Hallmarks of cancer

-Avoiding immunity
Group-C
 5% of persons with congenital
immunodeficiency develop cancer, about 200
times the rate in immunocompetent
individuals.
Immunocompromised transplant recipients and
person with AIDS have also increased risk
 Most cancers we can see occurs in patients who
do not suffer from any overt immune deficiency
Therefor, it is evident that these tumor cells
must develop mechanisms to escape and
evade the immune system of
immunocompetent host.
 Selective out growth of antigen-
negative variants
Strongly immunogenic subclones eliminated
during tumor progression
 Loss or reduced expression of MHC molecules

Faliure to express normal levels of HLA

molecules
Leading escaping from attack of cytotoxic T-
cells
 Lack of costimulation
Sensitisation of T-cells require 2 signals- foreign
peptide & co-stimulatory molecules
Foreign peptide is expressed but the co-
stimulatory molecules are not expressed.
This causes prevention of sensitization of T-
cells, make T-cells anergic, and worst can cause
their apoptosis.
 Immunosupression
Many oncogenic agents & products supress host immune
response .
Ex-TGF-beta by tumor cells are potent
Immune response elicited by tumor cells can inhibit tumor
immunity .

Recognition of tumor cells

Engagement of t-cell inhibitory receptor or activation

of regulatory t-cells that supress immunity
 Antigen masking
Antigen masked my glycocalyx molecules, such
as
Sialic acid-containing
mucopolysaccharides

Tumor cells secrete abnormal amounts of

glycocalyx
 Apoptosis of cytotoxic T-cells
FasL-Fas interaction (FasL expressed by tumor
cells)
This interaction eliminates cytotoxic T-cells
Summary
 References
Robin & Cortan Pathologic Basis of Diseases 8th edition
www.ncbi.nlm.nih.gov