Topic 1 Cellular Abberation

1. CELLULAR ABERRATION

OVERVIEW

Cell appearance (morphology)a. Each normal mature cell type is

differentiated, with a distinct and recognizable appearance, size, and shape

b. The size of a normal cell nucleus is usually small compared with the size of the rest of the cell, including the cytoplasm

c. Normal cells generally have a small N:C ratiod. As cell matures, the nucleus:cytoplasm ratio

decrease

Anatomy of the Generalized CellAnatomy of the Generalized Cell

Slide 3.2Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings

Cells are not all the same

All cells share general structures

Cells are organized into three main regions Nucleus

Cytoplasm

Plasma membrane

Figure 3.1a

The NucleusThe Nucleus


Control center of the cell

Contains genetic material (DNA)

Three regions

Nuclear membrane

Nucleolus

Chromatin Figure 3.1b

Nuclear Membrane – double membrane or Nuclear Membrane – double membrane or envelopeenvelope


Barrier of nucleus

Consists of a double phospholipid membrane

Contain nuclear pores that allow for exchange of material with the rest of the cell – selectively permeable

NucleoliNucleoli


Nucleus contains one or more nucleoli

Sites of ribosome production

Ribosomes then migrate to the cytoplasm through nuclear pores

Chromatin (when not dividing)Chromatin (when not dividing)


Composed of DNA and protein

Scattered throughout the nucleus

Chromatin condenses to form chromosomes when the cell divides

Plasma MembranePlasma Membrane

Slide 3.7aCopyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings

Barrier for cell contents

Double phospholipid layer (fat – water) Hydrophilic heads

Hydrophobic tails

Other materials in plasma membrane Protein

Cholesterol

Glycoproteins

Plasma MembranePlasma Membrane

Slide 3.7bCopyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings

Figure 3.2

Plasma Membrane SpecializationsPlasma Membrane Specializations


Microvilli

Finger-like projections that increase surface area for absorption

Small intestine and nephrons of kidney

Figure 3.3

Cytoplasm Cytoplasm


Material outside the nucleus and inside the plasma membrane Cytosol

Fluid that suspends other elements

Organelles

Metabolic machinery of the cell

Inclusions

Non-functioning units – fat, pigments…..

Cytoplasmic OrganellesCytoplasmic Organelles


Figure 3.4



Ribosomes Made of protein and RNA

Sites of protein synthesis

Found at two locations

Free in the cytoplasm

Attached to rough endoplasmic reticulum



Endoplasmic reticulum (ER) Fluid-filled tubules for carrying substances

Two types of ER

Rough Endoplasmic Reticulum Studded with ribosomes

Site where building materials of cellular membrane are formed

Smooth Endoplasmic Reticulum Functions in cholesterol synthesis and

breakdown, fat metabolism, and detoxification of drugs



Golgi apparatus Modifies and packages proteins



Figure 3.5



Lysosomes Contain enzymes that digest nonusable

materials within the cell

Peroxisomes Membranous sacs of oxidase enzymes

Detoxify harmful substances

Break down free radicals (highly reactive chemicals)

Replicate by pinching in half



Mitochondria

“Powerhouses” of the cell

Change shape continuously

Carry out reactions where oxygen is used to break down food

Provides ATP for cellular energy



Cytoskeleton

Network of protein structures that extend throughout the cytoplasm

Provides the cell with an internal framework



Cytoskeleton

Three different types

Microfilaments

Intermediate filaments

Microtubules

Figure 3.6



Centrioles

Rod-shaped bodies made of microtubules

Direct formation of mitotic spindle during cell division

Cellular ProjectionsCellular Projections


Not found in all cells

Used for movement

Cilia moves materials across the cell surface

Flagellum propels the cell

OVERVIEW

Epithelial (glandular) tissues: breast (ductal), colon, liver

Connective (mesenchymal) tissue – adipose, blood vessel, bone, skeletal and smooth muscle

Hematopoietic cells – blood cells

Body TissuesBody Tissues


Cells are specialized for particular functions

Tissues Groups of cells with similar structure and

function

Four primary types Epithelium Connective tissue Nervous tissue Muscle

Epithelial TissuesEpithelial Tissues


Found in different areas Body coverings Body linings Glandular tissue

Functions Protection Absorption Filtration Secretion

Epithelium CharacteristicsEpithelium Characteristics


Cells fit closely together

Tissue layer always has one free surface

The lower surface is bound by a basement membrane

Avascular (have no blood supply)

