Podcast
Questions and Answers
What characteristic distinguishes benign tumors from malignant tumors?
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?
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?
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?
Which of the following is NOT considered a tumor promoter in cancer development?
What is the primary feature of malignant tumors compared to benign tumors?
What is the primary feature of malignant tumors compared to benign tumors?
Which phase of carcinogenesis involves the acquisition of additional mutations leading to invasive cancer?
Which phase of carcinogenesis involves the acquisition of additional mutations leading to invasive cancer?
During which process do abnormal cancer cells invade neighboring tissues?
During which process do abnormal cancer cells invade neighboring tissues?
What is the definition of metastasis in the context of cancer?
What is the definition of metastasis in the context of cancer?
Which virus is primarily linked to cervical cancer?
Which virus is primarily linked to cervical cancer?
What is a significant non-modifiable risk factor for cancer?
What is a significant non-modifiable risk factor for cancer?
Which of the following is a characteristic of a weakened immune system related to cancer risk?
Which of the following is a characteristic of a weakened immune system related to cancer risk?
What concept was introduced by Douglas Hanahan and Robert Weinberg in their paper published in 2000?
What concept was introduced by Douglas Hanahan and Robert Weinberg in their paper published in 2000?
What commonly misunderstood aspect relates to carcinogens?
What commonly misunderstood aspect relates to carcinogens?
Which of the following bacterial infections is associated with an increased risk of stomach cancer?
Which of the following bacterial infections is associated with an increased risk of stomach cancer?
Which statement about genetic predisposition to cancer is true?
Which statement about genetic predisposition to cancer is true?
Which of the following best describes the expanded understanding of cancer hallmarks since 2000?
Which of the following best describes the expanded understanding of cancer hallmarks since 2000?
What is primarily responsible for the self-sufficiency in growth signals in tumors?
What is primarily responsible for the self-sufficiency in growth signals in tumors?
Which hallmark characteristic is NOT one of the original hallmarks of cancer as proposed by Weinberg and Hanahan?
Which hallmark characteristic is NOT one of the original hallmarks of cancer as proposed by Weinberg and Hanahan?
How does RAS contribute to tumor growth according to the content?
How does RAS contribute to tumor growth according to the content?
In what way do the recruited normal cells in a tumor contribute to cancer?
In what way do the recruited normal cells in a tumor contribute to cancer?
Which function does inflammation NOT serve in the context of the hallmarks of cancer?
Which function does inflammation NOT serve in the context of the hallmarks of cancer?
Which is NOT considered one of the enabling characteristics of cancer?
Which is NOT considered one of the enabling characteristics of cancer?
Which component plays a critical role in the activation of signal transduction pathways downstream of growth factor receptors?
Which component plays a critical role in the activation of signal transduction pathways downstream of growth factor receptors?
What effect does genome instability have on cancer cells?
What effect does genome instability have on cancer cells?
Which diagnostic method is primarily used for the detection of cervical carcinoma?
Which diagnostic method is primarily used for the detection of cervical carcinoma?
What does immunohistochemistry primarily help determine about a tumor?
What does immunohistochemistry primarily help determine about a tumor?
Which cytological method is most commonly used with palpable lesions such as the breast or lymph nodes?
Which cytological method is most commonly used with palpable lesions such as the breast or lymph nodes?
What type of biopsy involves the removal of a small tissue sample for examination?
What type of biopsy involves the removal of a small tissue sample for examination?
What classification method is used routinely for leukemias and lymphomas?
What classification method is used routinely for leukemias and lymphomas?
Which of the following is NOT a benefit of using immunohistochemistry?
Which of the following is NOT a benefit of using immunohistochemistry?
Which tumor marker is specifically used to monitor prostate cancer?
Which tumor marker is specifically used to monitor prostate cancer?
Which method uses spontaneously exfoliated cells for cancer detection?
Which method uses spontaneously exfoliated cells for cancer detection?
What molecular technique is used primarily to detect genetic changes and chromosomal abnormalities?
What molecular technique is used primarily to detect genetic changes and chromosomal abnormalities?
In histopathological examination, what is typically obtained for diagnosis?
