TUMOR MARKERS Flashcards
Used to diagnose cancer and categorize types of cancers
Tumor Markers
What tumor markers determine?
Tumor burden
What are the Ideal Tumor Markers?
Specificity
Lead time
Sensitivity
Short half-life
Cost effective
It is highly specific to a given tumor and present in patients with malignancies
Specificity
Should not be seen on healthy individuals; only in _______ if ever present.
Specificity; trace amounts
Produce measurable amounts even in small quantities
Lead Time
Low false positive rates
Sensitivity
Indicates precise progression or regression of tumors
Short half-life
Inexpensive and acceptable to the target population
Cost effective
2 Classification of Tumor Markers
According to Location
According to Chemical Structure
What are included in According to Location?
a. Circulating tumor markers
b. Tumor tissue markers
What are included in According to Chemical Structure?
a. Enzymes
b. Hormones
c. Oncofetal antigens
d. Tumor-associated antigen
e. Special serum proteins
f. Miscellaneous markers
Where Circulating tumor markers can be found?
Blood
Urine
Stool
other body fluids
Tumor tissue markers can found in:
Actual Tumors
Circulating Tumor Markers can be used to:
Estimate prognosis
Detect residual disease
Assess treatment response
Monitor resistance to treatment
Tumor tissue markers can be used to:
Diagnose, stage, and or classify cancer
Estimate prognosis
Select an appropriate treatment
What are the Enzymes that are included in Chemical Structure of Tumor Markers?
Acid Phosphatase (ACP)
Alkaline Phosphatase (ALP)
Lactate Dehydrogenase (LDH)
Terminal Deoxyribonucleotidyl transferase (TdT)
Neuron-specific enolase
> 3ng/mL: prostatic cancer (advanced phase)
Acid Phosphatase (ACP)
Metastases to bone
Liver and osteogenic sarcoma
Alkaline Phosphatase (ALP)
Lactate Dehydrogenase
Cervix
Colon
Leukmia
Liver
Lymphoma
C2L3
Increases concentration in RBC
LD1 & LD2
Increase LDH
Increase RBC destruction in leukemic states
Leukemia
Terminal Deoxyribonucleotidyl transferase (TdT)
Neuron-specific enolase
Brain Tumor
Neuroblastoma
Small cell tumor of lungs
What are the Hormones in Chemical structure?
Adrenocorticotropic Hormone
Calcitonin
Catecholamines
Human chorionic gonadotropin (Beta-HCG)
Thyroid kinase
Human Chorionic gonadotropin (Beta-HCG)
Choriocarcinoma
Germ cell tumor (ovary and testes)
Pregnant
Trophoblastic tumors
(CGPT)
Catecholamines
Ganglioneuroma
Neuroblastoma
Pheochromocytoma
Produced by Adrenal gland
Calcitonin
Medullary thyroid tumor
Adrenocorticotropic hormone
adrenals
Cell carcinoma of lung
Thyroid kinase evaluate disease spread in patients with:
Brain tumor
breast cancer
Leukemia
Lymphoma
Small cell lung tumor
(B2L2S)
What are Oncofetal Antigens?
Alpha-fetoprotein (AFP)
Carcinoembryonic antigen (CEA)
> 1200ng/mL: confirm the diagnosis of primary liver (hepatocellular) cancer
Alpha-fetoprotein(AFP)
Alpha-fetoprotein:
(percentage) specific: non-seminoma germ tumor
60%
Cancers in Alpha-fetoprotein
Pancreas
Lungs
Ovary
Testes
Gastric
(PlotG)
It is Colorectal Cancer
Carcinoembryonic antigen (CEA)
Carcinoembryonic Antigen
Breast
Lungs
Metastases
What are the tumor associated antigen?
Carcinomic Antigen
•CA 15-3
•CA 125
•CA 19-9
•Prostate specific antigen (PSA)
CA 15-3
> 30U/mL:______
Breast Cancer
CA 125
>35U/mL:______
Breast cancer
Benign/malignant gynecological disease
Cervical cancer
Endometrial cancer
CA 15-3
Others: ______
Cervical
GI
Ovarian
Lung
Prostatic
CGOLP
CA 125
Others:
Lung cancer
Peritoneal malignant mesothelioma
Prostatic cancer
CA 19-9 is more specific in?
Pancreatic and Liver cancer
CA 19-9
•Gastrointestinal tumors
•Colorectal, Gastric, and Ovarian Cancer
Prostate Specific Antigen is specific for?
Prostatic Cancer
What are the Special Serum Proteins?
Beta-2-Microglobulin
Bombesin
Ferritin
S-100 Protein
Thyroglobulin
(B2FST)
Hodgkin’s Lymphoma
Ferritin
Follicular Thyroid carcinoma
Thyroglobulin
Iron binding capacity
Ferritin
Acute Leukemia
Ferritin
Ferritin
Lungs
Liver
Prostatic Cancer
Chronic Lymphoid Leukemia & Lymphomas
Beta-2-Microglobulin
Beta-2-Microglobulin
Breast
Colorectal cancer
Lung
Pancreatic
Bombesin
Gastric cancer
Neuroblastoma
Pancreatic cancer
small cell carcinoma of lungs
Prognostic factor of S-100 Protein
Malignant melanoma
S-100 Protein
Astrocytoma
Glioblastoma
Meningioma
Neurinoma
What are the Miscellaneous Markers?
Polyamines
Nucleosides
Tissue polypeptide antigen (TPA)
Elevated in URINE in cases of rapid generation of cells of certain tissue
Polyamines
Polyamines
Spermine
Spermidine
Putrescine
Nucleosides are component of?
RNA
Nucleosides
Dimethyl guanosine
Pseudoridine
Enters the circulation in large amounts in cases of enhanced cellular proliferation=malignant processes
Nucleosides
Non-specific marker of enhanced cellular proliferation
Tissue Polypeptide antigen
Immunologic detection relies on:
Monoclonal antibodies
Specific antibodies are incubated with tissue sections
Immunohistochemistry & Immunofluorescence
It detects the presence/abscence of antigen
Immunohistochemistry & Immunofluorescence
Colorimetric or fluorescent secondary antibodies
Immunohistochemistry & Immunofluorescence
It is the most commonly used method to measure tumor markers
Immunoassays
Example of Immunoassays
Radioimmunoassay (RIA) & Enzyme-linked immunosorbent assay (ELISA)
Automate testing & rapid analysis
Immunoassays
What are the methods of detection of tumor markers?
I. IMMUNOLOGIC DETECTION
II. HIGH-PERFORMANCE LIQUID CHROMATOGRAPHY
III. ENZYME ASSAY
IV. FLOW CYTOMETRY
V. CYTOGENETIC ANALYSIS
VI. GENETIC ANALYSIS
VII. PROTEOMICS
It is commonly used to detect small molecules
High-perfomance liquid chromatography
It detect catecholamine metalobites in plasma and urine
High-performance liquid chromatography
Requires more experience and skill than automated immunoassays
High-performance liquid chromatography
Enzyme Assays
ALP & LDH
ALP:
Bone
liver
leukemia
sarcoma
LDH:
Liver
Lymphomas
Leukemia
others
Analyze the presence and percentage to antibody tagged cells
Flow Cytometry
What are the Cytogenetic Analysis?
a. Fluorescent in-situ hybridization
b. Spectral karyotyping
c. Comparative genomic hybridization
What are the Genetic analysis?
a.Sequencing (automated)
b. Reverse transcription
c. Gel electrophoresis
d. DNA micro-array analysis
Surface enhanced laser desorption/ionization
Proteomics