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TUMOR MARKERS Flashcards

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1
Q

Tumor Marker types
[6]

A

enzymes
proteins
hormones
oncofetal antigens
metabolites
receptors

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2
Q

ENZYMES
—Located [inside/outside] the cells; Each organ has specific enzymes
— [Specific/Nonspecific] that can be cancer indicator.
— A variety of enzymes are → # [INC/DEC] nonspecifically in tumors.
- tend to correlate with _______, making them clinically useful for monitoring the success of therapy.

A

inside
nonspecific
INC
tumor burden

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3
Q

Tumor markers of ENZYMES
[4]

A

PSA+ACP
LD
ALP
Neuron-specific enolase

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4
Q

an enzyme that is more definitive indicator of cancer

A

PSA + ACP

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5
Q

Methods for tumor markers:
PSA+ACP
LD
ALP
Neuron-specific enolase

A

IA
EA
EA
RIA/HCC

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6
Q

Clinical utility for tumor markers:
PSA+ACP
Neuron-specific enolase

A

Screening: Prostate CA
Therapy: monitoring/recurrence

Prognosticator indicator
Monitoring: progression for neuroendocrine tumors

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7
Q

ENZYMES associated with certain malignant diseases [6]

A

Lysozyme
LDH
Sialytransferase
Fucosyltransferase
Thymidine kinase
TdT

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8
Q

Malignant disease associated with Lysozyme

A

Colon cancer
Monocytic/Myelomonocytic Leukemia

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9
Q

Malignant disease associated with LDH

A

Leukemia
Lymphoma
Breast& Lung cancer
Germ cell tumor
Metastatic colon

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10
Q

Malignant disease associated with Sialytransferase

A

Nonspecific

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11
Q

Malignant disease associated with Fucosyltransferase

A

Multiple Malignant tumor

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12
Q

Malignant disease associated with Thymidine Kinase

A

Hodgkin’s lymphoma
Lung’s small cell carcinoma

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13
Q

Malignant disease associated with Terminal dioxyribonucleotidase transferase

A

Immature lymphocytes

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14
Q

Isoenzymes associated with malignant diseases

A

CK-BB
Type 2 Macro-CK
Mitochondrial CK-1IgA complex
Placental like ALP
Liver ALP
Bone ALP
LD1, LD4, LD5

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15
Q

Malignant disease associated with CK-BB

A

ADENOMA CARCINOMA OF
prostate
stomach
lungs

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16
Q

Malignant disease associated with Type 2 macro-ck

A

Metastatic liver cancer

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17
Q

Malignant disease associated with Mitochondrial CK-IgA complex

A

[Prognosticator indicator] advance tumor

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18
Q

Malignant disease associated with Regan

A

Germ cell tumors
Ovarian cancers

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19
Q

Malignant disease associated with Liver ALP

A

Liver metastasis
Seminoma
Ovaraian cancer

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20
Q

Malignant disease associated with Bone ALP

A

Bone metastasis
Osteoma

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21
Q

LD1, LD4, LD5

A

Advance stage cancer
Testicular germ cell tumor

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22
Q

— Carcinoembryonic proteins produced during fetal dev’t
— [X] indicate cancer BUT as a person grows → these proteins diminishes → & when it is redetected → used as indicator of cancer.

A

Serum proteins

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23
Q

Under normal conditions expression of all protein is subjected to?

A

genetic regulation

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24
Q

Tumor markers of serum protein [3]

A

Serum M-protien
Serum free light chain
B2-microglobulin

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25
Q

Tumor marker of serum protein associated with hematologic malignancies

A

B2-microglobulin

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26
Q

Methods for tumor markers:
Serum M-protein
Serum free light chain
B2-microglobulin

A

SPE/IFE

IA
IA

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27
Q

Clinical utility of serum m-protein & serum free light chain

A

Dx of plasma cell dyscrasia TM

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28
Q

Clinical utility of B2 microglobulin

A

[Prognostic marker] Lymphoproliferative diseases

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29
Q

— by endocrine organs just like enzymes
— Usually made up of ______.
􏰀 Widely used as a SPECIFIC MARKERS OF SECRETING TUMORS.

