Learning outcomes:
1. Define benign and malignant tumors with their morphological characteristics.
2. Identify tumors macroscopically and microscopically.
3. Analyse of morphological characteristics with the aim of distinguishing carcinoma, sarcoma, lymphoma, teratoma and teratocarcinoma and teratosarkoma.
4. Differentiate laboratory methods in the diagnosis of various tumors: macroscopic and histological diagnosis of benign and malignant tumors, histochemical diagnostics and methods used in the differential diagnosis of various malignant tumors.
5. Differentiate histochemical methods of marking that are used in the diagnosis of tumors: PAS, Giemsa, Gomory, Malory, Sudan III, Oil red, Congo red ....
6. Elucidate the use of electron microscopy in the diagnosis of malignant tumors.
7. Analyse immunohistochemical methods (PAP method) marking and histopathological differential diagnosis and molecular methods used in the histologic diagnosis of tumors: FISH, CISH, PCR.
8. Clarify the application of molecular methods in the histologic diagnosis and their influence on the histopathologic diagnosis, and thus the choice of therapy smart drugs (imunocitostatika).
9. Integrate the acquired knowledge of morphological differentiation and main characteristics of the different types of cancer (squamous cell carcinoma, adenocarcinoma, melanoma, breast cancer, colon cancer, thyroid cancer, etc.)
10. Integrate acquired knowledge of cutaneous melanoma, clinical and morphological differentiation of the growth phase of melanoma, the classification of four basic types of melanoma (NM, SSM, LMM, ALMM)
COURSE
LECTURES:
1. General definition of the tumor. Criteria and identification of benign and malignant tumors.
Tumors histopathological terminology. Histological types and categories of tumors. Clinical and fundamental morphological differences between cell carcinoma, sarcoma, lymphoma and teratoma and teratocarcinoma and teratosarkoma. Determination of histological grade of the tumor according to the degree of morphological differentiation of tumor cells with examples (squamous cell carcinomas with various degrees of differentiation-by Broders) histological grade of breast cancer by Bloom-Richardson ... Definition of tumor staging and identification and classification of tumors in the TNM system.
2. Laboratory diagnosis of tumors. Introduce students to the levels used in the histologic diagnosis, namely: histological diagnosis, histochemical diagnostics and its methods, electron microscopy, immunohistochemical diagnosis (PAP method) and methods of molecular pathology (CISH, FISH, PCR), and the importance and application of the above the above methods with examples so that students can predict and infer the exact histopathological diagnosis and to assess the further course of treatment and disease outcome.
3. Definition of precancers with basic explanation of the definition and example metaplasia and type of metaplasia, with the example and the definition of 3 degrees of dysplasia (light, medium and heavy), with the definition of carcinoma in situ, with the definition of microinvasive carcinoma and definition of true invasive cancer and morphological patterns and pathohistological preparations metaplasia, various degrees of dysplasia, carcinoma in situ and microinvasive example and true invasive cancer. (All examples are morphologically shown in metaplasia and various degrees of dysplasia and carcinoma in situ and microinvasive cancer, skvamokolumnarne border uterine cervical carcinoma.
4. Definition of vasculogenesis and angiogenesis, and the identification and recognition of the difference between vasculogenesis and angiogenesis. Factors stimulating angiogenesis and receptors involved in angiogenesis (VEGF, angiopoietin, proteins from the extracellular matrix). The stabilization of newly created blood vessels using (angiopoietin 1 and 2, PDGF platelet derived growth factor and TGF-beta transforming growth factor).
Integrins, cell matrix proteins and proteinases and their role in angiogenesis.
The difference between the stimulators and inhibitors of angiogenesis. Cytotoxic drugs that inhibit tumor angiogenesis (avastin, neovastat, angiostati, extracellular matrix proteins Vitaxin)
5. Tumor markers - diagnosis and treatment of tumors. Definition of tumor markers and their role in the diagnosis and screening and treatment of cancer patients. Definition of immunodiagnostic tests used for the detection of tumors and monitoring of remission and relapse of the disease and the effect of chemotherapy and markers used for screening suspected cancer patients (PSA, AFP)
6. Markers in imunohistochemcal diagnosis. Introducing markers that differentiate the fundamental group of cancers of the group's sarcoma and lymphoma (cytokeratin, vimentin, LCA). The role of individual cytokeratin in the diagnosis and differentiation of various types of cancer. The role of tumor markers in the search for primary tumor metastases from the primary tumor.
7. Melanoma skin. Definition of skin melanoma, the definition precursor lesions for melanoma-dysplastic nevi and melanoma in situ. Morphological criteria for recognition of dysplastic nevi and melanoma in situ. Morphological differentiation of nodular melanoma, superficial expanding melanoma, lentigo maligna melanom and acral lentigo melanoma. Definition of degrees of malignancy after Calrck and Breslow, TNM classification of melanoma, immunohistochemical markers used in the diagnosis of primary and metastatic melanomas, and diagnosis of the sentinel lymph node in melanoma.
8. Breast Cancer. Definition of breast cancer, exploring the different morphological types of breast cancer and histological classification of breast cancer. Definition of in situ breast cancer, the definition of microinvasive breast cancer and morphological criteria for differentiation of breast cancer in situ and microinvasive breast cancer. The differentiation of ductal invasive lobular carcinoma of the breast cancer, clinical, histopathological and immunohistochemical criteria for distinguishing between. Definition of inflammatory breast cancer, determining immunohistochemical markers in breast cancer (estrogen, progesterone, Het 2, Ki-67 and retesting Her 2 ++ CISH test method). St Gallen immunohistochemical classification of breast cancer.
9. Malignant tumors of the thyroid gland. Macromorphological and microscopic criteria for distinguishing adenomas thyroid follicular thyroid carcinoma. Microscopic and immunohistochemical criteria for distinguishing papillary and medullary thyroid cancer. Payment metastasis of certain types of thyroid cancer. Immunohistochemical detection of metastatic thyroid cancer.
10. FISH, CISH amplification Her2 genes and their role in the treatment of breast cancer PCR, determination of Ki-ras, N-ras and their significance and impact on the choice of therapy in colorectal cancer.
PRACTICAL EXERCISES:
The aim is developing skills for analysing the characteristics of different tumor types.
1. Histological types and groups of tumors and basic morphological and clinical differences
2. Determination of the histological grade of the tumor according to the degree of morphological differentiation of tumor cells
3. Histopathology metaplasia and dysplasia
4. Tumor marker
5. Immunodiagnostic tests
6th Markers in immunohistochemical diagnosticis
7. Melanoma Skin
8. Breast Cancer
9. Malignant tumors of the thyroid
10. Methods: FISH, CISH and amplification of HER-2 gene
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