Term
| what types of CANCERS have a declining death rate? |
|
Definition
MALES-->lung, prostate and colon cancer, stomach
FEMALES-->breast and colorectal cancer, stomach |
|
|
Term
what ENVIRONMENTAL FACTORS can lead to the following cancers:
BLADDER
MESOTHELIOMA
CANCER OF OROPHARYNX AND LUNG |
|
Definition
BLADDER-->aniline dyes, smoking
MESOTHELIOMA-->asbestos
CANCER OF OROPHARYNX AND LUNG-->smoking, asbestos, radon (also arsenic and nickel) |
|
|
Term
| what chemical in PLASTICS are especially dangerous? what does this give rise to? |
|
Definition
| vinyl chloride-->angiosarcoma of the liver |
|
|
Term
| what affect does AGE of patients have on cancer? |
|
Definition
| usually more common in older patients, but some types of cancers are very prevalent and dangerous to younger populations (leukemia, lymphoma, retinoblastoma, rhabdomyosarcoma) |
|
|
Term
| what are some characteristics of DYSPLASIA? |
|
Definition
-Loss of uniformity
-Loss of architecture
-Pleomorphism
-Hyperchromasia
-Abnormal located mitosis
*DIFFERENT TERMS USED IN GRADING OF CERVICAL DYSPLASIA (can be mild moderate or severe) |
|
|
Term
| what is the worst kind of DYSPLASIA? |
|
Definition
“Carcinoma in situ”-->FULL THICKNESS dysplasia
BASEMENT MEMBRANE IS INTACT |
|
|
Term
|
Definition
| erosion of basement membrane, cells go into the vascular channel |
|
|
Term
what cancers can the following findings lead to:
ORAL LEUKO-PLAKIA? |
|
Definition
|
|
Term
what cancers can the following findings lead to:
BARRAT'S ESOPHAGUS? |
|
Definition
|
|
Term
what cancers can the following findings lead to:
Chronic atrophic gastritis of pernicious anemia? |
|
Definition
|
|
Term
what cancers can the following findings lead to:
CHRONIC ULCERATIVE COLITIS? |
|
Definition
| ADENOCARCINOMA OF THE COLON |
|
|
Term
what cancers can the following findings lead to:
HEPATITIS B or C? |
|
Definition
| hepato-cellular carcinoma |
|
|
Term
| ***what is the function of the BRCA genes?*** |
|
Definition
| DNA repair--> mutation leads to breast and ovarian cancers-->involves HYPERMETHYLATION of the PROMOTER |
|
|
Term
what cancers can the following findings lead to:
Solar keratosis of skin |
|
Definition
| skin cancer--> usually squamous cell carcinoma |
|
|
Term
| what are the MECHANISMS involved in the activation of an oncogene? |
|
Definition
-point mutations
-chromosomal translocations
-gene amplification |
|
|
Term
| what type of mutations affect RAS? what type of cancers does this lead to? |
|
Definition
| point mutation, leads to colon or pancreatic cancer |
|
|
Term
| ***Which are the important chromosomal translocations? *** |
|
Definition
-C-ABL-->Chronic myelogenous leukemia (CML)
-APML or AML-M3-->Acute pro-myelocytic leukemia
-C-MYC-->Burkitt's lymphoma (8-14) |
|
|
Term
| what is the Rb gene? when it is functioning properly, what is it doing? |
|
Definition
tumor supressor-->Regulates G1-S phase
normal function is to block E2F-->normally phosphorylated |
|
|
Term
| what type of cancer are seeing a RISE in DEATH RATE? |
|
Definition
|
|
Term
| what are ASBESTOS BODIES? |
|
Definition
| asbestos that has entered the lung and has been engulfed by macrophages forming a brownish fibrous mass |
|
|
Term
| cancer GENE involvement: RB, APC, P53, NF1&2 |
|
Definition
*all are tumor suppressors
RB--> retinoblastoma
APC-->adenomatous polyposis colon cancer
p53--> Li Fraumeni (multiple cancers
NF1&2--> neurofibromatosis |
|
|
Term
| what condition should you think of with a history of multiple cancers of the SKIN? ENDOCRINE? UNRELATED CANCERS? |
|
Definition