Regenerate easily if well nourished

Classification of EpitheliumClassification of Epithelium


Number of cell layers

Simple – one layer

Stratified – more than one layer

Figure 3.16a

Classification of EpitheliumClassification of Epithelium


Shape of cells

Squamous – flattened

Cuboidal – cube-shaped

Columnar – column-like

Figure 3.16b

Simple EpitheliumSimple Epithelium


Simple squamous Single layer of flat

cells

Usually forms membranes

Lines body cavities

Lines lungs and capillaries

Figure 3.17a



Simple cuboidal Single layer of

cube-like cells

Common in glands and their ducts

Forms walls of kidney tubules

Covers the ovaries Figure 3.17b



Simple columnar

Single layer of tall cells

Often includes goblet cells, which produce mucus

Lines digestive tract

Figure 3.17c



Pseudostratified Single layer, but

some cells are shorter than others

Often looks like a double cell layer

Sometimes ciliated, such as in the respiratory tract

May function in absorption or secretion

Figure 3.17d

Stratified EpitheliumStratified Epithelium


Stratified squamous Cells at the free edge

are flattened

Found as a protective covering where friction is common

Locations Skin Mouth Esophagus Figure 3.17e



Stratified cuboidal Two layers of cuboidal cells

Stratified columnar Surface cells are columnar, cells

underneath vary in size and shape

Stratified cuboidal and columnar Rare in human body

Found mainly in ducts of large glands



Transitional epithelium

Shape of cells depends upon the amount of stretching

Lines organs of the urinary system

Figure 3.17f

Glandular EpitheliumGlandular Epithelium


Gland – one or more cells that secretes a particular product

Two major gland types Endocrine gland

Ductless

Secretions are hormones

Exocrine gland

Empty through ducts to the epithelial surface

Include sweat and oil glands

Connective TissueConnective Tissue


Found everywhere in the body

Includes the most abundant and widely distributed tissues

Functions

Binds body tissues together

Supports the body

Provides protection

Connective Tissue CharacteristicsConnective Tissue Characteristics


Variations in blood supply

Some tissue types are well vascularized

Some have poor blood supply or are avascular

Extracellular matrix

Non-living material that surrounds living cells

Connective Tissue TypesConnective Tissue Types


Bone (osseous tissue) Composed of:

Bone cells in lacunae (cavities)

Hard matrix of calcium salts

Large numbers of collagen fibers

Used to protect and support the body Figure 3.18a



Hyaline cartilage Most common

cartilage

Composed of:

Abundant collagen fibers

Rubbery matrix

Entire fetal skeleton is hyaline cartilage Figure 3.18b



Elastic cartilage

Provides elasticity

Example: supports the external ear



Fibrocartilage

Highly compressible

Example: forms cushion-like discs between vertebrae

Figure 3.18c



Dense connective tissue Main matrix element

is collagen fibers

Cells are fibroblasts

Examples Tendon – attach

muscle to bone

Ligaments – attach bone to bone Figure 3.18d



Areolar connective tissue Most widely

distributed connective tissue

Soft, pliable tissue

Contains all fiber types

Can soak up excess fluid Figure 3.18e



Areolar connective tissue Most widely

distributed connective tissue

Soft, pliable tissue

Contains all fiber types

Can soak up excess fluid Figure 3.18e



Reticular connective tissue Delicate network of

interwoven fibers

Forms stroma (internal supporting network) of lymphoid organs Lymph nodes Spleen Bone marrow

Figure 3.18g



Blood

Blood cells surrounded by fluid matrix

Fibers are visible during clotting

Functions as the transport vehicle for materials

Figure 3.18h

Muscle TissueMuscle Tissue


Function is to produce movement

Three types Skeletal muscle

Cardiac muscle

Smooth muscle

Muscle Tissue TypesMuscle Tissue Types


Skeletal muscle Can be controlled

voluntarily

Cells attach to connective tissue

Cells are striated

Cells have more than one nucleus

Figure 3.19b



Cardiac muscle Found only in the

heart

Function is to pump blood (involuntary)

Cells attached to other cardiac muscle cells at intercalated disks

Cells are striated

One nucleus per cell Figure 3.19c



Smooth muscle Involuntary muscle

Surrounds hollow organs

Attached to other smooth muscle cells

No visible striations

One nucleus per cell Figure 3.19a

Nervous TissueNervous Tissue


Neurons and nerve support cells

Function is to send impulses to other areas of the body

Irritability

Conductivity Figure 3.20

OVERVIEW

Normal cell functionsa. Gastric cells – secrete HClb. Nerve cells – generate action potential and

conduct impulsesc. Beta cells of the pancreasd. Type II pneumocytese. Immune system

