Principles of Malignancy + Cancer Pathogenesis Flashcards

(31 cards)

1
Q

What is a tumour?

A

Mass of abnormal tissue that arises without obvious cause from pre-existing body cells, and is characterised by a tendency to independent growth

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2
Q

What is a cancer (malignancy)?

A

Characterise by the unregulated cell growth leading to invasion of surrounding tissues + spread

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3
Q

What is benign?

A

Lacks the ability to invade neighbouring tissue or spread around the body
BUT doesn’t mean they can’t become a cancer

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4
Q

What is malignant?

A

Gained the ability to invade surrounding tissues, disseminate to other sites within the body
BUT doesn’t mean always lethal

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5
Q

Describe the features of a benign tumour

A

Encapsulate edges
No metastasis
No invasion
Cells are good comparison to normal
Low growth rate
Normal nuclei
Not normally life-threatening

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6
Q

Describe the features of a malignant tumour

A

Irregular edges
Metastasis
Invasion
Cells are variable to normal
High growth rate
Irregular nuclei
Usually life-threatening

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7
Q

How are cancers formed?

A

Accumulation of errors in vital regulatory pathways
Expansion of cell numbers from a single cell
Different for each cancer/tumour type
Can take many years, even a lifetime

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8
Q

What are the structure of neoplastic cells of malignant tumours?

A

Reproduce to variable extent
= invade neighbouring tissue environments

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9
Q

What are the structure of stroma cells of malignant tumours?

A

Connective tissue framework which provides support + nutrition to tumour cells
Growth of tumour depends upon ability to induce blood vessels
Fibroblasts give mechanical support

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10
Q

What is differentiation?

A

Extent to which neoplastic cells resemble comparable normal cells - BOTH morphologically + functionally

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11
Q

Describe well differentiated tumours

A

Composed of cells resembling normal cells of tissue of origin

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12
Q

Describe poorly differentiated tumours

A

Cells lacking resemblance to normal cells of the tissue of origin

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13
Q

What is the TNM classification?

A

T = tumour size
N = presence + no. of lymph nodes involved
M = metastases

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14
Q

How do you determine the prognosis of malignancy?

A

Tumour type = origin from normal structure
Grade of differentiation = assessment of aggressiveness
Stage/extent of spread = determined by examination of resected tumour + assessment by imaging techniques

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15
Q

What is the grade?

A

Degree of histological resemblance to parent tissue

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16
Q

What is the stage?

A

Anatomical extent of spread

17
Q

What is histogenesis?

A

Indicates cell type of origin of tumour

18
Q

What is a sarcoma?

A

Connective tissue origin

19
Q

What is carcinoma?

A

Epithelial origin

20
Q

What causes cancer?

A

Hormones
Genetics
Diet
Parasites
Asbestos
Sun/UV
Viruses - eg. HPV
Ionizing radiation
Cigarettes

21
Q

What factors influence the incidence of cancer?

A

Lifestyle = smoking + alcohol (various cancers)
Environmental = UV + radiation
Diet = fatty diets (colonic cancer)
Hormonal = oestrogens (breast + ovarian cancer)
Bacterial = H.pylori (stomach cancer)
Parasitic = schistosomiasis (squamous bladder cancer)
Viral = papillomaviruses (cervical cancer)
Occupational = asbestos (mesothelioma)
Genetic = polymorphisms + mutations
Familial = retinoblastoma

22
Q

What are somatic mutations?

A

In nongermline tissues
Non-inheritable
eg. cigarette smoke + viruses

23
Q

What are germline mutations?

A

Present in egg or sperm
Are inheritable
Cancer family syndrome

24
Q

What are oncogenes?

A

Control cell growth = accelerate cell growth + divisions
Mutation = cancer = constant cell growth

25
What are tumour suppressor genes?
Check for damages = tell cells to undergo apoptosis = prevent cancer Mutation = turned off = no error checking
26
Describe tumorigenesis
Initiation = irreversible genetic change in cell - eg. cigarette smoke Promotion = further genetic errors + growth rate = pre-neoplastic Progression = cells gain metastatic potential = tumour
27
Describe the initiation step of tumorigenesis
Genetic change caused by carcinogen or inherited Most cells with genetic changes are "deleted" BUT some persist Errors in genes involved with replication or DNA repair = pre-neoplastic state
28
Describe the promotion step of tumorigenesis
Acquiring further genetic changes Associated with genomic instability + perturbation of oncogenes + tumour suppressor genes
29
Describe the progression step of tumorigenesis
Acquired changes in cellular pathways Cells now have metastatic potential
30
Describe cancer pathogenesis
Normal cell DNA damage = failure of DNA repair Mutations in genome of somatic cells = activation of growth-promoting oncogenes = alterations of genes that regulate apoptosis = inactivation of cancer suppressor genes Expression of altered gene products = malignant neoplasm
31
How do we treat cancer?
Surgery Radiotherapy Chemotherapy = traditional vs targeted Treatment aims = curative or palliative