Neoplasia-II Mind map

Neoplasia-II

1. 8 Hallmarks of cancer

   • Insensitivity to anti-growth signals
     • Tumor suppressor genes
       • Loss of function mutations
       • APC(Ch.5)
         • Familial adenomatous polyposis
         • Normal function: Binds to beta-catenin and degrades
       • NF-1
         • Neurofibromatosis
           • Multiple cutaneous tumors
         • Normal: Neurofibromin GTPase activity
       • NF-2
         • b/L Acoustic neuroma+schwannoma
         • Normal: cytoskeletal protein merlin
       • BRCA-1&2
         • Familial breast cancer
         • Normal: DNA Repair
       • Rb
         • Knudson 2 hit
         • Retinoblastoma
           • Familail
             • Bilateral
             • Osteosarcoma
           • Sporadic
             • Unilateral
             • No osteosarcoma
       • DCC
         • Colon cancer
       • p53
         • Lifraumeni syndrome
       • VHL(CH3)
         • RCC+ Cerebellar hemagiblastoma
       • WT-1
         • Nephroblastoma
         • Normal : Helps in differentiation of fetal kidney
   • Limitless replicative potential
   • Altered metabolism
     • Aerobic glycolysis
     • Principle of PET scan
   • Evasion of apoptosis
     • bcl-2
       • Follicular lymphoma
   • Sustained angiogenesis
     • Notch pathway
       • Angiostatin inhibits
       • FGF PDGF Promotes
   • Ability to invade and metastasis
     • steps
       • 1. Loosening by loss of E-cadherin
       • 2. Degradation of BM by MMPs
       • 3. Integrin binding
       • 4. Locomotion of tumor cells form emboli
   • Self sufficient growth signals
     • Oncogenes
       • Growth factors
         • PDGF
           • Astrocytoma
       • Growth factor receptor
         • Her-2-neu
           • Breast ca
         • ret
           • MEN medullary carcinoma thyroid
         • kit
           • GIST
       • Signal transduction pathway
         • abl
           • CML
         • braf
           • Melanoma
           • Hairy cell leukemia
         • K-RAS
           • Colon carcinoma
         • H-RAS
           • Kidney cancer
           • Bladder cancer
       • Nuclear regulators
         • N-myc
           • Neuroblastoma
         • c-myc
           • Burkitt lymphoma
         • Cyclin D
           • Mantle cell lymphoma
       • Oncogene addiction
         • E.g. CML, Breast cancer, Burkitt lymphoma
       • Gain of function mutation
   • Ability to invade host immunity
     • 1. Reduced HLA-1
     • Increased TREGs

2. Nonlethal genetic damage

3. Oncogeneic viruses

   • HBV/HCV
     • HBx gene
   • EBV
     • Burkitt lymphoma
     • LMP gene
   • HHV-8
     • Kaposi sarcoma
   • HPV
     • E7, E6
       • Cervical cancer
   • HTLV
     • Adult Tcell leukemia
     • Tax gene

4. Clinical aspects of neoplasia

   • Cancer cachexia
     • TNF-A
   • Grading and staging
     • Grading by Pathologists
     • TNM Staging by oncologists
       • Metastasis(M) CARRIES A BAD
   • Paraneoplastic syndromsa
     • Cushings syndrome
       • Small cell carcinoma
       • ACTH
     • SIADH
       • Small cell carcinoma
       • ADH
     • Hypercalcemia
       • SCC lung
       • PTH
     • Myasthenia
       • Thymoma
       • Ab to postsynaptic ACH receptors
     • Lambert-Eaton
       • small cell lung cancer
       • Ab to presynaptic Ca channels
   • Dancing eye
     • Neuroblastoma
   • Migratory thrombophlebitis
     • Pancreatic cancer

5. Tumor markers

   • CEA
     • Colon cancer
   • HCG
     • Choriocarcinoma
   • PSA
     • Prostate cancer
   • AFP
     • HCC , non seminomas
   • CA-125
     • Ovarian ca

6. Lab diagnosis of cancer

   • H&E
   • FNAC
   • IHC
     • Role of intermediate filaments
       • Cytokeratin
         • Carcinoma
       • Vimentin
         • Sarcoma
       • Desmin
         • Rhabdomyosarcoma
       • S-100
         • Melanoma
       • GFAP
         • Astrocytoma
   • FISH
   • Flowcytometry
   • Frozen section