In histopathological examination, what is typically obtained for diagnosis?
Which of the following is NOT a function of tumor markers?
Which of the following is NOT a function of tumor markers?
Which tumor marker is primarily associated with pancreatic cancer?
Which tumor marker is primarily associated with pancreatic cancer?
Which of the following molecular techniques is considered advanced for reading DNA quickly?
Which of the following molecular techniques is considered advanced for reading DNA quickly?
What is the role of tumor suppressor genes in cell cycle regulation?
What is the role of tumor suppressor genes in cell cycle regulation?
Which of the following is a known carcinogen associated with adenocarcinoma of the lung?
Which of the following is a known carcinogen associated with adenocarcinoma of the lung?
Which statement best describes the Warburg effect in cancer cells?
Which statement best describes the Warburg effect in cancer cells?
What is the main purpose of using tumor markers in cancer care?
What is the main purpose of using tumor markers in cancer care?
Which of the following statements about carcinogenesis is correct?
Which of the following statements about carcinogenesis is correct?
What happens when a DNA damaged cell attempts to divide?
What happens when a DNA damaged cell attempts to divide?
How do cancer cells typically alter their metabolism for growth?
How do cancer cells typically alter their metabolism for growth?
What is a key characteristic of the intrinsic pathway of apoptosis in cancer cells?
What is a key characteristic of the intrinsic pathway of apoptosis in cancer cells?
What is the primary consequence of the inactivation of tumor suppressor genes in cancer?
What is the primary consequence of the inactivation of tumor suppressor genes in cancer?
Which tumor suppressor gene is commonly known as the 'Guardian of the genome'?
Which tumor suppressor gene is commonly known as the 'Guardian of the genome'?
What is the main role of second messengers in signal transduction?
What is the main role of second messengers in signal transduction?
What phase of the cell cycle involves both chromosome duplication and preparation for mitosis?
What phase of the cell cycle involves both chromosome duplication and preparation for mitosis?
Which phase of the cell cycle is the shortest in duration?
Which phase of the cell cycle is the shortest in duration?
During which phase of the cell cycle does a cell double in size?
During which phase of the cell cycle does a cell double in size?
Which of the following correctly describes interphase?
Which of the following correctly describes interphase?
What is the primary activity that occurs during G2 phase of the cell cycle?
What is the primary activity that occurs during G2 phase of the cell cycle?
What significant event occurs during the M phase of the cell cycle?
What significant event occurs during the M phase of the cell cycle?
Which statement about the S phase is true?
Which statement about the S phase is true?
What is primarily synthesized during the G1 phase of the cell cycle?
What is primarily synthesized during the G1 phase of the cell cycle?
What is a consequence of mutations in the p53 tumor suppressor gene?
What is a consequence of mutations in the p53 tumor suppressor gene?
Which statement accurately describes Rb in the context of cancer?
Which statement accurately describes Rb in the context of cancer?
How do RAS mutations influence cell proliferation?
How do RAS mutations influence cell proliferation?
What role does p53 play concerning cellular stress and potential cancer development?
What role does p53 play concerning cellular stress and potential cancer development?
Which of the following is a common characteristic of tumor suppressor genes like p53 and Rb?
Which of the following is a common characteristic of tumor suppressor genes like p53 and Rb?
What is the primary role of the Rb protein in the cell cycle?
What is the primary role of the Rb protein in the cell cycle?
According to Knudson's two-hit hypothesis, which of the following is true regarding retinoblastoma?
According to Knudson's two-hit hypothesis, which of the following is true regarding retinoblastoma?
What types of tumors are associated with mutations in the Rb gene?
What types of tumors are associated with mutations in the Rb gene?
Which statement best describes the nature of mutations in retinoblastoma?
Which statement best describes the nature of mutations in retinoblastoma?
What is the impact of Rb protein on E2F proteins during the G1 phase?
What is the impact of Rb protein on E2F proteins during the G1 phase?
In non-inherited retinoblastoma, how many mutations must occur?
In non-inherited retinoblastoma, how many mutations must occur?
What chromosome is the Rb gene located on?
What chromosome is the Rb gene located on?