OVERVIEW

Immunity – the body’s specific protective response to a foreign agent or organism

Immune system – part of the body’s defense mechanism against invasion and allows a rapid response to foreign substance

Genetic and cellular responses result when the immune system is activated

Tolerance – mechanism by which the immune system is programmed to eliminate foreign substances such as microbes, toxins, and cellular mutations but maintains the ability to accept self-antigens

OVERVIEW Immunopathology – the study of diseases

that result from dysfunctions within the immune system

Immune function is affected by a variety of factors

1. Central nervous system integrity2. General physical status3. General emotional status4. Stress5. Illness6. Trauma7. Surgery

IMMUNE SYSTEM DISORDERS

Autoimmunity - is the failure of an organism to recognize its own constituent parts as ''self'', which allows an immune response against its own cells and tissues.

Hypersensitivity - refers to excessive, undesirable (damaging, discomfort-producing and sometimes fatal) reactions produced by the normal immune system.

Gammopathies - abnormal proliferation of the lymphoid cells producing immunoglobulins. Ex: hodgkins disease

Immune deficiencies - is a state in which the immune system's ability to fight infectious disease is compromised or entirely absent.

a. Primary b.Secondary

ANATOMIC AND PHYSIOLOGIC OVERVIEW Epitopes – antigenic determinants that are

present on foreign materials, initiating a series of action in a host, including the inflammatory response, the lysis of microbial agents, and the disposal of foreign toxins

Bone marrow (B lymphocytes originates) Lymphoid tissues – spleen, lymph nodes WBCs, antibodies Types of immunity1. Natural immunity – or innate immunity is

nonspecific and is present at birth (intact skin, phagocytes, compliment system)

2. Acquired or adaptive immunity – specific and develops after birth (humoral & Cellular immunity)

BASIC CONCEPTS

Components of the Immune System Immune cells Central immune structures: bone marrow

and thymus (where immune cells are produced and mature)

Peripheral immune structures: lymph nodes, spleen (where the immune cells interact with the antigen)

BASIC CONCEPTS

Components of the Immune System Immune cells: T and B lymphocytes

(primary cells), macrophages (accessory cells) which aid in processing and presentation of antigens to the lymphocytes

Cytokines: molecules that form a communication link between immune cells and other tissues and organs of the body

Lymph NodesLymph Nodes

Slide 12.6b

Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings

Figure 12.3

Lymph Node StructureLymph Node Structure

Slide 12.7b


Figure 12.4

Other Lymphoid OrgansOther Lymphoid Organs


Several other organs contribute to lymphatic function

Spleen

Thymus

Tonsils

Peyer’s patchesFigure 12.5

The SpleenThe Spleen

Slide 12.10


Located on the left side of the abdomen

Filters blood

Destroys worn out blood cells

Forms blood cells in the fetus

Acts as a blood reservoir

The ThymusThe Thymus

Slide 12.11


Located low in the throat, overlying the heart

Functions at peak levels only during childhood

Produces hormones (like thymosin) to program lymphocytes

TonsilsTonsils

Slide 12.12


Small masses of lymphoid tissue around the pharynx

Trap and remove bacteria and other foreign materials

Tonsillitis is caused by congestion with bacteria

Peyer’s PatchesPeyer’s Patches

Slide 12.13


Found in the wall of the small intestine

Resemble tonsils in structure

Capture and destroy bacteria in the intestine

Mucosa-Associated Lymphatic Mucosa-Associated Lymphatic Tissue (MALT)Tissue (MALT)

Slide 12.14


Includes:

Peyer’s patches

Tonsils

Other small accumulations of lymphoid tissue

Acts as a guard to protect respiratory and digestive tracts

Body DefensesBody Defenses

Slide 12.15a


The body is constantly in contact with bacteria, fungi, and viruses (pathogens)

The body has two defense systems for foreign materials

Nonspecific defense system

Mechanisms protect against a variety of invaders

Responds immediately to protect body from foreign materials

Body DefensesBody Defenses

Slide 12.15b


Specific defense system

Specific defense is required for each type of invader

Also known as the immune system

Nonspecific Body DefensesNonspecific Body Defenses

Slide 12.16


Body surface coverings

Intact skin

Mucous membranes

Specialized human cells

Chemicals produced by the body

Surface Membrane Barriers – Surface Membrane Barriers – First Line of DefenseFirst Line of Defense

