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Flashcards in Neoplasia II Deck (48):
1

What allows for the increased rate of growth in neoplasms (3)?

1. Evasion of host control
2. Limitless replicative potential
3. Loss of contact inhibition

2

What is the percentage of cell in the cell cycle in normal tissues? Benign neoplasms? Malignant neoplasms?

Normal = 1%
Benign = 1-10%
Malignant = 20-80%

3

What happens to apoptotic rates in neoplasms?

Inhibited apoptosis

4

What are the three factors that we use to measure increased growth rate?

1. Doubling time
2. Fraction of tumor cells in proliferative pool
3. Cell production vs cell loss

5

How many doubling times are needed for cells to become a mass of 1 g (the clinically detectable amount)?

30 doublings

6

How many doublings are needed for cells to develop a 1 kg mass (the max compatible with life)?

40 doublings

7

What happens to the growth fraction in the submicroscopic phase?

High growth fraction

8

What is the relative growth fraction in later stages of cell growth?

<20%

9

How do you measure mitotic activity?

No. of mitotic figures / 10 HPF

10

What is Ki-67?

Cell marker for cell proliferation

11

What is PCNA?

Proliferating cell nuclear antigen

12

What are the two marker proteins that are used to identify cell proliferation (in high quantities)?

Ki-67
PCNA

13

What is the difference between the fragmentation of nuclear chromatin in apoptotic cells, vs normal cells in prophase?

Much more clumped together in apoptotic bodies

14

What type of cell/when are more susceptible to chemotherapy?

Cells within the cell cycle (high growth rate)

15

What is differentiation?

Cells or tissues resemble their normal progenitors in both appearance and function

16

True or false: neoplastic cells within the cell cycle cannot differentiate

True

17

What does the degree of differentiation of neoplastic cells depend on?

Proportion of cells within the cell cycle

18

What are the four categories of differentiation?

1. Well
2. Moderately
3. Poorly
4. Undifferentiated (anaplastic)

19

What happens to nuclei in tumors?

pleomorphic

20

What happens when a capsule around a tumor breaks?

Becomes malignant

21

Anaplastic = ?

Undifferentiated tissue mass

22

How can you tell where a tumor came from? (2)

Expression of cell markers (e.g. keratin marks epithelial cell)

Cytological findings

23

What is polarization? What happens in neoplasms?

Polarization is the orientation of cells

Loss of polarity = disorganization

24

What causes the loss of polarity in anaplastic cells?

Mutations and lack of differentiation as the cells migrate/proliferate

25

What are the three diagnostic criteria for cellular atypia?

1. Cellular pleomorphism
2. Nuclear changes
3. increase from 1:1 N/C ratio

26

What are the nuclear changes in cellular atypia? (4)

1. Nuclear pleomorphism
2. Dense and irregular nuclear outline
3. Nuclear hyperchromicity
4. Nucleolar Pleomorphism

27

What happens to the Nucleus/Cytoplasm ratio in cellular atypia?

Greater than 1:1 (normal is 1:5)

28

What is hyperchromasia?

Abundant DNA
Extremely dark staining

29

What is pleomorphism?

Variation is size and shape of cells and nuclei

30

What is anaplasia?

Term referring to a lack of differentiation

31

What happens to the nucleoli in tumors?

Gets bigger

32

What happens to the size of cells in tumors?

Bizarre tumor giant cells

33

What happens to tissue architecture/function in anaplastic tumors?

Loss of tissue architecture/function = more aggressive

34

What are giant tumor cells? What do giant tumor cells represent?

Single huge polymorphic nucleus or >2 nuclei

Represent Anaplasia

35

True or false: mitoses alone is used to define malignancies

False--also cellular atypia

However, more mitoses = more likely malignant

36

What is desmoplasia?

Hyperplasia of activated fibroblasts, resulting in abundant collagenous stroma

37

What is the stain used to identify collagen?

Trichrome staining = blue

38

What are the three proangiogenic factors?

VEGF
bFGF
HIF

39

What are the four anti-angiogenic factors?

Thrombospondin-1
Angiostatin
Endostatin
Tumstatin

40

Proangiogenic or antiangiogenic: VEGF

Pro

41

Proangiogenic or antiangiogenic: thrombospondin-1

Anti

42

Proangiogenic or antiangiogenic: angiostatin

anti

43

Proangiogenic or antiangiogenic: HIF

Pro

44

Proangiogenic or antiangiogenic:bFGF

Pro

45

Proangiogenic or antiangiogenic: Tumstatic

Anti

46

Proangiogenic or antiangiogenic: Endostatin

Anti

47

Why do malignant tumors show central necrosis?

Tumors are limited by the ability of nutrients to diffuse into it, to a diameter of 1-2 mm

(it outgrows its blood supply)

48

True or false: A tissue with many mitotic cells = malignant CA

False--could be benign