Which phase of the cell cycle does the Rb protein primarily regulate?
Which phase of the cell cycle does the Rb protein primarily regulate?
What triggers the conformational change in Ras that allows it to bind GTP?
What triggers the conformational change in Ras that allows it to bind GTP?
What is the role of activated ERK in the cellular response to Ras activation?
What is the role of activated ERK in the cellular response to Ras activation?
Which of the following pathways is primarily initiated by active Ras proteins?
Which of the following pathways is primarily initiated by active Ras proteins?
How does Ras contribute to cell proliferation?
How does Ras contribute to cell proliferation?
What is the primary difference between GDP and GTP in the context of Ras activation?
What is the primary difference between GDP and GTP in the context of Ras activation?
Which of the following best describes the classification of oncogenes related to Ras signaling?
Which of the following best describes the classification of oncogenes related to Ras signaling?
What is a major consequence of active Ras signaling in the context of gene regulation?
What is a major consequence of active Ras signaling in the context of gene regulation?
Which signaling molecule is NOT directly activated by Ras in downstream signaling?
Which signaling molecule is NOT directly activated by Ras in downstream signaling?
What is the primary decision made at the G1 phase of the cell cycle?
What is the primary decision made at the G1 phase of the cell cycle?
What characterizes the S phase in the cell cycle?
What characterizes the S phase in the cell cycle?
What is the role of the G2 checkpoint in the cell cycle?
What is the role of the G2 checkpoint in the cell cycle?
What happens to the chromosomes during the S phase?
What happens to the chromosomes during the S phase?
Which of the following describes the transition between the G1 phase and the S phase?
Which of the following describes the transition between the G1 phase and the S phase?
What effect does point mutation in protein kinases like Src have on substrate specificity?
What effect does point mutation in protein kinases like Src have on substrate specificity?
Which of the following statements about gene amplification is correct?
Which of the following statements about gene amplification is correct?
What key factor is checked at the G2 checkpoint to ensure the cell can proceed to mitosis?
What key factor is checked at the G2 checkpoint to ensure the cell can proceed to mitosis?
What is the primary consequence of errors in DNA repair or chromosome segregation?
What is the primary consequence of errors in DNA repair or chromosome segregation?
In which phase are the original chromosomes and their duplicates connected at the centromere?
In which phase are the original chromosomes and their duplicates connected at the centromere?
How does the RAS gene primarily contribute to tumor development?
How does the RAS gene primarily contribute to tumor development?
Which of the following statements best describes the G0 phase?
Which of the following statements best describes the G0 phase?
Which statement describes the function of GAPs in relation to Ras?
Which statement describes the function of GAPs in relation to Ras?
Which of the following cancers is most commonly associated with mutations in the RAS gene?
Which of the following cancers is most commonly associated with mutations in the RAS gene?
What results from the GDP-bound form of Ras?
What results from the GDP-bound form of Ras?
Which statement about GEFs in relation to Ras is accurate?
Which statement about GEFs in relation to Ras is accurate?
Which cancers exhibit a substantially increased risk due to BRCA1 mutations?
Which cancers exhibit a substantially increased risk due to BRCA1 mutations?
What is a common feature of ER-positive breast cancers?
What is a common feature of ER-positive breast cancers?
Which type of breast cancer is primarily associated with loss of BRCA1 function?
Which type of breast cancer is primarily associated with loss of BRCA1 function?
Which imaging test is useful for distinguishing solid masses from fluid-filled cysts?
Which imaging test is useful for distinguishing solid masses from fluid-filled cysts?
What cellular consequence is associated with defective versions of BRCA1 and BRCA2 genes?
What cellular consequence is associated with defective versions of BRCA1 and BRCA2 genes?
Which condition is NOT a precursor lesion for ER-positive cancers?
Which condition is NOT a precursor lesion for ER-positive cancers?
What is true regarding BRCA2 mutations?
What is true regarding BRCA2 mutations?
What diagnostic method provides detailed images especially useful for high-risk breast cancer patients?
What diagnostic method provides detailed images especially useful for high-risk breast cancer patients?
What characterizes nonproliferative fibrocystic change in the breast?
