Chemistry 14 (Tumor markers) Flashcards
Hook effect
very high concentrations give falsely low result
free PSA and CA
decreased free and increased bound correlated with CA
percent free PSA markedly affected by
protatic and urethral instrumentation
pro-PSA
increased in CA
non-neoplastic conditions with increased CEA
smoking, PUD, IBD, pancreatitis, hypothyroidism, biliary obstruction, cirrhosis
T1/2 of thyroglobulin
65hr
anti-thyroglobulin abs
10% of normal, >20% with thyroid CA
Tumor-associated trypsin inhibitor (TATI) is seen in
mucinous ovarian CA ureothelial CA RCC Gastric CA Panc CA pancreatitis
CA-125 shows greatest sensitivity for
non-mucinous ovarian epithelial tumors
____ is especially elevated in signet ring gastic CA
TATI
non-neoplastic conditions with increased CA125
pregnancy, fibrouds, benign ovarian cysts
PID, ascites, endometriosis
palpable adnexal mass + _____ = ______ for ovarian malig
+ CA125>65
= >95% PPV for ovarian malignancy
CA125 and prognosis
preop >65 is unfavorable
CA27.29 and CA15-3
different epitopes of Brease CA assd MUC1 gene
better sens/spec between CA27.29 and CA15-3
CA 27.29
best marker for pancreato-biliary CA
CA19-9
CA19-9 also increased in
esophageal CA, pancretitis
cholestasis
cholangitis
cirrhosis
CA19-9 is not produced by people
who are Lewis Negative
AFP synthesized by
fetal yolk sac, live, GI tract
variant of gastric CA with increased AFP
hepatoid
_____ use has been assd with low level increased HCG
marijuana
beta2-microglobulin is independent pronositc factor in
myeloma
forgut carcinoids produce
5-HT, catecholamines, 5-hydroxytryptophane
midgut carcinoids produce
only serotonin
hindgut carcinooids produce
usually are non-secretory
somes produce HCG
what is metabolite of serotonin
5-HIAA
____ may be most accurate marker for detection of carcinoid tumors
platelet serotonin
increased chomogranini seen in
pheochromocytoma
carcinoid
islet cell tumors
small cell CA
calcitonin increased in
medullary thyroid hashimoto small cell breast CA chronic renal failure zollinger-ellison syndrome
marker also increased in medullary ca
CEA
pheochromocytomas usually produce
epinephrine and norepinephrine
extra-adrenal paragangiomas usually produce
only norepinephrine
metabolite or normetanephrine
VMA
metabolism of epinephrine
made into metanephrine, then sulfated or conjugated and excreted in urine or metabolised into VMA
most accurate test for initial screening of paraganglioma/pheo
free plasma metanephrine
____ elevated in neuroblastoma
urine VMA and HVA
HVA is final metabolic product of
DOPA and dopamine
VMA is final metabolic product of
epinephrine and norepinephrine
poorly diff neuroblastomas make more ___ than ___
HVA than VMA
decreased VMA/HVA is bad
increased levels of NMP22 have been seen in
urothelial CA
FISH for aneuploidy of ____ in urothelial CA
3,7,9,17
PCA3 is expressed in
prostativ glandular epithelium
encodes protein DD3
DD3 overexpressed in
95% of prostate CA
urine obtained after prostatic massage is tested for
DD3 RNA transcripts
