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tumor immunology Flashcards

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1
Q

how do tumors work

A

cell growth outnumbers cell death

-these cells are transformed
-can’t respond to normal growth signals

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2
Q

another name for tumor cells

A

neoplastic cells

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3
Q

benign

A

tumor that encapsulated or has defined margins of growth

-can be life threatening if impedes normal function

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4
Q

malignant

A

growing outside the boundary

-abnormal biochemical activity
-can spread to other sites of the body

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5
Q

most cancers are clonal cells that originate from

A

signal cell and continually dividing and growing

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6
Q

carcinomas

A

cancer of epithetical origin

80% or more of cancer of these

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7
Q

sarcomas

A

from embryonic mesoderm

-such as bone, connective tissue, fat, or smooth muscle

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8
Q

leukemia or lymphomas

A

arise from hematopoietic cells

9% of cancer

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9
Q

lymphoma

A

t or b cell orientated cells, from lymphoid tissue

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10
Q

leukemia

A

move throughout blood stream

more common in children

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11
Q

angiogenesis

A

tumor causes new blood vessels to be formed in order to feed them

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12
Q

qualitative differences known as

A

tumor specific antigens

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13
Q

tumor specific antigens

A

can be attacked by own immune system because foreign

ex. philadelphia chromosome

-caused by mutation

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14
Q

quantitative difference known as

A

tumor associated antigens

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15
Q

tumor associated antigens

A

Present on normal cells but expressed in greater difference on a tumor cell

ex. Her2 gene

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16
Q

what else is apart tumor associated antigens

A

oncofetal antigens

ex.alpha fetoprotein or CD10

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17
Q

what are oncofetal antigens

A

expressed early on in development or early on in cell development but not normally expressed later in life

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18
Q

inducible mutation

A

something induced transformation of cells to make them cancerous

-either physical or chemical composition that induce this tumor

ex. skin cancer

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19
Q

where are inducible mutations expressed

A

differently on many tumor cells

-little to no cross reactivity

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20
Q

virally induced

A

express a lot of tumor cross reactivity, similar to each other

ex. EBV, HTLV, HPV, Herpes 8

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21
Q

tumor markers

A

aid in the diagnosis of cancer, not absolute, more screening tool

-there are false + and -

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22
Q

PSA

A

prostrate specific antigen

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23
Q

normal PSA

A

<4

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24
Q

PSA is what specific

A

organ specific
NOT tumor

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25
things that cause increase in PSA
○ Benign prostrate hyperplasia and other conditions ○ Digital rectal exam ○ Ejaculation
26
why was measuring only free PSA bad
large gray area between 4-10 with lots of false + and -
27
how do we measure PSA
tPSA/fPSA ratio -do if suspected of having prostrate cancer or have a previous kind of cancer
28
how does tPSA/fPSA ratio work
lower the percent the higher the risk of cancer
29
alpha fetoprotein
oncofetal antigen -tumor associated
30
alpha fetal protein used as a screen for
hepatocellular liver cancer -testicular cancer, gastric cancer, pancreatic cancer
31
Hcg
oncofetal marker
32
Hcg good screen for
testicular cancer also indication for choriocarcinoma - hydatidiform mole
33
CEA- Carcinoembryonic Ag used for
colon rectal cancer oncofetal
34
if CEA keeps rising after treatment
tumor is metastasizing
35
if CEA is - and sus
go in and do a biopsy
36
screen for CEA
occult blood
37
CEA is also used in
pancreatic cancer
38
marker for ovarian cancer
CA-125 -not detected in early stages
39
stage 1 or 2 ovarian cancer
survival rate 95% for 5 years
40
stage 3 or 4 ovarian cancer
5 year survival rate 5%
41
CA-125 increased in
PID- pelvic inflammatory disease
42
Her2 stands for
Human epithelial growth factor receptor 2
43
her2 is gene for
breast cancer -overexpression of gene
44
gastrin released by
stomach and pancreas -need to digest food
45
when is gastrin increased
normal insulin producing tumors of the pancreas
46
what does increased gastrin result in
Zollinger-Ellison syndrome -Increased amount of gastrin and gastric acid, in no response to food
47
gastrin tumor marker for
pancreatic
48
CA 19-9
Pancreatic marker-- most common marker for it
49
who does not synthesize CA19-9
Lewis a and b (-) can not synthesize this marker --- so can't be used for these people
50
5-HIPAA detects
carcinoid tumor develops in GI tract MADDIE diarrhea at night and flushing of the skin
51
with a carcinoid tumor you will find 5-HIPPA
in higher amounts in urine -need 24 hours to bypass diurnal variation
52
5-HIPAA is a what metabolite
serotonin
53
what testing is 5-HIPAA done with
chromogranin A testing - protein found in these tumors secreted in the blood stream
54
specimens for 5-HIPAA
blood or urine
55
host response to tumors involves what 3 things
NK cells macrophages cytotoxic t cells
56
NK cells
-no antigen presented -can kill tumors lacking MHC -kill either perforin or ADCC target in blood stream
57
macrophages
stimulated by t cells, gamma interferon can kill release tumor necrosis -can have negative impact
58
cytotoxic t cells
look at altered self -presented MHC 1 which stimulates them
59
ACT
adoptive cell transfer -take patients own cells and transform them into targeting cancer cells and put them back into patient
60
CAR T cells
chimeric Ag receptor
61
how do CAR T cell work
T cells collected from patient, then use disarmed virus, t cells genetically engineered to produce receptors on their surfaces known as CAR receptors -bind to specific antigen on tumor cell
62
once CAR t cells are multiplied in lab
IV drip back into patient -receptors find and attack cancer cells
63
where was CAR t cell first done
ALL -b cell type
64
drawbacks of ACT
- tumors have to express enough antigen so t cells can find it -When introducing lots of t cells again can stimulate cytokine storm -Sometimes don't proliferate in the lab
65
monoclonal antibodies better with
tumor specific antigens link with cytotoxic drugs
66
FISH used to
detect chromosomal rearrangement and genetic amplification find targeted genes of DNA or RNA to bind to and fluoresce
67
procedure of FISH
Heat or chemically treat sample, add labeled probe, and allow hybridization
68
what can be seen in FISH
absence of a gene, overexpression, or gene rearrangement
69
next generation sequencing
Sequence of tumor and matches to a data base and matched tumor to very specific MADDIE
70
drawbacks of immunoassays
-Not specific enough for specific antigens - Lots of cross reactivity - Not sensitive
71
majority of people with cancer are older patients-- theory
thymus doesn't work as you get older, BM takes over but not as efficient in producing number of t cells needed for the immune system
72
tumors secrete immunosuppressant substances that suppress the release of
gamma interferon and IL-2 and allow over proliferation of T regulatory cell (stops the immune system)
73
downregulation of MHC molecules on tumor cells NORMAL person
Cytotoxic t cells need antigen presented with MHC class 1
74
downregulation of MHC molecules on tumor cells TUMOR PEOPLE
They go unchecked or unseen in the immune system

immuno (12 decks)

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