tumor markers

Question 1

second leading cause of death in north america

Answer 1

cancer

Question 2

definition of cancer

Answer 2

uncontrolled growth of cells that can develop into a tumor and spread to other areas.

Question 3

cancer is staged based on

Answer 3

tumor size, histology, regional lymph node involvement, presence of metastasis (1-4)

Question 4

stage 1 cancer

Answer 4

localized tumor

Question 5

stage 2 cancer

Answer 5

invasion of primary tumor thorugh epithelium and into blood vessels

Question 6

stage 3 cancer

Answer 6

migration of tumor into regional lymph nodes

Question 7

stage 4 cancer

Answer 7

metastasis of tumor to distant tissues (ex. lung, heart)

Question 8

tumor origin in epithelial tissue

Answer 8

carcinoma

Question 9

epithelial cells that form glandular structures

Answer 9

adenocarcinoma

Question 10

supportive or connective tissue tumor (ex. muscle, bone, catilage, fat, blood vessels)

Answer 10

sarcoma

Question 11

cancer in lymphoid tissue

Answer 11

lymphoma

Question 12

cancer of melanocytes

Answer 12

melanoma

Question 13

cancer of white blood cells

Answer 13

leukemia

Question 14

enzyme tumor marker

Answer 14

levels of enzymes correlate with tumor burden.

ex. ALP: bone, liver, intestine

Question 15

serum proteins (B2-microglobulin and immunoglobulins) as tumor markers

Answer 15

multiple myeloma light chains

Question 16

hormones and metabolizes as tumor markers

Answer 16

specific markers of secreting tumors (ex. ACTH: Pituitary adenoma and ectopic lung tumor)

Question 17

oncofetal antigens as tumor markers

Answer 17

present during fetal devleopment but found in adults. (ex. carcinoembryonic antigen (CEA), alpha-fetoprotein (AFP) )

Question 18

CEA is associated with what cancer

Answer 18

colon cancer

Question 19

presence of estrogen receptor assay and progesterone receptor assay suggests what

Answer 19

that tumor will respond to treatment

Question 20

why would screening asymptomatic populations result in detection of false positives

Answer 20

most tumor markers are found in normal cells, not just cancer cells (ex. PSA)

Question 21

diagnosis of cancer

Answer 21

uses results from markers, imaging, risk factors, and symptoms

Question 22

prognosis of cancer

Answer 22

concentration of the marker determines prognosis (highest levels associated with metastasis)

Question 23

decreased levels of tumor markers indicate therapy is working, increased levels of tumor marker may indicate what

Answer 23

need for change in therapy

Question 24

detection of recurrence

Answer 24

once tumor is removed, elevations of marker can indicate regrowth

Question 25

ideal tumor marker

Answer 25

tumor specific absent in healthy individuals readily detectable in bodily fluids

Question 26

diagnostic sensitivity

Answer 26

likihood that given the presence of disease, an abnormal test result predicts the disease

Question 27

diagnostic specificity

Answer 27

likelihood that given the absence of disease, a normal test result excludes the disease

Question 28

why is it not best practice to compare test results from two different assays for a cancer diagnosis

Answer 28

differences in antibody specificity, lack of standard reference material, variation in reference ranges

Question 29

most common tumor marker measurement

Answer 29

immunoassay

Question 30

challenges of immunoassay

Answer 30

levels above linearity, may show hook effect, samples exceeding range should be diluted.

Question 31

tumor marker interferences

Answer 31

heterophile antibodies lipemia hemolysis

Question 32

other tests used for tumor markers

Answer 32

high-performance liquid chromatography | immunochemistry (test solid tissue...ERA, PRA)

Question 33

what is AFP

Answer 33

an abundant protein synthesized by fetal liver

Question 34

when would AFP be increased

Answer 34

patients with hepatoellular carcinoma, and testicular cancer. decreased in down syndrome, increased in spina bifida

Question 35

function of AFP

Answer 35

normally functions as transport protein, and is involved in regulating oncotic pressure

Question 36

cancer antigen 125

Answer 36

detecting and monitoring ovarian tumors | annual test

Question 37

carinoembryonic antigen (CEA)

Answer 37

expressed during development.

Question 38

CEA (nonspecific marker) indicates what

Answer 38

colorectal cancer, also incresed in lung, breast, GI tumors, pancreas, thyroid, and ovarian cancer. not diagnostic

Question 39

human chronic gonadotropin (hCG)

Answer 39

secreted by placental to maintain pregnancy

Question 40

hCG as a tumor marker

Answer 40

testicular cancer, gestational trophoblastic diseases | hydatiform mole, choriocarcinoma

Question 41

prostate specific antigen

Answer 41

glycoprotein produced in prostatic ducts. regulates seminal fluid viscosity

Question 42

patients with prostate levels have ____ level of free PSA

Answer 42

decreased

Question 43

normal range for PSA

Answer 43

<4ng/mL

Question 44

CA 15-3

Answer 44

metastatic cancer of breast