skin-->xeroderma pigmentosum
endocrine--> multiple endocrine neoplasia (MEN1&2)
unrelated cancer--> Li Fraumeni syndrome |
|
|
Term
| main GROWTH FACTOR mutation that can cause cancer (type)? |
|
Definition
| SIS (PDGFbeta)--> astrocytoma |
|
|
Term
| main GROWTH FACTOR RECEPTOR mutations that can cause cancer (type)? |
|
Definition
-ERBB1&2 (HER2/NEU)-->Breast and ovarian cancer (poor prognosis)
*think of this if no FAMILY HISTORY of breast cancer
-RET--> multiple endocrine neoplasia (MEN) |
|
|
Term
| main SIGNAL TRANSDUCTION PROTEIN mutations that can cause cancer (type)? |
|
Definition
KRAS-->PANCREATIC and colon cancer (POINT MUTATION)
ABL-->chronic myeloid leukemia (translocation 9-22) |
|
|
Term
| main NUCLEAR REGULATORY PROTEIN mutation that can cause cancer (type)? |
|
Definition
C-MYC-->BURKITT'S LYMPHOMA (B cells) translocation 8-14 (growth in the jaw***)
N-MYC-->neuroblastoma (primitive neural crest cell proliferation) amplification in children |
|
|
Term
| what DRUG is used to treat AML? what mechanism is it affecting? |
|
Definition
| IMATINIB-->tyrosine kinase mutations |
|
|
Term
| what type of CANCER is caused by a BCL2 mutation? |
|
Definition
| follicular lymphoma--> BCL2 amplification (14:18 translocation) *MOST COMMON INDOLENT CANCER-->B cell lymphoma |
|
|
Term
| what cancers are associated with RB gene mutations? |
|
Definition
| retinoblastoma, osteosarcoma--> usually in children-->BOTH Rb genes must be lost |
|
|
Term
| what TUMOR SUPRESSOR gene is involved in kidney cell carcinoma? |
|
Definition
| VHL-->Von Hippel Lindau syndrome* |
|
|
Term
| what is the role of Viral proteins E6 and E7 in cancer? |
|
Definition
| bind to and inhibit functions of Rb and p53 tumor suppressors |
|
|
Term
| What is the importance of the INK4a /ARF gene? |
|
Definition
| familial MELANOMA involvement |
|
|
Term
| NF-1 affects what protein? |
|
Definition
| GAP--> GTPase activation protein) |
|
|
Term
| genes involved in HEREDITARY NON-POLYPOSIS COLON CANCER SYNDROME- |
|
Definition
|
|
Term
| how is TELOMERASE tied in with cancer? |
|
Definition
| presence of telomerase in 90% of tumors--> Maintenance of telomere strength-->Prevention of cell cycle arrest and apoptosis |
|
|
Term
| how does INVASION of the extracellular matrix take place? |
|
Definition
1-Detachment of tumor cells from each other (E cadherins not produced)
2-Attachment to matrix component (increase in laminin)
3-Degradation of ECM (protease action)
4-Migration of tumor cells |
|
|
Term
| Carcinogenesis is a multistep process-->Accumulation of successive mutations |
|
Definition
|
|
Term
|
Definition
| WILM'S TUMOR--> supressor gene, aggressive childhood kidney tumors |
|
|
Term
| what is the Rb protein doing in the normal state? |
|
Definition
| normally HYPOphosphorylated--> inhibits E2F-->Cyclin D induced phosphorylation of Rb which causes E2F activation |
|
|
Term
| how does the APC protein function under normal circumstances? |
|
Definition
| APC acts to downregulate Beta catenin whose job is to drive cycle forward |
|
|
Term
| what is the WARBURG EFFECT? |
|
Definition
| cancer cells shift their ENERGY METABOLISM from AEROBIC to ANAEROBIC (glycolysis) in order to gain growth advantage-->occurs even if O2 is present--> detectable via PET scan |
|
|
Term
| what are CHEMICAL CARCINOGENS? |
|
Definition
highly reactive electrophiles that remove electrons from DNA, RNA or proteins - Cause cell damage
*either DIRECT or INDIRECT acting |
|
|
Term
| what is an INDIRECT vs. a DIRECT carcinogen? |
|
Definition
