LP/Tumor Markes

Question 1

Name a condition where elevated alpha fetoprotein is found

Answer 1

hepatoblastoma

Question 2

What tumor marker is derived from epithelial cells of the fallopian tubes, endometrium, endocervix

Answer 2

CA-125

Question 3

How many pts show test negative for CA-125 at time of dx

Answer 3

10-20%

Question 4

What organization’s cancer guidelines do we follow in the US?

Answer 4

NCCN: national comprehensive cancer network

Question 5

What benign diseases show elevated levels of CA-27.29?

Answer 5

breast, kidney, liver, ovarian cyst

Question 6

What is CA-27.29 used for and what is it’s level of sensitivity?

Answer 6

It is used for screening and diagnosis and it lacks sensitivity

Question 7

what is PSA’s sensitivity for prostate CA?

Answer 7

Its sensitivity is high

Question 8

List the guidelines for screening for PSA:

Answer 8

USPSTF: against screening >75 yrs
ACS: say men should be a part of screening decision
screening guidelines: >50 yrs in men or >44 yrs in AA men with fhx of prostate CA
PSA+DRE+fhx=all done together to screen

Question 9

Under what conditions should you offer a PSA test:

Answer 9

high risk pts

abnormal DRE

Question 10

What type of PSA increase is predictive of prostate CA.

Answer 10

0.75 ng/mL per year

Question 11

What are some benign conditions that show an increased PSA level?

Answer 11

BPH

prostatic trauma

Question 12

What condition has elevated free PSA levels?

Answer 12

BPH

Question 13

Will the fPSA/tPSA ratio be higher or lower in prostate CA?

Answer 13

lower

Question 14

Is the PAP test sensitive but not specific?

Answer 14

yes

Question 15

Where can PAP be found in

Answer 15

liver, RBC, bone marrow, platelets

Question 16

What is the PAP test useful for?

Answer 16

monitoring the response to tx

Question 17

Is a PAP test good on its own?

Answer 17

no, it’s beneficial when combined with the PSA test.

Question 18

What is the calcitonin test used for?

Answer 18

to dx, monitor, and recurrence

Question 19

When will CEA levels be elevated?

Answer 19

liver cancer, prostate CA, medullary thyroid CA

Question 20

what happens to TG levels after a thyroidectomy?

Answer 20

levels will be low (< 2ng/mL) which means no recurrence

Question 21

When testing CEA levels, what does a level of > 20 ng/mL mean

Answer 21

metastasis

Question 22

What are some of the characteristics of a positive HER2/NEU test?

Answer 22

it occurs in 25-30% metastatic breast CA and it metastases very rapidly