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Flashcards in CP 22 - Behaviour of Tumour Deck (26):
1

does patients with basal cell carcinoma usually have metastasis

basal cell carcinoma does not usually metastasis

2

how can tumour cells achieve greater motility or less adhesion

- mutation of E-cadherin leads to loss of cell-cell adhesion and contact inhibition

- changes in integrin expression leads to decreased cell-matrix adhesion

3

what does cadherins do

cell to cell adhesion molecules

4

what does integrins do

cell to matrix adhesion molecules

5

what are the difference between epithelial cell and mesenchymal cells

E - tightly connected, polarised and tethered

M - loosely connected, able to migrate

6

what must the tumour cells undergo before metastasis?

epithelial - mesenchymal transition (in cancer, epithelial cells gain mesenchymal properties and so can invade and migrate)

7

what will happen after the epithelial-mesenchymal transition

proteolytic enzymes are released in order to digest through the walls and start the process of metastasis

8

which enzyme is responsible for degrading extracellular matrix

matrix metalloproteinases

9

what are the specific proteolytic enzymes for each collagen

interstitial collagenases - collagen I, II, III

gelatinases - collagen IV, gelatin

stomolysins - collagen IV, proteoglycans

10

how can mechanical pressure cause metastasis

uncontrolled proliferation - mass

pressure occludes vessels

pressure atrophy
spreading lines of least resistance

11

what are the different routes for metastasis

lymphatic, blood (haemogenisus), transcoelomic, implantation

12

what are the different stages of metastasis

detachment invasion (from original sites towards blood vessels) - intravasation - survival against host defences - adherence extravasation (adhered to the vessels wall) - angiogenesis - growth

13

what route does carcinoma usually use to spread?

lymphatic spread first

14

what route does sacromas usually use to spread?

blood spread first

15

which cancers usually have bone metastasis

thyroid, breast, lungs, kidney, prostate

16

which cancers usually have metastasis through transcoelomic route?

ovarian

17

which cancer spread to brain and adrenal gland

lung cancer

18

what is a rough guide for stage?

how advance is the tumour, has the cancer spread and if so what is the extend of spread

19

what is a rough guide for grade

how aggressive is the tumour - how different does it look from tissue of origin

20

what does T, M and N means in the TMN system

T - tumour
M - metastasis
N - Node

21

for breast cancer, how is the T staging work?

Tis - in situ disease
T1 - 5cm
T4 - involving skin or chest wall

22

for breast cancer, how is the N staging work?

N0 - no nodes
N1 - ipsilateral nodes
N2 - >node involvement

23

how is the staging of a particular cancer calculated?

combination of clinical, radiological, pathological diagnoses

24

what is the staging of breast cancer

0 - Tis
1 - T1, N0, M0,
2 - T1-2, N1 or T3
3 - T(any), N2 or T4
4 - T(any), N(any), M1

25

what is another Dukes 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

26

what does grading take into account?

differentiation (resemblance to tissue of origin), nuclear pleomorphism and size, mitotic activity, necrosis