Cancer Biology Quiz

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Questions and Answers

What characteristic distinguishes benign tumors from malignant tumors?

  • They are always lethal to patients.
  • They are derived from the Latin word for 'crab'.
  • They remain localized and do not metastasize. (correct)
  • They always invade adjacent tissues.

Which term describes the process by which cancer cells spread to distant sites?

  • Invasion
  • Metastasis (correct)
  • Initiation
  • Promotion

What step in multistep carcinogenesis involves a permanent change in DNA?

  • Promotion
  • Malignancy
  • Progression
  • Initiation (correct)

Which of the following is NOT considered a tumor promoter in cancer development?

<p>Stress (A)</p> Signup and view all the answers

What is the primary feature of malignant tumors compared to benign tumors?

<p>They can cause significant morbidity and are harder to manage. (D)</p> Signup and view all the answers

Which phase of carcinogenesis involves the acquisition of additional mutations leading to invasive cancer?

<p>Progression (C)</p> Signup and view all the answers

During which process do abnormal cancer cells invade neighboring tissues?

<p>Invasion (C)</p> Signup and view all the answers

What is the definition of metastasis in the context of cancer?

<p>The release of cancer cells into the bloodstream to form secondary tumors. (C)</p> Signup and view all the answers

Which virus is primarily linked to cervical cancer?

<p>Human papillomavirus (B)</p> Signup and view all the answers

What is a significant non-modifiable risk factor for cancer?

<p>Age (C)</p> Signup and view all the answers

Which of the following is a characteristic of a weakened immune system related to cancer risk?

<p>Greater susceptibility to some types of cancer (B)</p> Signup and view all the answers

What concept was introduced by Douglas Hanahan and Robert Weinberg in their paper published in 2000?

<p>The hallmarks of cancer (A)</p> Signup and view all the answers

What commonly misunderstood aspect relates to carcinogens?

<p>They can also affect genetic mutations (B)</p> Signup and view all the answers

Which of the following bacterial infections is associated with an increased risk of stomach cancer?

<p>Helicobacter pylori (D)</p> Signup and view all the answers

Which statement about genetic predisposition to cancer is true?

<p>It increases the likelihood of specific types of cancer (C)</p> Signup and view all the answers

Which of the following best describes the expanded understanding of cancer hallmarks since 2000?

<p>They have been increased to eight capabilities and two enabling capabilities (A)</p> Signup and view all the answers

What is primarily responsible for the self-sufficiency in growth signals in tumors?

<p>Gain-of-function mutations in proto-oncogenes (D)</p> Signup and view all the answers

Which hallmark characteristic is NOT one of the original hallmarks of cancer as proposed by Weinberg and Hanahan?

<p>Abnormal metabolic pathways (C)</p> Signup and view all the answers

How does RAS contribute to tumor growth according to the content?

<p>By blocking hydrolysis of GTP to GDP (A)</p> Signup and view all the answers

In what way do the recruited normal cells in a tumor contribute to cancer?

<p>They create a conducive tumor microenvironment. (B)</p> Signup and view all the answers

Which function does inflammation NOT serve in the context of the hallmarks of cancer?

<p>Facilitating apoptosis of cancer cells (A)</p> Signup and view all the answers

Which is NOT considered one of the enabling characteristics of cancer?

<p>Genome stability (C)</p> Signup and view all the answers

Which component plays a critical role in the activation of signal transduction pathways downstream of growth factor receptors?

<p>GTP-binding proteins (C)</p> Signup and view all the answers

What effect does genome instability have on cancer cells?

<p>It enhances the acquisition of hallmark traits. (A)</p> Signup and view all the answers

Which diagnostic method is primarily used for the detection of cervical carcinoma?

<p>Cytopathological examination (A)</p> Signup and view all the answers

What does immunohistochemistry primarily help determine about a tumor?

<p>Specific proteins and tumor nature (D)</p> Signup and view all the answers

Which cytological method is most commonly used with palpable lesions such as the breast or lymph nodes?

<p>Fine-needle aspiration cytology (A)</p> Signup and view all the answers

What type of biopsy involves the removal of a small tissue sample for examination?

<p>Needle biopsy (C)</p> Signup and view all the answers

What classification method is used routinely for leukemias and lymphomas?

<p>Flow Cytometry (B)</p> Signup and view all the answers

Which of the following is NOT a benefit of using immunohistochemistry?

<p>Providing genomic sequencing information (D)</p> Signup and view all the answers

Which tumor marker is specifically used to monitor prostate cancer?

<p>Prostate-specific antigen (PSA) (D)</p> Signup and view all the answers

Which method uses spontaneously exfoliated cells for cancer detection?

<p>Exfoliative cytology (A)</p> Signup and view all the answers

What molecular technique is used primarily to detect genetic changes and chromosomal abnormalities?

<p>Fluorescence in situ hybridization (FISH) (B)</p> Signup and view all the answers

In histopathological examination, what is typically obtained for diagnosis?

<p>Tissue samples (D)</p> Signup and view all the answers

Which of the following is NOT a function of tumor markers?

<p>Diagnose hereditary predisposition (D)</p> Signup and view all the answers

Which tumor marker is primarily associated with pancreatic cancer?

<p>Carbohydrate antigen 19-9 (CA19-9) (A)</p> Signup and view all the answers

Which of the following molecular techniques is considered advanced for reading DNA quickly?

<p>Next-generation sequencing (NGS) (B)</p> Signup and view all the answers

What is the role of tumor suppressor genes in cell cycle regulation?

<p>They encode proteins that help repair DNA damage. (B)</p> Signup and view all the answers

Which of the following is a known carcinogen associated with adenocarcinoma of the lung?

<p>Asbestos (C)</p> Signup and view all the answers

Which statement best describes the Warburg effect in cancer cells?

<p>Cancer cells rely on lactic acid fermentation despite having oxygen. (C)</p> Signup and view all the answers

What is the main purpose of using tumor markers in cancer care?