A

Hormones/Metabolites

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30
Q

When there is an increase in the presence of tumor in the hormone-producing organs what happens? [2]

A

Tumor compresses the tissues/organs

Overproduction of hormones

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31
Q

Tumor markers of hormones/metabolites [13]

A

HVA & VMA
Metanephrines
Catecholamines
5’HIAA & Serotonin
Calcitonin
PTH
GH
PRL
ACTH
Cortisol
ADH
Chromogranina
C-peptide

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32
Q

Tumor types/Clinical utility of HVA/VMA

A

Pheochromocytoma
Paraganglioma
Neuroblastoma

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33
Q

TM types of:
Metanephrines
Catecholamines

A

Severe aplastic anemia
Pheochromocytoma

Severe aplastic anemia
Pheochromocytoma
Paranganglioma
Neuroblastoma

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34
Q

TM types of 5-HIAA & serotonin

A

Carcinoid tumors

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35
Q

TM types of Calcitonin

A

Medullary thyroid cancer
Neuroendocrine tumors

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36
Q

TM types of PTH

A

Pituitary adenoma

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37
Q

TM types of GH

A

Pituitary adenoma
Ectopic GH- tumor surgical secreting

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38
Q

Method of PRL

A

IA

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39
Q

TM types of ACTH

A

Pituitary adenoma
Ectopic ACTH- producing tumor

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40
Q

TM types of Cortisol

A

Adrenal tumor

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41
Q

TM types of ADH

A

Posterior pituitary tumor

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42
Q

TM types of Chromagranina

A

Pheochromocytoma
Neuroblastoma
Carcinoid tumors
Small cell lung CA

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43
Q

Clinical utility of C-peptide

A

insulinoma affecting b-cells islet of langerhans = glucanoma. [glucagon]

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44
Q

Methods of:
HVA/VMA
Metanephrines
Catecholamines
5-HIAA & Serotonin

A

HPLC

HPLC

HPLC
LC-MS
MS

HPLC

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45
Q

Methods of:
Calcitonin
PTH
GH
PRL
ACTH
Cortisol
ADH

A

IA

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46
Q

Methods of:
Chromogranina
C-peptide

A

ELISA
RIA

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47
Q

ANTIGEN
_________– one of the 1st tumor markers discovered
- [+] fetal development; [-] as person grows
- When it is redected= ________.

[2] – expressed transiently during normal development and are then turned on again in the formation of tumors. _

___________were directly identified from human tumor extracts / cell lines. These are directed toward specific [2] and are best used for monitoring treatment of tumor that secrete these ______.

A

Oncofetal Ag
malignancy

CEA & AFP

Monoclonal defined Ag
CA
specific carbohydrates

epitopes

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48
Q

TUmor markers of Antigen
[4]

A

CA-19-9
CA 15-3
CA 27-29
CA 125

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49
Q

CA 19-9 tumor type + clinical utility

A

GI cancer
Adenocarcinoma

Pancreatic CA

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50
Q

CA 15-3 & CA 27-29 tumor type

A

Breast cancer
Metastatic carcinoma

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51
Q

CA-125 tumor type

A

Ovarian cancer

52
Q

— used to classify tumors for therapy = Good TM
􏰀 Prototypic examples of such a marker are [2]

A

Receptors

Estrogen
Progesterone receptor

53
Q

UNDER RECEPTORS

Solid tumor biopsies [+] these markers → _________ is more likely to be effective.

