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Flashcards in TumourPath Deck (32):
1

Type of tumour

- Benign
- Malignant. Ability to invade into adjacent tissue and to metastasise and and grow at other sites within body

2

Nomenclature of epithelium tumours

- Glandular:
Benign: adenoma and malignant: adeno-carcinoma
- Squamous:
Benign: squamous papilloma and malignant: squamous carcinoma

3

Nomenclature of connective tissue tumours

- Bone
Benign: osteoma, malignant: osteo-sarcoma
- Fat
Benign: lipoma, malignant: lipo-sarcoma

4

Nomenclature of blood tumours

- cells, not vessels
- Malignant: white blood cells, leukaemia

5

Nomenclature of lymphoid tissue tumours

Malignant: lymphoma

6

Nomenclature of neural tissue tumours

- Central nervous system: astrocytoma
- Peripheral nervous system: Schwannoma

7

Nomenclature of germ cell tumours

- Teratomas:
Tumour composed of various tissues
- Ovarian, benign
- Testicular, malignant

8

Main features of benign tumours

- Non-invasive growth pattern
- Usually encapsulated
- No evidence of invasion
- No mets
- Cells similar to normal
- Tumours 'well differentiated'
- Function similar to normal tissue
- Rarely cause death

9

Main features of malignant tumours

- Invasive growth pattern
- No capsule or capsule breached by tumour cells
- Cells abnormal
- Cancer are often poorly differentiated, don't look anything like cells around it
- Loss of normal function
- Evidence of spread of cancer
- Can cause death

10

Properties of cancer cells

- Altered genetics
- Altered cellular function (tumour related proteins and loss of function)
- Abnormal morphology
- Cells capable of independent growth

11

Altered genetics of cancer cells

- Loss of tumour suppressor genes
- Gain of function of oncogenes

12

What can tumour biomarkers be used for?

You can pick up tumour-related proteins and used these for screening, diagnosis, prognosis and predictive (using a particular therapy)

13

Onco-fetal proteins examples

- Alpha-fetoprotein: teratoma of testis, hepatocellular carcinoma

14

Oncogenes

- Kras: colorectal cancer. (know for treatment type)
- Braf: melanoma

15

Growth factors and receptors and what cancer they're related to

- Oestrogen receptor - predictive biomarker: breast cancer
- Prostate specific antigen: prostate cancer
- EGFR: lung cancer
- Her2 (EGFR related protein): Breast cancer and gastric cancer

16

Loss of cellular function in cancer cells

- Loss of cell-to-cell adhesion
- Altered cell-to-matric adhesion

17

Abnormal morphology

- Balance between cell growth and cell death
- Angiogenesis vs. apoptosis
- Angiogenesis is a route for release of tumour cells into circulation
- Apoptosis regulates cell growth
Angiogenesis is in favour in cancer

18

Types of cancer spread

- Local
- Lymphatic
- Blood spread
- Transcoelomic spread (thorax and abdo)

19

Local spread of cancer

- Malignant tumour spreads locallt and ends up in lymph or blood vessels

20

Lymphatic spread of cancer

- Tumour cells adhere to lymph vessels and invade the lymphatics
- Mets in lymph node, divide and grow
- This is when it becomes clinically evident

21

Blood spread of cancer

- Same concept as lymphatic
- Invade blood vessels, invade the tissue
- Metastasise, can line vascular endothelium if it is conducive to growth

22

Trans-coelomic spread

- Spread in body cavities, special form of local invasion

23

What influences where they metastasise to?

- blood flood
- tumour related factors
- host factors

24

Common sites of metastasis

- Liver (CRC)
- Lung
- Brain
- Bone: axial skeleton (breast, prostate)
- Adrenal gland

25

Local effects of benign tumours

- Pressure: can apply pressure to adjacent groups
- Obstruction: intestinal or urinal tract
- You can get pressure effects causing an obstruction

26

Local effects of malignant tumours

- Pressure
- Obstruction
- Tissue destruction: ulceration/infection. If exposed to microorganisms, you can get a secondary infection
- Bleeding: anaemia or haemorrhage
- Pain: pressure on nerves, perineural infiltration, bone pain in pathological fractures
- Effects of treatment

27

Systemic effects of cancer

- Secretion of hormones
- Weight loss: cachexia
- Paraneoplastic syndromes
- Effects of treatment

28

Secretion of hormones

- Normal: if tumour is in endocrine organs then it has an abnormal control of secretion
- Abnormal: hormones not normally produced at site. Can be useful in diagnosing lung cancer

29

Paraneoplastic syndromes

- fever, myopathy, neuropathy
- Can present with these symptoms rather than direct symptoms of cancer
- could be immune mechanism or production of hormone factor

30

Dysplasia

- Pre-malignant change on pathway to the development of cancer.
- Abnormality in cell structure that leads to malignancy
- Earliest change in the process of malignancy that can be visualised
- Identified in the epithelium
- Has the capability of becoming cancer

31

Features of dyplasia

- Disorganisation of cells: increase in nuclear size, increased mitotic activity, abnormal mitoses
- The higher that grade, the higher possibility of malignancy
- No invasion

32

Early detection of cancer

- Need an effective test
- Has to be sensitive/specific
- Acceptable to population
- Example: detection dysplastic cells from squamous epithelium of cervix