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DEPARTMENT		OF	PATHOLOGICAL	PHYSIOLOGY- 2019
The Plan of Lecture
1. Hyperbiotic and hypobiotic processes
2. Neoplasia. Tumor
3. Nomenclature of tumor
4. Carcinogenic factors
5. Pathogenetic mechanisms of tumors
6. Protooncogenes
7. Tumor suppressor genes
8. Genes of apoptosis
9. DNA repair genes
10.Atypicalness.
11.Metastases
12.Mechanisms of anti-blastomic resistance
Disorders of the tissue growth may occur at all periods of the individual
(intrauterine as well as postnatal) development of the organism:
PRENATAL PERIOD
a) gametopathies- occur at the period of maturation of gametes (spermatozoon and
ovum ) and fertilization
b) blastopathies- occur from the moment of fertilization up to the 15th day of
pregnancy
c) embryopathies - occur from the 16th up to the 75th day of pregnancy;
d) fetopathies – occur from the 76th up to the 280th day of the pregnancy (up to
the birth);
POSTNATAL PERIOD
1.Hypobiotic	processes- inhibition	of	the	tissue	growth
2.	Hyperbiotic processes- acceleration	of	the	tissue	growth
Hyper- and hypobiotic processes
nucle
us
Normal cell
Disaplasia
Hyperplasia
Hypertrophy
Atrophy
Metaplasia
Atrophy- is the pathological process which is
characterized by diminution of the volume of
cells, tissues or organs.
-Physiological and pathological forms
-General and local forms
Reasons:
-disfunctional
-neurogenic
-mechanical compression
-physical, chemical factors and etc .
Hypertrophy – increasing of the volume of
tissue due to increasing of each cell volume .
- Increased work load
-Physiological and pathological hypertrophy
-Compensatory or vicarious hypertrophy
-Regeneration hypertrophy
-Correlation hypertrophy
-True and false (pseudo-) hypertrophy
Hyperplasia – increasing of the
volume of tissues as a result of an
increase in the number of cells (division
of cells).
-Physiological and pathological forms
-Hormonal and
-Compensator types of hyperplasia
Regeneration – is the restoration
of destructed or lost tissue.
-physiological regeneration
-reparative regeneration
-pathological forms:
-hyperregeneration
-hyporegeneration
-metaplasia
- dysplasia
• Metaplasia — means replacement of one
type of the cell by other one derived from the
same tissue.
• Dysplasia	— is the proliferation and
formation of different sized, shaped and
structured cells in the tissue due to genetic
reprogramming.
Neoplasia — non-controllable,
uncoordinated, unlimited, excessive, rapid,
abnormal proliferation of cells that leads to
the formation of tumor. This typical
pathological process arise under influence of
carcinogenic factors.
The	reason	for	development	of	
Neolasia is	oncogenic mutations
• 1.Protooncogenes
• 2.Tumor-supressor	genes
• 3.Genes	of	apoptosis
• 4.	DNA	repair	genes
C
a
r
c
i
n
o
g
e
n
i
c
f
a
c
t
o
r
s
Chemical
Action of soot and tar, chrome, nickel,
arsenic compounds, cobalt, asbestos,
benzol, polycyclic and aromatic
hydrocarbons, aromatic amins, aflatoksin,
hormons (estrogen)
Physical
Ionizing radiation, ultraviolet rays , X-rays,
burns , mechanical trauma and etc.
Biological
Oncogenic -viruses:
DNA-included	oncoviruses : human
papilloma virus (HPV), herpes virus (HHV-
8), Epstain-Barr virus (EBV), hepatitis B and
C virus (HBV and HCV)
RNA-included oncoviruses: HIV (AIDS),
HTLV-1 and etc.
Nomenclature	of	tumors	
vThe name of tumors are usually formed by adding the suffix “-oma” to the
names of tissue from which they develop. Malignant tumors of the epithelial
tissue are called cancer or carcinoma, and malignant tumors of connective
tissue- sarcoma.
BENIGN
Fibroma – tumor of connective tissue. It
frequently is observed in brest, uterus and
etc.
Myoma — tumor developed in the muscle
tissue.
Leiomyoma ― tumor developed from
smooth muscles.
Rabdomyoma ― tumor developed from
striated muscles.
Hemangyoma — tumor of vascular origine.
Lymphangyoma ― tumor developed from
the lymph vessel.
Lipoma — tumor of fat tissue.
Osteoma – tumor developed from bones.
Хоndroma ― tumor developed from
cartilages.
MALIGNANT
Fibrosarcoma	- malignant tumor of
connective tissue.
