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Questions and Answers
Questions and Answers
Which of the following is associated with elevated levels of β-HCG?
Which of the following is associated with elevated levels of β-HCG?
- Testicular tumors (correct)
- Liver cancer
- Lung cancer
- Breast cancer
What is the normal range for PSA levels in adults?
What is the normal range for PSA levels in adults?
- < 10 ng/mL
- Normal varies by age
- < 20 ng/mL
- < 4 ng/mL (correct)
Which condition is NOT indicated by increased PSA levels?
Which condition is NOT indicated by increased PSA levels?
- Kidney stones (correct)
- Prostate cancer
- Benign prostatic hypertrophy
- Chronic prostatitis
What is a primary use of tumor markers like β-HCG and PSA?
What is a primary use of tumor markers like β-HCG and PSA?
Which statement about clinically relevant tumor markers is true?
Which statement about clinically relevant tumor markers is true?
What is characteristic of a malignant tumor?
What is characteristic of a malignant tumor?
What defines a metastatic tumor?
What defines a metastatic tumor?
Which of the following is NOT a characteristic of cancer cells?
Which of the following is NOT a characteristic of cancer cells?
What is the role of tumor-associated antigens?
What is the role of tumor-associated antigens?
What defines virus-induced tumors?
What defines virus-induced tumors?
What is the function of oncogenes?
What is the function of oncogenes?
Which of the following is true about proto-oncogenes?
Which of the following is true about proto-oncogenes?
What is a feature of tumor-specific peptides?
What is a feature of tumor-specific peptides?
What is the primary use of tumor markers?
What is the primary use of tumor markers?
Carcinoembryonic antigen (CEA) is mainly associated with which type of cancer?
Carcinoembryonic antigen (CEA) is mainly associated with which type of cancer?
What is the normal level range of CEA in healthy individuals?
What is the normal level range of CEA in healthy individuals?
Which condition can cause elevated levels of α-fetoprotein (AFP)?
Which condition can cause elevated levels of α-fetoprotein (AFP)?
How is a significant rise in AFP levels used in clinical monitoring?
How is a significant rise in AFP levels used in clinical monitoring?
What are the subunits of Human Chorionic Gonadotropin (HCG)?
What are the subunits of Human Chorionic Gonadotropin (HCG)?
Which of the following can lead to elevated CEA levels, aside from cancer?
Which of the following can lead to elevated CEA levels, aside from cancer?
Which condition is notably associated with elevated HCG levels?
Which condition is notably associated with elevated HCG levels?
What is α-fetoprotein (AFP) classified as?
What is α-fetoprotein (AFP) classified as?
Which mechanism is NOT involved in natural immunity to tumors?
Which mechanism is NOT involved in natural immunity to tumors?
What protein is often associated with colorectal cancer?
What protein is often associated with colorectal cancer?
Which statement accurately describes T cell-mediated immunity?
Which statement accurately describes T cell-mediated immunity?
What role do antibodies play in humoral-mediated immunity against tumors?
What role do antibodies play in humoral-mediated immunity against tumors?
What is a common way that tumors evade the immune system?
What is a common way that tumors evade the immune system?
Which immune cells are primarily responsible for macrophage-mediated cytotoxicity?
Which immune cells are primarily responsible for macrophage-mediated cytotoxicity?
Which component is NOT a part of humoral-mediated immunity?
Which component is NOT a part of humoral-mediated immunity?
Which tumor marker is primarily associated with liver cancer?
Which tumor marker is primarily associated with liver cancer?
What type of therapy uses the immune system to destroy tumor cells?
What type of therapy uses the immune system to destroy tumor cells?
Which of the following is NOT a use of CA 19-9 tumor marker?
Which of the following is NOT a use of CA 19-9 tumor marker?
What method detects genetic mutations associated with cancer?
What method detects genetic mutations associated with cancer?
Which tumor marker is commonly used in diagnosing ovarian cancer?
Which tumor marker is commonly used in diagnosing ovarian cancer?
What do monoclonal antibodies in passive immunotherapy target?
What do monoclonal antibodies in passive immunotherapy target?
What type of cancer is associated with the use of PSA tumor markers?
What type of cancer is associated with the use of PSA tumor markers?
Which is an example of therapeutic cancer vaccines?
