Tumor Markers

Question 1

Which of the following is NOT true about tumor markers?

They can be produced by the host as a response to tumors
They can be biologic substances synthesized by cancer
Most tumor markers are inflammatory cytokines
They can be detected in urine

Answer 1

Most tumor markers are inflammatory cytokines

Question 2

(T or F) A genetic mutation can be considered a tumor marker.

Answer 2

True

Question 3

Which of the following is characteristic of an ideal tumor marker?

Maker stays within the tumor
Marker has a long half-life
Produced only once the tumor has metastasized
Marker is cancer specific

Answer 3

Marker is cancer specific

Question 4

Which is true when comparing tumor markers for screening purposes to other screening methods (PAP, colonoscopy, mammography)?

Tumor marker screening testing is sometimes more accessible for patients with barriers to healthcare
Tumor marker screening testing is invasive
Tumor marker screening testing tends to be more expensive
Currently available tumor marker testing tends to be more sensitive and specific

Answer 4

Tumor marker screening testing is sometimes more accessible for patients with barriers to healthcare

Question 5

Rank the screening tests for colorectal cancer in order of increasing sensitivity and specificity.

FIT-DNA < FIT < gFOBT < colonoscopy
gFOBT < FIT-DNA < FIT < Cologuard
gFOBT < FIT < FIT-DNA < colonoscopy
Colonoscopy < FIT-DNA < FIT < gFOBT

Answer 5

gFOBT < FIT < FIT-DNA < colonoscopy

Question 6

Which of the following is true about PSA (Prostate Specific Antigen)?

It is only produced when a tumor reaches stage 2
It can become elevated by bike riding
Current guidelines recommend PSA testing starting at 50yo
It is specific to prostate tumor cells

Answer 6

It can become elevated by bike riding

Question 7

Why does ovarian cancer have such poor survival rates?

Answer 7

Presentation is vague and is often diagnosed after metastasis has occurred

Question 8

Which of the following is true about CA125? (2)

It is a newly identified biomarker and noes not have much clinical use
It is strongly associated with ovarian cancer
It is increased in many cancers
It is highly sensitive for early stage disease

Answer 8

It is strongly associated with ovarian cancer
It is increased in many cancers

Question 9

Alpha fetoprotein is used to:

Answer 9

Test for treatment response
And
Screen high risk populations for hepatocellular carcinoma

Question 10

Alpha Fetoprotein: Composition, conditions, uses.

Answer 10

• Composition: Protein synthesized by fetal liver, expressed in certain tumors
• Conditions: Liver cancer, chronic hepatitis
• Uses: Monitor treatment and recurrence of disease, high risk individuals

Question 11

CA-125: Composition, conditions, uses.

Answer 11

• Composition: Mucin type O linked glycoprotein
• Conditions: Ovarian cancer
• Uses: Adjunctive to a pelvic mass, response to therapy, detection of recurrence, prognosis if >65, screening high risk pts with BRCA 1 and 2

Question 12

PSA: Composition, conditions, uses.

Answer 12

• Composition: Glycoprotein produced by epithelial cells
• Conditions: Prostate cancer, benign prostatic hyperplasia, acute prostatos
• Uses: Biopsy, not specific. Not recommended for screening.

Question 13

Cologuard: Composition, conditions, uses.

Answer 13

• Composition: Fecal occult blood test looking at presence of blood plus methylated BMO3 and NDRG4, gene promoter regions, mutant KRAS, and immunochemical assay for human hemoglobin.
• Conditions: Colorectal cancer
• Uses: Used for dx

Question 14

Carcinoma Embryonic Antigen Test: Composition, conditions, uses

Answer 14

• Composition: Produced by cancer cells, oncofetal antigen
• Conditions: Colorectal cancer
• Uses: Prognosis following treatment