme means you can't maintain the DNA replication exactly and the microsats become unstable
Leads to mutations in other genes MSH2 and MLH1
Ex: HNPCC

2

HNPCC

Inherited mutation in DNA mismatch repair enzyme
De nova tumor (not adenoma to carcinoma) that arises at a young age, usually right sided
Increased risk of colorectal, ovarian, and endometrial carcinoma

3

Populations with an increased risk of colorectal carcinoma

Ulcerative colitis patients (chronic inflammation)
Putigier syndrome patients

4

Screening for colorectal cancer

Colonoscopy
Fecal occult blood testing
Begins at 50
Remove adenomatous polyps before carcinoma develops and detect cancer early (before it presents clinical symptoms)

5

Left sided carcinoma

Napkin ring lesion (circular growth around the colon)
Decreased stool caliber "pencil thin stool"
LLQ pain
Blood streaking in stool
Adenoma carcinoma sequence more common cause

6

Right sided colon cancer

Grows as a raised lesion, larger caliber so doesn't result in obstrution
Iron deficiency anemia
Vague pain
More commonly associated with microsatalite sequence

7

Colonrectal cancer increases the risk for what infection?

Streptococcus bovis endocarditis
Endocarditis, strep bovis, test for colorectal carcinoma

8

Staging for colorectal carcinoma

Most important are depth of invasion (T) and spread to lymph nodes (N)

9

What is spread of colorectal cancer

Liver

10

What is the tumor marker for colorectal cancer?

CEA
Useful for looking at treatment response
Useful to detect recurrence
Not good for screening

11

What is the most common molecular pathway for colonic carcinoma?

Adeno-carcinoma sequence that begins with an APC mutation and then acquires other mutations
Seen with Familial Adematous Polyposis