Myosarcoma — malignant tumor
developed in the muscle tissue.
Liposarcoma	– malignant tumor of fat
tissue.
Angiosarcoma	— malignant tumor of
vascular origin.
Оsteosarcoma	- malignant tumor
developed from bones.
Хоndrosarcoma.	– malignant tumor
developed from cartilages
Fibroma
Hemangioma
BENIGN
1. Consist of differentiated cells.
2. Tissue atypicalness is observed.
3. Moderate rate of growth is characteristic.
4. Expansive pathway of growth is
characteristic.
5. Don’t metastasize.
6. Enveloped into capsule.
7. Metabolism in benign tumors does not
differ from that of in normal tissue.
MALIGNANT
1. Consist of undifferentiated cells
2. Tissue and cell atypicalness are observed.
3. Invasive pathway of growth and excess
rapid growing are characteristic.
4. Metastases are frequent.
5. Recidivating is frequent.
6. Don’t poses capsule.
7. Inverts metabolism in the organism,
intoxication and cachexia are observed
•Epigenomic mechanism
•Mutation mechanism
Steps of Virus Cancerogenesis
• Cytoreception of virus
• Internalization
• Integration
• Persist replication of viruses inside the cell
• Transformation of cell
• Promotion
• Progression.
Mutated	gens	in	oncogenesis
1.Protooncogenes
2.Tumor-supressor	genes
3.Genes	of	apoptosis
4.DNA	repair	genes
Protooncogen Tumor
ERB-1 Lung cancer, glyoma
ERB-2 Brest cancer, ovarian cancer
K-RAS Lung Cancer , cancer of pancreas
and intestine
H-RAS Cancer of kidneys
N-RAS Melanoma
Abl Chronic mieloleukosis
C-myc Burkitt limfoma
N-myc Neuroblastoma
L-myc Small cellular cancer of lungs
Antioncogen Tumor
E-kadherin Brest and stomach cancer
NF-1 Neurofibromatosis I-type
NF-2 Neurofibromatosis II-type
APC Cancer of stomach, pancreas
and intestine
Rb Retinoblastoma
p53 Li-Fraumeny syndrome
WT-1 Willms tumor
BRCA-1 Brest and ovarian cancer
BRCA-2 Brest cancer in women and
men
Mutation	of	p53		gen
Steps	of	chemical	
carcinogenesis
• Initiation (transformation of normal cell
into the neoplastic)
• Promotion (action of promoters
stimulate the rapid proliferation of
neoplastic cells)
• Tumor progression (due to additional
mutations tumor cells undergo to
malignisation)
Characteristic	features		of	tumor
• Atypicalness. The tumor cells differ from
the normal, also from the cells that are
observed in other pathological processes.
As distinct from the proliferative
inflammation, hyperplasia, regeneration,
etc., in tumors reproduction of cells does
not depend on regulative mechanisms of
the organism.
• Morphological, biochemical, functional,
immunological and growth atypycalnesses are
observed.
vMorphological	atypicalness:
• Cellular: Hyperchromic, enlarged nuclei,
chromosomal abnormality, multinuclear
cells are observed. The volume of
cytoplasm decreases, the number of
ribosome's increases. The form and
volume of mitochondria changes.
Membrane surface larger than in the tumor
cells and weakening of the intercellular
connections are observed.
• Tissue atypicalness: atypical structural
changes in the tumor growing tissue
Stages of neoplasia
vAnomaly	of	division (unlimited,
noncontrollable division, immortality of cells).
v Anomaly	of	differentiation	(lack of
differentiation).
Characteristic features of tumor
vAtypicalness of growth - anomalies of cell
division, lack of differensation, ability of
invasion and metastasis, relapse.
Mechanism of invasion
Metastasis by hematogenic pathway
Biochemical	atypicalness
Accelerated consumption of amino acids,
glucose, cholesterol by tumor cells and
activation of anaerobic glycolysis.
Tumor cell is a "trap" for nitrogen-containing
compounds
Tumor cell is a "trap" for carbohydrates
Tumor cell is a "trap" for lipids
Functional atypicalness
Hypofunction
Hyperfunction
Dysfunction
Tumor	antigens	recognised	by
T-lymphocytes	(CD8+)
Mechanisms of antiblastomic resistance
Anticancerogenic
Antimutation
Anticellular (specific,
non-specific)
Diagnosis and general principles for the treatment of neoplasia.
TNM system (T - tumor, N - lymph node, M - metastasis).
T - indicates the size of the tumor,
N - involvement of regional lymph nodes in the process,
M - indicates the presence of metastases.