| INDIRECT needs metabolic conversion whereas DIRECT doesn't |
|
|
Term
| what does SNUFF cause? what type of cancer did CHIMNEY SWEEPS get historically? |
|
Definition
snuff-->nasal polyps
chimney sweeps--> scrotal cancer-->told to bathe after work, greatly reduced cancers |
|
|
Term
|
Definition
| test that determines if a substance is a CARCINOGEN or not |
|
|
Term
| what chemical in smoke and smoked meats is a carcinogen? what cancers does this cause? |
|
Definition
| polycylic aromatic hydrocarbons--> cause lung and bladder cancer |
|
|
Term
| what cancer do Aromatic Amines and Azo Dyes cause? |
|
Definition
| liver --> hepatocellular carcinomas |
|
|
Term
| what does β-naphthylamine (aniline dyes and rubber industry) cause? |
|
Definition
|
|
Term
| what are examples of PROMOTERS? |
|
Definition
| phorbol esters and phenobarbital |
|
|
Term
| where is AFLOTOXIN B1 found? what is it? |
|
Definition
| NATURAL CARCINOGEN from FUNGUS found on improperly stored CORN |
|
|
Term
PROMOTERS of chemical carcinogenesis:
Estrogen-
Diethyl Stilbesterol-
High dietary fat- |
|
Definition
Estrogen- liver cancer
Diethyl Stilbesterol- endometrial cancer, vaginal caner in offspring
High dietary fat-colon cancer |
|
|
Term
| what type of UV is the most dangerous? |
|
Definition
| UV B--> can cause skin cancer, pyrimadine dimers |
|
|
Term
radiation induced neoplasms:
atomic bombs-
x ray workers-
radium- |
|
Definition
atomic bombs- leukemia
x ray workers- skin cancers
radium- osteosarcoma |
|
|
Term
| what is the EPSTEIN BARR VIRUS? |
|
Definition
| c myc, 8:14 translocation, Burkitt's lymphoma and Nasopharyngeal carcinoma |
|
|
Term
| how can BURKITT'S LYMPHOMA be identified histologically? |
|
Definition
| "starry sky" appearance with MACROPHAGE accumulation |
|
|
Term
| what causes KAPOSI SARCOMA? what patients normally see this type of cancer? |
|
Definition
| herpes virus (HHP 8)--> seen in AIDS patients |
|
|
Term
| what does Human T-cell leukemia virus Type 1 (HTLV-1) cause? |
|
Definition
| T-cell leukemia/lymphomas |
|
|
Term
| How is Helicobacter pylori infection associated with neoplasia? |
|
Definition
Gastric lymphoma
MALT lymphomas; marginal zone lymphomas
Gastric carcinoma |
|
|
Term
| how is HYPERCALCEMIA a symptom of para-neoplastic syndrome? |
|
Definition
| squamous cell carcinoma of the lung--> release of PTH RELATED peptide (NOT PTH!!!)--> hypercalcemia |
|
|
Term
| what is a PARA-NEOPLASTIC SYNDROME? examples |
|
Definition
Distant effects of a tumor unrelated to primary tumor or metastasis-->HORMONE is overproduced
-endocrinopathies-->ACTH
-hyponatremia SIADH-->ADH
-carcinoid syndrome-serotonin
-acanthosis nigricans |
|
|
Term
|
Definition
| PHYSICAL EXAM->MORPHOLOGIC METHODS (biopsy, FNAC,etc)-->MOLECULAR METHODS (flow cytometry, DNA probe)-->BIOCHEMICAL ASSAY (tumor markers) |
|
|
Term
| How would you know that a tumor is EPITHELIAL in origin? |
|
Definition
| If the tumor is positive for CYTOKERATIN, keratin or epithelial membrane antigen (EMA), it indicates an epithelial origin |
|
|
Term
| What does VEMINTIN positivity indicate? |
|
Definition
|
|
Term
| what would Positive S-100, HMB-45 and melanin be a sign of? |
|
Definition
|
|
Term
| Which IHC marker would you use if you suspected the tumor to be NEURO-ENDOCRINE in origin? |
|
Definition
-Neuron-specific enolase (NSE)
-Chromogranin
-Bombesin
-Synaptophysin |
|
|
Term
|
Definition
| substance found in the blood, urine, or body tissues that can be elevated in cancer, among other tissue types |
|
|
Term
the following TUMOR MARKERS are indications of what type of cancer?