<p>To monitor and evaluate treatment effectiveness (B)</p> Signup and view all the answers

Which of the following statements about carcinogenesis is correct?

<p>Carcinogenesis occurs in multiple steps. (C)</p> Signup and view all the answers

What happens when a DNA damaged cell attempts to divide?

<p>Tumor suppressor proteins halt its proliferation. (C)</p> Signup and view all the answers

How do cancer cells typically alter their metabolism for growth?

<p>They prefer lactic acid fermentation even with oxygen available. (D)</p> Signup and view all the answers

What is a key characteristic of the intrinsic pathway of apoptosis in cancer cells?

<p>Progression through the intrinsic pathway is often disrupted. (C)</p> Signup and view all the answers

What is the primary consequence of the inactivation of tumor suppressor genes in cancer?

<p>Uncontrolled proliferation of mutated cells. (A)</p> Signup and view all the answers

Which tumor suppressor gene is commonly known as the 'Guardian of the genome'?

<p>p53 gene (B)</p> Signup and view all the answers

What is the main role of second messengers in signal transduction?

<p>To transmit signals from receptors to nuclear regulatory factors. (C)</p> Signup and view all the answers

What phase of the cell cycle involves both chromosome duplication and preparation for mitosis?

<p>S phase (A)</p> Signup and view all the answers

Which phase of the cell cycle is the shortest in duration?

<p>M phase (B)</p> Signup and view all the answers

During which phase of the cell cycle does a cell double in size?

<p>G1 phase (D)</p> Signup and view all the answers

Which of the following correctly describes interphase?

<p>The longest stage of the cell cycle (B)</p> Signup and view all the answers

What is the primary activity that occurs during G2 phase of the cell cycle?

<p>Preparation for mitosis (D)</p> Signup and view all the answers

What significant event occurs during the M phase of the cell cycle?

<p>Chromosome segregation takes place (A)</p> Signup and view all the answers

Which statement about the S phase is true?

<p>DNA is synthesized during this phase (C)</p> Signup and view all the answers

What is primarily synthesized during the G1 phase of the cell cycle?

<p>RNA and proteins (C)</p> Signup and view all the answers

What is a consequence of mutations in the p53 tumor suppressor gene?

<p>Decreased apoptosis rates in cells (A), Increased susceptibility to genetic damage (D)</p> Signup and view all the answers

Which statement accurately describes Rb in the context of cancer?

<p>Rb is classified as a tumor suppressor gene. (A), Rb is involved in regulating the G1 to S phase transition. (C)</p> Signup and view all the answers

How do RAS mutations influence cell proliferation?

<p>They lead to overactive cell signaling pathways. (B)</p> Signup and view all the answers

What role does p53 play concerning cellular stress and potential cancer development?

<p>It coordinates DNA repair and cell cycle arrest. (A)</p> Signup and view all the answers

Which of the following is a common characteristic of tumor suppressor genes like p53 and Rb?

<p>They are involved in inhibiting cancerous cell formation. (A)</p> Signup and view all the answers

What is the primary role of the Rb protein in the cell cycle?

<p>Inhibiting transcription of genes required for cell cycle progression (D)</p> Signup and view all the answers

According to Knudson's two-hit hypothesis, which of the following is true regarding retinoblastoma?

<p>In inherited cases, the first mutation is typically inherited. (D)</p> Signup and view all the answers

What types of tumors are associated with mutations in the Rb gene?

<p>Retinoblastoma and osteosarcoma (B)</p> Signup and view all the answers

Which statement best describes the nature of mutations in retinoblastoma?

<p>Different types of mutations can lead to different forms of retinoblastoma. (A)</p> Signup and view all the answers

What is the impact of Rb protein on E2F proteins during the G1 phase?

<p>Rb binds to E2F, inactivating its ability to drive the cell cycle. (C)</p> Signup and view all the answers

In non-inherited retinoblastoma, how many mutations must occur?

<p>Two mutations are required for tumor development. (A)</p> Signup and view all the answers

What chromosome is the Rb gene located on?

<p>Chromosome 13 (D)</p> Signup and view all the answers

Which phase of the cell cycle does the Rb protein primarily regulate?

<p>G1 phase (C)</p> Signup and view all the answers

What triggers the conformational change in Ras that allows it to bind GTP?

<p>Binding of extracellular signals to cell surface receptors (C)</p> Signup and view all the answers

What is the role of activated ERK in the cellular response to Ras activation?

<p>Translocation to the nucleus to phosphorylate transcription factors (D)</p> Signup and view all the answers

Which of the following pathways is primarily initiated by active Ras proteins?

<p>MAPK/ERK pathway (B)</p> Signup and view all the answers

How does Ras contribute to cell proliferation?

<p>By stimulating the expression of genes that promote cell cycle progression (B)</p> Signup and view all the answers

What is the primary difference between GDP and GTP in the context of Ras activation?

<p>GTP promotes a conformational change in Ras (A)</p> Signup and view all the answers

Which of the following best describes the classification of oncogenes related to Ras signaling?

<p>Cytoplasmic signal transduction molecules, including Ras, are classified as oncogenes (D)</p> Signup and view all the answers

What is a major consequence of active Ras signaling in the context of gene regulation?

<p>Transcriptional regulation leading to changes in gene expression (C)</p> Signup and view all the answers

Which signaling molecule is NOT directly activated by Ras in downstream signaling?

<p>Caspase (C)</p> Signup and view all the answers

What is the primary decision made at the G1 phase of the cell cycle?

<p>The cell enters the G0 phase or proceeds to S phase (B)</p> Signup and view all the answers

What characterizes the S phase in the cell cycle?

<p>The DNA is replicated resulting in chromatids (B)</p> Signup and view all the answers

What is the role of the G2 checkpoint in the cell cycle?

<p>To ensure DNA replication has occurred correctly (A)</p> Signup and view all the answers

What happens to the chromosomes during the S phase?

<p>They are replicated, resulting in two sets of chromatids (B)</p> Signup and view all the answers

Which of the following describes the transition between the G1 phase and the S phase?

