Quiz 10: Circulating Tumor Markers

Question 1

Tumor markers may be defied as

(a) Biological substances synthesized and released by cancer cells or substances produced by the host in response to cancer cells
(b) Analytic tests (e.g., immunoassays) used to mark cancer cells
(c) Radioactive substances and chemicals used to help they physician identify cancer cells
(d) None of the above

Answer 1

(a) Biological substances synthesized and released by cancer cells or substances produced by the host in response to cancer cells

Question 2

What is the major limitations of tumor markers?

(a) Sensitivity and specificity
(b) Cost
(c) Turnaround time
(d) Imprecision

Answer 2

(a) Sensitivity and specificity

Question 3

The major clinical use for cancer antigen 125 (CA 125) is monitoring treatment response of

(a) Ovarian carcinoma
(b) Colorectal cancer
(c) Prostatic cancer
(d) Breast cancer

Answer 3

(a) Ovarian carcinoma

Question 4

Which of the following enzymes is commonly used as a tumor marker?

(a) Alanine aminotransferase (ALT)
(b) Lactate dehydrogenase (LD)
(c) Lipase
(d) Prostate specific antigen (PSA)

Answer 4

(b) Lactate dehydrogenase (LD)

Question 5

A tumor marker used in the assessment of choriocarcinoma or hydatidiform mole is

(a) beta-HCG
(b) CEA
(c) AFP
(d) IgG

Answer 5

(a) beta-HCG

Question 6

Which of the following methods is commonly used to measure endocrine metabolites?

(a) Gas chromatography
(b) High liquid performance chromatography (HPLC)
(c) Immunoassays
(d) Serum protein electrophoresis

Answer 6

(b) High liquid performance chromatography (HPLC)

Question 7

Which of the following tumor markers is classified as a tumor suppressor gene?

(a) BRCA-1
(b) Carcinoembryonic antigen (CEA)
(c) hCG
(d) Nuclear matrix protein (NMP)

Answer 7

(a) BRCA-1

Question 8

In general, in which of the following situations is the analysis of a glycoprotein tumor marker, such as carbohydrate-associated antigen-125 (CA-125), most useful?

(a) Diagnosis
(b) Prognosis
(c) Screening
(d) Testing for recurrence

Answer 8

(d) Testing for recurrence

Question 9

Which tumor marker is associated with cancer of the urinary bladder?

(a) CA 19-9
(b) CA 72-4
(c) NMP
(d) Cathepsin-D

Answer 9

(c) NMP

Question 10

Which of the following tumor markers is used to monitor persons with breast cancer for recurrence of disease?

(a) Cathepsin-D
(b) CA 15-3
(c) Retinoblastoma gene
(d) Estrogen receptor (ER)

Answer 10

(b) CA 15-3

Question 11

What is the primary clinical utility of measuring carcinoembryonic antigen (CEA)?

(a) Diagnosis of liver cancer
(b) Diagnosis of colorectal cancer
(c) Screening for cancers of endodermal origin
(d) Monitoring for recurrence of cancer

Answer 11

(d) Monitoring for recurrence of cancer

Question 12

A person is suspected of having testicular cancer. Which type of hCG test would be the most useful?

(a) Plasma immunoassay for intact hCG only
(b) Plasma immunoassay for intact hCG and the beta-hCG subunit
(c) Plasma immunoassay for the free alpha and beta-hCG subunits
(d) Urine assay for hCG beta-core

Answer 12

(b) Plasma immunoassay for intact hCG and the beta-hCG subunit

Question 13

Which type of cancer is associated with the high levels of alpha fetal protein (AFP)?

(a) Breast cancer
(b) Colon cancer
(c) Hepatoma
(d) Ovarian cancer

Answer 13

(c) Hepatoma

Question 14

A 55-year-old male with early-stage prostate cancer diagnosed through biopsy had his prostate gland removed (simple prostatectomy). His PSA prior to surgery was 10.0 ng/mL. If the surgery was successful in completely removing the tumor cells, what would the PSA result be 1 month after surgery?

(a) Undetectable
(b) 1 to 3 ng/mL
(c) Less than 4 ng/mL
(d) Less than 10 ng/mL

Answer 14

(a) Undetectable

Question 15

Which of the following proteins is normally produced by the fetus but is found in increased amounts in the amniotic fluid in cases of spina bifida?

(a) alpha-1 Acid glycoprotein
(b) alpha-1 Antitrypsin
(c) alpha-1 Fetoprotein
(d) alpha-2 Macroglobulin

Answer 15

(c) alpha-1 Fetoprotein

Question 16

A male patient, 48 years old, mentions during his annual physical that he has been having difficulty urinating. The physician performs a rectal examination, and he orders a total prostate-specific antigen (PSA) and free PSA. The patient has the tests done the following week, and the total PSA results is 3.1 ng/mL and the free PSA is 0.3 ng/mL. What do these results suggest?

(a) Benign prostatic hypertrophy
(b) Both are normal, no disease present
(c) Free PSA is low and does not correlate with total PSA
(d) Increased risk of prostate cancer

Answer 16

(d) Increased risk of prostate cancer

Question 17

Which of the following is NOT associated with carcinoembryonic antigen?

(a) Glycoprotein in nature
(b) Increased levels seen with malignancies of the colon but not specific for colon cancer
(c) Quantified by using high performance liquid chromatography
(d) Used to monitor treatment of colon cancer

Answer 17

(c) Quantified by using high performance liquid chromatography

Question 18

In cases of hepatoma, which protein not normally found in adult serum is synthesized by liver cells?

(a) alpha-1 Acid glycoprotein
(b) alpha-1 Fetoprotein
(c) alpha-2 Macroglobulin
(d) Carcinoembryonic antigen

Answer 18

(b) alpha-1 Fetoprotein

Question 19

The value for PSA with the presence of prostate cancer is considered most unlikely is:

(a) 1.0 ng/mL
(b) 2.5 ng/mL
(c) 4.0 ng/mL
(d) 6.0 ng/mL

Answer 19

(a) 1.0 ng/mL

Question 20

Which of the following is a marker for pancreatic carcinoma?

(a) CA 19-9
(b) CA 15-3
(c) CA 549
(d) CEA

Answer 20

(a) CA 19-9