CEA-
beta HCG-
PSA- |
|
Definition
CEA-->Carcino-embryonic antigen-->colon cancer
Beta HCG--> choriocarcinoma
PSA-->prostate specific antigen-->prostate cancer |
|
|
Term
|
Definition
| Transformation of normal to neoplastic cells--> caused by exogenous or endogenous factors |
|
|
Term
| What are Carcinogenic Agents? |
|
Definition
| Agents that cause genetic damage and induce neoplastic change-->chemical carcinogens, radiation, oncogenic viruses/microbes |
|
|
Term
| What are the steps involved in Chemical carcinogenesis? |
|
Definition
INITIATION- agents that directly or indirectly cause permanent DNA damage
PROMOTION- passing on of damaged DNA trait to subsequent generations of cells--> leads to tumorigenesis
**INITIATION must be followed by PROMOTION |
|
|
Term
| what cancers do AMINES and NITROSAMINES lead to? |
|
Definition
| Gastric carcinoma--> converted to nitrites in the stomach by bacteria, common in JAPANESE population |
|
|
Term
| Which subtypes of HPV are associated with cancer? |
|
Definition
-benign genital warts (6,11 low risk)
-cervical cancer (16,18,31 high risk)
-E6=p53 mutation
-E7=Rb mutation |
|
|
Term
HORMONAL carcinogenesis:
ESTROGEN-
CONTRACEPTIVES-
ANABOLIC STEROIDS- |
|
Definition
ESTROGEN-breast and cervical cancer
CONTRACEPTIVES- liver tumors
ANABOLIC STEROIDS- liver tumors |
|
|
Term
| What are the clinical features in a patient with a tumor? |
|
Definition
-Local or hormonal effects
-Cancer cachexia
-Para-neoplastic syndromes |
|
|
Term
|
Definition
| when you do not know the CELL OF ORIGIN of the tumor--> UNDIFFERENTIATED or POORLY DIFFERENTIATED tumors |
|
|
Term
the following TUMOR MARKERS are indications of what type of cancer?
alpha FP-
CA-125-
NSE- |
|
Definition
alpha FP-->alpha fetoprotein--> hepato-cellular carcinoma
CA-125-->ovarian carcinoma
NSE-small cell carcinoma of the lung |
|
|
Term
the following TUMOR MARKERS are indications of what type of cancer?
calcitonin-
CA 19-9-
CA 15-3- |
|
Definition
calcitonin-Medullary thyroid carcinoma
CA 19-9- Colon cancer, pancreatic cancer
CA 15-3-Breast carcinoma |
|
|
Term
| name some important EM findings in cancer- |
|
Definition
-tonofilaments
-weibel palade bodies
-neuro-secretory granules
-melanosomes
-Birbeck granules |
|
|
