Up ] [ Principles of neoplasia ] Clinicopathological staging of cancer ] Cancer genetics ] Chemotherapy ] Radiotherapy ] Malignant melanoma ] Skin cancers ] Benign skin lesions ] Nail disorders ] Benign breast disease ] Fibroadenoma ] Breast cysts ] Breast pain ] Breast sepsis ] Nipple discharge ] Gynaecomastia ] Breast cancer ] Breast reconstruction ] Breast screening ] Breast  assessment ] Palliative care ] Quality of life ] Informed consent ] The Coroner ] Clinical audit ] Statistics for surgeons ] Design of clinical trials ]

Principles of neoplasia

Pathological terms

  • Atrophy
    • Reduction in organ size due to a reduction in size of individual cells
    • Occurs in immobility or nutritional deficiency
  • Hyperplasia
    • An increase in organ size due to cell proliferation
    • Occurs with breast enlargement during pregancy
  • Hypertrophy
    • An increase in organ size due to increase in size of individual cells
    • Occurs with ventricular hypertrophy due to aortic stenosis
  • Metaplasia
    • A change from one differentiated cell type to another
    • Occurs with bronchial squamous metaplasia in response to smoking
    • Barrett's oesophagus is also a metaplastic process
  • Dysplasia
    • Disordered cellular development
    • Often pre-malignant
    • Examples include cervical intra-epithelial neoplasia

Tumour markers

  • The ideal tumour marker would
    • Be present in the blood
    • Be undetectable in health
    • Be produced only by malignant tissue
    • Be organ specific
    • Would have circulating levels proportional to tumour mass
  • The ideal does not exist
  • Tumour markers can be used for
    • Screening for primary disease
    • Diagnosis of primary disease
    • Monitoring response to treatment
    • Establishing prognosis
    • Detection of recurrence

Specific tumour markers

  • CA-125 - ovary
  • CEA - colon, pancreas, stomach
  • PSA - prostate
  • Alpha-fetoprotein - teratoma, hepatoma
  • Beta-hCG - seminoma, choriocarcinoma
  • CA19.9 - pancreas
  • CA15.3 - breast
  • CA 27.29 - breast

Bibliography

Labdenne P,  Heikinheimo M.  Clinical use of tumour markers in childhood malignancies.  Ann Med 2002;  34:  316-323.

Lamerz R.  Role of tumour markers and cytogenetics.  Ann Oncol 1999;  10 (Suppl 4): S145-149

McDermott U,  Longley D B, Johnston P G.  Molecular and biochemical markers in colorectal cancer.  Ann Oncol 2002;  13 (Suppl4):  S235-245.

Rhodes J M.  Usefulness of novel tumour markers.  Ann Oncol 1999;  10 (Suppl 4):  S118-121

 

 
 

Copyright 1997- 2013 Surgical-tutor.org.uk