<p>The cell commits to division at the restriction point (B)</p> Signup and view all the answers

What effect does point mutation in protein kinases like Src have on substrate specificity?

<p>It broadens substrate specificity to include new mitogenic proteins. (C)</p> Signup and view all the answers

Which of the following statements about gene amplification is correct?

<p>It is an increase in the number of gene copies, often resulting in overproduction of proteins. (B)</p> Signup and view all the answers

What key factor is checked at the G2 checkpoint to ensure the cell can proceed to mitosis?

<p>Presence of mitosis promoting factor (MPF) (D)</p> Signup and view all the answers

What is the primary consequence of errors in DNA repair or chromosome segregation?

<p>Changes in chromosome structure or number that increase gene copy number. (D)</p> Signup and view all the answers

In which phase are the original chromosomes and their duplicates connected at the centromere?

<p>S phase (D)</p> Signup and view all the answers

How does the RAS gene primarily contribute to tumor development?

<p>Through point mutations that activate signaling pathways. (D)</p> Signup and view all the answers

Which of the following statements best describes the G0 phase?

<p>It allows some cells to exit the active cell cycle phase (C)</p> Signup and view all the answers

Which statement describes the function of GAPs in relation to Ras?

<p>GAPs inactivate Ras by stimulating GTP hydrolysis. (B)</p> Signup and view all the answers

Which of the following cancers is most commonly associated with mutations in the RAS gene?

<p>Cholangiocarcinoma. (B)</p> Signup and view all the answers

What results from the GDP-bound form of Ras?

<p>It is in an inactive state preventing signal transduction. (D)</p> Signup and view all the answers

Which statement about GEFs in relation to Ras is accurate?

<p>GEFs activate Ras by facilitating its exchange of GDP for GTP. (D)</p> Signup and view all the answers

Which cancers exhibit a substantially increased risk due to BRCA1 mutations?

<p>Epithelial ovarian cancers and prostate cancer (D)</p> Signup and view all the answers

What is a common feature of ER-positive breast cancers?

<p>Involvement of chromosomal gains and losses (B)</p> Signup and view all the answers

Which type of breast cancer is primarily associated with loss of BRCA1 function?

<p>Basal-like tumors (C)</p> Signup and view all the answers

Which imaging test is useful for distinguishing solid masses from fluid-filled cysts?

<p>Ultrasound (D)</p> Signup and view all the answers

What cellular consequence is associated with defective versions of BRCA1 and BRCA2 genes?

<p>Development of chromosomal breaks and severe aneuploidy (C)</p> Signup and view all the answers

Which condition is NOT a precursor lesion for ER-positive cancers?

<p>Atypical apocrine adenosis (D)</p> Signup and view all the answers

What is true regarding BRCA2 mutations?

<p>Enhance risk for cancers in both genders (B)</p> Signup and view all the answers

What diagnostic method provides detailed images especially useful for high-risk breast cancer patients?

<p>MRI (C)</p> Signup and view all the answers

What characterizes nonproliferative fibrocystic change in the breast?

<p>It features localized dilatation of ducts and cyst formation. (D)</p> Signup and view all the answers

Which statement about fibroadenomas is true?

<p>They usually present as solitary tumors detected during mammography. (B)</p> Signup and view all the answers

Which HPV types are primarily associated with the development of condylomas in the lower genital tract?

<p>Types 6 and 11 (C)</p> Signup and view all the answers

What is the primary factor that influences the prognosis for invasive breast carcinoma?

<p>The molecular characteristics of the carcinoma cells. (D)</p> Signup and view all the answers

Which type of carcinoma is a precursor lesion for ductal carcinoma?

<p>Ductal carcinoma in situ. (B)</p> Signup and view all the answers

Which diagnostic procedure uses a magnifying instrument to examine abnormal areas of the cervix?

<p>Colposcopy (B)</p> Signup and view all the answers

How do cystic changes in breast tissue typically arise?

<p>Due to irregularities in response to menstrual cycle variations. (A)</p> Signup and view all the answers

What is the primary purpose of regular Pap Smears and HPV Testing in cervical cancer prevention?

<p>To detect precancerous changes or infections early (C)</p> Signup and view all the answers

Which statement about lobular carcinomas is accurate?

<p>They arise chiefly from the lobules of the breast. (D)</p> Signup and view all the answers

Which surgical procedure is aimed specifically at removing a cone-shaped section of abnormal cervical tissue?

<p>Conization (B)</p> Signup and view all the answers

What type of therapy uses drugs that specifically target pathways utilized by cancer cells to promote growth?

<p>Targeted Therapy (C)</p> Signup and view all the answers

What typically happens to nonproliferative fibrocystic changes after menopause?

<p>They often recede. (A)</p> Signup and view all the answers

What type of breast carcinoma represents over 90% of cases and arises from the ducts?

<p>Ductal carcinoma. (C)</p> Signup and view all the answers

Which prevention strategy is recommended to significantly reduce the risk of HPV infection?

<p>HPV Vaccination (D)</p> Signup and view all the answers

What is the purpose of Endocervical Curettage in cervical diagnostics?

<p>To scrape cells from the cervical canal (B)</p> Signup and view all the answers

What type of cancer treatment is often combined with chemotherapy to enhance the destruction of cancer cells?

<p>Radiation Therapy (A)</p> Signup and view all the answers

What is the primary purpose of hormone receptor tests in cancer diagnosis?

<p>To check if cancer cells have specific hormone receptors (C)</p> Signup and view all the answers

Which surgical procedure involves the removal of a tumor along with some surrounding tissue?

<p>Lumpectomy (B)</p> Signup and view all the answers

What is the action of immunotherapy in cancer treatment?

<p>To enhance the body's immune response against cancer cells (D)</p> Signup and view all the answers

Which of the following is NOT a common recommendation to reduce the risk of breast cancer?

<p>Increased consumption of processed foods (B)</p> Signup and view all the answers

Which treatment specifically targets the HER2 protein in certain breast cancers?

