Path-Neopasia V & VI
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- What is meant by Ionizing radiation?
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Electromagnetic Ray - (Xrays & gamma-rays
Particulate Radiations - alpha & beta particles, protons & neutrons - How do viruses cause carcinogenesis?
- Viruses transformed into host cell & integrated into cell cycle
- Name 3 viruses associated with cancer & which type of cancer
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HPV - cervical cancer
Eptein-Barr - Burkitt's lymphoma, B-cell lymphomas
Hep B,C & D - Liver cancer
Human T-cell Leukemia Virus Type I - Which bacteria is associated with carcinogenesis?
- Helicobactor Pylori - gastric lymphoma
- Immune surveillance?
- recognition & destruction of non-self tumor cells
- TSAs?
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Tumor-specific antigens
Present only on turmor cells and not on any normal cells
EX: Prostate screening - TAAs?
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Tumor-associated antigens
Present on tumor cells and ALSO on some normal cells. Harder to recognize & treat - Antitumor Effector Mechanisms?
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Methods of immune system to kill off tumors
Cytotoxic T
NK
Macrophages
Humoral mechanisms - What are mechanisms for the tumor to escape immunosurveillance?
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Selection outgrouth of antigen negative variants
Loss/reduced exp of HLA atigens
Lack of costimulation
Immuosuppression
Apoptosis of cytotoxic Ts - What is Cachexia?
- Wasting syndrome that can associated with neoplasm (or HIV or several other things)
- What is meant by "paraneoplastic syndromes?"
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A group of signs/symptoms caused by factors produced by tumors.
Examples: Endocrinopathies, nerve/muscle syndromes, etc - How are tumors graded?
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Based on the degree of differentiation of tumor cells & number of mitoses within tumor
I-IV with increasing anaplasia - What's an HLA?
- Human MHC Antigen - markers for "self" on human cells. Used in Tissue typing.
- Description of Grade I Neoplasm
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Well-differentiated, tumor tissue closely resemebles tissue of origin
Few mitoses, little variation in size/shape of tumor cells - Description of Grade II Neoplasm
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Moderately differentiated, doesn't resemble tissue of origin as well.
Increased mitoses & increased variation in size/shape of tumor cells - Description of Grade III & IV
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Poorly differentiated, doesn't resemble tissue of origin
Many mitoses
Large variation in size/shape of tumor cells - How are tumors "staged"?
- Based on size of primary tumor & it's extent of spread into regional lymph nodes & presence/absence of blood-borne metastases
- What are the neoplastic stages?
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TX, T0, Tis
T1, T2, T3, T4 - Describe the TX tumor stage
- Primary tumor can't be assessed - or tumor proven by presence of malignant cells in sputum/bronchial washings but can't be visualized by imaging/bronchoscopy
- T0 - what does this tumor stage mean?
- No evidence of primary tumor
- Tis - what does this tumor stage mean?
- Carcinoma in situ
- What is the T staging system?
- Part of Cancer staging system dealing with the primary *T* - size and how far it has invaded. Classified Tx (can't assess), T0 (No tumor) and T1-T4. Specifics on T staging are different for each type/location of primary tumor
- Grading vs. Staging
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Grading describes the how differentiated the tumor is.
Staging describes the primary tumor and how far it has spread - What is the N staging system?
- Part of the Cancer stage system dealing with lymph Nodes. NX - can't be assessed, N0 - no node metastasis. Goes thru N3 - Metasisis in nodes on both sides
- What is the M staging system?
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Part of Cancer staging system dealing with Metasisis
MX - can't be assessed
M0 - no distant metastasis
M1 - distant metatasis -
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Start at Slide 199, 7:35 - aj;
- How are cancers diagnosed cytologically?
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Exfoliated cells (Sputum, urine, cdf, body cavity fluids)
Brushings/scrapings of epithelium
FNA - Fine needle aspiration - Hare are cancers diagnosed histologically?
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Frozen section method
Paraffin section method
Electron microscopy
Immunoperoxidase techniques (Labeled Abs used to id marker Ags in tumors) - Is cytological or histological diagnose definitive?
- Histologic
- What information is provided by pathological diagnosis?
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Type
Biological behavior
Histologic grade
Degree of invasion/spread
Pathologic stage - How are cancers diagnosed via serum?
- Detects secreted cancer products & Ag released by dead cancer cells
- What is CEA?
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Carcinoembryonic antigen - a substance tested for in serum for diagnoses or follow-up of:
GI, breast & lung cancer.
(Can be elevelate in some non-cancerous states) - What is AFP?
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a-Fetoprotein found in serum
In Hepatoma, or yolk sac tumors - What is HCG?
- Human Chorionic Gonadotropin - greatl elevated in Choriocarcinom. Rarely elevated in other neoplasms
- What is prostatic acid phosphatase & prostate-specific epithelian antigen?
- 2 different molecules that are elevated in metastatic prostate cancer
- What is monoclonal immunoglobulin?
- Ig detected in serum with Myelomas and some B cell lymphomas
- Name4 Hormone tumor markers and assoc cancer (if any)
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HCG - trophoblastic & non-seminomatous testicular
Calcitonis - Medullary carc of thyroid
Catecholamines - Pheochromcytoma
Ectopic hormones - Paraneoplastic syndromes - Naem 3 Oncofetal Antigen tumor markers and assoc cancer (if any)
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a-fetoprotein - lever cell, non seminomatous germ cell tumor of testis
Carcinoembryonic antigen - Colon, pancrease, lung, stomach & heart - Name 2 isoenzyme tumor markers and assoc cancer (if any)
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Prostatic acid phosphatase - prostate
Neuron-specific enolase - Small cell cancer of lung, neuroblastoma - Name specific protein tumor markers and assoc cancer (if any)
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IGs - multiple myeloma & other gammopathies
Prostate-specific & Pros-spec membrane Ags - Prostate
CA-125 - Ovaria
CA-19-9 - Colon & pancreatic
CA-15-3 - Breast - What are radiologic methods of cancer diagnosis?
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Xray
CT
MRI
PET
& "Many others" - What are some of the therapies used for cancer?
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Surgery
Radiation
Chemotherapy
Immunotherapy
Radioimmunotherapy
Bone Marrow Transplat