_________ this receptor → will respond to chemotherapy

A

Tamoxifen chemoterapy

Breast cancer

54
Q

Tumor markers of RECEPTORS
[4]

A

Estrogen receptor
Progesterone receptor
He-2/Neu
Epidermal GF receptor

55
Q

Method used for all Antigen Tumor Markers

A

IA

56
Q

Methods for Tumor markers:
Estrogen receptor
Progesterone receptor
He-2/Neu
Epidermal GF receptor

A

IHC
IHC
IHC, FISH, ELISA
IHC

57
Q

— One of the oncofetal protein which decreases in adult levels [age: _______]
— Synthesized by the fetal ____.

A

Alpha-fetoprotein

7-10 months

liver

58
Q

AFP is involved in regulating _______in the fetus.

when AFP is redetected during malignancy, it is classified as a _________ protein.

A

oncotic pressure

carcinoembryonic protein

59
Q

AFP is increased in what conditions? [3]

A

Hepatocellular carcinoma/HCC
Germ cell tumors
Neural tube defects [Spina bifida]

60
Q

AFP is decreased in what conditions? [3]

A

Down syndrome

61
Q

Experts recommend AFP to be used in high risk developing _____ patients; patients with ________virus induced ________.

A

HCC
Hepa B/C
liver cirrhosis

62
Q

AFP
[#] kD glycoprotein related to albumin
Upper normal limit: [#] ng/mL.

A

70

15

63
Q

AFP

–Completely [specific/ not specific] with a sensitivity levels of: [2]

A

Not specific

40%-65%
80%-95%.

64
Q

Major use of AFP is the classification and monitoring therapy of ________.

[2 TYPES]

A

Testicular CA

Seminomatous testicular CA

Nonseminomatous testicular CA

65
Q

tumor formed directly from malignant germ cells; slow growing

A

Seminomatous testicular CA

66
Q

Nonseminomatous testicular CA came from ______, and it spreads [slow/fast]. Differentiation [4]

A

other sources.
fast

Yolk sac tumors
Embryonal carcinoma
teratoma
choricarcinoma

67
Q

Nonseminomatous testicular CA increased in AFP

A

Yolk sac tumors
Embryonal carcinoma

68
Q

Nonseminomatous testicular CA increased in HcG

A

Choriocarcinoma

69
Q

AFP Staging of Nonseminomatous testicular cancer

[3]

A

Stage 1: 10-20%
Stage 2: 50-80%
Stage 3: 90-100%

70
Q

2 Methods of AFP

A

Automated IA
In serum/amniotic fluids

71
Q

— a murine monoclonal antibody raised against a serous ovarian carcinoma cell line.
— expressed in the ovary, in other tissues of ______ duct origin [embryonic tissue] + human ovarian carcinoma cells.

A

CA-125

Mullerian

72
Q

— ONLY CLINICALLY ACCEPTED SEROLOGIC MARKER OF OVARIAN CANCER but is [X] Specific.

A

CA 125

73
Q

CA 125 levels w/ ovarian cancer stage:
▪ Stage I – increases by ___%
▪ Stage II – increases by ____%
▪ Stage III and IV – increases ____%

A

50%
90%
>90%

74
Q

CA 125 is FALSELY [INC]: ewandi

A

E1D/EWANDI
Endometriosis
1st trimester of pregnancy
During menstruation

75
Q

Methodology for ca 125

A

IA with the use of OC 125 + M11 Ab

76
Q

Upper normal limit of CA 125

A

35 u/ml

77
Q

— HMW mucin glycoprotein expressed by various adenocarcinoma especially those associated with the breast

A

CA 15-3

78
Q

True or False

Carcinoembryonic Ag is more specific/sensitive than Metastatic Cancer

A

False

79
Q

CA 15-3 is falsely increased in what conditions?

A

Chronic hepatitis
Liver cirrhosis
Sarcoidosisis
TB
SLE

80
Q

Upper normal limit of CA 15-3

A

25U/ml

81
Q

— glycoprotein produced only in the epithelial cells of the acini and prostatic ducts in the prostate.

