part 4 Flashcards
(24 cards)
Treg cells
suppress tumor immunity (verzwakt afweer)
promote immune tolerance
maintain lymphocyte homeostasis
produces: TGF-B, IL-10, IL-35
a lot of Treg cells in tumor indicated bad prognosis
Th1 cells
promote tumor immunity (versterkt afweer)
for intracellular pathogens
drives auto-immunity
produces TFN-G
Th2 cells
for extracellular pathogens
allergy
asthma
produces: IL-4, IL-5, IL-13
HLA-MHC I loss
= missing self
can cause immune escape
PDL1 expression
causes immune escape
often in lung cancer
presented on cancer cells, inhibits T-cells
immune suppressed microenvironment
can cause immune escape
created through production of cytokines like TGF-B
also through attraction of regulatory T-cells
immunotherapy: IL-2 therapy
works in metastatic melanoma and metastatic renal cell carcinoma
high toxicity bc it stimulates all T cells
immunotherapy: TIL therapy
= tumor infiltrating lymphocytes specific autologous cells personalised highly dependant on in vitro manipulation (Time/costs)
immunotherapy: adoptive T-cell transfer
same as TIL but T cells are not taken from tumor but elsewhere and then cultured w/ tumors to become specific for that tumor.
Then given back to patient
immunotherapy: antigen therapies
viral proteins
ex. HPV (baarmoederhals kanker)
antigen therapies: neo-antigen targeted therapies
specific
personalised
highly dependant on in vitro prep.
= vaccine w/ mutated peptides
antigen therapies: tumor-associated proteins
ex. GP100
not tumor specific
limited efficacy
Tumor grades
GX: undetermined G1: well-differentiated (low grade) G2: moderately differentiated (intermediate grade) G3: poorly differentiated (high grade) G4: undifferentiated (high grade)
TNM staging: T
size T1: < 2cm T2: 2-5 cm T3: > 5 cm T4: extension into other organs
TNM staging: N
regional lymph node involvement
N0: none
N1: small amount of lymph nodes involved
N2: more
TNM staging: M
distant metastasis
MX: undetermined
M0: none
M1: yes
TNM staging; prefixes
c= clinical (before treatment) p= histopathologically yp= histopathologically after treatment x= unclassified
Breast cancer staging
0= in situ cancer 1= localised cancer 2= further local spread, usually includes spread to nearest lymphnodes 3= usually indicates more extensive lymph node spread 4= always indicates distant spread (metastasis)
Lung cancer classification: N
N1: lymph nodes within lung involved
N2: lymph nodes in mediastinum involved
N3: supraclavicular lymph nodes involved
Lung cancer staging
1= only small tumor in lung 2= local lymph node involvement 3= mediastinal lymph node involvement 4= distant metastasis
Duke’s classification
for colon cancer
Ann arbour classification
for lymphomas
Breslow scale + Clarks level
for melanome
FIGO
for gynaecological tumors (cervix, vulva, endometrium)