Slide 12.17a


The skin

Physical barrier to foreign materials

pH of the skin is acidic to inhibit bacterial growth

Sebum is toxic to bacteria

Vaginal secretions are very acidic

Surface Membrane Barriers – Surface Membrane Barriers – First Line of DefenseFirst Line of Defense

Slide 12.17b


Stomach mucosa

Secretes hydrochloric acid

Has protein-digesting enzymes

Saliva and lacrimal fluid contain lysozyme

Mucus traps microogranisms in digestive and respiratory pathways

Defensive CellsDefensive Cells

Slide 12.18a


Phagocytes (neutrophils and macrophages)

Engulfs foreign material into a vacuole

Enzymes from lysosomes digest the material

Figure 12.6b

Macrophage attacking e-coli.

•

Macrophage attacking e-coli.

•

Defensive CellsDefensive Cells

Slide 12.18b


Natural killer cells

Can lyse and kill cancer cells

Can destroy virus- infected cells

Figure 12.6b

Inflammatory Response - Inflammatory Response - Second Line of DefenseSecond Line of Defense

Slide 12.19


Triggered when body tissues are injured

Produces four cardinal signs Redness

Heat

Swelling

Pain

Results in a chain of events leading to protection and healing

Functions of the Inflammatory Functions of the Inflammatory ResponseResponse

Slide 12.20


Prevents spread of damaging agents

Disposes of cell debris and pathogens

Sets the stage for repair

Steps in the Inflammatory ResponseSteps in the Inflammatory Response

Slide 12.21


Figure 12.7

Antimicrobial ChemicalsAntimicrobial Chemicals

Slide 12.22a


Complement A group of at

least 20 plasma proteins

Activated when they encounter and attach to cells (complement fixation) Figure 12.8


Slide 12.22b


Complement (continued)

Damage foreign cell surfaces

Will rupture or lyse the foreign cell membrane

Figure 12.8


Slide 12.22c


Interferon

Secreted proteins of virus-infected cells

Bind to healthy cell surfaces to inhibit viruses binding

Interferons are a family species-specific proteins synthesized by eukaryotic cells in response to viruses and a variety of natural and synthetic stimuli. There are several different interferons commonly used as therapeutics, termed alpha, beta, and gamma. These peptides are used to treat hairy cell leukemia, AIDS-related Kaposi's sarcoma, laryngeal papillomatosis, genital warts, and chronic granulomatous disease. Side effects include black tarry stools, blood in the urine, confusion, and loss of balance.

FeverFever

Slide 12.23


Abnormally high body temperature

Hypothalmus heat regulation can be reset by pyrogens (secreted by white blood cells)

High temperatures inhibit the release of iron and zinc from liver and spleen needed by bacteria

Fever also increases the speed of tissue repair

Specific Defense: The Immune Specific Defense: The Immune System – Third Line of DefenseSystem – Third Line of Defense

Slide 12.24


Antigen specific – recognizes and acts against particular foreign substances

Systemic – not restricted to the initial infection site

Has memory – recognizes and mounts a stronger attack on previously encountered pathogens

Types of ImmunityTypes of Immunity

Slide 12.25


Humoral immunity

Antibody-mediated immunity

Cells produce chemicals for defense

Cellular immunity

Cell-mediated immunity

Cells target virus infected cells

Antigens (Nonself)Antigens (Nonself)

Slide 12.26


Any substance capable of exciting the immune system and provoking an immune response

Examples of common antigens Foreign proteins

Nucleic acids

Large carbohydrates

Some lipids

Pollen grains

Microorganisms

Self-AntigensSelf-Antigens

Slide 12.27


Human cells have many surface proteins

Our immune cells do not attack our own proteins

Our cells in another person’s body can trigger an immune response because they are foreign

Restricts donors for transplants

AllergiesAllergies

Slide 12.28


Many small molecules (called haptens or incomplete antigens) are not antigenic, but link up with our own proteins

The immune system may recognize and respond to a protein-hapten combination

The immune response is harmful rather than protective because it attacks our own cells

Cells of the Immune SystemCells of the Immune System

Slide 12.29


Lymphocytes Originate from hemocytoblasts in the red bone

marrow

B lymphocytes become immunocompetent in the bone marrow

T lymphocytes become immunocompetent in the thymus

Macrophages Arise from monocytes

Become widely distributed in lymphoid organs

Activation of LymphocytesActivation of Lymphocytes

Slide 12.30


Figure 12.9

Humoral (Antibody-Mediated) Humoral (Antibody-Mediated) Immune ResponseImmune Response

