CLINICAL FEATURES OF NEOPLASIA

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CLINICAL FEATURES OF NEOPLASIA

• BY DR(MRS)B.J.THANENTHIRAN(MBBS)

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Effects of tumor on host

1. Direct effects due to primary tumors.
2. Effects due to metastasis.
3. Effects due to paraneoplastic syndromes.

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• Effects are
• Mechanical pressure obstruction.
• Destruction of tissue infiltrate destroy vital
  organs.
• Haemorrhage.
• Secondary infections.
• 
  

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• Haematological disorders.
• Anaemia.
• Neutrophil leucocytosis.
• Eosinophilia.
• Pain, anxiety insomnia.
• Immunological effects.
• Hodgkins depress cell mediated immunity.
• Multiple myeloma suppress immunoglobulins.
• Amyloidosis.
• Nephrotic syndrome.

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• Cancer cachexia wasting syndrome.
• progressive loss of body fat lean body mass,
  accompanied by profound weakness, anorexia
  anaemia.
• Origin of cancer cachexia is multifactorial.
• Anorexia
• Reduced food intake due to abnormalities of taste
  in the central control of appetite.
• Malabsorption.
• Liver involvement.
• High calorie expenditure due to increased basal
  metabolic rate.
• Infection.

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• Paraneoplastic syndromes
• Symptom complexes other than cachexia
• Occurs in patients with cancer
• Cannot be explained by local / distant spread of
  tumor or by the elaboration of hormones
  indigenous to the tissues of origin of the tumor.
• They may represent the earliest manifestation of
  an occult neoplasm.
• They may mimic metabolic lesions.
• They may represent significant clinical problems
  may be lethal.

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Grading staging of tumor

• Grading Based on the cytological
  differentiation of tumor cells the number of
  mitosis within the tumor.
• Grade I
• Grade II Increasing anaplasia
• Grade III
• Grade IV
• Criteria for individual grades vary with each
  form of neoplasia.

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• Staging Depends on
• Size of the primary lesion T(tumor)
• Spread to regional lymph nodes N(nodes)
• Presence/absence of metastasis M(mets)
• With increasing size of the tumor
• T1 lt T2 lt T3 lt T4
• Progressively advancing nodal involvement
• N0 lt N1 lt N2 lt N3
• Absence or presence of metastasis
• M0 / M1
• Compared to grading, staging has greater clinical
  values.

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Laboratory diagnosis of cancer

1. Morphological methods
2. Biochemical assays
3. Molecular diagnosis
4. Molecular profiling of tumors

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• Morphological methods
• Sampling by
• Excision
• Biopsy
• FNAC
• Cytological smears

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• Immunocytochemistry
• Immunohistochemistry
• Flow cytometry
• 
  
  

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• Biochemical assays
• Measuring enzymes, hormones other tumor markers
  in blood.
• These assays contribute to finding cases are
  useful in determining the effectiveness of
  therapy.
• Eg PSA, CEA

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• Molecular diagnosis
• PCR ( Polymerase Chain Reaction)
• FISH ( Fluorescent insitu hybridization)
• Molecular profiling of tumors
• DNA micro assay analysis

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