Flashcards in GI Neoplasia Deck (69):
what is interchangeable with carcinoma in situ?
malignancy is defined by?
more than 2 chromosomes, inappropriate numbers: chromosomal instability
proto-oncogenes need one or two hits?
how many hits for TSGs?
P53 active between which cell phases?
G1 and S
G2 and M
RBactive between which cell phases?
G1 and S
carcinoma is cancer of?
sarcoma is cancer of?
dysplasia signs? 3
cancer is defined by?
invasion and breach of basement membrane to stroma
bone is a common site for breast and prostate possibly due to?
similar micro environment
example of physiological metaplasia?
cervical transformation zone during menstrual cycle
pathological metaplasia in oesophagus?
barrett's oesophagus due to chronic GORD
HPV is only on cervix?
ubiquitous: >150 serotypes
What are the high risk cancer HPVs?
16 and 18
What are the low risk cancer HPVs?
6 and 11
what part of HPV genes leads to cervical cancer?
E2 gene disruption during viral genome integration leads to too much E6, E7 then loss of p53 and Rb tumour suppressors
What does HPV E6 and E7 oncoproteins do?
inhibits tumour suppressor protein
cervix intraepithelial neoplasia increased risk are which 2 categories?
ClN2 and ClN3
diagnostic criteria for Barrett's oesophagus?
endoscopic evidence of columnar
histo: metaplasia (goblet cells)
what gives you an increased 10% lifetime risk of oseophageal adenocarcinoma?
What is the most common familial colorectal cancer syndrome?
gland fusion or fusion with lamina propria is a feature of?
what happens to nucleus of dysplastic cells?
loss of polarity
dysplastic changes to basement membrane?
separation of basal cell layer
fused glands in mucosa indicates what?
lamina propria invasion
what is a pre-invasive term for severe dysplasia?
carcinoma in situ
is there metaplastic precursor in breast ductal carcinoma in situ?
breach in what = invasive carcinoma for cervix?
breach in what = invasive carcinoma for prostate?
basal cell layer loss
breach in what = invasive carcinoma for breast?
myoepithelial cell layer loss
breach in what = invasive carcinoma for oesophagus?
breach in what = invasive carcinoma for colon?
4 ways of carcinoma spread?
what are adenomatous dysplastic polyps?
Are Tubular adenoma/villous adenoma invasive? what are their features
nope. precursor, no invasion
if the polyp is >1cm and high grade dysplasia then what?
increased risk of malignancy
cancer risk if you have Familial adenomatous polyposis?
cancer risk if you have lynch syndrome?
Familial adenomatous polyposis recessive or dominant?
where are the lymphatics in the colon?
not in the lamina propria
how to treat adenomatous polyps?
are adenomatous polyps invasive?
no invasion beyond muscularis mucosae
are hyperplastic polyps benign? or malignant?
at what point do you get colorectal adenocarcinoma?
invasion beyond muscularis mucosae
what happens to stroma witth colorectal adenocarcinoma?
desmoplastic stromal reaction
3 colorectal cancer pathways
microsatellite instability (MSI)
CpG island methylator phenotype (CIMP)
which TSGs are lost in carcinoma?
which proto-oncogenes are lost in carcinoma?
what is the most common familial colorectal cancer syndrome?
Lynch Syndrome dominant or recessive? onset of cancer?
mean age 45
extracolonic cancers in Lynch Syndrome?
2 things in micro satellite instability pathway?
defective DNA mismatch repair
widespread mutations in DNA micro satellites
where do sessile serrated adenoma/polyps usually arise?
sessile serrated adenoma/polyps easy or heard to detect?
hard to detect at colonoscopy
what is serrated in sessile serrated adenoma/polyps ?
elongation and serration of crypts
How do colorectal cancers grow in:
1. proximal colon
2. distal colon
1. bulky, polypoid: due to more liquid stool
2. annular, stenosing, ulcerated: due to more solid stool
invasion assessment of colon cancer. 4 things
infiltration of adjacent organs
perforation into peritoneal cavity
Australian staging for colorectal cancer:
ACPS A: beyond muscularis mucosae
ACPS B: beyond muscularis propria
ACPS C: lymph node metastasis
ACPS D: distant metastase
TMN staging is?
Tumour invasion Tis, T1,2,3,4
Node metastases: N0,1,2
M etastases: Mx, M0,1
what organ is common site of metastases for colorectal cancer?
liver cause of portal system
neoadjuvant therapy is? Grade 1 is best or worse?
grade 1 is complete tumour destruction
early onset cancer should raise suspicion of?
2 things that dysplasia has histologically:
complete excision of dysplasia will cure?
Cetuximab and panitumumab block what?
K-RAS and B-RAF mutation predicts what?
poor response to EGFR-targeted therapy so need to screen before targeted therapy