Slide 12.31a


B lymphocytes with specific receptors bind to a specific antigen

The binding event activates the lymphocyte to undergo clonal selection

A large number of clones are produced (primary humoral response)

Humoral (Antibody Mediated) Humoral (Antibody Mediated) Immune ResponseImmune Response

Slide 12.31b


Most B cells become plasma cells

Produce antibodies to destroy antigens

Activity lasts for four or five days

Some B cells become long-lived memory cells (secondary humoral response)

Humoral Immune ResponseHumoral Immune Response

Slide 12.32


Figure 12.10

Active ImmunityActive Immunity

Slide 12.34


Your B cells encounter antigens and produce antibodies

Active immunity can be naturally or artificially acquired

Figure 12.12

Passive ImmunityPassive Immunity

Slide 12.35


Antibodies are obtained from someone else Conferred naturally from a mother to her

fetus

Conferred artificially from immune serum or gamma globulin

Immunological memory does not occur

Protection provided by “borrowed antibodies”

Antibodies (Immunoglobulins) (Igs)Antibodies (Immunoglobulins) (Igs)

Slide 12.37


Soluble proteins secreted by B cells (plasma cells)

Carried in blood plasma

Capable of binding specifically to an antigen

Antibody ClassesAntibody Classes

Slide 12.39


Antibodies of each class have slightly different roles

Five major immunoglobulin classes – (Do Not Need to know!) IgM – can fix complement

IgA – found mainly in mucus

IgD – important in activation of B cell

IgG – can cross the placental barrier

IgE – involved in allergies

Cellular (Cell-Mediated) Immune Cellular (Cell-Mediated) Immune ResponseResponse

Slide 12.42


Antigens must be presented by macrophages to an immunocompetent T cell (antigen presentation)

T cells must recognize nonself and self (double recognition)

After antigen binding, clones form as with B cells, but different classes of cells are produced

Cellular (Cell-Mediated) Immune Cellular (Cell-Mediated) Immune ResponseResponse

Slide 12.43


Figure 12.15

T Cell ClonesT Cell Clones

Slide 12.44a


Cytotoxic T cells

Specialize in killing infected cells

Insert a toxic chemical (perforin)

Helper T cells

Recruit other cells to fight the invaders

Interact directly with B cells

T Cell ClonesT Cell Clones

Slide 12.44b


Suppressor T cells

Release chemicals to suppress the activity of T and B cells

Stop the immune response to prevent uncontrolled activity

A few members of each clone are memory cells

Summary of the Immune ResponseSummary of the Immune Response

Slide 12.45


Figure 12.16

Organ Transplants and RejectionOrgan Transplants and Rejection

Slide 12.46a


Major types of grafts

Autografts – tissue transplanted from one site to another on the same person

Isografts – tissue grafts from an identical person (identical twin)

Allografts – tissue taken from an unrelated person

Xenografts – tissue taken from a different animal species

Organ Transplants and RejectionOrgan Transplants and Rejection

Slide 12.46b


Autografts and isografts are ideal donors

Xenografts are never successful

Allografts are more successful with a closer tissue match

BASIC CONCEPTS

Components of the Immune System Major Histocompatibility Complex (MHC) –

membrane molecules that help the immune system recognise the self from the non-self

HLA – (Human Leukocyte Antigens) are human MHC proteins that were first detected on white blood cells; play a role in transplant rejection and are detected in immunologic tests

BASIC CONCEPTS

Major Histocompatibility Complex Key recognition molecules which is an

essential feature of adaptive or specific immunity

Able to discriminate between the body’s own molecules against foreign antigens

Coded by closely linked genes in chromosome 6

BASIC CONCEPTS

Major Histocompatibility Complex (Two Classes): MHC I - differentiate viral infected and

abnormal cells from normal cells MHC II - allow appropriate interactions among

immune cells

Properties HLA antigens Distribution Functions

Class I MHC HLA-A, HLA-B, HLA-C(Human Leucocyte Antigen - helps the immune system distinguish the body's own proteins from proteins made by foreign invaders such as viruses

and bacteria. )

Virtually all nucleated cells

Present processed antigen to cytotoxic CD8 T-cells; restrict cytolysis to virus-infected cells, tumor cells and transplanted cells

Class II MHC HLA-DR, HLA-DP, HLA-DQ

Immune cells, antigen-presenting cells, and macrophages

Present processed antigenic fragments to CD4 T-cells; necessary for effective interaction among immune cells

