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Lab Med > Tumor Markers > Flashcards

Tumor Markers Flashcards

1
Q

where a cancer starts

A

primary tumor

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2
Q

where cancer spreads to other parts of the body

A

secondary tumor / metastasis

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3
Q

the most common type of cancer in women

A

breast cancer

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4
Q

the most common type of cancer in men

A

prostate cancer

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5
Q

a biochemical substance present in or produced by a tumor or by the body in response to it

A

tumor markers

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6
Q

what does concentration of the tumor marker tell us?

A

volume of the tumor cells

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7
Q

in a tumor marker, quantity of marker must correlate with ____

A

tumor burden

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8
Q

what does it mean when a tumor marker has a long lead-time mean?

A

detectable at the early stage of the tumor while it is susceptible to treatment

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9
Q

what does it mean when a tumor marker has a short half-life?

A

good for serial monitoring in response to treatment/recurrence

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10
Q

a tumor marker produced by specific tumor cells

A

tumor specific proteins

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11
Q

tumor markers produced by host response factors to the presence of a tumor

A

non-specific proteins

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12
Q

tumor markers found in the body but are expressed or secreted at a much higher rate by malignant cells

A

increased production protein

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13
Q

glycoprotein synthesized by the fetal liver, yolk sac, and GI tract

A

alpha fetoprotein

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14
Q

AFP is homologous to which protein?

A

albumin

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15
Q

when is AFP the highest?

A

during fetal development

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16
Q

when does AFP rapidly clear?

A

after birth

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17
Q

how long is AFP half-life?

A

5-7 days

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18
Q

elevated levels of AFP indicate what 2 malignancies?

A

hepatocellular carcinoma
testicular non-seminomatous germ cell tumors

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19
Q

elevated levels of AFP are present in which 3 benign conditions?

A

hepatitis
cirrhosis
pregnancy

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20
Q

when is the MSAFP screening test done?

A

15-21 weeks in pregnancy

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21
Q

what do high levels of MSAFP indicate? (3)

A

spina bifida
anencephaly
multiple gestation

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22
Q

what do low levels of MSAFP indicate?

A

down syndrome

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23
Q

what test is used to check for down syndrome in pregnancy?

A

triple marker screen: MSAFP + HCG + estriol

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24
Q

a measure of how far an individual test result deviates from the median

A

multiple of median (MoM)

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25
Q

what does an abnormal MoM require?

A

repeat test to confirm

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26
Q

what does a 2nd elevated MoM indicate for MSAFP?

A

need for fetal sonogram

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27
Q

protein found in fetal intestine, pancreas, and liver

A

carcinoembryonic antigen (CEA)

28
Q

elevated levels of CEA indicate what malignancies? (4)

A

colon ca
pancreatic ca
breast ca
ovarian/uterine ca

29
Q

elevated levels of CEA indicate what benign conditions? (4)

A

hepatitis
cirrhosis
hypothyroidism
peptic ulcers

30
Q

glycoprotein synthesized by the placenta in pregnancy

A

HCG

31
Q

how early can HCG be detected?

A

1 week after conception

32
Q

when does HCG peak?

A

1st trimester (60-90 days)

33
Q

which subunit of HCG is most commonly assessed?

A

beta

34
Q

elevated levels of HCG indicates what malignancies? (3)

A

Hyatidaform moles
Choriocarcinoma
Germ cell cancer

35
Q

tumor develops inside the uterus from tissue that forms after conception

A

gestational trophoblastic disease

36
Q

elevated levels of HCG indicates what benign conditions? (2)

A

pregnancy
marijuana use

37
Q

glycoprotein produced by prostate tissue

A

prostate specific antigen (PSA)

38
Q

what is PSA highly sensitive for?

A

prostate cancer

39
Q

elevated levels of PSA indicate what benign conditions? (2)

A

BPH
prostatitis

40
Q

what is the most common risk factor for prostate cancer?

A

age

41
Q

what form of PSA is present in BPH and prostate cancer?

A

complexed form

42
Q

what 3 types of medications can lower PSA results? (3)

A

statins
NSAIDs
thiazides

43
Q

glycoprotein found in cells that line the pelvic organs and peritoneum

A

cancer antigen-125 (CA)

44
Q

elevated levels of CA-125 indicate what malignancies? (2)

A

ovarian ca
endometrial ca

45
Q

elevated levels of CA-125 indicate what benign conditions? (5)

A

endometriosis
ovarian cysts
liver disease
menstruation
pregnancy

46
Q

after treatment, what CA-125 level provides strong evidence of residual tumor?

A

over 35 U/ml

47
Q

testing CA-125 is not very sensitive for ovarian cancer in _____ _____

A

asymptomatic women

48
Q

what other modalities will enhance the sensitivity of CA-125?

A

pelvic exam
transvaginal US
CA 19-9
CA 15-3

49
Q

synthesized by normal human pancreatic and biliary ductal cells, gastric, colon, endometrial, and salivary epithelial cells

A

cancer antigen 19-9

50
Q

elevated CA 9-19 levels indicate what malignancies? (3)

A

pancreatic ca
colon ca
gastric ca

51
Q

elevated levels of CA 19-9 indicate what benign conditions?

A

pancreatitis
cirrhosis

52
Q

which test is primarily used to differentiate between benign and malignant diseases?

A

CA 19-9

53
Q

what level of CA 19-9 indicates malignancy?

A

over 37 U/ml

54
Q

CA 19-9 has a specificity of 76%. what does this mean?

A

not good enough to be used for screening early stage pancreatic disease

55
Q

levels in biopsy tissue that predict the natural history and response to hormonal manipulations

A

estrogen/progesterone receptor assay

56
Q

how are estrogen and progesterone receptor assays reported?

A

as percent of positive cells

57
Q

how is a positive estrogen/progesterone receptor assay indicated?

A

> 1%

58
Q

what do positive levels of estrogen and progesterone receptor assays help us determine in clinic?

A

response to hormonal therapy

59
Q

why do ER negative tumors have a worse prognosis?

A

no signals for hormones = harder to locate/treat

60
Q

what is the treatment goal in breast cancer?

A

deprive cells of estrogen

61
Q

why do we want to deprive breast cancer cells of estrogen?

A

estrogen fuels them to grow and divide

62
Q

what are 2 local treatment options for breast cancer?

A

surgery
radiation

63
Q

what are 3 systemic treatment options for breast cancer?

A

hormone therapy
chemotherapy
targeted therapy

64
Q

what is the most common cause of cervical cancer?

A

HPV

65
Q

exposure to what can lead to cervical cancer?

A

diethylstilbestrol (DES)

66
Q

what is DES also known as?

A

synthetic estrogen

67
Q

what is the most common cause of penile cancer?

A

HPV

Lab Med (19 decks)

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