Which is an example of therapeutic cancer vaccines?
What characterizes a malignant tumor?
What characterizes a malignant tumor?
What distinguishes benign tumors from malignant tumors?
What distinguishes benign tumors from malignant tumors?
What type of genes are considered proto-oncogenes?
What type of genes are considered proto-oncogenes?
What happens when there are mutations in tumor-suppressor genes?
What happens when there are mutations in tumor-suppressor genes?
Which of the following best describes a neoplasm?
Which of the following best describes a neoplasm?
What is a characteristic of cancer cells compared to normal cells?
What is a characteristic of cancer cells compared to normal cells?
Which of the following is a common characteristic of major body defenses against cancer?
Which of the following is a common characteristic of major body defenses against cancer?
What is a potential outcome of immunoediting in tumor biology?
What is a potential outcome of immunoediting in tumor biology?
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Flashcards
Flashcards
Neoplasm
Neoplasm
An abnormal mass of tissue caused by uncontrolled cell growth, even after the growth stimulus is removed.
Benign tumor
Benign tumor
A mild, non-progressive tumor that doesn't invade surrounding tissues.
Cancer
Cancer
A malignant tumor that can invade surrounding tissues and spread to other parts of the body.
Proto-oncogene
Proto-oncogene
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Tumor-suppressor gene
Tumor-suppressor gene
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Causes of cancer
Causes of cancer
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Characteristics of cancer cells
Characteristics of cancer cells
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Tumor marker
Tumor marker
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Malignant Tumor
Malignant Tumor
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Metastatic Tumor
Metastatic Tumor
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Sustained Proliferation
Sustained Proliferation
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Induce Angiogenesis
Induce Angiogenesis
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Evasion of Immune Defenses
Evasion of Immune Defenses
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Tumor-Associated Antigens
Tumor-Associated Antigens
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Tumor-Specific Peptides
Tumor-Specific Peptides
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Oncogenes
Oncogenes
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Oncofetal Antigens
Oncofetal Antigens
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Alpha Fetoprotein (AFP)
Alpha Fetoprotein (AFP)
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Natural Immunity to Tumors
Natural Immunity to Tumors
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Cytokines
Cytokines
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Cytotoxic T lymphocytes (CTLs)
Cytotoxic T lymphocytes (CTLs)
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MHC I Downregulation
MHC I Downregulation
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Natural Killer (NK) Cells
Natural Killer (NK) Cells
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Tumor Immune Evasion
Tumor Immune Evasion
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What is Prostate-Specific Antigen (PSA)?
What is Prostate-Specific Antigen (PSA)?
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What conditions are associated with increased PSA levels?
What conditions are associated with increased PSA levels?
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What are tumor markers?
What are tumor markers?
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How are tumor markers used for diagnosis?
How are tumor markers used for diagnosis?
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How are tumor markers used for population screening?
How are tumor markers used for population screening?
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Carcinoembryonic Antigen (CEA)
Carcinoembryonic Antigen (CEA)
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CEA Levels in Normal Individuals
CEA Levels in Normal Individuals
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α-Fetoprotein (AFP)
α-Fetoprotein (AFP)
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Normal Range of AFP
Normal Range of AFP
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Human Chorionic Gonadotropin (HCG)
Human Chorionic Gonadotropin (HCG)
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β-HCG
β-HCG
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Tumor Markers and Cancer Treatment
Tumor Markers and Cancer Treatment
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What is Immunohistochemistry?
What is Immunohistochemistry?
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What are Immunoassays?
What are Immunoassays?
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What are Molecular Methods?
What are Molecular Methods?
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What is Immunotherapy?
What is Immunotherapy?
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What is Active Immunotherapy?
What is Active Immunotherapy?
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What is Passive Immunotherapy?
What is Passive Immunotherapy?
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What are Monoclonal Antibodies?
What are Monoclonal Antibodies?
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Flashcards
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Study Notes
Study Notes
Immunology & Serology I - 0202308
- Course offered by Al-Quds University, Faculty of Health Professions, Department of Medical Laboratory Sciences
- Instructor: Dr. Rasmi Abu-Helu (Ph.D., Immunology)
- Course code: 0202308
Tumor Immunology
- Course covers tumor biology, tumor antigens, clinically relevant tumor markers, laboratory tests for tumors, immune defenses against tumors, immunoediting and tumor escape, and immunotherapy.