A

Prostatic Specific Antigen

82
Q

PSA is a serine protease of the _______ gene family and functionally regulates _____ fluid viscosity & instrumental in dissolving the_______ [protects egg cell] → allowing sperm to enter.

A

kalikrein

seminal fluid viscosity

cervical mucus gap

83
Q

2 forms of PSA IN THE BLOOD:
1. ________– unbound
2. ________ – bound w/ [2]

A

Free
Complexed
a1-antichymotrypsin
a2-macroglobulin

84
Q

FALSELY increased values of PSA:

A

Benign Prostatic Hyperplasia
Recent ejaculation & Direct rectal exam
Irritation
Prostate infection

85
Q

Known interferences of PSA [FALSE NEGATIVE]
[2]

A

Hook effect
Human anti-animal Ab/HAMAS

86
Q

METHODOLOGY:
􏰀 IA: free + complexed PSA [both, if not, which one?]

Which is used?
a1-antichymotrypsin
OR a2-macroglbulin

􏰀 Standard total cutoff: _____.

A

both

a1-antichymotrypsin

<4ng/ml

87
Q

— HMW mucin indicator of pancreatic cancer
— Related to ______blood group substance
EXAMPLES: [2]

A

ca-19-9

lewis

Lea [a+, b-], Lea [a-,b+]

88
Q

PSA INDICATOR: GLPC
— [INC] various adenocarcinoma:
Gastric
Lung
Pancreatic
Colorectal

A

GALUPAC

Gastric
Lung
Pancreatic
Colorectal

89
Q

Upper Normal Limit is 37U/mL

A

CA 19-9

90
Q

— Large heterogenous glycoprotein that is part of the Ig superfamily and is involved in apoptosis, immunity, cell adhesion.

A

Carcinoembryonic Antigen/CEA

91
Q

— # used tumor marker for COLORECTAL CANCER and is also # [INC] Lung, Breast, and GI tumors

A

CEA

92
Q

CEA is FALSE POSITIVE in what conditions?

A

HLCRA/hala sira

Heavy smoking
Liver damage
Chemoterapy
Radiation treatment

93
Q

CEA

Half-life: ____ days
Upper Normal Limit:
Definitve Malignancy:

A

2-8 days
2.5-5 ng/ml
>10ng/ml

94
Q

Methodology of CEA
[Assay] + use of ________.

essential that the same assay be used for _____ monitoring.
- monitored every ______ to detect recurrence and determine therapy efficacy.

A

IA + monoclonal anti-CEA antibodies

serial monitoring

2-3mos

95
Q

— Major soluble protein of the
chromaffin granules
— catecholamine storage vesicle — released from adrenal medulla w/ catecholamines

A

Chromogranin A

96
Q

Chromogranin A is an INDICATOR of what conditions:
[5]

A

Pheochromocytoma
Neuroblastoma
Peptide producing tumor
Pancreatic tumor
Small cell lung cancer
Carcinoid tumor

97
Q

— localized in the nuclei of mammary & uterine tissue

A

Estrogen/Progesterone receptor

98
Q

— GOOD TUMOR MARKER – small tendency of reoccurrence ← due to it being present.

A

Estrogen/Progesterone receptor [ER/PgR]

99
Q

— Used to identify PX MOST LIKELY TO BENEFIT FROM ENDOCRINE THERAPY
— Px whom primary tumor is rich to this → after ________ → experience longer disease-free interval.

A

ER/PgR

mastectomy

100
Q

Human Chorionic Gonadotrophin
— [#] kD glycoprotein consisting of [2] subunits.
— dimeric hormone normally secreted by _______ in the placenta to maintain the ________ during pregnancy.

