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Chemistry! > Tumor Markers > Flashcards

Tumor Markers Flashcards

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1
Q

cancer is defined as the ________ ______ of _____. What is tumorigenesis and metastasis?

A

cancer is the uncontrolled growth of cells

tumorigenesis: inherited or acquired genetic mutations that lead to tumor formation

metastasis: a tumor that has spread to a different site in the body

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2
Q

what are three causes/promotors of cancer?

A

oncogenes (cancer-causing genes)
growth factors
inhibitor of apoptosis

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3
Q

Solid tumors are called what? And what are the four stages of cancer?

A

solid tumors = neoplasms

  • stage I: localized primary tumor
  • stage II: invasion of blood vessels and endothelium by tumor
  • stage III: migration of tumor into lymph nodes in region
  • stage IV: invasion of tumor into distant tissues
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4
Q

biomarkers are found in what two general places in the body? What are 5 categories of tumor markers?

A

found in the blood or tissue

enzymes, hormones, metabolites, neoplasm, oncofetal antigens

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5
Q

what is CEA, what kind of tumor marker is it, and what is it used for?

A

carcinoembryonic antigen, an oncofetal antigen

used for colorectal cancer
- diagnosis, prognosis, and therapy monitoring

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6
Q

what other four places can you see CEA increased other than for its primary use?

A

lung, breast, and GI tumors, as well as increased in smokers

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7
Q

what is CA-125, what kind of tumor marker is it, and what is it primary use?

A

cancer antigen 125 is a glycoprotein used for ovarian cancer

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8
Q

what is CA-125 not useful for? Who is it useful for?What other reasons (other than its primary one) may you see CA-125 increased?

A

not useful for screening in asymptomatic people

useful in people who have a family history

increased in endometrial, breast, and pancreatic cancer, as well as during pregnancy and benign ovarian cysts

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9
Q

what is CA 19-9, what kind of tumor marker is it, and what is the main usage for it?

A

carbohydrate antigen 19-9, a modified Lewis-a blood group antigen, is a marker for pancreatic adenocarcinoma

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10
Q

what other cancers will Ca 19-9 be increased, and who will be negative for this antigen?

A

hepatobiliary, GI, and colorectal cancers, as well as pancreatitis

people who are Le-a neg

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11
Q

what is CA 15-3, what kind of tumor marker is it, and what is its primary use?

A

cancer antigen 15-3 is a transmembrane glycoprotein gene that used for the early detection of recurrent breast cancer, and also for monitoring therapy

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12
Q

what four conditions is CA 15-3 increased in?

A

colon, ovarian, pancreatic, and lung cancers

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13
Q

what is CA 27-29?

A

it’s another breast cancer antigen, but just with another epitope

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14
Q

what is CA 72-4, what kind of tumor marker is it, and what is its primary use? what else can it be increased in?

A

carbohydrate antigen 72-4 is a glycoprotein used for stomach cancer

increased also in: colon, cervix, ovarian, and pancreatic cancer

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15
Q

what is PSA, what kind of tumor marker is it, and what population is it mostly used for?

A

prostate specific antigen is a serine protease used for prostate cancer screening for men over the age of 50

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16
Q

PSA is _______ specific but not _______ specific. What are some examples of this?

A

it’s prostate specific but not cancer specific

increased in other benign prostate conditions
- benign prostatic hyperplasia
- prostatitis
- vigorous prostate massage
- prostate infarction

17
Q

what patient levels for PSA are indicative of 25% chance of prostate cancer? What is a 50% chance level?

A

levels 4 - 10 are 25% chance

levels over 10 are 50% chance

18
Q

what is the tumor marker for urothelial carcinoma?

A

BTA

19
Q

ALP is elevated in what two things? What abut increases in the placenta?

A

ALP increased in osteogenic sarcoma (bone metastasis, and also liver metastasis

ALP placental = lung carcinoma
- look for Regan isoenzyme

20
Q

what do chromogranin A and beta-2 microglobulin each look for as tumor markers?

A

Chromogranin A: endocrine tumor marker (eg adrenal medulla problems)

Beta-2 Microglobulin: hematologic malignancies (eg mm, B-cell problems, CLL)

21
Q

what conditions would we see AFP increased?

A

alpha fetoprotein increased in adults in hepatocellular carcinoma, gonadal tumors, GI tumors

22
Q

what conditions are the following tumor markers used to ID?
- Alpha-1 antitrypsin
- hCG
- DHEA-S

A
  • Alpha-1 antitrypsin: hepatocellular carcinoma (decrease may mean lung carcinoma)
  • hCG: germ cell tumors of the testes
  • DHEA-S: androgen secreting tumors / adrenocortical carcinoma
23
Q

prolactin is a hormone marker for what condition? What about serotonin and ACP?

A

prolactin: pituitary adenoma
serotonin: neuroendocrine tumors of the midgut
ACP: prostate

24
Q

5-HIAA is a hormone marker for ____ _______. You would confirm this by screening with what?

A

marker for midgut carcinoid

confirm with platelet serotonin level

25
Q

what is BRCA-1/2 a hormone marker for? And APC?

A

BRCA-1/2: familial breast and ovarian cancer

APC: adenomatous polyposis coli gene, along with occult blood, is a marker for adenocarcinoma of the colon

26
Q

what is the most common way to test tumor marker levels? What are four interferences for testing for tumor markers?

A

mostly use immunoassays

interferences: icterus, lipemia, hemolysis, and (heterophile) Ab cross reactivity

27
Q

what happens when the tumor marker value exceeds linearity? What is it called when the analyte concentration exceeds the range?

A

you need to dilute the specimen

hook effect

28
Q

what is paraneoplastic syndrome? What are five hormones that are markers for lung cancers?

A

it’s cancer-fighting antibodies that mistake cancer normal cells
- lung/ovarian/lymphatic/breast cancers

hormone markers:
- ACTH, ADH, CRH, PTH, and prolactin

29
Q

what are two hormone markers for liver cell carcinoma

A

insulin and EPO

30
Q

what is being evaluated for with a combination of Hgb, HCT, RBC increases?

A

EPO secreting tumors, polycythemia vera, renal cell/hepatocellular carcinoma

31
Q

what is LDH and ALP used to evaluate?

A

LDH: solid tumors/lymphomas

ALP: primary and secondary skeletal and liver tumors

32
Q

what is analyzed with sodium/osmolarity? What about for gamma globulins/bence jones proteins? And PLT count?

A

sodium/osmo: SIADH in paraneoplastic syndrome

gamma globulins/bence jones: plasma cell myeloma/mm

PLT count: ET

Chemistry! (9 decks)

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