Chapter Overview
- Topics covered are tumor biology, tumor antigens, clinically relevant tumor markers, laboratory tests for tumors, immune defenses against tumors, immunoediting and tumor escape, and immunotherapy.
Learning Objectives
- Students will be able to compare benign and malignant tumors.
- Students will be able to define and give examples of proto-oncogenes.
- Students will be able to describe the role of oncogenes.
- Students will be able to describe the characteristics of the major body defenses against cancer.
- Students will be able to identify and discuss the characteristics of tumor markers.
- Students will be able to discuss new developments in cancer diagnostic testing.
Introduction to Tumor Biology
- Tumor (neoplasm) is an abnormal cell mass.
- Cancer is malignant tumors that can spread.
- Cancer is caused by mutations in proto-oncogenes and tumor suppressor genes.
- Causes include uncontrolled cell division and other characteristics
Definitions
- Neoplasm: An abnormal mass of tissue resulting from uncontrolled growth of normal cells, even after the growth stimulus is removed.
- Benign tumor: A mild and non-progressive tumor that pushes aside normal tissue but does not invade it as it expands.
- Malignant tumor: Consisting of poorly differentiated cells that grow rapidly, invade surrounding tissue, and rob normal tissue of nutrients.
- Metastatic tumor: A secondary tumor derived from a malignant primary tumor.
Characteristics of Cancer Cells
- Sustained proliferation
- Resist death
- Induce angiogenesis
- Immortality
- Invasion and metastasis
- Avoid suppressors of cell growth
- Altered metabolism
- Evasion of immune defenses
- Genomic instability
- Accelerated growth in the presence of inflammation.
Tumor-Associated Antigens
- For immune system to react against tumor, it must have antigens recognized as foreign.
- Examples include enzymes, receptors, and membrane antigens, etc.
- Most relevant are surface membrane molecules, which can be either antigenic or suppress membrane proteins essential for immune recognition and activation.
Tumor-Specific Peptides
- Intracellular proteins expressed on tumor cells with MHC class I and II.
- This expression can be chemically induced.
Virus-Induced Tumors
- Tumors caused by viruses.
- Tumor cells express viral antigens on their surfaces.
- Tumor cells recognized as non-self by the immune system.
Genome-Encoded Tumor Antigens
- Oncogenes: if downregulated, the protein product can lead to tumor.
- Proto-oncogenes: found in all nucleated cells (yeast to human), involved in cell growth; alterations in gene expression or protein structure may lead to abnormal cell growth.
Oncofetal Antigens
- Found on normal fetal cells.
- Produced in minute amounts after birth.
- Become expressed later after malignant transformation.
- Examples: a-fetoprotein (AFP) and carcinoembryonic antigen (CEA).
- ~90% of colorectal cancers have CEA.
Immunity to Tumors
- Natural immunity:
- Macrophage-mediated cytotoxicity: Macrophages killing tumor cells on contact.
- NK cells: 50% of tumors have mutations decreasing MHC class I on their surfaces, facilitating killing by NK cells.
- Humoral-mediated immunity:
- Antibodies: Antibodies produced targeting tumor cell surface antigens.
- Lysis of tumor cells (via complement activation and antibody-dependent cellular cytotoxicity (ADCC) reactions involving NK cells, PMNs, and macrophages).
- T cell-mediated immunity:
- Cytokines: IL-1 activates T, B, and NK cells, TNFα destroys tumor cells, IFNg produced by activated T, B, and NK cells.
- CTLs (cytotoxic T lymphocytes): directly lyse tumor cells.
Immune Defenses Against Tumor Cells
- Immune system comprises various components (e.g., NK cells, macrophages, CTLs, antibodies, cytokines) acting in concert to eliminate or control tumor cells.
- Elimination, equilibrium, and escape phases are associated with immune response to tumors.
- These processes involve apoptosis and other mechanisms to eliminate altered cells and maintain immune surveillance to control tumor growth.
Body Defenses Against Cancer
- Various factors contribute to immune evasion by tumors including antigen loss variants of tumor cells, defective MHC I expression or dysfunction and immunosuppressive cytokines that prevent effective anti-tumor immune response.