OVERVIEW Normal cells and functionsa. Most normal human cells have 23 pairs of

chromosomesb. All normal cells (except the sex cells and the

mature red blood cells) have the entire human genome in every cell

c. Normal cells have about 35,000 genes, and about 50 of these genes are very active during embryonic life

d. Normal cells undergo mitosis either to develop normal tissue during embryonic development, childhood, and adolescence or to replace lost or damaged normal tissue

THE CELL CYCLE

THE CELL CYCLE

The Cell Cycle – consists of 4 phases:1. Gap 1 (G1) – the cell enlarges and

synthesizes proteins to prepare for DNA replication

2. Synthesis (S) phase – DNA is replicated and the chromosomes in the cell are duplicated

3. Gap 2 (G) – the cell prepares itself for mitosis4. Mitosis (M) phase – final step, where the

parent cell divides into two exact copies called daughter cells, each having identical genetic material

THE CELL CYCLE

The cells after the M phase immediately enter the G1 where they begin another cell cycle again

Or the cells divert into a resting phase called G0

The cell cycle is controlled by cyclin-dependent kinases

Some cyclins cause a “braking” action and prevent the cycle from proceeding

Checkpoints in the cell cycle ensure that it proceeds in the correct order

THE CELL CYCLE

A malfunction of any of these regulators of cell growth and division can result in the rapid proliferation of immature cells

In some cases these proliferating immature cells are considered cancerous (malignant)

Knowledge of the cell cycle events is used in the development of chemotherapeutic drugs, which are designed to disrupt the cancer cells during different stages of their cell cycle

OVERVIEW

In embryonic life, there are early development genes called proto-oncogenes, and their activity is not needed after embryonic life

Other genes are called tumor suppressor genes, which slow down cell division, repair DNA mistakes, and tell cells when to die (apoptosis, or programmed cell death)

Tumor suppressor genes can also reduce expression of proto-oncogenes by negative feedback mechanisms

Proto-oncogenes are not abnormal genes, and are part of every human’s normal cellular DNA

Normal Cell (homeostasis)

Reversible Injury

Adaptation Cell Injury

Irreversible Injury

Necrosis Apoptosis

Stress Injurious stimulus

Inability to adapt Severe,

progressive

CELL DEATH

Mild, transient

OVERVIEW

Adaptations are reversible changes in the size, number, phenotype, metabolic activity, or functions of cells in response to changes in their environment

a. Hypertrophy – increase in the size of cells, resulting in an increase in the size of the organ

b.Hyperplasia – an increase in the number in an organ or tissue, usually resulting in increased mass of the organ or tissue

c. Atrophy – reduced size of an organ or tissue resulting from a decrease in cell size and number

OVERVIEW

e. Metaplasia – reversible change in which one differentiated cell type (epithelial or mesenchymal) is replaced by another cell type

f. Necrosis – cell deathg. Apoptosis – programmed cell deathh. Differentiation - process by which cells or

tissues undergo a change toward a more specialized form or function, especially during embryonic development

i. Dysplasiaj. Anaplasia

OVERVIEW

e. Dysplasia - abnormal development or growth of tissues, organs, or cells

f. Anaplasia - abnormal development or growth of tissues, organs, or cells

EPIDEMIOLOGY OF CANCER

2004 – The American Cancer Society estimates that 1,368,030 people will be diagnosed with cancer in the US

Cancer continues to be the second leading cause of death in the US

62% of those diagnosed with cancer can expect to be alive in 5 years

Incidence and mortality rates for cancer have dropped approximately 1% per year since 1991

EPIDEMIOLOGY OF CANCER The American Cancer Society has established

the goal of a 25% reduction in the overall age-adjusted cancer incidence rate and a 50% reduction in the overall age-adjusted cancer mortality rate by 2015

Nurses should play a pivotal role in the attainment of these goals through active involvement in cancer prevention and early detection activities

Survival rate represents the percentage of persons alive 5 years from now after diagnosis, whether cured, in remission, or with evidence of disease

Estimated New Cases Estimated New Deaths

Male Female Male Female

Prostate (38%)Lung and bronchus (13%)Colon and rectum (10%)Urinary bladder (7%)Melanoma of the skin (5%)Non-Hodgkin lymphoma (4%)Kidney and renal pelvis (3%)Leukemia (3%)Oral cavity and pharynx (3%)Pancreas (2%)All sites (100%)