<p>Trastuzumab (D)</p> Signup and view all the answers

What is the main goal of neoadjuvant chemotherapy?

<p>To shrink tumors before surgery (B)</p> Signup and view all the answers

What type of therapy is primarily intended for cancers that have metastasized to the bone?

<p>Bone-directed therapy (C)</p> Signup and view all the answers

What is primarily responsible for the formation of neuritic plaques in Alzheimer's disease?

<p>Deposits of β-amyloid fragments (B)</p> Signup and view all the answers

Which of the following is a key dietary recommendation for reducing breast cancer risk?

<p>Eating a diet rich in fruits and vegetables (A)</p> Signup and view all the answers

Which enzyme is NOT involved in the cleavage of amyloid precursor protein (APP)?

<p>δ-secretase (B)</p> Signup and view all the answers

What change occurs to tau protein in Alzheimer's disease?

<p>It shifts to a somatic-dendritic distribution. (D)</p> Signup and view all the answers

What is the primary abnormality associated with Alzheimer’s disease?

<p>Accumulation of β-amyloid and tau (C)</p> Signup and view all the answers

Which statement about neurofibrillary tangles in Alzheimer’s disease is correct?

<p>They are aggregates of hyperphosphorylated tau protein. (D)</p> Signup and view all the answers

What is the consequence of tau protein losing its ability to bind to microtubules in Alzheimer's disease?

<p>Formation of neurofibrillary tangles (C)</p> Signup and view all the answers

What is a secondary effect of the accumulation of plaques and tangles in Alzheimer's disease?

<p>Neuron death and dysfunction (C)</p> Signup and view all the answers

Which protein does the amyloid precursor protein (APP) lead to the production of when cleaved by the appropriate enzymes?

<p>β-amyloid (B)</p> Signup and view all the answers

What role does the E6 protein play in oncogenesis?

<p>It binds to p53, leading to its degradation. (C)</p> Signup and view all the answers

Which consequence arises from the integration of the HPV genome into the host genome?

<p>Overexpression of E6 and E7 oncoproteins. (D)</p> Signup and view all the answers

What characteristic distinguishes high-risk HPV types from low-risk types?

<p>Increased affinity for p53 and RB proteins. (D)</p> Signup and view all the answers

How does the E7 protein contribute to tumorigenesis?

<p>By displacing E2F transcription factors from RB. (A)</p> Signup and view all the answers

What is the primary consequence of the persistence of high-risk HPV types in infected individuals?

<p>Increased risk of progression to cancer. (B)</p> Signup and view all the answers

Which factor is primarily linked to the pro-oncogenic mutations in host cancer genes?

<p>Integration of the HPV genome into the host genome. (B)</p> Signup and view all the answers

Which types of HPV are primarily responsible for the majority of cervical carcinoma cases?

<p>Types 16 and 18. (C)</p> Signup and view all the answers

What impact does HPV infection have on the host cell cycle regulation?

<p>It accelerates progression through the G1-S checkpoint. (D)</p> Signup and view all the answers

Flashcards

Benign Tumor

A type of tumor characterized by its relatively slow growth, localized nature, and ability to be easily removed surgically. Generally, these tumors are non-life-threatening, but they may still cause problems.

Malignant Tumors

Tumors that exhibit rapid growth, invasion into surrounding tissues, and the potential to spread to distant sites (metastasize). These tumors can be life-threatening.

Metastasis

The process by which cancer cells spread from the original tumor site to other parts of the body.

Invasion

When cancer cells invade and destroy nearby tissues by directly migrating and growing into them.

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Initiation

The first step in cancer development, involving a permanent change in DNA caused by a carcinogen.

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Promotion

The second step in cancer development, where a promoted cell is stimulated to grow and multiply. Examples of tumor promoters include alcohol, high estrogen, and dietary fat.

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Progression and Malignancy

The final stage of cancer development, where an initiated cell undergoes multiple mutations, leading to malignancy and invasive cancer.

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Metastasis: The Journey of a Cancer Cell

The process by which a cancer cell travels to a distant site through the bloodstream or lymphatic system, establishing a new tumor (metastasis).

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Viral Infections and Cancer Risk

Viral infections, such as HPV, Hepatitis B and C, and Epstein-Barr, can increase the risk of developing certain cancers.

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Bacterial Infections and Cancer

Certain bacteria, like Helicobacter pylori, can cause inflammation in the stomach, which increases the risk of stomach cancer.

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Age and Cancer Risk

The risk of developing cancer increases with age due to increased exposure to carcinogens and time for genetic mutations to occur.

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Carcinogens

Substances that alter cell behavior, increasing the likelihood of cancer development.

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Genetic Predisposition to Cancer

Inherited genetic variations that increase the risk of developing specific types of cancer.

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Immune System and Cancer

People with weakened immune systems are more susceptible to developing some cancers due to their compromised ability to fight off diseases.

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Hallmarks of Cancer

A set of acquired properties in cancer cells that contribute to their growth, survival, and spread.

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What are the hallmarks of cancer?

The hallmarks of cancer are a group of eight biological capabilities acquired during cancer development. These capabilities allow cancer cells to grow uncontrollably, invade other tissues, and spread throughout the body.

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Gain-of-function mutation

A type of gene mutation that changes a normal proto-oncogene into an oncogene, promoting uncontrolled cell growth.

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Proto-oncogenes

Genes that encode proteins that promote cell growth and proliferation in a regulated manner.

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Oncogenes

Genes that arise from mutations in proto-oncogenes, leading to uncontrolled cell growth and cancer.

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Oncoproteins

Proteins produced by oncogenes that promote cell growth and proliferation even in absence of normal regulatory signals.

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Mutations in signaling pathways

Mutations in genes encoding signaling components downstream of growth factor receptors, granting cells independence from normal growth signals.

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RAS oncogene

The most frequently mutated oncogene in human cancers, responsible for uncontrolled cell growth by promoting uncontrolled signaling.

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Autocrine growth factor production

The process where cancer cells produce their own growth factors, stimulating their own growth and proliferation.

