tumor markers Flashcards by Melissa May

biomarkers for tumor markers are usually what?

proteins

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severity of cancer is classified by:

tumor size
histology
regional lymph node involvement
presence of metastasis

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types of tumor markers:

proteins
oncofetal antigens
hormones
metabolites
receptors
enzymes

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tumor specific antigens

chemically induced
unique to tumor

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tumor associated antigens

coded for by tumorigenic viruses
expressed on host cells

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tumor markers are used for:

screening populations at risk
diagnosis
determining prognosis
monitoring response to treatment

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ideal tumor markers:

high specificity
correlates w/ tumor mass
increases w/ metastases
if in healthy is lower in [ ]
gives indication of effective therapy
[ ] correlates w/ prognosis
methods for determination are cheap and simple

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enzyme tumor markers

CK
LD
PSA
Prostate acid phosphatase
amylase

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carbohydrate antigen tumor markers

CA 125
CA 19-9
CA 27-29

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oncogene tumor markers

Her 2 (breast, ovary)
N-ras (neuroblast, ALL)
C-myc (lung, lymphoma, GI, brain colon)
C-abl/brc (trans. Philadelphia)

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PSA

prostate specific antigen
glycoprotein prod. by prostatic epi.
high sensitivity for prostate caner (75%)

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PSA elevations also seen in..

benign prostate hypertrophy (old age)
prostatitis
irritation

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prostate gland

produces fluid component of semen, PSA, and AP

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tumor markers: hormones, hCG

prod. by placenta
alpha and beta subunit
beta confers specificity

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hCG elevations in..

pregnancy
trophoblastic tumors
choricarcinoma
germ cell tumors of ovary and testes

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tumor markers; oncofetal antigens

normally expressed during fetal development
detectable during tumor formation
ex. CEA, AFP

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CEA tumor marker

carcinoembryonic antigen
expressed during: fetal devel., tumor growth, pancreatic/ GI/ lung/ ovarian cancers, breast cancer, cirrhosis, IBS, chronic lung disease, pancreatitis

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true or false
CEA is satisfactory tumor marker screening for healthy population

false: not satisfactory
used after malignancy has been confirmed
used to monitor tumor recurrence, and success of treatment

AFP tumor marker

alpha fetoprotein
normal fetal prot.
synthesized by liver, yolk sac, GI tract
used as analyte for if baby is ready for delivery (transport prot. that regulates oncotic pressure)
elevations in hepatocellular tumors

Alpha fetoprotein is associated with what tumor

germ cell tumor of testes and ovaries

alpha fetoprotein levels are used for:

diagnosis
montioring recurrence and treatment response
determination of prognosis (>100K kU/Lhigh risk)

AFP is less frequently elevated with what cancers

pancreatic
gastric
colonic
bronchogenic

AFP as a biomarker

screen pregnant mothers for neural tube defects in fetus (spina bifida)

tumor marker CA-125

mucin like glycoprotein
expressed on surface of coelomic epi during fetal development

elevations of CA-125 is seen in

ovarian, enometrial, pancreatic, lung, breast, colon cancer menstruation pregnancy endometriosis gynecological conditions

sensitivity of CA-125

85% ovarian cancer 50% + during early stage higher levels assoc. w/ increasing tumor size

tumor marker CA-125 is sensitive or insensitive test?

insensitive: only 20% positivity in early stage tumors

CA-125 is useful in screening

BRCA1-2 carriers

CA-125 is useful in monitoring..

ovarian cancer recurrence and treatment

CA-19-9 tumor marker

high predictive value where tumor is present (differentiates benign from malignant) found in pancreatic and biliary tract cancers low predictive value as screening test

CA-15-3 tumor marker

high moleuclar weight glycoprotein expressed on ductal cell surface of most glandular epi cells associated w/ breast cancer

is CA-15-3 tumor marker a differential or diagnostic test?

differential not diagnostic- monitors metastasis after mastectomy

elevations of CA-15-3 is seen in

pancreatic, lung, ovarian, colorectal, liver cancers >32 U/ml indicative of advanced breast cancer

tumor marker CA 27-29

monoclonal Ab to MUC1 (on surface of norm. epi in breast cancer) not useful for screening

sensitivity of CA 27-29 tumor marker

early stage 1/3+ late stage 2/3+

Her2 tumor marker

prot. that stimulates growth of cancer cells associated w/ increased tumor aggressiveness and reduced survival rate

Her2 is encoded by what

oncogene expressed in 15-20% of invasive breast cancers

Her2 can also be elevated in what

stomach and esophageal cancers

true or false Her2+ tumor respond to drugs that target the receptor on cancer cells

true

what mutations are associated w/ high risk of breast/ovarian cancer

BRCA1 BRCA2

What are BRCA1 &2 mutations known as

familial breast-ovarian cancer syndrome

BRCA1&2 are what type of genes?

tumor-suppressing genes

what percentage risk for breast cancer does a person have who is + for the BRCA1&2 mutations?

85% lifetime risk for breast cancer 40% risk for ovarian