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Tumour

immunology
Von Ryan F. Lingcallo, RMT
Tumor immunology is the study of
the antigens associated with tumors,
the immune response to tumors, the
tumors effect on the hosts immune
status, and the use of the immune
system to help eradicate the tumor.
Proto-oncogenes - can cause uninhibited cell
division if their expression is altered or if they
are mutated into oncogenes.
Tumour suppressor genes
Benign tumour
Malignant tumour
Metastasis is when the malignant cells travel
through the body, causing new foci of
malignancy until body function is so disrupted
that death occurs.
TNM system
T
N
M
Immunosurveillance
immune system to eradicate cancer cells as
they form has long been postulated.
The immune system provides tumor surveillance for
the body:
NK cells, T lymphocytes (tumor infiltrating
lymphocytes[TIL]), and macrophage infiltrates have
been demonstrated in some tumors, and they are
associated with a better prognosis
A common characteristic of many tumors is loss of
MHC expression and subsequent poor antigen
presentation, allowing tumor cells to escape from T
cells.
Certain therapeutic advances directed toward
upregulating the immune system to fight a particular
cancer have shown some success.
Spontaneous regression of some tumors has been
observed.
Immunohistochemistry - can detect expressed
antigens using labeled antibodies, and
molecular techniques such as fluorescent in
situ hybridization (FISH) can detect abnormal
gene expression using nucleic acid probes
LAB TESTS FOR TUMOR MARKER
DETECTION
Cytogenetic studies: Many cancers are
associated with particular karyotypes.
However, as more precise knowledge of the
exact gene defects present in various cancers
is gained, testing for the aberrant genes is
becoming more prevalent.
Nucleic acid amplification techniques:
Polymerase chain reaction (PCR) and its
variants increase the inherent level of DNA or
RNA, allowing the detection of small
populations of cancer cells (including
circulating cells in metastasis) and the
detection of mutations, deletions, and gene
rearrangements/translocations.
Fluorescent in situ hybridization (FISH):
Nucleic acid probes capable of binding to
sequences of interest are tagged with
fluorophors and applied to cells. Cells
containing the sequence of interest can be
visualized with fluorescent microscopes.
Similar techniques using nonfluorescent labels
such as enzymes and silver stains are also
becoming available.
The BCR-ABL translocation associated with
chronic myelogenous leukemia is a well-
respected marker for this disease.
The future may lie with microarray tests that
are currently being developed with multiple
nucleic acid tests contained on a single chip to
allow for simultaneous testing of a sample for
multiple genes.
Immunotherapy
Passive Immunity - Passive transfer of
allogeneic cellular immunity from one person
to another to fight cancer has many barriers
because of possible recipient rejection of
foreign cells, graft-versushost disease (GVHD),
and the fragility of live cells, although research
models are being studied.
Active Immunotherapy
The goal of active immunotherapy is to have
the patient develop an immune response that
will help eliminate the tumor.

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