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Flashcards in Neoplasia Basics Deck (21):

Define Neoplasia

Abnormal cell growth and differentiation.

• Neoplasia is the process, neoplasm is the mass of cells or tumors (generally not malignant) but can be serious if in a location with limited space (cranium, major organ)
• Most cases not reversible. Doesn’t progress or regress

*Anaplasia generally means malignant, neoplasia is just new growth though Ahmed calls it abnormal


Distinguish between Benign and Malignant

*See Table 8-2*

• Still abnormal, uncontrolled, slow growth.
• May stop or regress (regression not common)
• Partly differentiated (normally differentiated same as local tissue) non invasive (i.e not breaking down other tissue)

• Disorderly, rapid growth, poorly differentiated cells
• Invasive and damaging
• Cancer- Malignant tumor caused by mutated genes


4 Categories of Genes Associated with Neoplasia

1) TP53 Genes
2) DNA repair Genes (spellcheck)
3) Proto-Oncogenes (go/start)
4) Tumor Suppressor Genes (stop)
Notes: Normal= cell division controlled by genes (start/stop/spellcheck). Genes located on chromosomes (as triplet code using ATCG) always code for proteins. Cell makes the protein and proteins do all the jobs. Any defective genes that brings about uncontrolled growth are called onco genes. Oncogenes bring about malignant growth.


TP53 Genes

... cause apoptosis when DNA is damaged

• All cells have it
• This refers to the gene (P53 is the protein)
• 50% of CA have a defective TP53


Describe the start, stop and Spell check Genes

DNA repair genes (spell check) – general group of genes
• Read code – finds errors – corrects them
• Repairs all genes
• A major target of carcinogens

Proto- oncogenes (“go” genes)
• Increase cell division
• if mutated – uncontrolled division – increase growth

Tumor suppressor Genes- (stop genes)
• Decrease of cell division
• If mutated can cause uninhibited cell division and increased growth


3 Basic Naming Rules for Tumors (Type and suffix)

Benign tumors use suffix “oma”

Malignant use suffix
• Carcinoma (if epithelial tissue)
• Sarcoma (if mesenchyme tissue) * mesenchyme is an embryonic tissue that in adults gives rise to all other tissue muscle, connective, adipose)


Basic rules of Tumor Growth Curve

Fig 8-5
• Generally 10yrs to clinically detectable
• 30 doublings – 1 billion cells
• Tumors on average double every 100 days


3 Methods of Spread

• Extension and Invasion- Growing locally and killing local cells
• Seeding in body cavities- Fall off and land on other organs (namely Abd cavity) The new site is the secondary site
• Metastasis- via blood and lymph


Define Metastasis

• Spread of CA cells from 1* to a 2* site. Via blood and lymph (distinction of route vs site)

• Lymphatic tissue is the common 2* site (especially carcinoma)
o Then in order: liver, lungs, bone and brain (especially sarcomas)
o Generally 2* site is well vascularized and large in size


3 Stages of Metastasis and Description

Stage 1-
• Invades local tissue, Tumor releases in enzymes which break apart tissue at primary site
• Emboli (multiple groups of CA cells) Enter blood or lymph
o Most emboli are destroyed by immune response

Stage 2-
• Travel via blood and lymph until they reach an area of resistance (i.e. capillary bed)
• Must attach to a suitable site- cells actually sense the site for suitability
o Use mediators- cytokines and growth factors

Stage 3- Angiogenesis (formation of new blood vessels) and cell growth at secondary site
• Cells remain the same, destroys local cells
• Platelets can mask emboli- FIg 8-4


Describe TNM Stages of Tumors

Staging (clinical criteria) Global TNM system
o T [0-4] = size (o is no tumor)
o N (0-3) = regional lymph node involvement (extent of involvement , not specific number)
o M (0-1) = metastasis

o TNM(x) = can’t be assessed


Describe the Grading of Tumors

Based on localized extension and invasion

Graded l-lV restrictive to extensive


Standard Options for CA Tx

Depends on type of CA, patient specifics, and progression

Radiation, chemotherapy, surgery, immunotherapy, hormone therapy, or combination


Describe the 3 most common CA TX's- Radiation, Chemotherapy and Surgery

• Radiation – will damage other cell
o Necrosis via: Generation of free radicals, Disruption of DNA bonds

• Chemotherapy- Medications to target fast cell division. Often damages other cells, normally a cocktail of drugs
o Targets cell division, Prevents/slows growth of cells

• Surgery (Sx) –cleanest way of removing Ca
o Excise tumore (must remove ALL malignant cells)


Describe Immunotherapy

o Uses cytokines and Abs (get immune system going artificially uses a particularly strong antigen)
o Stimulates IR to destroy CA cells
o Larger tumors cell growth can outpace IR


Describe CA Hormone therapy

Tumors are supported/nurtured by hormones
o Use an anti / opposing hormone OR weird one- use hormone that is supporting tumor, provide hormone to reduce receptors on tumor and this disrupts regulatory function (For Hormone responsive tumors)


Problems Associated with Therapy

• Focus- difficulties specifically targeting the tumor
• Normal cells (damage?)
• Recurrence (CA return)


Compare Cell characteristic of benign vs malignant Tumors

Well-differentiated cells that resemble cells in the tissue of origin
Cells are undifferentiated, with ananplasia (reversion of cells to an immature or less differentiated form) and atypical structure that often bears little resemblance to cells in the tissue of origin


Compare rate of growth in Benign and Malignant tumors

Usually progressive and slow; may come to a standstill or regress
Variable and depends on level of differentiation; the more anaplastic (less differentiated cells) the cells, the more rapid the rate of growth


Compare mode of growth in Benign and Malignant tumors

Grows by expansion without evading the surrounding tissues; usually encapsulated
Grows by invasion, sending out processes that infiltrate the surrounding tissues


Compare metastasis in Benign and Malignant tumors

Does not spread by metastasis
Gains access to blood and lymph channels to metastasize to other areas of the body