What characterizes nonproliferative fibrocystic change in the breast?
Which statement about fibroadenomas is true?
Which statement about fibroadenomas is true?
Which HPV types are primarily associated with the development of condylomas in the lower genital tract?
Which HPV types are primarily associated with the development of condylomas in the lower genital tract?
What is the primary factor that influences the prognosis for invasive breast carcinoma?
What is the primary factor that influences the prognosis for invasive breast carcinoma?
Which type of carcinoma is a precursor lesion for ductal carcinoma?
Which type of carcinoma is a precursor lesion for ductal carcinoma?
Which diagnostic procedure uses a magnifying instrument to examine abnormal areas of the cervix?
Which diagnostic procedure uses a magnifying instrument to examine abnormal areas of the cervix?
How do cystic changes in breast tissue typically arise?
How do cystic changes in breast tissue typically arise?
What is the primary purpose of regular Pap Smears and HPV Testing in cervical cancer prevention?
What is the primary purpose of regular Pap Smears and HPV Testing in cervical cancer prevention?
Which statement about lobular carcinomas is accurate?
Which statement about lobular carcinomas is accurate?
Which surgical procedure is aimed specifically at removing a cone-shaped section of abnormal cervical tissue?
Which surgical procedure is aimed specifically at removing a cone-shaped section of abnormal cervical tissue?
What type of therapy uses drugs that specifically target pathways utilized by cancer cells to promote growth?
What type of therapy uses drugs that specifically target pathways utilized by cancer cells to promote growth?
What typically happens to nonproliferative fibrocystic changes after menopause?
What typically happens to nonproliferative fibrocystic changes after menopause?
What type of breast carcinoma represents over 90% of cases and arises from the ducts?
What type of breast carcinoma represents over 90% of cases and arises from the ducts?
Which prevention strategy is recommended to significantly reduce the risk of HPV infection?
Which prevention strategy is recommended to significantly reduce the risk of HPV infection?
What is the purpose of Endocervical Curettage in cervical diagnostics?
What is the purpose of Endocervical Curettage in cervical diagnostics?
What type of cancer treatment is often combined with chemotherapy to enhance the destruction of cancer cells?
What type of cancer treatment is often combined with chemotherapy to enhance the destruction of cancer cells?
What is the primary purpose of hormone receptor tests in cancer diagnosis?
What is the primary purpose of hormone receptor tests in cancer diagnosis?
Which surgical procedure involves the removal of a tumor along with some surrounding tissue?
Which surgical procedure involves the removal of a tumor along with some surrounding tissue?
What is the action of immunotherapy in cancer treatment?
What is the action of immunotherapy in cancer treatment?
Which of the following is NOT a common recommendation to reduce the risk of breast cancer?
Which of the following is NOT a common recommendation to reduce the risk of breast cancer?
Which treatment specifically targets the HER2 protein in certain breast cancers?
Which treatment specifically targets the HER2 protein in certain breast cancers?
What is the main goal of neoadjuvant chemotherapy?
What is the main goal of neoadjuvant chemotherapy?
What type of therapy is primarily intended for cancers that have metastasized to the bone?
What type of therapy is primarily intended for cancers that have metastasized to the bone?
What is primarily responsible for the formation of neuritic plaques in Alzheimer's disease?
What is primarily responsible for the formation of neuritic plaques in Alzheimer's disease?
Which of the following is a key dietary recommendation for reducing breast cancer risk?
Which of the following is a key dietary recommendation for reducing breast cancer risk?
Which enzyme is NOT involved in the cleavage of amyloid precursor protein (APP)?
Which enzyme is NOT involved in the cleavage of amyloid precursor protein (APP)?
What change occurs to tau protein in Alzheimer's disease?
What change occurs to tau protein in Alzheimer's disease?
What is the primary abnormality associated with Alzheimer’s disease?
What is the primary abnormality associated with Alzheimer’s disease?
Which statement about neurofibrillary tangles in Alzheimer’s disease is correct?
Which statement about neurofibrillary tangles in Alzheimer’s disease is correct?
What is the consequence of tau protein losing its ability to bind to microtubules in Alzheimer's disease?