PI- proliferation index is the criteria to verify the
degree of histological and biological malignancy of the
tumor. The marker for determining PI is the
expression of Ki-67.
Ki-67 is a nuclear antigen, which is an indicator of the
cell being in the stage of division (proliferation) stage.
Classical triad for the treatment of cancer:
Surgical → chemotherapy → radiotherapy.
Immunotherapy (monoclonal antibodies)
is also used.

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7. Tumor.pdf

  • 2. The Plan of Lecture 1. Hyperbiotic and hypobiotic processes 2. Neoplasia. Tumor 3. Nomenclature of tumor 4. Carcinogenic factors 5. Pathogenetic mechanisms of tumors 6. Protooncogenes 7. Tumor suppressor genes 8. Genes of apoptosis 9. DNA repair genes 10.Atypicalness. 11.Metastases 12.Mechanisms of anti-blastomic resistance
  • 3. Disorders of the tissue growth may occur at all periods of the individual (intrauterine as well as postnatal) development of the organism: PRENATAL PERIOD a) gametopathies- occur at the period of maturation of gametes (spermatozoon and ovum ) and fertilization b) blastopathies- occur from the moment of fertilization up to the 15th day of pregnancy c) embryopathies - occur from the 16th up to the 75th day of pregnancy; d) fetopathies – occur from the 76th up to the 280th day of the pregnancy (up to the birth); POSTNATAL PERIOD 1.Hypobiotic processes- inhibition of the tissue growth 2. Hyperbiotic processes- acceleration of the tissue growth
  • 4.
  • 5. Hyper- and hypobiotic processes nucle us Normal cell Disaplasia Hyperplasia Hypertrophy Atrophy Metaplasia
  • 6.
  • 7. Atrophy- is the pathological process which is characterized by diminution of the volume of cells, tissues or organs. -Physiological and pathological forms -General and local forms Reasons: -disfunctional -neurogenic -mechanical compression -physical, chemical factors and etc .
  • 8.
  • 9. Hypertrophy – increasing of the volume of tissue due to increasing of each cell volume . - Increased work load -Physiological and pathological hypertrophy -Compensatory or vicarious hypertrophy -Regeneration hypertrophy -Correlation hypertrophy -True and false (pseudo-) hypertrophy
  • 10. Hyperplasia – increasing of the volume of tissues as a result of an increase in the number of cells (division of cells). -Physiological and pathological forms -Hormonal and -Compensator types of hyperplasia
  • 11. Regeneration – is the restoration of destructed or lost tissue. -physiological regeneration -reparative regeneration -pathological forms: -hyperregeneration -hyporegeneration -metaplasia - dysplasia
  • 12. • Metaplasia — means replacement of one type of the cell by other one derived from the same tissue. • Dysplasia — is the proliferation and formation of different sized, shaped and structured cells in the tissue due to genetic reprogramming.
  • 13. Neoplasia — non-controllable, uncoordinated, unlimited, excessive, rapid, abnormal proliferation of cells that leads to the formation of tumor. This typical pathological process arise under influence of carcinogenic factors.
  • 14. The reason for development of Neolasia is oncogenic mutations • 1.Protooncogenes • 2.Tumor-supressor genes • 3.Genes of apoptosis • 4. DNA repair genes
  • 15. C a r c i n o g e n i c f a c t o r s Chemical Action of soot and tar, chrome, nickel, arsenic compounds, cobalt, asbestos, benzol, polycyclic and aromatic hydrocarbons, aromatic amins, aflatoksin, hormons (estrogen) Physical Ionizing radiation, ultraviolet rays , X-rays, burns , mechanical trauma and etc. Biological Oncogenic -viruses: DNA-included oncoviruses : human papilloma virus (HPV), herpes virus (HHV- 8), Epstain-Barr virus (EBV), hepatitis B and C virus (HBV and HCV) RNA-included oncoviruses: HIV (AIDS), HTLV-1 and etc.
  • 16.
  • 17. Nomenclature of tumors vThe name of tumors are usually formed by adding the suffix “-oma” to the names of tissue from which they develop. Malignant tumors of the epithelial tissue are called cancer or carcinoma, and malignant tumors of connective tissue- sarcoma. BENIGN Fibroma – tumor of connective tissue. It frequently is observed in brest, uterus and etc. Myoma — tumor developed in the muscle tissue. Leiomyoma ― tumor developed from smooth muscles. Rabdomyoma ― tumor developed from striated muscles. Hemangyoma — tumor of vascular origine. Lymphangyoma ― tumor developed from the lymph vessel. Lipoma — tumor of fat tissue. Osteoma – tumor developed from bones. Хоndroma ― tumor developed from cartilages. MALIGNANT Fibrosarcoma - malignant tumor of connective tissue. Myosarcoma — malignant tumor developed in the muscle tissue. Liposarcoma – malignant tumor of fat tissue. Angiosarcoma — malignant tumor of vascular origin. Оsteosarcoma - malignant tumor developed from bones. Хоndrosarcoma. – malignant tumor developed from cartilages
  • 18.