Breast (32%)Lung and bronchus (12%)Colon and rectum (11%)Uterine corpus (6%)Non-Hodgkin lymphoma (4%)Melanoma of the skin (4%)Ovary (3%)Thyroid (3%)Urinary bladder (2%)Pancreas (2%)All sites (100%)

Lung and bronchus (31%)Prostate (10%)Colon and rectum (10%)Pancreas (5%)Leukemia (4%)Esophagus (4%)Liver and intrahepatic bile duct (3%)Non-Hodgkin lymphoma (3%)Kidney and renal pelvis (3%)All sites (100%)

Lung and bronchus (27%)Breast (15%)Colon and rectum (10%)Ovary (6%)Pancreas (6%)Leukemia (4%)Non-Hodgkin lymphoma (3%)Uterine corpus (3%)Multiple myeloma (2%)Brain and other nervous system (2%)All sites (100%)

Estimated Incidence (2008) Estimated Deaths (2008)

Male Female Male Female

Melanoma of the skin (5%)Oropharynx (3%)Lung (15%)Pancreas (3%)Kidney (4%)Colon and rectum (10%)Urinary bladder (7%)Prostate (25%)Leukemia (3%)Hon-Hodgkin lymphoma (5%)All others (20%)

Melanoma of the skin (4%)Thyroid (4%)Lung (14%)Breast (26%)Kidney (3%)Colon and rectum (10%)Ovary (3%)Uterus (6%)Leukemia (3%)Non-Hodgkin lymphoma (4%)All others (23%)

Lung (31%)Esophagus (4%)Liver (4%)Pancreas (6%)Kidney (3%)Colon and rectum (8%)Urinary bladder (3%)Prostate (10%)Leukemia (4%)Non-Hodgkin Lymphoma (3%)All others (24%)

Brain (2%)Lung (26%)Breast (15%)Liver (2%)Pancreas (6%)Colon and rectum (9%)Ovary (6%)Uterus (3%)Leukemia (3%)Non-Hodgkin Lymphoma (3%)All others (25%)

Robbins Pathologic Basis of Disease 8th edition

EPIDEMIOLOGY OF CANCER Risk factors1. Heredity – 5 to 10% of cancers have a hereditary

component2. Age – 76% of cases occur after age 55; hormonal

changes, immune system changes3. Gender 4. Poverty5. Stress6. Diet7. Occupation 8. Infection9. Tobacco use 10.Alcohol use11.Recreational drug use12.Obesity – increased risk of hormone-dependent cancers13.Sun exposure

EPIDEMIOLOGY OF CANCER Endogenous risk factors:1. Genetic predisposition2. Sex3. Age4. Race5. Family history Exogenous risk factors:1. Alcohol2. Diet3. Exercise4. Occupational exposure5. Cigarette smoking6. Sexual activity

EPIDEMIOLOGY OF CANCERRisk Factors and Signs and Symptoms of Common Cancers

Cancer Site Risk Factors Signs and Symptoms

Breast Female genderAge >50 yearsFamily historyPersonal history of breast cancer2 or more first-degree relativesKnown BRCA1 or BRCA2 mutationBiopsy historyAtypical hyperplasiaDCIS or LCISPostmenopausal obesityEarly menarche/late menopauseLate first pregnancy/nulliparousOCPRadiation to chest wallAlcoholObesity and high fat dietHormone replacement therapy

Lump or massThickening in breast or axillaChange in size or contour or textureSkin dimpling or retractionPeau d’orange skinNipple discharge, retraction, or scalinessErythemaPain or tenderness



Prostate Male genderAge >50 yearsAfrican American ethnicityFamily history of first-degree relative (greater if first-degree relative diagnosed before age 40)High-fat diet

Weak urinary stream and urinary frequencyDifficulty in initiating stream or stopping urinary streamPain or burning on urinationUrinary retentionHematuria

Colorectal Age >60 yearsInflammatory bowel conditionsSedentary lifestyleDiet high in fat and low in fruits and vegetablesHeavy alcohol consumptionFamily history of colorectal cancer especially if before the age of 40



Prostate Male genderAge >50 yearsAfrican American ethnicityFamily history of first-degree relative (greater if first-degree relative diagnosed before age 40)High-fat diet

Weak urinary stream and urinary frequencyDifficulty in initiating stream or stopping urinary streamPain or burning on urinationUrinary retentionHematuria

Colorectal Familial genetic syndromes, e.g., familial adenomatous polyposis (FAP) and hereditary nonpolyposis colon cancer (HNPCC)

Change in bowel habitsRectal bleedingAbdominal painDecreased diameter of stoolsAnemiaRectal pressure or painWeight lossanorexia


