Path - Neoplasia (Tumor markers)

Question 1

How should versus should not tumor markers be used clinically?

Answer 1

Tumor markers should not be used the primary tool for cancer diagnosis; They may be used to monitor tumor recurrence and response to therapy, but definitive diagnosis can be made only via biopsy

Question 2

How is a definitive diagnosis of cancer make clinically?

Answer 2

… definitive diagnosis can be made only via biopsy

Question 3

What are 4 tumors for which Alkaline phosphatase is used a tumor marker?

Answer 3

(1) Metastases to bone, (2) liver, (3) Paget diseases of bone, (4) seminoma (placental ALP)

Question 4

What tumor is associated with placental ALP?

Answer 4

seminoma (placental ALP)

Question 5

What normally makes alpha-fetoprotein?

Answer 5

Normally made by fetus

Question 6

What are 5 tumors for which alpha-fetoprotein is a tumor marker?

Answer 6

(1) Hepatocellular carcinoma (2) Hepatoblastoma (3) Yolk sac (endodermal sinus) tumor (4) Testicular cancer (5) Mixed germ cell tumor (co-secreted with beta-hCG)

Question 7

With what is alpha-fetoprotein co-secreted in the context of a mixed germ cell tumor?

Answer 7

Mixed germ cell tumor (co-secreted with beta-hCG)

Question 8

What is another name for a yolk sac tumor? With what tumor marker is this associated?

Answer 8

Yolk sac (endodermal sinus) tumor; Alpha-fetoprotein

Question 9

What are 3 tumors for which Beta-hCG is a tumor marker?

Answer 9

(1) Hydatidiform moles and (2) Choriocarcinomas (Gestational trophoblastic diseases), (3) Testicular cancer

Question 10

Aside from being a tumor marker, with what condition is Beta-hCG commonly associated?

Answer 10

Commonly associated with pregnancy

Question 11

What are the 2 tumor markers for breast cancer?

Answer 11

CA-15-3/CA-27-29

Question 12

What is the tumor marker for pancreatic adenocarcinoma?

Answer 12

CA-19-9

Question 13

What is the tumor marker for ovarian cancer?

Answer 13

CA-125

Question 14

For what type of cancer is calcitonin a tumor marker?

Answer 14

Medullary thyroid carcinoma

Question 15

What is CEA? How and/or for what is it used as a tumor marker? What 2 cancers are most associated with it, and at what percentage?

Answer 15

CarcinoEmbyronic Antigen. Very nonspecific but produced by ~70% of colorectal and pancreatic cancers; also produced by gastric, breast, and medullary thyroid carcinomas

Question 16

What is PSA? What condition is it used to follow clinically? In what other 2 conditions can it elevated?

Answer 16

Prostate-specific antigen. Used to follow prostate adenocarcinoma. Can also be elevated in BPH and prostatitis.

Question 17

What is important to know about PSA screening?

Answer 17

Questionable risk/benefit for screening

Question 18

What embyrological origin does tumor marker S-100 indicate? Give 3 examples of such tumors. What is another tumor for which S-100 is applicable although it does not share this origin?

Answer 18

Neural crest origin (e.g., melanomas, neural tumors, schwannomas); Langerhans cell histiocytosis

Question 19

What is TRAP? For what is it used as a tumor marker?

Answer 19

Tartate-Resistant Acid Phosphatase (TRAP); Hairy cell leukemia - a B-cell neoplasm. Think: “TRAP the HAIRY anmimal.”

Question 20

What is important to know about the use of TRAP in modern medicine?

Answer 20

Largely replaced by flow cytometry