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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).
The study describes the organ location of neoplasms, their classification, karyotypic and phenotypic changes and biomarkers. The majority of neoplasms mentioned in the study behave typically in their local growth, infiltration and destruction of neighboring tissues, recurrence and metastasis. Nonetheless, numerous exceptions from that rule are noted. The study discusses the process of the formation of monoclones in malignant tumors, especially in lymphomas. The phenotypic markers of differentiation have been useful in the classification of neoplasms. Neoplastic differentiation begins at the molecular level, which is reflected in the phenotype of the cells, and the direction of differentiation usually corresponds to the initial tissue. The neoplastic cell genome is unstable and susceptible to mutation, which may also be influenced by viruses that change the genetic code. This affects the cell cycle and results in proliferation prevailing over necrosis and apoptosis. The karyotypic changes in neoplastic cells are transmitted from generation to generation; they are irreversible and progressive. Moreover, these cells, as compared to normal cells, show higher resistance to various stress factors, which may play an important role in their progression to a malignant phenotype. It has been shown that malignant neoplasms express the whole range of malignant characteristics, although this feature is not constant and may be influenced by the genetic instability of the cells, by the microenvironment and/or by the treatment.
Sarcomas (sarcomata – sa) are neoplasms that have a mesenchymal origin or are differentiating in that direction. Their growth is chaotic and progressive: the cells divide constantly in time and tumor space. They can be caused by viruses, chemical compounds, physical factors or even autoimmune reactions. They result from a disruption in a balance between protooncogenes and suppressor genes. This can be an effect of the accumulation of mutation within those genes, often with the participation of viruses that can modify the cell’s genetic information. The changes in genes are transmitted from one generation of cells to subsequent ones and are irreparable and progressive. Sarcomas are vimentin-positive, S-100-negative, LCA-negative and HMB-45- -negative. They can show positive or negative reactions to keratin and EM. The frequency of sarcomas as compared to cancers is like 1 : 50 and so they constitute approximately 1% of malignant neoplasms in humans. In animals this ratio is reversed: sarcomas (except in the mammary gland and skin) are far more common than carcinomas. Sarcomas tumors are accompanied by various disturbances in circulation, regressive changes (degeneration, necrosis) and inflammation, including immune reactions or a response to bacterial or fungal co-infection. Sarcomas, similarly to cancers, show neoplastic cannibalism; i.e. an ability of one cell to absorb another cell. Moreover, they are less mature than mother and can show histoformative features. They also manifest a wide range of malignancy features. Because of their localization in deeply lying tissues, the diagnosis is often delayed and the clinical prognosis is poor.
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