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Carcinogenesis
Is the process whereby external influence causes cancer.
Classified to:
1.Initiation in which the cells undergo transformation to a premalignant stage.
2.Promotion in which these cells are induced to form a cancer.
The agents which causes cancer are termed carcinogens.
1.Chemical carcinogens, eg : tobacco causing lung cancer, Asbestos causing pleural
cancer, Alcohol causing ca. esophagus.
2.Physical carcinogens eg: Uv. Light causing skin cancer , X-ray damaging bone marrow.
3.Viruses eg: papilloma virus causing CX. Cancer , E.B virus causing Burkitts
Lymphoma.
4.Diet eg: heavily cooked meat is rich in hetero cyclic Amine which is a potent
carcinogen , on contrary high vegetable intake is associated with low rate of cancer, both
vegetables and fruits are rich in anti-oxidants , they have protective effect.
Cell death
As in normal tissue the commonest form of cell death in tumour is by apoptosis
this physiological process involves a series of steps which consists of
condensation and fragmentation of chromatin and sub sequent shrinkage of
the cell.
Cell remnant is taken by macrophage without involving an inflammatory
reaction.
The other sort of cell death is by necrosis which does involve an inflammatory
reaction.
There is a balance in normal tissue between cell loss and cell proliferation .
In the tumour either the cell proliferation is more than normal or cell death is
slower than normal.
Cell cycle
We have five stages in the cell cycle ,G1 ,S,G2,M,and Go.
M:- mitosis
G1:- gap phase
S:- synthesis , DNA replication
G2:- 2nd gap phase
Go:-resting or clonogenic cells
Gompertzian curve
1.Small tu. Grow rapidly large tu. Grow slowly because of decrease in blood
supply .
2.Small tu. Have large growth fraction , large tu. Have small G.F.
3.Small tu. More sensitive to C.T and R.T.