Tumor Markers Flashcards
cancer is defined as the ________ ______ of _____. What is tumorigenesis and metastasis?
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
what are three causes/promotors of cancer?
oncogenes (cancer-causing genes)
growth factors
inhibitor of apoptosis
Solid tumors are called what? And what are the four stages of cancer?
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
biomarkers are found in what two general places in the body? What are 5 categories of tumor markers?
found in the blood or tissue
enzymes, hormones, metabolites, neoplasm, oncofetal antigens
what is CEA, what kind of tumor marker is it, and what is it used for?
carcinoembryonic antigen, an oncofetal antigen
used for colorectal cancer
- diagnosis, prognosis, and therapy monitoring
what other four places can you see CEA increased other than for its primary use?
lung, breast, and GI tumors, as well as increased in smokers
what is CA-125, what kind of tumor marker is it, and what is it primary use?
cancer antigen 125 is a glycoprotein used for ovarian cancer
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?
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
what is CA 19-9, what kind of tumor marker is it, and what is the main usage for it?
carbohydrate antigen 19-9, a modified Lewis-a blood group antigen, is a marker for pancreatic adenocarcinoma
what other cancers will Ca 19-9 be increased, and who will be negative for this antigen?
hepatobiliary, GI, and colorectal cancers, as well as pancreatitis
people who are Le-a neg
what is CA 15-3, what kind of tumor marker is it, and what is its primary use?
cancer antigen 15-3 is a transmembrane glycoprotein gene that used for the early detection of recurrent breast cancer, and also for monitoring therapy
what four conditions is CA 15-3 increased in?
colon, ovarian, pancreatic, and lung cancers
what is CA 27-29?
it’s another breast cancer antigen, but just with another epitope
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?
carbohydrate antigen 72-4 is a glycoprotein used for stomach cancer
increased also in: colon, cervix, ovarian, and pancreatic cancer
what is PSA, what kind of tumor marker is it, and what population is it mostly used for?
prostate specific antigen is a serine protease used for prostate cancer screening for men over the age of 50
PSA is _______ specific but not _______ specific. What are some examples of this?
it’s prostate specific but not cancer specific
increased in other benign prostate conditions
- benign prostatic hyperplasia
- prostatitis
- vigorous prostate massage
- prostate infarction
what patient levels for PSA are indicative of 25% chance of prostate cancer? What is a 50% chance level?
levels 4 - 10 are 25% chance
levels over 10 are 50% chance
what is the tumor marker for urothelial carcinoma?
BTA
ALP is elevated in what two things? What abut increases in the placenta?
ALP increased in osteogenic sarcoma (bone metastasis, and also liver metastasis
ALP placental = lung carcinoma
- look for Regan isoenzyme
what do chromogranin A and beta-2 microglobulin each look for as tumor markers?
Chromogranin A: endocrine tumor marker (eg adrenal medulla problems)
Beta-2 Microglobulin: hematologic malignancies (eg mm, B-cell problems, CLL)
what conditions would we see AFP increased?
alpha fetoprotein increased in adults in hepatocellular carcinoma, gonadal tumors, GI tumors
what conditions are the following tumor markers used to ID?
- Alpha-1 antitrypsin
- hCG
- DHEA-S
- Alpha-1 antitrypsin: hepatocellular carcinoma (decrease may mean lung carcinoma)
- hCG: germ cell tumors of the testes
- DHEA-S: androgen secreting tumors / adrenocortical carcinoma
prolactin is a hormone marker for what condition? What about serotonin and ACP?
prolactin: pituitary adenoma
serotonin: neuroendocrine tumors of the midgut
ACP: prostate
5-HIAA is a hormone marker for ____ _______. You would confirm this by screening with what?
marker for midgut carcinoid
confirm with platelet serotonin level
what is BRCA-1/2 a hormone marker for? And APC?
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
what is the most common way to test tumor marker levels? What are four interferences for testing for tumor markers?
mostly use immunoassays
interferences: icterus, lipemia, hemolysis, and (heterophile) Ab cross reactivity
what happens when the tumor marker value exceeds linearity? What is it called when the analyte concentration exceeds the range?
you need to dilute the specimen
hook effect
what is paraneoplastic syndrome? What are five hormones that are markers for lung cancers?
it’s cancer-fighting antibodies that mistake cancer normal cells
- lung/ovarian/lymphatic/breast cancers
hormone markers:
- ACTH, ADH, CRH, PTH, and prolactin
what are two hormone markers for liver cell carcinoma
insulin and EPO
what is being evaluated for with a combination of Hgb, HCT, RBC increases?
EPO secreting tumors, polycythemia vera, renal cell/hepatocellular carcinoma
what is LDH and ALP used to evaluate?
LDH: solid tumors/lymphomas
ALP: primary and secondary skeletal and liver tumors
what is analyzed with sodium/osmolarity? What about for gamma globulins/bence jones proteins? And PLT count?
sodium/osmo: SIADH in paraneoplastic syndrome
gamma globulins/bence jones: plasma cell myeloma/mm
PLT count: ET