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Paracrine growth factor production

The process where cancer cells induce nearby stromal cells to produce growth factors, creating a favorable environment for their own growth.

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What do tumor suppressor genes do?

Tumor suppressor genes are key proteins that regulate cell cycle checkpoints, ensuring DNA is repaired before proceeding with cell division. If DNA repair is impossible, these genes trigger cell death (apoptosis).

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What happens when tumor suppressor genes are inactivated?

When tumor suppressor genes are inactivated, they lose their ability to control cell division, leading to uncontrolled growth of mutated cells.

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How does cancer cell metabolism differ from normal cells?

Cancer cells have higher glucose uptake than normal cells, preferring lactic acid fermentation even in the presence of oxygen. This 'glucose-hunger' rapidly produces building blocks for rapid growth.

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What is the Warburg effect?

The Warburg effect is the phenomenon where cancer cells prioritize fermentation, even with oxygen, to get quick building blocks for growth, unlike normal cells that use respiration for energy.

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What is apoptosis?

Apoptosis is a programmed cell death process that eliminates damaged or unwanted cells, crucial for maintaining tissue integrity.

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How do cancer cells evade apoptosis?

Cancer cells often evade apoptosis by interfering with its pathways, especially the intrinsic (mitochondrial) pathway. Preventing cell death is a key survival strategy for cancer.

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How is the signal to divide transmitted from the cell surface to the nucleus?

Second messengers or signal transduction molecules relay signals from the cell surface to the nucleus, activating regulatory factors that initiate DNA transcription and protein synthesis required for cell division.

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How does the cell cycle relate to tumor suppressors?

Cell cycle progression involves a series of stages regulated by checkpoints, ensuring proper DNA replication and division. Tumor suppressor genes monitor these checkpoints.

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What are carcinogens?

These are substances that can cause cancer, damaging DNA and leading to uncontrolled cell growth.

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What is metastasis?

This is the spread of cancer cells from the original tumor to other parts of the body, forming new tumors.

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What is molecular diagnosis?

This involves testing for specific genetic changes or alterations in cells that can indicate the presence of cancer.

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What is carcinogenesis?

This is the process by which normal cells transform into cancerous cells, involving multiple steps and changes in the cell's DNA.

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What are tumor promoters?

These are substances that promote the growth and development of cancer cells, even after initiation.

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What are tumor markers?

They are produced by tumor cells and can be found in the blood or other bodily fluids, helping to monitor cancer progression or treatment effectiveness.

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What is Polymerase Chain Reaction (PCR)?

This is a test used to detect and amplify specific DNA sequences linked to cancer, helping in diagnosis and monitoring.

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What is Fluorescence in situ hybridization (FISH)?

This technique uses fluorescent probes to detect specific genetic abnormalities or chromosomal changes within cells.

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Histopathological Examination

A type of laboratory test that examines the microscopic features of a tumor to determine its characteristics, such as its type and growth pattern.

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Flow Cytometry

Used to classify leukemias and lymphomas. In this method, antibodies labeled with fluorescent dyes are used to identify specific proteins on the surface of malignant cells.

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Immunohistochemistry

A powerful technique used in conjunction with routine histologic examination to identify specific proteins in tissue sections. Antibodies are used to bind to these proteins, allowing for their visualization.

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Cytopathological Examination

A type of laboratory test where a sample of cells is collected from a suspected tumor and examined under a microscope. These smears are often used to diagnose cervical cancer.

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Fine-Needle Aspiration Cytology

The process where a thin needle is inserted into a tumor or suspicious area to collect cells for examination.

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Exfoliative Cytology

Collecting cells that have naturally shed from a body cavity, such as the lining of an organ, for laboratory examination

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Immunosuppression and Cancer Risk

Patients with weakened immune systems are more susceptible to developing certain types of cancer because they lack the ability to effectively fight off infections and harmful cells.

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Viral Infections and Cancer in Immunosuppressed Patients

Cancer caused by specific DNA viruses is often seen in immunosuppressed patients because viruses may replicate and cause harm unchecked due to a weakened immune response.

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What is the purpose of the cell cycle?

The basic function of the cell cycle is to duplicate DNA and then separate the copies into two identical daughter cells.

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What happens during the S phase?

The S phase is dedicated to DNA synthesis, copying all the genetic material. This crucial step takes about half of the cell's total cycle time.

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What does the M phase consist of?

The M phase is when the cell separates chromosomes and divides itself. This phase includes mitosis (nuclear division) and cytokinesis (cytoplasmic division).

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What are the phases of the cell cycle?

The cell cycle features four main phases: G1, S, G2, and M. G1, S, and G2 together are called interphase. This is the longest stage of the cell cycle.

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What happens during the G1 phase?

The G1 phase is a growth phase where the cell synthesizes proteins and mRNA in preparation for mitosis. It also duplicates its organelles.

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How long does DNA synthesis (S phase) take?

The S phase requires 10-12 hours in mammalian cells, representing a significant portion of the cell cycle.

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How long does mitosis (M phase) take?

The M phase usually takes less than an hour in mammalian cells, making it much shorter than interphase.

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How does the cell cycle relate to tumor suppressor genes?

The cell cycle consists of a series of phases that ensure proper DNA replication and division. Tumor suppressor genes play a vital role in monitoring these checkpoints.

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G1 Restriction Point

A critical checkpoint that determines if a cell will continue dividing or enter a resting state. It checks for favorable conditions and the necessary requirements for cell division.

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G0 Phase

A resting phase where cells exit the cell cycle and enter a state of inactivity. Some cells only spend a short time here, while others never divide.

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S Phase

The phase where DNA replication occurs. The cell focuses on doubling its genetic material and preparing for division.

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G2 Phase

The second growth phase where the cell prepares for mitosis. It ensures enough proteins and organelles are ready for cell division.

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G2 Checkpoint

A checkpoint at the end of G2 phase that makes sure the cell is ready for mitosis. It checks for the presence of a specific protein called Mitosis Promoting Factor (MPF).

