1. CLINICAL FEATURES OF NEOPLASIA
BY : DR(MRS)B.J.THANENTHIRAN(MBBS)

2. Effects of tumor on host
Direct effects due to primary tumors.
Effects due to metastasis.
Effects due to paraneoplastic syndromes.

3. Effects are
Mechanical pressure & obstruction.
Destruction of tissue infiltrate & destroy vital organs.
Haemorrhage.
Secondary infections.

4. Haematological disorders.
Anaemia.
Neutrophil leucocytosis.
Eosinophilia.
Pain, anxiety & insomnia.
Immunological effects.
Hodgkins depress cell mediated immunity.
Multiple myeloma suppress immunoglobulins.
Amyloidosis.
Nephrotic syndrome.

5. Cancer cachexia – wasting syndrome.
progressive loss of body fat & lean body mass, accompanied by profound weakness, anorexia & anaemia.
Origin of cancer cachexia is multifactorial.
Anorexia
Reduced food intake due to abnormalities of taste & in the central control of appetite.
Malabsorption.
Liver involvement.
High calorie expenditure due to increased basal metabolic rate.
Infection.

6. Paraneoplastic syndromes
Symptom complexes other than cachexia
Occurs in patients with cancer
Cannot be explained by local / distant spread of tumor or by the elaboration of hormones indigenous to the tissues of origin of the tumor.
They may represent the earliest manifestation of an occult neoplasm.
They may mimic metabolic lesions.
They may represent significant clinical problems & may be lethal.

9. Grading & staging of tumor
Grading – Based on the cytological differentiation of tumor cells & the number of mitosis within the tumor.
Grade I
Grade II Increasing anaplasia
Grade III
Grade IV
Criteria for individual grades vary with each form of neoplasia.

10. Size of the primary lesion T(tumor)
Staging – Depends on
Size of the primary lesion T(tumor)
Spread to regional lymph nodes N(nodes)
Presence/absence of metastasis M(mets)
With increasing size of the tumor
T1 < T2 < T3 < T4
Progressively advancing nodal involvement
N0 < N1 < N2 < N3
Absence or presence of metastasis
M0 / M1
Compared to grading, staging has greater clinical values.

11. Laboratory diagnosis of cancer
Morphological methods
Biochemical assays
Molecular diagnosis
Molecular profiling of tumors

12. Morphological methods
Sampling by
Excision
Biopsy
FNAC
Cytological smears

13. Immunocytochemistry
Immunohistochemistry
Flow cytometry

14. Biochemical assays
Measuring enzymes, hormones & other tumor markers in blood.
These assays contribute to finding cases & are useful in determining the effectiveness of therapy.
Eg – PSA, CEA

15. Molecular profiling of tumors
Molecular diagnosis
PCR ( Polymerase Chain Reaction)
FISH ( Fluorescent insitu hybridization)
Molecular profiling of tumors
DNA micro assay analysis

16. THANK YOU