A

45
alpha
beta

trophoblasts
corpus luteum

101
Q

__________IT IS UNIQUE:
— Degraded into multiple fragments:

A

HCG

Free beta subunit
Hyperglycosylated form
Intact molecules
Nicked hCG

102
Q

HCG [INC]
— _____ hCG: in malignancies — ______ hCG: nonseminomatous tumors

A

beta
free-beta

103
Q

HCG INDICATOR + ELEVATED:

A

Trophoblastic tumor
Choriocarcinoma
Germ cell cancer [ovary,testes]
Gestational Trophoblastic disease

104
Q

Gestational Trophoblastic disease of HCG is comprised of? [4]

A

choriocarcinoma
hydatid form mole
placental site
persisent/invasive gestational trophoblastic neoplasia

105
Q

METHODOLOGY of HCG
􏰀 _________ capture & tracer

􏰀 Ab targeted toward epitopes in the [2] hCG.

􏰀 ________: most useful because they detect both intact hormone and free b-hCG

A

Monoclonal

beta subunits
intact hCG

Total beta HCG assays

106
Q

APPLICATION & PATHOPHYSIOLOGY of HCG

􏰀 Nonseminomatous testicular cancer → ________ [INC] in [#]% - [#]% of patients

􏰀 In combination with _____ + _______ → diagnose subtypes of testicular cancer

A

free-beta HCG

60%
70%

AFP
Biopsies

107
Q

Detected by Pregnancy Kits

A

HCG

108
Q

— acidic metabolites of catecholamines

A

HMV & VMA

109
Q

— Excreted in larger than normal amount in px w/ tumor originating from _______ [embryonic tissue]

A

HMV & VMA
neural crest

110
Q

SQUAMOUS CELL CARCINOMA ANTIGEN (SCCA)
||INDICATIVE OF:
Squamous cell carcinoma:
[7 organs/body parts]

A

head
neck
esophagus
lung
renal failure
advanced cervical CA
anal canal

111
Q

________ is increased in hematologic malignancies:
[4]

A

Lipid associated sialic acid in plasma

Leukemia
Lymphoma
Hodgkin’s lymphoma
Melanoma

112
Q

— gamma subunit of an enolase isoenzyme in the glycolytic pathway

A

Neuron-specific enolase

113
Q

NSE is an INDICATOR
of:
[2]

A

Neuroendocrine tumor Neuroblastoma [children]

114
Q

NSE is increased in tumors originating from the neuroendocrine cell system:
[2 conditions]

A

insulinomas
glucanomas

115
Q

NSE values is highest in these 2 conditions:

A

Small cell lung cancer/Oat cell cancer [LOS]

116
Q

— low molecular weight protein
— part of constant L-chain of MHC locus Ag that is expressed on the surface of # nucleated cell.
— secreted by all nucleated cells

A

B2-microglobulin

117
Q

What is the specific marker of B2 microglobulin?

A

high cell turnover [hich cell proliferation]

118
Q

It is increased in solid tumor and inflammatory disorders like RA, SLE, Sjogren’s, and Chron’s disease

A

B2-microglobulin

119
Q

B2 microglobulin is stable in serum or plasma?

In urine: ____pH [degrades slowly/rapidly]

Normal value:

A

serum

<6. 0
rapidly

0.9 – 2.5 mg/L

120
Q

enumerate angiogenic factors

A

VEGF
alpha/beta FGF [acidic/basic fibroblast]
TGF alpha

121
Q

Molecular dx for susceptibility

A

BRCA1/2
Adenomatous polyposis colin gene

122
Q

when cell cycle is mutated what happens?

A

INC
genetic instability
cellular evolution
malignancy progression

123
Q

EC stimuli [signal transduction]

A

Antigens
hormones
cytokines
C-erbB2
TGF B2
EGF
Nerve GF

124
Q

apoptosis markers [3]

A

Bcl2
Fas ligand
P53

125
Q

EGP/Oncogenes/ k-ras
Tumor suppresor/Cell Cycle regulators [3]

A

BRCA 1
Cyclins
P53

126
Q

Adhesion molecules

A

selectins
integrins
Ig family

127
Q

Loss of cell adhesion proteins

A

B-catenin
E-cadherin

CLIN CHEM (12 decks)

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