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M Phase

The final stage of the cell cycle where the cell divides into two daughter cells. It consists of mitosis and cytokinesis.

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Mitosis

The process within M phase where the duplicated chromosomes condense and separate into two identical sets, ensuring each daughter cell receives a complete copy of the genome.

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Cytokinesis

The process where the cytoplasm divides, creating two distinct daughter cells after mitosis. It completes the cell division process.

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What is Ras?

Ras is a small GTPase. The active form of Ras is bound to GTP and the inactive form is bound to GDP. GAPs inactivate Ras by stimulating the hydrolysis of bound GTP to GDP.

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What is the function of GAPs?

GAPs (GTPase activating proteins) inactivate Ras by stimulating the hydrolysis of GTP to GDP. The inactivated Ras is tightly bound to GDP.

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What is the function of GEFs?

GEFs (guanine nucleotide exchange factors) activate Ras by promoting the exchange of GDP for GTP.

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How common are RAS mutations in cancer?

Mutated RAS oncogenes can contribute to 15-20% of human cancers with high rates in cancers of the pancreas and colon.

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Why are RAS mutations important?

Point mutations in RAS are the most common abnormality found in human tumors. These mutations can make Ras constitutively active, meaning it is always switched on, leading to uncontrolled cell growth.

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What type of mutations occur in RAS?

Point mutations in the RAS gene lead to a single amino acid change in the protein, preventing the GTPase activity of the protein making it constitutively active. These mutations can lead to uncontrolled cell growth and the development of cancer.

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What is gene amplification?

Gene amplification can increase the copy number of a gene. Myc is a mitogenic gene regulatory protein that is often overproduced in cancer cells due to gene amplification.

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How can errors in DNA replication contribute to cancer?

Errors during DNA replication and repair can lead to changes in chromosome structure or number. These changes can increase the copy number of genes and drive cancer development.

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Knudson's Two-Hit Hypothesis

A process where two separate mutations are required to inactivate a tumor suppressor gene, leading to uncontrolled cell growth and cancer development.

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Retinoblastoma Gene (Rb Gene)

A gene located on chromosome 13 that functions as a tumor suppressor. It is involved in regulating cell cycle progression and preventing uncontrolled cell growth.

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Rb Protein

A protein that plays a crucial role in regulating the cell cycle by stopping cell division at the G1 checkpoint. It binds and inactivates E2F proteins, which are essential for the expression of genes related to DNA replication and cell cycle progression.

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E2F Proteins

A family of transcription factors that are essential for the expression of genes required for DNA replication and cell cycle progression. Rb proteins bind to and inhibit their activity.

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Retinoblastoma

A type of cancer that affects the eye, particularly in children. It is caused by mutations in the Rb gene, resulting in uncontrolled cell growth and tumor formation.

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Hereditary Retinoblastoma

Occurs when the first mutation in the Rb gene is inherited from a parent, making the individual predisposed to developing retinoblastoma.

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Sporadic Retinoblastoma

Occurs when both mutations in the Rb gene are acquired during an individual's lifetime, leading to a later onset of retinoblastoma.

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Tumor Suppressor Genes (TSGs)

Genes responsible for regulating cell growth and division. Their inactivation removes the brake on cell division, leading to uncontrolled cell growth and cancer.

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How is Ras activated?

Ras proteins are activated when they bind to GTP, switching to their active state. They then activate downstream signaling pathways.

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What's the MAPK/ERK pathway?

One of the major signaling pathways activated by Ras is the MAPK/ERK pathway, crucial for cell growth and differentiation. This pathway involves a chain of proteins (Raf, MEK, ERK) that relay the signal.

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What cellular responses are influenced by activated Ras?

Active Ras proteins promote cell division, prevent programmed cell death (apoptosis), and regulate cell differentiation.

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What is an oncogene?

A mutated gene that promotes uncontrolled cell growth and proliferation, frequently found in various cancers.

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What is a proto-oncogene?

A proto-oncogene is a normal gene that controls cell growth and proliferation. A mutation in this gene can transform it into an oncogene, leading to uncontrolled cell growth.

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What is the cell cycle?

A tightly regulated series of events that ensures proper growth and division of cells, involving DNA replication and cell division.

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What is the RAS oncogene?

A type of oncogene, often mutated in various cancers, particularly in cancers related to signaling pathways, like the one involving Ras.

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Tumor Suppressor Gene

A gene that protects against cancer by controlling cell growth and division, preventing uncontrolled cell proliferation.

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p53

A tumor suppressor gene that acts as a transcription factor, regulating genes involved in cell cycle control and DNA repair. It can arrest the cell cycle if DNA is damaged, allowing for repair.

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Rb

A tumor suppressor gene that plays a critical role in regulating the cell cycle by inhibiting the activity of transcription factors necessary for cell cycle progression, preventing uncontrolled cell division.

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RAS

A proto-oncogene that becomes an oncogene when mutated. It plays a significant role in cellular signaling pathways, and mutations can lead to excessive cell growth and division.

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BRCA1 and BRCA2 mutations

BRCA1 and BRCA2 are genes that help repair damaged DNA. Mutations in these genes increase the risk of developing certain cancers, including breast, ovarian, prostate, and others.

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ER-positive breast cancer

ER-positive breast cancers are a type of breast cancer that is sensitive to estrogen. They often have certain genomic changes, like gains of chromosome 1 and losses of chromosome 16.

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HER2-overexpressed breast cancer

HER2-overexpressed breast cancer is caused by an overabundance of the HER2 protein, usually due to gene amplification. These cancers may be positive or negative for estrogen sensitivity.

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Basal-like tumor

Basal-like tumors are a type of breast cancer that is negative for estrogen receptors and HER2. They are genomically unstable and often have a loss of function in BRCA1 and TP53.

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Mammogram

A mammogram is an X-ray of the breast used to detect abnormalities. It's a common screening tool for breast cancer.

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Breast Ultrasound

An ultrasound uses sound waves to create an image of the breast, helping differentiate between solid masses and cysts. It is another common screening tool.