What is the consequence of tau protein losing its ability to bind to microtubules in Alzheimer's disease?
What is a secondary effect of the accumulation of plaques and tangles in Alzheimer's disease?
What is a secondary effect of the accumulation of plaques and tangles in Alzheimer's disease?
Which protein does the amyloid precursor protein (APP) lead to the production of when cleaved by the appropriate enzymes?
Which protein does the amyloid precursor protein (APP) lead to the production of when cleaved by the appropriate enzymes?
What role does the E6 protein play in oncogenesis?
What role does the E6 protein play in oncogenesis?
Which consequence arises from the integration of the HPV genome into the host genome?
Which consequence arises from the integration of the HPV genome into the host genome?
What characteristic distinguishes high-risk HPV types from low-risk types?
What characteristic distinguishes high-risk HPV types from low-risk types?
How does the E7 protein contribute to tumorigenesis?
How does the E7 protein contribute to tumorigenesis?
What is the primary consequence of the persistence of high-risk HPV types in infected individuals?
What is the primary consequence of the persistence of high-risk HPV types in infected individuals?
Which factor is primarily linked to the pro-oncogenic mutations in host cancer genes?
Which factor is primarily linked to the pro-oncogenic mutations in host cancer genes?
Which types of HPV are primarily responsible for the majority of cervical carcinoma cases?
Which types of HPV are primarily responsible for the majority of cervical carcinoma cases?
What impact does HPV infection have on the host cell cycle regulation?
What impact does HPV infection have on the host cell cycle regulation?
Flashcards
Benign Tumor
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
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
Metastasis
The process by which cancer cells spread from the original tumor site to other parts of the body.
Invasion
Invasion
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Initiation
Initiation
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Promotion
Promotion
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Progression and Malignancy
Progression and Malignancy
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Metastasis: The Journey of a Cancer Cell
Metastasis: The Journey of a Cancer Cell
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Viral Infections and Cancer Risk
Viral Infections and Cancer Risk
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Bacterial Infections and Cancer
Bacterial Infections and Cancer
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Age and Cancer Risk
Age and Cancer Risk
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Carcinogens
Carcinogens
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Genetic Predisposition to Cancer
Genetic Predisposition to Cancer
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Immune System and Cancer
Immune System and Cancer
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Hallmarks of Cancer
Hallmarks of Cancer
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What are the hallmarks of cancer?
What are the hallmarks of cancer?
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Gain-of-function mutation
Gain-of-function mutation
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Proto-oncogenes
Proto-oncogenes
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Oncogenes
Oncogenes
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Oncoproteins
Oncoproteins
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Mutations in signaling pathways
Mutations in signaling pathways
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RAS oncogene
RAS oncogene
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Autocrine growth factor production
Autocrine growth factor production
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Paracrine growth factor production
Paracrine growth factor production
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What do tumor suppressor genes do?
What do tumor suppressor genes do?
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What happens when tumor suppressor genes are inactivated?
What happens when tumor suppressor genes are inactivated?
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How does cancer cell metabolism differ from normal cells?
How does cancer cell metabolism differ from normal cells?
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What is the Warburg effect?
What is the Warburg effect?
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What is apoptosis?
What is apoptosis?
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How do cancer cells evade apoptosis?
How do cancer cells evade apoptosis?
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How is the signal to divide transmitted from the cell surface to the nucleus?
How is the signal to divide transmitted from the cell surface to the nucleus?
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How does the cell cycle relate to tumor suppressors?
How does the cell cycle relate to tumor suppressors?
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What are carcinogens?
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What is metastasis?
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What is molecular diagnosis?
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What is carcinogenesis?
What is carcinogenesis?
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What are tumor promoters?
What are tumor promoters?
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What are tumor markers?
What are tumor markers?
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What is Polymerase Chain Reaction (PCR)?
What is Polymerase Chain Reaction (PCR)?
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What is Fluorescence in situ hybridization (FISH)?
What is Fluorescence in situ hybridization (FISH)?
