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CLIN PATH > TUMOR MARKERS 1 > Flashcards

TUMOR MARKERS 1 Flashcards

1
Q

The pathogenesis of the disease has been associated historically with

A

(1) chemical carcinogens (diet, fumes, skin contacts),
(2) radiation,
(3) viruses, and
(4) heredity

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2
Q

The DNA content of a tumor cell can be examined for

A

mutations, presence of oncogenes

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3
Q

Is a substance synthesized by the host in response to a tumor that can be used to detect the presence of the tumor.

A

tumor marker

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4
Q

An ideal tumor marker has the following characteristics:

A
  • Specificity,
  • Sensitivity,
  • tumor load
  • consistent concentration of the tumor marker
  • short half life
  • levels of the marker should have prognostic value
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5
Q

Uses of Tumor Markers

A

1) Screening for disease in asymptomatic population
2) Diagnosis of disease in symptomatic patients
3) Aid in clinical staging
4) Measurement of tumor burden
5) Therapeutic monitoring and selection
6) Detection of recurrence of disease (relapse).
7) Prognostic indicator

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6
Q

The primary use of tumor markers is to

A

Monitor therapy in patients who have been diagnosed as having a malignant tumor.

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7
Q

Tumors that are generally well differentiated.

A

Benign tumors

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8
Q

The cells in a benign tumor are similar to the cells of the corresponding normal tissue, and therefore the tumor markers produced are typically the products found in the

A

normal tissue

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9
Q

When a normal cell is transformed into a tumor cell, this changes

A

gene expression

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10
Q

Tumors are assumed to be _____ in origin.

A

unicellular

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11
Q

CHEMICAL ANALYTES MAY SERVE AS POSSIBLE MARKERS of neoplastic disease and often serve as a clue to the origin of the disease:

A

1) Enzymes
2) Hormones/Receptors (estrogen, progesterone, androgen, and corticosteroid)
3) Proteins (immunoglobulins, glycoproteins, carcinoembryonic proteins, or oncofetal antigens)
4) Other markers (sialic acid conjugates, polyamines, and amino acids

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12
Q

Is not a reliable screening or early disease diagnostic tool.

A

ACP (Acid phosphatase)

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13
Q

Elevated levels of the ___ of acid phosphatase have been used to diagnose and monitor prostate cancer but may not necessarily be found when malignancy is present, especially in the early stages of disease.

A

prostatic isoenzyme (PAP)

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14
Q

It is sometimes used in conjunction with PSA to discriminate between patients who have extracapsular disease and those whose disease is encapsulated’

A

ACP (Acid phosphatase)

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15
Q

Is useful in the diagnosis of primary bone and hepatic malignancies and metastases to these organs.

A

uantitation of total phosphatase (ALP) (Alkaline phosphate)

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16
Q

Elevations of ___ correlate well with osteoblastic activity and be used to monitor therapy and look for recurrence in patients with osteosarcoma or metastatic prostate cancer.

A

ALP

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17
Q

Commonly known as the brain fraction, is normally not observed in serum due to the blood-brain barrier.

A

BB isoenzyme of creatine kinase (CK-BB, CK-1)

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18
Q

Is the fetal form of the enzyme and as such is associated with many malignant diseases, especially those of epithelial cell origin.

A

CK-BB

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19
Q

CK-BB isoenzymes are identified and quantitated using

A

electrophoresis

20
Q

Is a nonspecific marker.

A

Lactate dehydrogenase (LD)

21
Q

Elevated serum ____ has been described in germ cell tumors.

A

LD-1

22
Q

Increased serum concentrations of ___ are observed in patients with leukemias and lymphomas

A

LD-3

23
Q

Increased serum concentration of this are seen in px with colon, breast, lung, liver, stomach cancers, and a variety of adenocarcinomas such as that of prostate.

