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, endodermal sinus (yolk sac) tumor, Mixed germ cell tumor, Ataxia-telangiectasia, Neural tube defects
(HE-MAN is the alpha male)
- high levels associated with neural tube and abdominal wall defects
- low levels associated with Down syndrome

Question 3

ß-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 (alone and in MEN2A/2B)

Question 8

CEA

Answer 8

Main: colorectal and pancreatic cancers
Minor: gastric, breast, and medullary thyroid carcinomas
- CarinoEmbryonic Antigen - very nonspecific

Question 9

Chromogranin

Answer 9

neuroendocrine tumors

Question 10

LDH

Answer 10

testicular germ cell tumors, ovarian dysgerminoma, other cancers

Question 11

PSA

Answer 11

prostate cancer

• Prostate-Specific Antigen
• can also be elevated in BPH and prostatitis