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
• 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.

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

P-glycoprotein

Answer 10

AKA multidrug resistance protein 1 (MDR1)

Classically seen in *adrenal cell carcinoma but also expressed by other cancer cells (eg, colon, liver)

Used to pump out toxins, including chemotherapeutic agents (one mechanism of  responsiveness or resistance to chemotherapy over
time).