tumor markers

Question 1

tumor marker methodology include all of the following except
- immunoassays
- gas chromatography
- immunohistochemistry
- enzyme analysis

Answer 1

• gas chromatography

Question 2

which of the following tumor markers is classified as an oncofetal antigen
- CA 19-9
- CEA
- BRCA-1
- hCG

Answer 2

CEA

Question 3

which tumor marker is associated with neuroblastoma
- CA-15-3
- CEA
- CA125
- HVA

Answer 3

HVA

Question 4

what percent of males and females will develop invasive cancer?

Answer 4

42% males
38% females

Question 5

list stages of cancer progression

Answer 5

• proliferation
• transformation
• invasion
• metastasis
• vascularization

Question 6

describe the cancer staging and progression for tumors

Answer 6

• stage 1: localized primary tumor
• stage 2: invasion of primary tumor into blood vessels
• stage 3: migration into lymph nodes
• stage 4: metastasis and invasion into distant tissue

Question 7

define tumor marker

Answer 7

biomarker found in the blood or tissue and when elevated is linked to cancer

Question 8

describe enzyme tumor markers

Answer 8

• enzymes elevated non-specifically
• inc from high metabolic demand of proliferative cells
• monitor the success of therapy

Question 9

describe serum protein tumor markers

Answer 9

• includes beta macroglobulin and immunoglobulins
• monitor therapy

Question 10

describe endocrine tumor markers

Answer 10

• found in endocrine malignancies
  ex: neuroblastomas (kids), pituitary and adrenal adenomas

Question 11

ID the characteristics or properties of an ideal tumor marker

Answer 11

• tumor-specific
• absent in healthy patients
• readily detectable in BF

Question 12

describe oncofetal antigens

Answer 12

• one of the first classes of tumor markers
• expressed transiently during normal development but lower in adults
• increase in tumor formation
  ex: CEA and AFP

Question 13

describe carbohydrate and cancer antigen tumor markers and list examples

Answer 13

• monoclonal antibodies directed towards specific carb or cancer antigens
• monitor treatment of tumors that secrete specific epitopes
  ex: CA-125 (ovarian cancer), CA 19-9 (GI and adenocarcinoma), CA15-2 & CA27-29 (metastatic breast cancer)

Question 14

describe and list receptor tumor markers

Answer 14

• non serological markers
• used to classify tumors for therapy
• helps choose between endocrine and cytotoxic therapy
  ex: estrogen receptor

Question 15

describe immunoassay test method

Answer 15

• common for tumor marker
• unique: assay linearity, hook effect, potential for heterophile antibodies (false pos)

Question 16

describe how heterophile antibodies affect immunoassays

Answer 16

• heterophile antibodies are antibodies against test reagents

Question 17

list common concerns w/ tumor marker immunoassay

Answer 17

• icterus
• lipemia
• hemolysis
• heterophile (antibody crossover)
• carry over

Question 18

describe high performance liquid chromatography (HPLC)

Answer 18

• extraction process
• detects hormones and metabolites secreted by tumors
• used to help diagnose: neuroblastoma, pheochromocytoma, carcinoid tumors

Question 19

general neuroblastoma description

Answer 19

common malignant tumor in kids
high lvls of plasma epinephrine, norepinephrine and dopamine
measured w/ HVA

Question 20

general description of pheochromocytoma

Answer 20

rare tumor w/ hypertension
elevated plasma metanephrines
diagnosis from HPLC

Question 21

general description of carcinoid tumors

Answer 21

serotonin-secreting tumors from small intestine

Question 22

describe immunohistochemistry

Answer 22

solid tissue tumor markers from aspiration

Question 23

describe enzyme assays

Answer 23

The only enzyme specifically inc for diagnosis is PSA
- non specific assay

Question 24

in what carcinoma is alpha fetoprotein increased in

Answer 24

HCC and germ cell tumors

Question 25

regulation and physiology of AFP

Answer 25

• glycoprotein related to albumin
• regulated fetal onconic pressure

Question 26

clinical usefulness and interpretation of AFP

Answer 26

• used for diagnosis/staging of HCC
• can be elevated in testicular cancer
• used with hCG for nonseminomatous tumor classification

Question 27

where do HCC tumors originate

Answer 27

liver
- can be from chronic disease

Question 28

describe clinical usefulness of AFP in relation to testicular cancer

Answer 28

• used for classification and monitoring
• AFP with hCG to classify nonseminomatous tumors

Question 29

define seminomatous tumors

Answer 29

testicular cancer tumors formed direclty from malignant germ cells

Question 30

define nonseminomatous tumors

Answer 30

testicular tumors that differentiate into other tumors

Question 31

describe CA-125

Answer 31

• ovarian cancer
• early tumor detection
• immunoassay use OC125 and M11 antibodies
• can be used to diff between benign masses and ovarian cancer

Question 32

describe HPLC testing

Answer 32

• high performance liquid chromatography
• extraction based on size, polarity, and charge
• detects metabolites
• necessary to diagnose: neuroblastoma, pheochromocytoma and carcinoid tumors

Question 33

describe immunohistochemistry and immunofluorescence

Answer 33

• solid tumor markers
• specific antibodies w/ tissue section for colorimetric antigen detection

Question 34

describe CA 15-3

Answer 34

• marker for breast cancer
• regulated by MUC1(which gets measured)
• immunoassay measurment

Question 35

describe CA 19-9

Answer 35

• pancreatic cancer marker

Question 36

describe HE4

Answer 36

• ovarian cancer marker more specific than CA-125

Question 37

describe NSE

Answer 37

• marker for neurodegenerative disorders
• measured in CSF or serum