Tumor Markers

Question 1

Alkaline Phosphatase

Answer 1

Metastases to bone, liver, Paget disease of bone, Seminoma (placental ALP)

Question 2

Alpha-Fetoprotein

Answer 2

Normally made by fetus. Hepatocellular carcinoma, hepatoblastoma, yolk sac (endodermal sinus) tumor, testicular cancer, mixed germ cell tumor (co-secreted with beta-hCG)
Transiently elevated in pregnancy; high levels with neural tube and abdominal wall defects
Low levels associated with Down Syndrome

Question 3

Beta-hCG

Answer 3

Hydatidiform moles and Choriocarcinomas (Gestational trophoblastic disease), testicular cancer, mixed germ cell tumor
Produced by syncitiotrophoblasts of placenta in pregnancy

Question 4

CA-15-3/CA27-29

Answer 4

Breast cancer

Question 5

CA-19-9

Answer 5

Pancreatic Cancer

Question 6

CA-125

Answer 6

Ovarian Cancer

Question 7

Calcitonin

Answer 7

Medullary thyroid cancer

Question 8

CEA

Answer 8

CarcinoEmbryonic Antigen. Very nonspecific but produced by ~70% of colorectal and pancreatic cancers; also produced by gastric, breast, and medullary thyroid carcinomas

Question 9

PSA

Answer 9

Prostate-specific antigen. Follow prostate adenocarcinoma. Can also be elevated in BPH and prostatitis. Questionable risk/benefit for screening

Question 10

S-100

Answer 10

Neural crest origin (melanomas, neural tumors, schwannomas, Langerhans cell histiocytosis)

Question 11

TRAP

Answer 11

Tartrate-Resistant Acid Phosphatase (TRAP)

Hairy cell leukemia - a B cell neoplasm

Question 12

Chromogranin

Answer 12

Neuroendocrine tumors/carcinoid