Tumor cell infiltration

Introduction Tumor cell infiltration: tumor infiltrating lymphocytes, infiltrating lymphocytes isolated from tumor tissue. It is rich in tumor-specific cytotoxic T lymphocytes and NK cells. The tumor is metastasized by amplifying it with interleukin-2 and transferring it to the tumor-bearing individual.

Cause

A tumor is essentially a genetic disease. Various environmental and genetic carcinogenic factors cause DNA damage in a synergistic or sequential manner, thereby activating proto-oncogenes and/or inactivating tumor suppressor genes, plus changes in apoptosis-regulating genes and/or DNA repair genes , in turn, causing abnormalities in expression levels, causing transformation of target cells. The transformed cells are mostly clonal hyperplasia, and after a long multi-stage evolution process, one of the clones is relatively unrestricted, and the subclones with different characteristics are selectively formed by additional mutations (heterogeneization). ), thereby obtaining the ability to infiltrate and metastasize (malignant transformation) to form a malignant tumor.

an examination

Related inspection

Tumor necrosis factor alpha tumor screening tumor acoustic contrast CT examination spiral CT examination

1. X-ray and other imaging examinations: X-ray examination is of great significance in the diagnosis of this disease. The X-ray manifestations of this disease are as follows:

1 Diffuse osteoporosis: tumor cell infiltration and tumor cell secretion of osteoclast-activating factors (IL-1, lymphotoxin, TNF, OAF) cause generalized osteoporosis. Vertebrates, ribs, pelvis, and skulls are often prominent, and can also be found in long bones of the extremities.

2 osteolytic lesions: the further development of osteoporosis lesions caused osteolytic lesions. Multiple round or oval, sharp and sharp edges like perforation, osteolytic lesions are typical X-ray signs of the disease, common in the skull, pelvis, ribs, vertebrae, occasionally in the limb bones.

3 pathological fractures: fractures occur on the basis of bone destruction, most commonly in the lower thoracic vertebrae and upper lumbar vertebrae, mostly manifested as compression fractures. Secondly found in the ribs, clavicle, pelvis, occasionally in the bones of the limbs.

4 Osteoporosis: This type of lesion is rare, usually characterized by localized bone sclerosis, which occurs around osteolytic lesions. Diffuse bone sclerosis is rare. IgD type myeloma is more likely to be complicated by bone sclerosis. Gamma-bone imaging is one of the means used to examine bone abnormalities in recent years. In this disease, osteolytic lesions show a concentration of radiation in the lesion. This method shows the bones of the body at one time and is more sensitive to X-rays. X-rays can only show lesions when the bone decalcification is more than 30%, and -bone imaging can show signs of radiation concentration in the early stage of the lesion. However, it is worth noting that although the sensitivity of -bone imaging is high, the specificity is not high. The increase of bone metabolism caused by any cause can lead to the sign of radiation concentration, so it should be noted. CT and magnetic resonance imaging (MRI) are also used for the diagnostic examination of this disease, especially when myeloma invades the spinal cord and nerve roots of the central nervous system or spinal fractures. CT and/or MRI can provide important diagnostics. information.

2. B-ultrasound: renal function damage, urinary stones, cardiac hypertrophy can be prompted.

3. Radionuclide: A renal map can determine the extent of renal impairment.

Differential diagnosis

Multiple myeloma is one of the more common medical conditions that are misdiagnosed. Clinically, it is often misdiagnosed as "osteoporosis", "bone metastasis cancer", "lumbar tuberculosis", "kidney disease", "recurrent pneumonia", "urinary tract infection" and other diseases. In the diagnosis, it is required to be associated with reactive plasmacytosis, unexplained monoclonal immunoglobulinemia, primary macroglobulinemia, primary systemic amyloidosis, and accompanying non-plasma disease. Identification of clonal immunoglobulins, bone metastases, primary bone tumors, primary nephropathy, hyperparathyroidism and other diseases.

1. Reactive plasmacytosis: a variety of pathogens (viruses, tuberculosis, etc.), antigens (drugs, tumors, etc.), immune dysfunction (Sjogren's syndrome, rheumatoid arthritis, etc.) can cause reactions Increased plasma cell and immunoglobulin levels need to be differentiated from multiple myeloma. The main points of identification are as follows:

(1) The increase of plasma cells in myeloma is limited: generally 3% but 15% and there are naive plasma cells (myeloma cells).

(2) Reactive plasmacytosis: The secreted immunoglobulin is normally polyclonal and has a limited increase in levels (eg, IgG 30 g/L).

(3) Reactive plasmacytosis itself does not cause clinical symptoms: its clinical manifestations depend on the primary disease, so there is no anemia, bone pain, bone destruction, hypoalbuminemia, normal immunoglobulin reduction, hypercalcemia Clinical manifestations such as syndrome and hyperviscosity syndrome.

(4) Reactive plasmacytosis has clinical manifestations of its primary disease.

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