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Clinical Chemistry > Cancer Markers > Flashcards

Cancer Markers Flashcards

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1
Q

cancer definition

A

uncontrolled growth of cells to form either a tumor or spreading to many other body areas (metastasis)

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2
Q

cancer genetics

A

tumors from inherited or aquired genetic mutations that activate growth factors & oncogenes while inhibiting apoptosis, tumor suppression genes & genes that regulate cell cycles

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3
Q

what is seen with a metastasis cancer

A

less cell adhesion & more genetic changes

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4
Q

ideal tumor markers would:

A

be tumor specific
absent in healthy people
readily detectable
useful in both screening & diagnosis

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5
Q

screening tumor markers:

A

when there is one marker that aids in IDing w/ some certainty that you have the disease

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6
Q

prognosis tumor marker

A

more marker present the more cancer present

going into metastasis

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7
Q

monitoring tumor marker

A

use tumor marker as tool for monitoring patient after drugs, radiation, or chemotherapy

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8
Q

QC issues for tumor marker assays

A 
antibodies used are variable
analytes are heterogenic
lack reference material; lack calibrators
kinetics unknown
lack standardized reference ranges
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9
Q

how to make tumor marker assays the most accurate as possible

A

test patient w/ same tumor marker from same kit & same methodology
use same reagent lot

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10
Q

common carcinomas

A 
lung
breast
colon
bladder
prostate
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11
Q

common sarcomas

A

fat
bone
muscle

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12
Q

alpha-fetoprotein and liver cancer

A

used to monitor hepatocellular carcinoma (HCC)
used for diagnosis, staging, prognosis & monitoring treatment of HCC
>1,000 ng/ml is a poor prognosis for HCC

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13
Q

alpha-fetoprotein & testicular cancer

A

used to classify stage of disease & for monitoring treatment of testicular cancer
10-20% increase = stage I
50-80% increase = stage II
90-100% increase = stage III

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14
Q

AFP assay type

A

immunassays w/ ‘sandwich’ type assays

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15
Q

CA-125

A

cancer antigen 125
used to detect & monitor ovarian tumors
not used for mass screenings
contains putative transmembrane region & a tyrosine phosphorylation site
not normally seen in serum

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16
Q

stages of ovarian cancer & CA-125

A

50% increase = stage I
90% increase = stage II
>90% increase = stage III & IV

17
Q

carcinoembryonic antigen (CEA)

A

oncofetal antigen- immunoglobulin that is part of group involved in apoptosis, immunity & cell adhesion
often expressed on tumor
not used for screening; used for monitoring & checking for re-occurrences

18
Q

cancers that often express CEA

A

colorectal
lung
breast
GI

19
Q

specificity of CEA

A

non-specific

associated w/ loss of cell adhesion (malignancy)

20
Q

human chorionic gonadotropin (hCG)

A

secreted from trophoblasts of placenta to maintain the corpus luteum during early pregnancy
also elevates in trophoblast tumors, choriocarcinoma & germ cell tumors of ovary & testes

21
Q

assay for hCG

A

hCG as a glycoprotein, has a alpha & beta subunit

look for free beta subunit as well as intact hCG forms

22
Q

hCG can indicate?

A

ovarian cancer
diagnostic for testicular cancer
most useful for detection of gestational trophoblastic diseases
aggresstive lung cancer

23
Q

4 distinct tumors of gestational trophoblastic disease

A

hydatidform mole
gestational trophoblastic neoplasms
choriocarcinoma
placental site trophoblastic tumors

24
Q

cancer hormone markers

A 
PTH
calcitonin
ACTH
Serotonin
Growth hormone
ADH
25
Q

hormone receptors & cancer treatmenet

A

if hormone receptors are present - use hormone therapy

if not present - use chemotherapy

26
Q

prostate specific antigen (PSA)

A

mild protease activity
glycoprotein from ch 19
has chromotrypsin-like & trypsin-like activity
a serine protease for kallikrein family
normal - should mostly be in the prostate
cancer- significant amount of PSA leaks into blood vessel

27
Q

2 forms of PSA

A

free PSA
PSA complexed with alpha-1-antichymotrypsin (ACT) or alpha-2-macroglobulin (A2M)
most assays recognize 90% ACT & 10% free PSA or 100% free PSA

28
Q

other causes of increased PSA

A

prostate infection
irritations
benign prostate hyperplasia
digital rectal exam prior to blood draw for PSA

29
Q

enzyme cancer markers

A

alkaline phosphatase
lactic dehydrogenase isoenzymes
prostate specific antigen
neuron-specific enolase

30
Q

suppressor p53

A

tumor suppressor protein that triggers cell apoptosis

31
Q

BRCA1 & BRCA2

A

present in some breast cancer patients

32
Q

bcl-2

A

may be involved in apoptosis in breast cancer

33
Q

suppressor genes includ

A

p53
retinoblasoma gene
p21

Clinical Chemistry (23 decks)

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