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Biopsy

A biopsy is a procedure where a sample of tissue is taken and examined under a microscope to determine if cancer cells are present.

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Clinical Breast Exam

A clinical breast exam is a manual check by a healthcare professional to detect lumps or other abnormalities in the breast.

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Core Needle Biopsy

A type of biopsy that removes a small cylinder of tissue using a larger needle.

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Surgical Biopsy

A type of biopsy that removes a part or all of a suspicious lump for examination.

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Fine-Needle Aspiration

A type of biopsy that uses a thin needle to extract cells or fluid.

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Sentinel Lymph Node Biopsy

A procedure that checks if cancer has spread to lymph nodes.

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Axillary Lymph Node Dissection

A procedure that removes additional lymph nodes if cancer is found during the sentinel lymph node biopsy.

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Chemotherapy

A type of therapy that uses drugs to destroy cancer cells, either before or after surgery.

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Radiation Therapy

A type of therapy that uses high-energy rays to kill cancer cells.

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Hormonal (Endocrine) Therapy

A type of therapy that blocks hormones that fuel cancer growth.

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Fibrocystic Change

A common benign condition in the breast, usually appearing in women between 20 and menopause. It involves the growth of glandular and fibrous tissue, leading to cysts within the breast.

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Fibroadenoma

The most typical benign tumor in the female breast, often occurring between the ages of 30 and 40. It involves both epithelial (glandular) and stromal tissue.

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Ductal Carcinoma

A type of breast cancer arising from the epithelium of milk ducts. It is the most common form of breast cancer.

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Ductal Carcinoma in Situ (DCIS)

A non-invasive form of breast cancer, primarily affecting the milk ducts. It is considered a precursor to invasive ductal carcinoma.

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Lobular Carcinoma in Situ (LCIS)

A non-invasive form of breast cancer originating in the milk-producing lobules. It is considered a precursor to invasive lobular carcinoma.

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Lobular Carcinoma

This type of breast cancer arises from the milk-producing lobules, unlike ductal carcinoma. It is less common but often presents with a more widespread pattern.

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Rb Gene

A key player in the regulation of cell division. It's a tumor suppressor gene that acts like a brake on cell growth, preventing uncontrolled proliferation.

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p53 Gene

A tumor suppressor gene that acts as a 'guardian of the genome.' It plays a crucial role in controlling cell cycle progression and promoting DNA repair.

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What does HPV E6 do?

HPV E6 protein promotes the degradation of the tumor suppressor protein, p53.

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What is different about E6 from high-risk HPV?

The E6 protein from high-risk HPV types has a stronger affinity for p53 compared to E6 from low-risk HPV types.

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What does HPV E7 do?

HPV E7 protein binds to and disables the RB protein, leading to uncontrolled cell growth.

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How is high-risk E7 different from low-risk?

E7 proteins from high-risk HPV types have a higher affinity for RB than those from low-risk types.

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Why is HPV integration important?

HPV integration into the host genome disrupts a negative regulatory region, leading to overexpression of the E6 and E7 oncoproteins.

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Why are high-risk HPVs dangerous?

High-risk HPVs are more likely to persist in the host cell, increasing the chance of developing cervical cancer.

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Which HPV types are most common in cervical cancer?

HPV types 16 and 18 are responsible for about 70% of cases of cervical cancer.

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What makes high-risk HPV integration unique?

High-risk HPVs are more likely to integrate into the host genome, disrupting the balance of viral and host genes.

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Pap Smear

A type of diagnostic test used to detect precancerous or cancerous cells on the cervix.

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Colposcopy

A medical procedure that uses a special magnifying instrument to examine the cervix for abnormal areas.

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Punch Biopsy

A type of biopsy that removes a small sample of cervical tissue using a punch tool.

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Cone Biopsy

A type of biopsy that removes a larger, cone-shaped section of cervical tissue.

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Trachelectomy

A surgical procedure that removes the cervix while potentially preserving fertility.

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HPV Vaccination

A vaccine that protects against the human papillomavirus (HPV), which causes many cervical cancers.

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Regular Cervical Cancer Screening

Regular screenings with Pap smears and HPV testing help identify precancerous changes or HPV infections early.

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What are neuritic plaques?

Abnormal buildup of a protein fragment called β-amyloid (Aβ) in the spaces between neurons.

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What are neurofibrillary tangles?

Abnormal clumps of the protein 'tau' inside neurons.

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What are β-secretase and α-secretase?

A type of enzyme that breaks down APP into fragments, including Aβ.

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How is Aβ created?

Aβ is generated when the transmembrane protein amyloid precursor protein (APP) is sequentially cleaved by the enzymes β-amyloid–converting enzyme (BACE) and γ-secretase.

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What are the effects of plaques and tangles?

Both neuritic plaques and neurofibrillary tangles are hallmarks of Alzheimer's disease, contributing to neuronal dysfunction.

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Study Notes

BIOL 2006SEF - CELLS IN HEALTH AND DISEASE

  • Course topic: Cell Cycle and Cancer Development I
  • Instructor: Heidi Wong
  • Contact: [email protected]

Outline

  • Overview of Cancer
  • Causes and risk factors of cancer
  • Hallmarks of cancer
  • Laboratory Diagnosis of Cancer

Major Cause of Death in Hong Kong

  • Malignant neoplasms (ICD-10: C00-C97) are the leading cause of death in Hong Kong.
  • Pneumonia (ICD-10: J12-J18) is a significant cause of death, along with other diseases like those of the heart, cerebrovascular diseases, external causes, nephritis, and dementia.

Key Facts of Human Cancer

  • Over 200 types of cancers exist.
  • In well-developed countries, cancer accounts for approximately 20-30% of deaths.
  • Roughly one in three people will experience cancer treatment.
  • No single cure exists for all cancers.
  • Cancer incidence will likely increase with extended lifespans.
  • An estimated 10 million people die from cancer each year globally.
  • Approximately one-third of common cancers are preventable.
  • Cancer is the second leading cause of death worldwide.
  • Low-to-middle-income countries account for 70% of cancer deaths.
  • Prevention, early detection, and treatment could save millions of lives annually.
  • Top 10 cancers in Hong Kong (2020/21 data) include lung, colorectal, breast, prostate, liver, stomach, corpus uteri, thyroid, non-Hodgkin lymphoma, and pancreatic cancer.