  • 20. BENIGN 1. Consist of differentiated cells. 2. Tissue atypicalness is observed. 3. Moderate rate of growth is characteristic. 4. Expansive pathway of growth is characteristic. 5. Don’t metastasize. 6. Enveloped into capsule. 7. Metabolism in benign tumors does not differ from that of in normal tissue. MALIGNANT 1. Consist of undifferentiated cells 2. Tissue and cell atypicalness are observed. 3. Invasive pathway of growth and excess rapid growing are characteristic. 4. Metastases are frequent. 5. Recidivating is frequent. 6. Don’t poses capsule. 7. Inverts metabolism in the organism, intoxication and cachexia are observed
  • 22. Steps of Virus Cancerogenesis • Cytoreception of virus • Internalization • Integration • Persist replication of viruses inside the cell • Transformation of cell • Promotion • Progression.
  • 24. Protooncogen Tumor ERB-1 Lung cancer, glyoma ERB-2 Brest cancer, ovarian cancer K-RAS Lung Cancer , cancer of pancreas and intestine H-RAS Cancer of kidneys N-RAS Melanoma Abl Chronic mieloleukosis C-myc Burkitt limfoma N-myc Neuroblastoma L-myc Small cellular cancer of lungs
  • 25. Antioncogen Tumor E-kadherin Brest and stomach cancer NF-1 Neurofibromatosis I-type NF-2 Neurofibromatosis II-type APC Cancer of stomach, pancreas and intestine Rb Retinoblastoma p53 Li-Fraumeny syndrome WT-1 Willms tumor BRCA-1 Brest and ovarian cancer BRCA-2 Brest cancer in women and men
  • 27.
  • 28. Steps of chemical carcinogenesis • Initiation (transformation of normal cell into the neoplastic) • Promotion (action of promoters stimulate the rapid proliferation of neoplastic cells) • Tumor progression (due to additional mutations tumor cells undergo to malignisation)
  • 30. • Atypicalness. The tumor cells differ from the normal, also from the cells that are observed in other pathological processes. As distinct from the proliferative inflammation, hyperplasia, regeneration, etc., in tumors reproduction of cells does not depend on regulative mechanisms of the organism. • Morphological, biochemical, functional, immunological and growth atypycalnesses are observed.
  • 31. vMorphological atypicalness: • Cellular: Hyperchromic, enlarged nuclei, chromosomal abnormality, multinuclear cells are observed. The volume of cytoplasm decreases, the number of ribosome's increases. The form and volume of mitochondria changes. Membrane surface larger than in the tumor cells and weakening of the intercellular connections are observed. • Tissue atypicalness: atypical structural changes in the tumor growing tissue
  • 33. vAnomaly of division (unlimited, noncontrollable division, immortality of cells). v Anomaly of differentiation (lack of differentiation). Characteristic features of tumor vAtypicalness of growth - anomalies of cell division, lack of differensation, ability of invasion and metastasis, relapse.
  • 34.
  • 37. Biochemical atypicalness Accelerated consumption of amino acids, glucose, cholesterol by tumor cells and activation of anaerobic glycolysis. Tumor cell is a "trap" for nitrogen-containing compounds Tumor cell is a "trap" for carbohydrates Tumor cell is a "trap" for lipids
  • 40. Mechanisms of antiblastomic resistance Anticancerogenic Antimutation Anticellular (specific, non-specific)
  • 41. Diagnosis and general principles for the treatment of neoplasia. TNM system (T - tumor, N - lymph node, M - metastasis). T - indicates the size of the tumor, N - involvement of regional lymph nodes in the process, M - indicates the presence of metastases. PI- proliferation index is the criteria to verify the degree of histological and biological malignancy of the tumor. The marker for determining PI is the expression of Ki-67. Ki-67 is a nuclear antigen, which is an indicator of the cell being in the stage of division (proliferation) stage. Classical triad for the treatment of cancer: Surgical → chemotherapy → radiotherapy. Immunotherapy (monoclonal antibodies) is also used.