Serum tumor markers

Question 1

Alkaline phosphatase

Answer 1

Metastases to bone or liver, Paget disease of

bone, seminoma (placental ALP).

Question 2

α-fetoprotein

Answer 2

Hepatocellular carcinoma, hepatoblastoma, yolk
sac (endodermal sinus) tumor, mixed germ
cell tumor.

Normally made by fetus. Transiently elevated in
pregnancy. High levels associated with neural
tube and abdominal wall defects, low levels
associated with Down syndrome.

Question 3

β-hCG

Answer 3

Hydatidiform moles and Choriocarcinomas
(Gestational trophoblastic disease), testicular
cancer, mixed germ cell tumor

Produced by syncytiotrophoblasts of the
placenta.

Question 4

CA 15-3/CA 27-29

Answer 4

Breast cancer.

Question 5

CA 19-9

Answer 5

Pancreatic adenocarcinoma.

Question 6

CA 125

Answer 6

Ovarian cancer

Question 7

Calcitonin

Answer 7

Medullary thyroid carcinoma

Question 8

CEA

Answer 8

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

Question 9

PSA

Answer 9

Prostate-specific antigen. Prostate cancer.

Can also be elevated in BPH and prostatitis.
Questionable risk/benefit for screening.

Question 10

S100

Answer 10

Melanoma or other crest tumors (schwanoma)

Question 11

TRAP

Answer 11

Hairy cell leukemia