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Clinical Pathology > Tumor markers > Flashcards

Tumor markers Flashcards

1
Q

Tumorigenesis occurs due to

A

Growth factors and oncogenes

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2
Q

Meaning of Sensitivity of Tumor Markers

A

No false negatives

Given presence of the disease, the test predicts presence

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3
Q

Meaning of Specificity of Tumor markers

A

No false positives

Given the absence of disease, the test excludes the presence

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4
Q

Challenges of immunoassay for detection of tumor markers

A

Markers above linearity
Hook effect(resulting in false lows)
Heterophile antibodies
Lipemia, hemolysis and antibody cross reactivity cause interference

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5
Q

Examples of Enzyme Tumor markers

A
  1. Alkaline Phosphatase
  2. Creatinine Kinase
  3. Lactate DH
  4. Prostatic acid phosphatase
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6
Q

Alkaline phosphatase is an enzymatic tumor marker present in

A

Bone
Liver
Intestine

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7
Q

Creatine kinase is an enzymatic tumor marker found in

A

Prostate
Lung
Breast
Colon
Ovarian

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8
Q

Lactate dehydrogenase is an enzymatic tumor marker found in

A

Liver
Lymphomas
Leukemias

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9
Q

Prostatic acid phosphatase is an enzymatic tumor marker found in

A

Prostate

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10
Q

Which enzyme is seen in Primary or Secondary liver cancer

A

ALP

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11
Q

Which enzyme level may be helpful in evaluating metastatic cancer with bone or liver involvement

A

ALP

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12
Q

Which regan isoenzyme elevates in ovarian, lung, GI cancers and Hodgkin’s disease

A

Placental ALP

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13
Q

Increased PAP activity may be seen in

A

Osteogenic sarcoma, Multiple myeloma and Bone metastasis of other cancers.
Osteoporosis
Hyperparathyroidism

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14
Q

The clinical use of PAP has been replaced by

A

PSA

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15
Q

PSA exists in 2 forms in blood circulation

A

Complexed PSA (majority)
Free PSA

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16
Q

PSA is more specific than PAP for detecting early cancer T/F

A

T

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17
Q

PSA testing itself is effective in detecting early prostate cancer T/F

A

F. It is not effective

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18
Q

Other prostatic diseases, urinary bladder catheterization and digital rectal exam may lead to a/an increased/decreased PSA level in serum

A

Increased

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19
Q

The ration between free and total PSA is a reliable marker for detection of prostatic cancer from BPH

A

F. It is unreliable

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20
Q

The use of PSA should be together with ………….. and followed by …………. for an accurate diagnosis of cancer

A

Digital Rectal Exam
Transrectal Ultrasonography

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21
Q

Serum level of PSA correlates with

A

Clinical stage
Grade
Metastasis

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22
Q

The greatest clinical use of PSA is

A

Monitoring of treatment

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23
Q

Treatment of Prostatic tumors and cancers include

A

Radical prostatectomy
Radiation therapy
Antiandrogen therapy

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24
Q

PSA levels should fall below the detection limit after treatment for how long

A

2-3 weeks

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25
Q

Androgen Deprivation Therapy may have DIRECT effect on the PSA level that is independent of the anti tumor effect T/F

A

T

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26
Q

Examples of Endocrine Tumor markers

A
  1. Beta-human Chorionic Gonadotropin
  2. Calcitonin
  3. Adrenocorticotropin Hormone
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27
Q

Elevated Calcitonin levels is usually associated with

A

Medullary Thyroid Cancer

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28
Q

Calcitonin reduces/increases CALCIUM concentration

A

reduces

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29
Q

Calcitonin levels are low in patients with cancer of lung, breast, kidney, liver T/F

