Cancer
Terminology
H. pylori
Genes
Normal
Carcinogens: Viral, Radiation, chemicals.
Clinical effects of neoplasm
Benign: Expansile
Neoplasia: Abnormality in mechanism of control of proliferation, metabolism, apoptosis.
Metaplasia: Cell adaptation to change in environment due to constant stress/insult. Alters appearance. Reversible.
Neoplasm= tumour
Squamous metaplasia: Salivary and pancreatic stones.
Tumour suppression: P53
Apoptosis: BCL-2
Proto-oncogenes: RAS, BRAF, KIT
DNA Repair: MLH 1, PMS2, MHS2/6
Inherited mutation: BRCA1/2, APC Gene, HNPCC
HPV: High risk 16,18
Low Risk: 6,11.
Viral Proteins 6+7: Inhibit Rb+P53: Growth arrest and apoptosis inhibited
Chronic gastritis, ulcers
Curved Gram negative
Breast Cancer
Glandular: Barrat's oesophagus. Squamous to columnar
Dysplasia: Disordered growth where cells transform, increased division and incomplete maturation, loss of architecture. Can be reversed. May progress to malignant (cervical).
Metaplasia
Dysplasia
Neoplasia
Uniform cell size and shape
Normal Nuclear: cytoplasm ratio
Malignant: Converse to above, pleomorphism
Few mitoses
Nuclear Atypia
Mitoses frequency
Tubular, glandular ,acinar
1: Regular size and variation
2: Larger cells, some variability
3: Larger and bizarre forms. Vesicular nuclei
Stage: Extent of spread, prognosis and treatment
TNM Scale: Tumour size (T0-T4), Nodular spread (N1-N3), metastasis (M0/1).
Local
Hormonal- Glandular destruction or elaboration
Intussusception
Displacement
Compression
Cachexia
Hallmarks of Cancer
Sustained angiogenesis
Tissue invasion and metastasis
Limitless replicative potential
Reprogramming of energy metabolism
Evasion of apoptosis
Evasion of immune cells
Insensitivity to anti-growth signals
Self sufficiency in growth signals
Cell Cycle
S Phase: DNA copy, 2 sister chromatids
G1: Increase organelles and proteins
G2: Preparation for divison- All DNA replicated?
Mitosis: Segregation. Chromosomes aligned?
DNA ready? Cell size correct? Environment optimal?
G0: Not in cell cycle. Can return unless post-mitotic (Cardiac/ neurone). Are cells required?