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INVASI
TUMOR GANAS
Dr. Humairah Medina Liza Lubis, M.Ked.(PA), Sp.PA
DEPARTEMEN PATOLOGI ANATOMI
FK-UNIBA BATAM
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Cancer: General Etiology andPathogenesis
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Cellular Basis of Cancer
Cancer is a collection of diseases
characterized by abnormal anduncontrolled growth
Cancer arises from a loss of normalgrowth control
In normal tissues, the rates of newcell growth and old cell death arekept in balance
In cancer, this balance is disrupted
This disruption can result from
1) uncontrolled cell growth or
2) loss of a cell's ability to undergoapoptosis
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Cancer Cell Do Not Grow Faster Than
Normal Cells
Rather, Their Growth is Just
Uncontrolled
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Benign tumorsgenerally do not
spread by
invasion or
metastasis
Malignant
tumors are
capable of
spreading by
invasion and
metastasis
Malignant versus Benign Tumors
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Overview
What is metastasis?
Molecular mechanisms of metastasis
Signalling pathways involved in
metastasis
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I) What is cancer metastasis?
Cancer defines as a population of cells that have
lost their normal controls of growth and
differentiation and are proliferating without check.
Metastasis is the process by which a tumor cell
leaves the primary tumor, travels to a distant site
via the circulatory system, and establishes a
secondary tumor.
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Invasion and Metastasis
Abnormal cells proliferateand spread (metastasize) toother parts of the body
Invasion - directmigration andpenetration intoneighboring tissues
Metastasis - cancer cellspenetrate into lymphatic
system and blood vessels
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Preferential metastatic sites
Primary tumour Common distant site (s)Breast adenocarcinoma Bone, brain, adrenal
Prostate adenocarcinoma Bone
Lung small cell carcinoma Bone, brain, liver
Skin cutaneous melanoma Brain, liver, Bowel
Thyroid adenocarcinoma Bone
Kidney clear cell carcinoma Bone, liver, thyroid
Testis carcinoma Liver
Bladder carcinoma Brain
Neuroblastoma Liver, adrenal
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Determining factors
Appropriate growth factorsor
extracellular matrix environment
Compatible adhesion siteson the
endothelial lumenal surface
Selective chemotaxisat which the organ
producing some soluble attraction factors
to the tumor cells
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5 major steps in metastasis
1. Invasion and infiltration of surrounding normal host
tissue with penetration of small lymphatic or vascular
channels;
2. Release of neoplastic cells, either or single cells orsmall clumps, into the circulation;
3. Survival in the circulation;
4. Arrest in the capillary beds of distant organs;
5. Penetration of the lymphatic or blood vessel wallsfollowed by growth of the disseminated tumor cells
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Stages of metastasis
Invasion : primary tumour cells enter
circulation
Circulation to the secondary site of tumour
growth
Colonisation: formation of secondary
tumour
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Tumor invasion
1. Translocation of cells across extracellular
matrix barriers
2. Lysis of matrix protein by specific
proteinases
3. Cell migration
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Components of invasion
a) Matrix degrading enzymes
b) Cell adhesion
c) Cell motility
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a) Matrix degrading enzymes
Required for a controlled degradation of
components of the extracellular matrix
(ECM)
The proteases involved in this process are
classified into serine-, cysteine-, aspartyl-,
and metalloproteinase.
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Cell adhesion and metastasis
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b) Cell attachment
1. Integrin: cell-matrix adhesion
2. E-cadherin/catenin adhesion complex:
cell-cell adhesion
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Metastasis per continuatum:
Lewat rongga tubuh (body cavity) Contoh: Ca ovarium --- ke peritoneum
Ca colon --- ke cavum peritoneum
Ca paru --- ke cavum pleura
Metastasis secara limfogen:
Terutama pada carcinoma
Pola penyebaran metastasis kelenjar limfemengikuti rute normal dari lymphatic drainage.
contoh: Ca mamma - metastasis KGB axilla
Ca paru metastasis ke KGB hilus
Ca nasofaring metastasis KGB colli
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Metastases secara hematogen
Terutama pada sarcoma Dapat juga terjadi pada carcinoma
Renal cell ca --- vena renalis
Penetrasi ke vena > arteri, karena arteri memilikidinding > tebal lebih tahan
Invasi pada vena --- sel tumor mengikuti aliran vena --- metastasis sering terjadi pada paru & hepar
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Hepar yang mengandung metastasis kanker
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TERIMA KASIH
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