Risk Factors and Signs and Symptoms of Common Cancers


Lung Cigarette smokingOccupational exposure to asbestos, arsenic, chromium, coal products, nickel refining, smelter workers, ionizing radiation, radon

Chronic cough and wheezingPersistent respiratory infectionsDull chest painHemoptysisDyspneaWeight loss


Carcinogens a. Virusesb. Drugs and hormones – can be either

genotoxic or promotionalc. Chemical agents – both genotoxic and

promotionald. Physical agents – for example radiation

Chemical Carcinogens and Relationship to Occupation

Chemical Agent Action Occupation

Polycyclic hydrocarbons (smoke, soot, tobacco, smoked foods)

Genotoxic Miners, coal/gas workers, chimner sweeps, migrant worker, workers in offices where smoking is allowed

BenzopyreneArsenic

Genotoxic Pesticide manufacturers, mining

Vinyl chloride Promotional Plastic workersArtistis

Methylaminobenzine Genotoxic Fabric workersRubber and glue workers

Chemical Carcinogens and Relationship to Occupation

Chemical Agent Action Occupation

Asbestos Promotional Construction workers, workers in old, run-down buildings with asbestos insulation, insulation makers

Wood and leather dust Promotional Woodwrokers, carpenters, leather toolers

Chemotherapy drugs Genotoxic Drug manufacturers, pharmacists, nurses

Occupational Cancers

Agent Cancer Typical use or occurrence

Arsenic and arsenic compounds

Lung, skin, hemangiosarcoma

Byproduct of metal smelting; component of alloys, electrical and semiconductor devises, medications and herbicides, fungicides, and animal dips

Asbestos Lung, mesothelioma, esophagus, stomach, large intestine

Formerly used for many applications because of fire, heat and friction resistance, still found in existing construction as well as fire-resistant textiles, friction materials (brake linings), underlayment and roofing papers, floor tiles



Benzene Leukemia, Hodgkin lymphoma

Principal component of light oil, despite known risk, many applications exist in printing and lithography, paint, rubber, dry cleaning, adhesives and coatings, and detergents, formerly widely used as solvent and fumigant

Beryllium and beryllium compounds

Lung Missile fuel and space vehicles, hardener for lightweight metal alloys, particularly in aerospace applications and nuclear reactors



Chromium compounds Lung Component of metal alloys, paints, pigments, and preservatives

Nickel compounds Nose, lung Nickel plating, component of ferrous alloys, ceramics, and batteries, by-product of stainless steel arc welding

Radon and its decay products

Lung From decay of minerals containing uranium, potentially serious hazard in quarries and underground mines

Vinyl chloride Angiosarcoma Refrigerant, monomer for vinyl polymers, adhesive for plastics, formerly inert aerosol propellant un pressurized containers



Cadmium and cadmium compounds

Prostate Uses include yellow pigments and phosphors; found in solders; used in batteries and as alloy and in metal platings and coatings


HSV types I and IIa. Carcinoma of the lipb. Cervical carcinomac. Kaposi sarcoma Human CMVa. Kaposi sarcomab. Prostate carcinoma


EBVa. Burkitt lymphoma HBVa. Primary HCC Papillomavirusa. Malignant melanomab. Cervical, penile, and laryngeal cancers HTLVa. Adult T-cell leukemia and lymphomab. Kaposi sarcoma


Approximately three fourths of all cancers occur in people over the age of 55

Overall cancer incidence in males has stabilized in recent years when compared with that in females

Men have a higher lifetime probability of developing and dying of cancer than women, but men have a greater recent decline in death rates

Children – overall, cancer is the leading cause of death due to disease in children between 1 and 14 years of age


Cause of Death by Age

Age (years) Males Females

20-39 1. Brain/CNS2. Leukemia 3. Lung

1. Breast2. Uterine/cervix3. Leukemia

40-59 1. Lung2. Colorectal3. Pancreas

1. Breast2. Lung3. Colorectal

60-79 1. Lung2. Colorectal3. Prostate

1. Lung2. Breast3. Colorectal

>80 1. Lung2. Prostate3. Colorectal

1. Lung2. Colorectal3. Breast

THE ROLE OF THE NURSE

Education Monitoring Documentation Proper referral Being up to date

Topic 1 Cellular Abberation

Education

pearson education

benjamin cummings slide

benjamin cummingsslide

cytoplasmic organelles

normal cell nucleus

cell dividescopyright

generalized cell cells

plasma membrane barrier