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Small Cell Lung Cancer (SCLC): Diagnosis Treatment and Natural History PowerPoint Presentation

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Description : This medical presentation on cancer titled "Small Cell Lung Cancer (SCLC): Diagnosis, Treatment and Natural History" provides us lung cancer epidemiology.

Tags : Small Cell Lung Cancer, SCLC, Pathology, Tumor markers, Genetics, Clinical course, Staging, Treatment

Published on : Apr 28, 2021 | Views : 1937 | Downloads : 9

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Small Cell Lung Cancer (SCLC): Diagnosis, Treatment and Natural History Gary L.Weinstein M.D.
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SCLC Lung cancer epidemiology SCLC Pathology Tumor markers Genetics Clinical course Staging Treatment
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SCLC, factoids 15 – 25 % of all lung cancers Almost exclusively in smokers Distinguished from NSCLC by: Rapid doubling time High growth fraction Early development of wide-spread mets
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SCLC, factoids (cont’d) Considered highly responsive to “chems and beams” BUT…usually relapses within 2 years despite treatment Overall, only 3 –8 % of all patients survive more than 5 years Most common malignancy associated with Neurologic paraneoplastic syndromes
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SCLC, pathology Most recent (1999) WHO classification Classical small cell carcinoma Large cell neuroendocrine cancer Combined small cell carcinoma with some NSCLC Cells are approx. 2 X’s the size of normal lymphocytes
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SCLC, pathology
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SCLC, pathology
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SCLC, clinical presentation Typically arise centrally Most common presentation is a large hilar mass with bulky mediastinal LAN Common symptoms cough, SOB, wt loss Approx. 70 % with overt mets at presentation Commonly spread to liver, adrenals, bone and brain Can present with paraneoplastic syndome
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SCLC, tumor markers 3 main groups: Neural, Epithelial, Neuroendocrine Epithelial: virtually all SCLCs are immunoreactive for Keratin and Epithelial Membrane Antigen 1 or more markers of Neural/Neuroendocrine differentiation found in approx. 75 % of SCLCs
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SCLC, tumor markers Leads to expression of dopa decarboxylase, calcitonin, neuron-specific enolase, chromogranin A, CD-56 (a neural cell adhesion molecule) gastrin releasing peptide and insulin-like growth hormone Occasionally patients produce antibodies that cross-react with both the SCLC cells and the CNS  cerebellar degeneration syndromes SCLC cells can produce a number of polypeptide hormones including ACTH and Vasopressin
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Neurologic Paraneoplastic Syndromes
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Lung cancer, Paraneoplastic Syndromes
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SCLC, genetics Development of lung cancers occur through stimulation of proliferation and mutagenesis, occurring over YEARS and resulting from exposure to tobacco and other carcinogens
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SCLC, genetics The most common genetics of SCLC are: P53 mutation is present in 75 -90 % Loss of heterozygosity of c-somes 9p and 10q in the majority Deletion of 3p  inactivation of as many as 3 tumor suppressor genes Loss of the retinoblastoma gene function is nearly ubiquitous Activation of telomerase in approx. 90 % (allows cells to divide forever)
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The End Questions?