Tumor Markers Flashcards
where a cancer starts
primary tumor
where cancer spreads to other parts of the body
secondary tumor / metastasis
the most common type of cancer in women
breast cancer
the most common type of cancer in men
prostate cancer
a biochemical substance present in or produced by a tumor or by the body in response to it
tumor markers
what does concentration of the tumor marker tell us?
volume of the tumor cells
in a tumor marker, quantity of marker must correlate with ____
tumor burden
what does it mean when a tumor marker has a long lead-time mean?
detectable at the early stage of the tumor while it is susceptible to treatment
what does it mean when a tumor marker has a short half-life?
good for serial monitoring in response to treatment/recurrence
a tumor marker produced by specific tumor cells
tumor specific proteins
tumor markers produced by host response factors to the presence of a tumor
non-specific proteins
tumor markers found in the body but are expressed or secreted at a much higher rate by malignant cells
increased production protein
glycoprotein synthesized by the fetal liver, yolk sac, and GI tract
alpha fetoprotein
AFP is homologous to which protein?
albumin
when is AFP the highest?
during fetal development
when does AFP rapidly clear?
after birth
how long is AFP half-life?
5-7 days
elevated levels of AFP indicate what 2 malignancies?
hepatocellular carcinoma
testicular non-seminomatous germ cell tumors
elevated levels of AFP are present in which 3 benign conditions?
hepatitis
cirrhosis
pregnancy
when is the MSAFP screening test done?
15-21 weeks in pregnancy
what do high levels of MSAFP indicate? (3)
spina bifida
anencephaly
multiple gestation
what do low levels of MSAFP indicate?
down syndrome
what test is used to check for down syndrome in pregnancy?
triple marker screen: MSAFP + HCG + estriol
a measure of how far an individual test result deviates from the median
multiple of median (MoM)
what does an abnormal MoM require?
repeat test to confirm
what does a 2nd elevated MoM indicate for MSAFP?
need for fetal sonogram
protein found in fetal intestine, pancreas, and liver
carcinoembryonic antigen (CEA)
elevated levels of CEA indicate what malignancies? (4)
colon ca
pancreatic ca
breast ca
ovarian/uterine ca
elevated levels of CEA indicate what benign conditions? (4)
hepatitis
cirrhosis
hypothyroidism
peptic ulcers
glycoprotein synthesized by the placenta in pregnancy
HCG
how early can HCG be detected?
1 week after conception
when does HCG peak?
1st trimester (60-90 days)
which subunit of HCG is most commonly assessed?
beta
elevated levels of HCG indicates what malignancies? (3)
Hyatidaform moles
Choriocarcinoma
Germ cell cancer
tumor develops inside the uterus from tissue that forms after conception
gestational trophoblastic disease
elevated levels of HCG indicates what benign conditions? (2)
pregnancy
marijuana use
glycoprotein produced by prostate tissue
prostate specific antigen (PSA)
what is PSA highly sensitive for?
prostate cancer
elevated levels of PSA indicate what benign conditions? (2)
BPH
prostatitis
what is the most common risk factor for prostate cancer?
age
what form of PSA is present in BPH and prostate cancer?
complexed form
what 3 types of medications can lower PSA results? (3)
statins
NSAIDs
thiazides
glycoprotein found in cells that line the pelvic organs and peritoneum
cancer antigen-125 (CA)
elevated levels of CA-125 indicate what malignancies? (2)
ovarian ca
endometrial ca
elevated levels of CA-125 indicate what benign conditions? (5)
endometriosis
ovarian cysts
liver disease
menstruation
pregnancy
after treatment, what CA-125 level provides strong evidence of residual tumor?
over 35 U/ml
testing CA-125 is not very sensitive for ovarian cancer in _____ _____
asymptomatic women
what other modalities will enhance the sensitivity of CA-125?
pelvic exam
transvaginal US
CA 19-9
CA 15-3
synthesized by normal human pancreatic and biliary ductal cells, gastric, colon, endometrial, and salivary epithelial cells
cancer antigen 19-9
elevated CA 9-19 levels indicate what malignancies? (3)
pancreatic ca
colon ca
gastric ca
elevated levels of CA 19-9 indicate what benign conditions?
pancreatitis
cirrhosis
which test is primarily used to differentiate between benign and malignant diseases?
CA 19-9
what level of CA 19-9 indicates malignancy?
over 37 U/ml
CA 19-9 has a specificity of 76%. what does this mean?
not good enough to be used for screening early stage pancreatic disease
levels in biopsy tissue that predict the natural history and response to hormonal manipulations
estrogen/progesterone receptor assay
how are estrogen and progesterone receptor assays reported?
as percent of positive cells
how is a positive estrogen/progesterone receptor assay indicated?
> 1%
what do positive levels of estrogen and progesterone receptor assays help us determine in clinic?
response to hormonal therapy
why do ER negative tumors have a worse prognosis?
no signals for hormones = harder to locate/treat
what is the treatment goal in breast cancer?
deprive cells of estrogen
why do we want to deprive breast cancer cells of estrogen?
estrogen fuels them to grow and divide
what are 2 local treatment options for breast cancer?
surgery
radiation
what are 3 systemic treatment options for breast cancer?
hormone therapy
chemotherapy
targeted therapy
what is the most common cause of cervical cancer?
HPV
exposure to what can lead to cervical cancer?
diethylstilbestrol (DES)
what is DES also known as?
synthetic estrogen
what is the most common cause of penile cancer?
HPV