A

F. They are high

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30
Q

Calcitonin levels are high/low in Hyperparathyroidism

A

High

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31
Q

Calcitonin levels are high in Paget’s disease and pancreatitis T/F

A

T

32
Q

Calcitonin levels are low in pregnancy T/F

A

F. They are high

Also high in myeloproliferative disorders

33
Q

hCH consists of how many subunits

A
  1. Alpha and Beta
34
Q

hCG is elevated in what conditions

A

Trophoblastic tumors
Choriocarcinoma
Germ cell tumors of ovary and testis

35
Q

Oncofetal antigens become detectable in tumor function T/F

A

T

36
Q

Oncofetal antigens are elevated in fetal development T/F

A

T. They are normal in fetal development

37
Q

Examples of oncofetal antigens

A

Carcino-embryonic antigen
Alpha-fetoprotein

38
Q

CEA can be used to detect what cancers

A

Colorectal, Lung, Breast, ovarian and GI cancers

39
Q

CEA levels are elevated in smokers T/F

A

T

40
Q

CEA levels are elevated in which benign conditions

A

Cirrhosis
Rectal Polips
Ulcerative colitis
Benign breast disease

41
Q

CEA testing should be used for screening, staging and monitoring therapy. T/F

A

F. Should not be used for screening. Some tumors don’t produce CEA

42
Q

AFP is synthesized by

A

Fetal liver

43
Q

AFP is Used to diagnose which types of tumors

A

Hepatocellular carcinoma
Germ cell tumors(testes, ovaries)

44
Q

AFP is useful for screening, determining prognosis and monitoring therapy of liver cancers T/F

A

T

45
Q

AFP levels greater than what level are indicative of cancer except pregnancy

A

1000 ug/L

46
Q

AFP is a prognostic indicator of survival T/F

A

T

47
Q

What’s the measure of serum AFP levels in healthy adults

A

10 ug/L

48
Q

AFP and hCG combined are useful in

A

Classifying and staging cell tumors

49
Q

Which markers are antigens on tumor cell surfaces or secreted by tumor cells

A

Carbonhydrate markers

50
Q

What antibodies have been developed against carbonhydrate markers?

A

Monoclonal antibodies

51
Q

Most reliable carbonhydrate markers

A

CA 15-3
CA 125
CA 19-9

52
Q

Which carbonhydrate marker is a marker for Breast Carcinoma

A

CA 15-3

53
Q

CA 15-3 is not useful for diagnosis. T/F

A

T

54
Q

Which carbonhydrate marker is non-specific and a marker for ovarian and endometrial cancers

A

CA 125

55
Q

CA 125 is a non specific marker for

A

Ovarian and endometrial cancers

56
Q

Uses of CA 125 concerning cancers

A
  1. Detecting residual diseases or recurrence after initial therapy (75% accurate)
  2. Differentiating benign from malignant disease in patients with ovarian masses
57
Q

CA 19-9 is a marker for

A

Colorectal and Pancreatic carcinoma

58
Q

Elevated levels of CA 19-9 are also seen in Hepatobiliary, Gastric, Hepatocellular and Breast cancer. T/F

A

T
Also in pancreatitis and benign GI diseases

59
Q

High CA 19-9 is indicative of recurrence after radiography T/F

A

F. It is indicative of recurrence before radiography

60
Q

Examples of the Most reliable protein markers

A

B2-Microglobulin
Ferritin
Thyroglobulin
Immunoglobulin

61
Q

B2-Microglobulin is a marker for

A

Multiple myeloma
Hodgkin lymphoma

62
Q

What protein marker increases in chronic inflammation and viral hepatitis

A

B2-Microglobulin

63
Q

Ferritin is a marker for

A

Hodgkin Lymphoma
Leukemia
Liver, Lung and breast cancer

64
Q

Thyroglobulin is a useful marker for detection of

A

Differentiated Thyroid Cancer

65
Q

Monoclonal immunoglobulin is used as a marker for

A

Multiple myeloma

66
Q

Monoclonal paraproteins appear as …………….. in the ……………. area of the Serum Protein Electrophoresis

A

Sharp Bands
Globulin area

67
Q

Bence-Jones protein is a free monoclonal immunoglobulin light chain in the urine and is a reliable marker for

A

Multiple Myeloma

68
Q

Estrogen and Progesterone receptors are used in breast cancer as indicators for

A

Hormonal Therapy

69
Q

Patients with negative estrogen and progesterone receptors tend to respond to hormonal treatment T/F

A

F. Patients with positive receptors respond to hormonal treatment

70
Q

Hormone receptors serve as prognostic factors in breast cancer T/F

A

T

71
Q

Patients with positive/negative receptor levels tend to survive longer

A

Positive

72
Q

Of patients with breast cancer, what percentage have tumors with estrogen receptor

A

60%

73
Q

What percentage of patients with estrogen receptor positive tumors respond to hormonal therapy

A

Two-thirds

74
Q

What percentage of patients with estrogen receptor negative tumors respond to hormonal therapy

A

5%

75
Q

Progesterone receptor synthesis is independent/dependent on estrogen action

A

Dependent

76
Q

Measurement of progesterone receptors confirms that all the steps of estrogen action are intact T/F

A

T

Clinical Pathology (5 decks)

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