Immunoediting and Tumor Escape
- Elimination phase: robust innate and adaptive immune responses kill tumor cells
- Equilibrium phase: immune system controls limited number of altered cells
- Escape phase: immune system is suppressed, and inflammation promotes uncontrolled tumor growth.
- Tumor cells highly altered & more resistant to immune responses; apoptosis is impaired.
Tumor Evasion of Immune System
- Anti-tumor antibodies might block sites for CTL binding.
- Tumor cells might express less class I MHC which prevents CTL-mediated death.
- Tumor cells might provide poor costimulatory signals.
Tumor Markers
- Glycoproteins found in small amounts in normal serum, but elevated in certain cancer types.
- Used to screen for cancer, monitor therapeutic response, and determine tumor burden.
Carcinoembryonic Antigen (CEA)
- Used in management of GIT tumors (e.g., colon cancer, adenocarcinoma of the colon, pancreas, liver, lung)
- Found in inflammatory bowel disease (IBD), ulcerative colitis, polyps, tumors of the GIT, Crohn disease, and cigarette smokers.
- Highest levels of CEA are found in metastatic disease.
- Normal CEA levels in normal people are up to 2.5 ng/ml.
- Levels 4-5 times normal have been used to predict colorectal tumor recurrence.
α-Fetoprotein (AFP)
- High levels in patients with hepatocellular carcinoma & hepatoblastoma, testicular & ovarian cancer, viral hepatitis & cirrhosis, and ulcerative colitis.
- Very important marker in monitoring cancer therapy.
- Normal range of AFP concentrations in humans is 0-20 ng/ml.
- A 5-fold or higher rise is used for monitoring hepatomas and testicular cancers.
- AFP levels may also be raised in some non-malignant liver conditions like cirrhosis, hepatitis.
Human Chorionic Gonadotropin (hCG)
- Composed of 2 subunits (α & β, β-hCG).
- Found in serum and urine during pregnancy.
- Produced by neoplastic cells of testicular cancer and other tumors.
- Levels useful for evaluating patients with gestational trophoblastic disease, testicular tumors, and ovarian germ cell tumors.
- Normal range in adults is <15 ng/mL.
Prostate-Specific Antigen (PSA)
- Glycoprotein that dissolves seminal gel after ejaculation.
- Found in very low amounts in blood of normal individuals.
- Increased in prostate cancer, benign prostatic hypertrophy (BPH), acute & chronic prostatitis.
- Levels correlate with prostate size, stage of cancer, response to treatment.
- Used in screening for prostate cancer—used in conjunction with digital rectal examination.
- PSA level below 4 ng/mL.
Clinically Relevant Tumor Markers
- Biological substances found in increased amounts in blood, body fluids, or tissues of patients with specific types of cancers.
- Concentration depends on tumor cell proliferation and size; elevated levels indicate a significant tumor mass.
- Ideal marker is highly sensitive and specific.
Clinical Uses of Tumor Markers
- Population screening: used to identify cancer in asymptomatic people.
- Diagnosis: used to identify cancer in a particular patient.
Common Serum Tumor Markers
- Various tumor markers (e.g., AFP, CA 125, CA 19-9, CEA, hCG, PSA) are associated with specific cancers or conditions, and are used clinically for diagnosis, prognosis, and monitoring.
Laboratory Tests for Tumors
- Immunohistochemistry: uses labeled antibodies to detect tumor antigens in tissue biopsies.
- Immunoassays: measures levels of circulating tumor markers.
- Molecular methods: detects genetic mutations associated with cancer (e.g., PCR, karyotyping, FISH, microarray, DNA sequencing).
Immunotherapy
- Also known as biological response modifier therapy.
- Uses the ability of the immune system to destroy tumor cells.
- Active immunotherapy: stimulates patient's immune system to respond to tumor antigens (cancer vaccines).
- Passive immunotherapy: administration of soluble components of the immune system (e.g., cytokines) and monoclonal antibodies that target specific tumor antigens (e.g., surface antigens, receptors, angiogenesis factors, and immune checkpoint molecules).
- Adoptive immunotherapy: transfer of cells of the immune system (e.g., TILs, CAR-T cells) to patients.
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