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Histopathological Examination
Histopathological Examination
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Flow Cytometry
Flow Cytometry
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Immunohistochemistry
Immunohistochemistry
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Cytopathological Examination
Cytopathological Examination
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Fine-Needle Aspiration Cytology
Fine-Needle Aspiration Cytology
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Exfoliative Cytology
Exfoliative Cytology
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Immunosuppression and Cancer Risk
Immunosuppression and Cancer Risk
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Viral Infections and Cancer in Immunosuppressed Patients
Viral Infections and Cancer in Immunosuppressed Patients
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What is the purpose of the cell cycle?
What is the purpose of the cell cycle?
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What happens during the S phase?
What happens during the S phase?
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What does the M phase consist of?
What does the M phase consist of?
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What are the phases of the cell cycle?
What are the phases of the cell cycle?
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What happens during the G1 phase?
What happens during the G1 phase?
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How long does DNA synthesis (S phase) take?
How long does DNA synthesis (S phase) take?
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How long does mitosis (M phase) take?
How long does mitosis (M phase) take?
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How does the cell cycle relate to tumor suppressor genes?
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G1 Restriction Point
G1 Restriction Point
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G0 Phase
G0 Phase
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S Phase
S Phase
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G2 Phase
G2 Phase
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G2 Checkpoint
G2 Checkpoint
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M Phase
M Phase
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Mitosis
Mitosis
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Cytokinesis
Cytokinesis
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What is Ras?
What is Ras?
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What is the function of GAPs?
What is the function of GAPs?
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What is the function of GEFs?
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How common are RAS mutations in cancer?
How common are RAS mutations in cancer?
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Why are RAS mutations important?
Why are RAS mutations important?
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What type of mutations occur in RAS?
What type of mutations occur in RAS?
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What is gene amplification?
What is gene amplification?
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How can errors in DNA replication contribute to cancer?
How can errors in DNA replication contribute to cancer?
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Knudson's Two-Hit Hypothesis
Knudson's Two-Hit Hypothesis
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Retinoblastoma Gene (Rb Gene)
Retinoblastoma Gene (Rb Gene)
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Rb Protein
Rb Protein
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E2F Proteins
E2F Proteins
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Retinoblastoma
Retinoblastoma
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Hereditary Retinoblastoma
Hereditary Retinoblastoma
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Sporadic Retinoblastoma
Sporadic Retinoblastoma
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Tumor Suppressor Genes (TSGs)
Tumor Suppressor Genes (TSGs)
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How is Ras activated?
How is Ras activated?
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What's the MAPK/ERK pathway?
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What cellular responses are influenced by activated Ras?
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What is an oncogene?
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What is the cell cycle?
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What is the RAS oncogene?
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Tumor Suppressor Gene
Tumor Suppressor Gene
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p53
p53
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Rb
Rb
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RAS
RAS
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BRCA1 and BRCA2 mutations
BRCA1 and BRCA2 mutations
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ER-positive breast cancer
ER-positive breast cancer
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HER2-overexpressed breast cancer
HER2-overexpressed breast cancer
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Basal-like tumor
Basal-like tumor
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Mammogram
Mammogram
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Breast Ultrasound
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Biopsy
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Clinical Breast Exam
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Core Needle Biopsy
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Surgical Biopsy
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Fine-Needle Aspiration
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Sentinel Lymph Node Biopsy
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Axillary Lymph Node Dissection
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Chemotherapy
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Radiation Therapy
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Hormonal (Endocrine) Therapy
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Fibrocystic Change
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Fibroadenoma
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Ductal Carcinoma
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Ductal Carcinoma in Situ (DCIS)
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Lobular Carcinoma in Situ (LCIS)
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Lobular Carcinoma
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Rb Gene
Rb Gene
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p53 Gene
p53 Gene
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What does HPV E6 do?
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What is different about E6 from high-risk HPV?
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What does HPV E7 do?
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Why is HPV integration important?
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Which HPV types are most common in cervical cancer?
Which HPV types are most common in cervical cancer?
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What makes high-risk HPV integration unique?
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Pap Smear
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Colposcopy
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Punch Biopsy
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Cone Biopsy
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Trachelectomy
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HPV Vaccination
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Regular Cervical Cancer Screening
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What are neuritic plaques?
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What are β-secretase and α-secretase?
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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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