What is Cancer?

  • Cancer arises from uncontrolled abnormal growth of normal cells forming a lump called a tumor; Leukemia is an exception.
  • Unchecked tumors can spread to surrounding normal tissue via bloodstream and lymphatic systems.
  • Can affect the digestive, nervous, and circulatory systems and potentially release hormones that impact bodily functions.

What is Tumor (Neoplasm)?

  • Neoplasia literally means "new growth."
  • Tumors can be benign or malignant (cancerous).
  • Benign tumors originate from epithelial or glandular tissues (carcinomas) in roughly 80-90% of cases.
  • Sarcomas arise from connective tissues, roughly in 5% of cases.
  • Malignant tumors originate from lymphatic cells (leukemia and lymphomas) in a smaller percentage (5-10%).

Benign vs. Malignant Tumors

  • Benign tumors are generally relatively harmless, remain localized, and are easily treatable with surgical removal. They may cause significant morbidity and even death in rare instances.
  • Malignant tumors, collectively called cancers, are aggressive and can invade neighboring tissues and spread to distant sites, a process called metastasis. This process can cause death.

Invasion & Metastasis

  • Abnormal cancer cells proliferate and spread to other parts of the body.
  • Invasion: Direct migration and penetration into neighboring tissues.
  • Metastasis: Cancer cells spread (metastasize) via lymphatic system and blood vessels.

Multistep Carcinogenesis

  • Initiation: Carcinogens (physical, chemical, or biological agents) trigger permanent DNA alterations.
  • Promotion: Initiated cells respond to growth stimuli, such as alcohol, dietary fat, etc.
  • Progression/Malignancy: Pre-neoplastic cells progressively acquire alterations resulting in malignancy.

The Main Steps in the Formation of a Metastasis

  • Primary tumor formation
  • Proliferation and angiogenesis
  • Detachment and invasion
  • Embolism and circulation
  • Transport and arrest in organs
  • Extravasation
  • Establishment of a microenvironment
  • Proliferation and angiogenesis

Metastasis

  • Metastasis is the process where cancer cells leave the primary tumor, travel to a distant site, and establish a secondary tumor through the circulatory system.
  • Vascularization is crucial for tumor growth.
  • Tumor cells invade the organ's stroma (connective tissue).
  • Cells spread through lymphatic and vascular channels
  • Tumors must navigate the circulatory system and resist the immune and non-immune systems.
  • Tumor cells must arrest in capillary beds of distant organs, extravasate into distant organs, and survive and proliferate in their new environment.
  • Metastasis is not random, driven by favorable conditions (the "seed and soil" hypothesis).

Metastasis in Not Random

  • The "seed and soil" hypothesis suggests metastasis is influenced by anatomical and hemodynamic factors of the vascular system, specific to certain organs.

Principles of the Seed and Soil Hypothesis

  • Tumors are biologically heterogeneous.
  • Metastasis is a selective process for cells with certain characteristics.
  • Metastasis success depends on interactions with the host organ's microenvironment.

Top 10 Cancers in Hong Kong (2020/21 Data)

  • Lung cancer, colorectal cancer, breast cancer, prostate cancer, liver cancer, stomach cancer, corpus uteri cancer, thyroid cancer, non-Hodgkin lymphoma, and pancreatic cancer were in the top 10.

Causes and Risk Factors of Cancer

  • Multiple factors cause cancer, often the result of several interacting risk factors.
  • Modifiable risk factors include excessive alcohol consumption, being overweight or obese, poor diet high in red meat, and inadequate physical activity.
  • Factors including tobacco smoke, ionizing radiation, workplace hazards, and infectious agents (like viruses) contribute.

Non-modifiable Risk Factors

  • Age (longer lifespan= greater exposure to carcinogens)
  • Cancer-causing substances (carcinogens) alter cell behavior, increasing cancer risk.
  • Genetics (predisposing factors, like BRCA genes)
  • Weakened immune systems increase cancer risk (organ transplant recipients, HIV/AIDS, etc).

IARC's Carcinogen Classifications

  • The International Agency for Research on Cancer (IARC) classifies substances into groups (1-4) based on evidence of carcinogenicity, with Group 1 representing the highest risk.

Hallmarks of Cancer

  • Set of properties imparted on cancer cells by genetic alterations (mutations, epigenetic).
  • Eight hallmark functions, with 2 enabling capabilities, now characterized in cancer cells.
  • Hanahan and Weinberg (paper "The Hallmarks of Cancer" published in 2000 in Cell, with a 2011 update).

Laboratory Diagnosis of Cancer

  • Cytopathological examinations like Pap smears detect cancer cells in body fluids.
  • Histological analysis of tissue samples (needle biopsies, endoscopic biopsies, excision biopsies).
  • Immunohistochemistry uses antibodies to identify specific proteins in tissue samples.
  • Flow cytometry is primarily used for classifying leukemias and lymphomas.
  • Tumor markers help monitor cancer progression and treatment efficacy.

Molecular Diagnosis

  • Molecular techniques like PCR, FISH, sequencing, and NGS analyze genetic changes in cells associated with cancer.
  • Used for diagnosing, assessing prognosis, detecting residual disease, determining predisposition to cancer, and guiding treatment decisions.

References

  • Vinay Kumar, Abul K. Abbas, Jon C. Aster, Andrea T. Deyrup. (2022). Robbins & Kumar Basic Pathology (11th ed.). Elsevier.
  • Hanahan D and Weinberg RA. (2000). The hallmarks of cancer. Cell. 100(1): 57-70.
  • Hanahan D and Weinberg RA. (2011). Hallmarks of Cancer: The Next Generation. Cell. 144(5): 646-674.

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