Pathomorphology of the carcinomas

Abstract

The paper describes the morphological and functional differentiation of cancer cells and mentions basic markers combined with that phenomenon. Table 1 presents cariotypic and immunophenotypic changes, neoplastic biomarkers and biological products present within the cells in selected cancer types. The authors also present changes in the cell cycle that leads to cancerogenesis with an emphasis put on the role of so-called genome guardians, i.e. TP53 and RB1 genes, and describe the main epigenetic factors, including the DNA methylation process in CDH1 (cadherin1) gene. The article also shows the morphologic types of proliferative changes: pre-cancer lesions (laesio praecancerosus), pre-cancer states (status praecancerosus) and pre-invasive carcinoma (carcinoma praeinvasivum, carcinoma in situ). A new classification of carcinomas is presented, including tumours originating from: a – a luminal epithelial-like cell line (with typical epithelial markers – E-cadherin, desmoplakin 1), b – a weakly luminal epithelial-like cell line (with a visibly weakened expression of epithelial antigenes) and c – a mesenchymal-like cell line (with the presence of proteins typical for mesenchymal cells – vimentin, N-cadherin, and lack of epithelial-specific antigens). Moreover, the authors extensively describe the so-called epithelial mesenchymal transition (EMT) that can be observed both in in vitro and in vivo conditions. The role of cancer-associated fibroblasts (CAFs) in that process is shown. The cells exhibit an increase in the expression of genes involved in adhesion and angiogenesis and an increased expression of neurotransmitter receptors (adrenaline, noradrenaline)....