BIOMARKERS Flashcards
metabolic products produced by tumor cells or related to presence of tumor, found in body fluids or tissue or tumor surface of patients with cancers.
Tumor Markers
substances that can be detected in higher than normal amounts in the blood, urine, or body tissues of some patients with certain types of cancer.
Tumor markers
A tumor marker may be made by a _____ itself or by the body in _____ to the tumor
tumor ; response
Some tumor products are appropriate to the tissue of origin, but others are not and are regarded as ectopic or inappropriate and these products are known as
Biological Markers
What is an ideal tumor marker?
- Highly specific: low false-positive tests (in normal individuals, benign diseaseS)
- Highly sensitive: low false-negative rate
- Circulating levels should correlate directly with the amount of viable tumor present
- Sensitive and specific assays must be reproducible and widely available at a reasonable cost.
- Present in all patients with a given malignancy.
- Detectable in occult disease,
- Absent in health and benign disease.
- The levels should correlate with the result of anticancer therapy.
- No ideal marker exist at present.
EPITHELIAL TUMOR MARKERS
- Keratin (CK7, CK20)
- Epithelial Membrane Antigen
- Carcinoembryonic Antigen
- Thyroid Transcription Factor-1
- Prostate Specific Antigen
highly sensitive for marker for epithelial cells and non-epithelial (mesotheliomas and non-seminomatous germ cell tumors)
Keratin
more frequently found in carcinomas of the lung, breast, uterus, and ovaries (serous tumors).
CK7 (CYTOKERATIN 7)
transitional cell carcinomas of the bladder and mucinous ovarian tumors are usually positive for both _____ and _____
CK7 and CK20
Renal cell carcinomas, hepatocellular carcinomas, prostatic adenocarcinomas, thyroid carcinomas and squamous cell carcinomas (skin, lung and esophagus) are negative for ____ and _____
CK7 and CK20
adenocarcinomas of breast, lung, kidneys
EMA (epithelial membrane antigen)
carcinomas of GIT, pancreas, lung, breast, ovary, uterus and cervix
CEA (Carcinoembryonic antigen)
positive for thyroid, lung and neuroendocrine tumors
TTF-1 (Thyroid transcription factor-1)
prostatic adenocarcinoma, pancreatic and salivary gland tumors
PSA (Prostate specific antigen)
INTERMEDIATE FILAMENT MARKERS
- Actin
- Vimentin
- Desmin
- Glial Fibrillary Acidic Protein (GFAP)
- Neurofilament
- S-100
IDENTIFY TUMORS FROM SMOOTH, SKELETAL, AND CARDIAC MUSCLE
actin
IS 57kD intermediate filament that is present in normal mesenchymal cells
VIMENTIN
Neuroendocrine Markers
- Neuron-specific Enolase
- Chromogranin
- Synaptophysin
Germ Cell Tumor Markers
- HCG-CHORIOCARCINOMA
- APP (ALPHA-FETOPROTEIN)
- PLAP (PLACENTA-LIKE ALKALINE PHOSPHATASE)
ENDODERMAL SINUS TUMORS SHOWING YOLK SAC DIFFERENTIATION
APP (ALPHA-FETOPROTEIN)
GERM CELL TUMORS (GERMINOMAS), EMBRYONAL CARCINOMAS, CHORIOCARCINOMAS AND ENDO-DERMAL SINUS TUMORS
PLAP (PLACENTA-LIKE ALKALINE PHOSPHATASE)
MESENCHYMAL TUMOR MARKERS
- MYOGENIC TUMORS
- FIBROHISTIOCYTIC TUMORS
- vascular tumors
- melanomas
- Lymphomas
MUSCLE-SPECIFIC ACTIN AND DESMIN, myo-D1, myoglobin and myogenin
MYOGENIC TUMORS
CD68 or FAM 56, combined with more nonspecific proteolytic enzymes such as alpha-1-antitrypsin and alpha-1-antichymotrypsin to diagnose malignant fibrohistiocytic sarcomas
FIBROHISTIOCYTIC TUMORS
-study of cells that are separated from superficial or deep serosal or mucosal surfaces
EXFOLIATIVE CYTOLOGY
exfoliative cytology, detects ______
malignancy
in exfoliative cytology, cells are shed into the _____ and _______ w/c are used for evaluation
body fluids ; secretions
in exfoliative cytology, if malignancy is suggested then ______ can be used for confirmatory
biopsies
cells are directly taken from the surfaces of excised/incised specimens by touching them with a clean glass slide
Imprint/abraded cytology
Imprint/abraded cytology is also known as
impression cytology
Imprint/abraded cytology is indicated in cases of _________
hematolymphoid malignancy
Imprint/abraded cytology, 5 techniques
smear (malignancy; chromosomal sex; type of infection;abnormalities); crush (mucoid and viscous fluids);technique;pull-push technique (other types of fluid)
ALL SAMPLES SHOULD BE PRESERVE WELL-EQUAL PARTS OF ________ AND _______ IS THE IDEAL FIXATIVE
ETHANOL (95% ETHYL ALCOHOL) ; ETHER
a paraffin-embedded specimen derived from different fluids and aspirated materials
CELL BLOCK TECHNIQUE
CELL BLOCK TECHNIQUE is Mainly used with smears as an adjunct for establishing a more definitive _______
cytopathologic diagnosis
CELL BLOCK TECHNIQUE is for _______ determination
malignancy
CELL BLOCK TECHNIQUE is also known as
microbiopsy
also used for architectural evaluation (histologic pattern of tumor)
CELL BLOCK TECHNIQUE
in CELL BLOCK TECHNIQUE, categorization of tumors is not seen in ____
smears
- Special stains and immunohistochemistry
- Immunophenotyping, molecular studies
- Archival material for future studies
CELL BLOCK TECHNIQUE
using filter paper with a specified pore size
MEMBRANE FILTER METHOD
MEMBRANE FILTER METHOD is made up of _______ and _______
polycarbonate and cellulose esters
cytodiagnosis in urine, spinal fluid, bronchial washing and substances with low cellular
MEMBRANE FILTER METHOD
content, sex chromatin determination on amniotic fluid
MEMBRANE FILTER METHOD
simple; small amount samples, availability, excellent preservation of cellular samples it needs
MEMBRANE FILTER METHOD
USES CYTOSPIN AND SEDIMENTATION PREPARATIONS
CONCENTRATION TECHNIQUE
cells are isolated thru series of centrifugation steps to concentrate the cells into a small Suspension
CONCENTRATION TECHNIQUE
enable cells to be spread in a monolayer
LIQUID-BASED CYTOLOGY
improve sensitivity of screening of cervico-vaginal smears; breast and thyroid samples
LIQUID-BASED CYTOLOGY
LIQUID-BASED CYTOLOGY methods
Thin Prep (Cytyc Corp.) and SurePap (Tripath Imaging, Inc)
LIQUID-BASED CYTOLOGY ADVANTAGES:
- improved cell representation;
= specificity,sensitivity; - abnormal cells are clearly seen and easily identified;
- remaining or residual cell suspension can be used to make further cytological preparations or other tests like detection of human papilloma virus (HPV) DNA and immunocytochemistry.
study cells that do not shed spontaneously
ASPIRATION CYTOLOGY
palpable lesion (fine needle aspirate-accuracy is dependent on _______: smaller size means less ______ diagnosis and cant distinguish between in _____ and _____ lesion)
size of lesion ; sensitive ; situ and invasive
deep seated/ non palpable lesions (_______ biopsy)
image-guided