A

LD-5

24
Q

Is a specific marker for tumors associated with the neuroendocrine system. Serum and/or CSF elevation

A

Neuron-specific enolase (NSE)

25
Q

May be quantitated by RIA and the levels correlate well withthe tumor burden

A

NSE

26
Q

Are more sensitive markers for liver cancer than ALP but neither specific for cancer. They may be both be elevated in cases of cirrhosis and GGT is elevated in a large percentage of pancreatic cancers.

A
  • 5’Nucleotidase (5’NT)

- gamma glutamyltransferase (GGT)

27
Q

Are enzymes associated with the pancreas.

A
  • Amylase (AMS),
  • lipase (LPS),
  • trypsin (TPS),
  • ribonuclease (RNase)
28
Q

lt is quantitated using an immunoassay (RIA or EIA) and is used to predict prognosis and responsiveness to drugs as well as to help classify the leukemias.

A

Terminal Deoxynucleotidyl Transferase

29
Q

Are part of a larger class of compounds known as proteases. Synthesized and secreted by malignant cells, these compounds are responsible for degrading the extracellular matrix and thus permitting their invasion and metastasis. Both can be quantitated in extracts from surgically removed solid tumors.

A

Collagenase and Cathepsin D

30
Q

___ is measured in bone malignancies and ___ is often quantitated in breast cancer patients.

A
  • Collagenase

- cathepsin D

31
Q

Has been used as a tumor marker in cases of medullary thyroid cancer to confirm a high level of calcitonin, which is normally found in this disease.

A

Histaminases or diamine oxidase (DAO)

32
Q

Is sometimes used in the monitoring of monocytic and myelomonocytic leukemias.

A

Muramidase

33
Q

Result from the excessive hormonal production, are often the first indication of malignancy and the quantitation of the hormone(s) in question can support or establish a diagnosis.

A

paraneoplastic endocrine syndromes

34
Q

Are protein structures located on external cell membranes and within the cell. The function is to recognize and bind a specific ligand such as a hormone or neurotransmitter.

A

Cell receptors

35
Q

Are assayed clinically to determine which breast cancer patients may respond to endocrine therapy.

A

Estrogen (ER) and progesterone (PgR)

36
Q

If tumor growth is stimulated by estrogen, an ___ such as tamoxifen may be used to limit the growth of the tumor.

A

antiestrogen

37
Q

Have been measured to predict the outcome of antiandrogen therapy in prostate cancer patients.

A

Androgen (AR) and progesterone (PgR) receptors

38
Q

Receptors as a prognostic indicator are being evaluated in cases of lymphoblastic leukemia.

A

glucocorticoid receptors

39
Q

Is a glycoprotein known to bind epidermal growth factor (EGF) and transforming growth factor alpha (TGF-a). The absence of this receptor correlates well with a good response to tamoxifen.

A

Epidermal growth factor receptor (EGFR)

40
Q

Is another potential marker for breast cancer. It is a major constituent of basement membrane

A

Laminin

41
Q

Are proteins that are normally expressed by the fetus but not by the healthy adult. Since these proteins are synthesized in high concentration by tumor cells in cancer patients, they were named for this.

A

Oncofetal proteins (oncofetal antigens)

42
Q

Were the first of these proteins discovered.

A

alpha-fetoprotein and carcinoembryonic antigen

43
Q

So named because it migrates electrophoretically between alpha, and albumin, is the most abundant protein present during fetal development. The level gradually drops until at the age of about 1 year, it is at normal adult levels (0 to 15 ng/mL). is associated with various germ cell tumors and hepatoma. lt is useful in characterization and staging of disease and in monitoring therapy.

A

Alpha-fetoprotein (AFP)

44
Q

In adults, high blood levels (over 500 nanograms/milliliter) of AFP are seen in only three situations:

A
  • HCC (Hepatocellular CA)
  • Germ cell tumors (cancer of the testes and ovaries)
  • Metastatic cancer in the liver (originating in other organs)
45
Q

Is a good marker for primary hepatoma because it is elevated in approximately 60-80% of the cases. lt shows potential as a screening tool for Down’s syndrome.

A

AFP

CLIN PATH (19 decks)

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