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Clinical Chemistry > Tumor Markers > Flashcards

Tumor Markers Flashcards

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1
Q

Tumor Marker Makeup

A

Proteins produced in response to cancer growth or from cancerous tissue

Can be specific or seen in multiple cancer types

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2
Q

Tumor Risk Factors

A

Genetic mutations

IVDMIA

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3
Q

IVDMIA

A

(in vitro Diagnostic Multivariate Index Assay)

Tests available to detect mutations and offer “risk index”

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4
Q

Apoptosis

A

Programmed cell death, self-destruction

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5
Q

Angiogenesis

A

New blood vessel formation, typically embedded within a tumor, allows tumor cells entry into circulation

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6
Q

Benign

A

Tumor at the primary site, small risk

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7
Q

Cancer

A

Abnormal cell growth, proliferation and/or differentiation

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8
Q

Hyperplasia

A

Multiplication of cells within an organ or tissue, may be controlled by stimuli as a normal response

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9
Q

Malignant

A

Tumor aggressive progress, infiltration, high risk

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10
Q

Metastasis

A

Uncontrolled proliferation involving numerous tumor cells and host cells interactions. Penetration into adjacent tissue of primary site, circulatory system, and spread to distant organs.

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11
Q

Neoplasia

A

Normal cells under cancerous proliferation due to hyperplasia, which is unregulated.

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12
Q

Tumor Marker Utilization

A
  • Screening
  • Diagnosis
  • Staging
  • Determine prognosis
  • Guidance of Treatment
  • Monitor Treatment
  • Determine recurrence
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13
Q

Tumor Marker Utilization: Screening

A

Useful for patients with a strong family history of a particular cancer. Example: PSA prostate cancer

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14
Q

Tumor Marker Utilization: Diagnosis

A

In patients with specific clinical symptoms, tumor markers can help identify the source of the cancer and differentiate from other conditions

Examples: CA-125, BRCA1 and BRCA 2

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15
Q

Tumor Marker Utilization: Staging

A

If a patient does have cancer, tumor marker elevations can be used to help determine how far the cancer has spread into other tissues and organs.

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16
Q

Tumor Marker Utilization: Determine prognosis

A

Some tumor markers can be used to help doctors determine how aggressive a cancer is likely to be.

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17
Q

Guidance of Treatment

A

Some tumor markers can provide information about what treatments their patients may have the best response.

Breast cancer patients who are Her2/neu positive are more likely to respond to Herceptin treatment).

18
Q

Monitor Treatment

A

Tumor markers can be used to monitor the effectiveness of treatment, especially in advanced cancers. If the marker level drops, the treatment is working; if it stays elevated, adjustments are needed.

Colorectal cancer and CEA testing: information must be used with care; not every colorectal cancer patient will have elevated levels of CEA.

19
Q

Determine recurrence

A

To monitor for cancer recurrence - If a tumor marker is elevated before treatment, low after treatment, and then begins to rise over time, then it is likely that the cancer is returning. (If it remains elevated after surgery, then chances are that not all of the cancer was removed)

20
Q

Tumor Grades

A

Well differentiated

Poorly differentiated

Anaplastic (without body)

21
Q

Tumor Marker Classifications

A

Enzymes

Hormones

Oncofetal Infections

Tumor antigens

Genetic Markers

22
Q

Enzymes

A

Catalytic activity vs mass measurements, detected with Immunoassays

23
Q

Hormones

A

Immunoassay detection

24
Q

Oncofetal Infections

A

AFP, CEA, PSA

25
Q

Tumor antigens

A

CA125, CA15-3, CA19-9

26
Q

Genetic Markers

A

Oncogene and tumor suppressor mutations

27
Q

Prostate Specific Antigen, level indications

A
  • Enzyme with protease activity in Prostate tissue
  • Exists in serum as bound (complexed with another protease inhibitor) or free, higher free PSA ratio in normal, healthy patients
  • Total PSA: 2.6-4ng/mL indicates early development
  • 4-10mg/mL is diagnostic gray zone
  • >10ng/mL have a 50% chance of having cancer
28
Q

hCG (Human Chorionic Gonadotropin)

A
  • Synthesized by trophoblast calls in placenta (used for pregnancy detection), made of 2 Alpha and Beta units
  • Beta is specific to hCG
  • Increased levels assoc. with Trophoblastic tumors, choriocarcinoma, testicular tumors, ovarian tumors
  • Immunoassay uses ß-hCG
29
Q

Oncofetal Proteins

A

Normally produced in fetal tissues, then decline after birth

A rise later in life (60yrs) can indicate cancer formation

30
Q

AFP (Alpha feto protein)

A
  • Marks Liver and Germ cell carcinoma, can also appear in viral hepatitis and chronic active hepatitis
  • Serum levels correlate to Liver tumor size
  • During pregnancy increased levels indiacte spina bifida, neural tube defects, and fetal distress; lowered levels indicate Down’s Syndrome
  • Normal adult levels should be lower than 20ng/mL
  • Found via enzyme immunoassay
31
Q

CEA (carcinoembryonic antigen)

A
  • Marker for colorectal, GI, lung, and breast cancer, found normally in GI of fetus
  • Not used as a screen as high levels are found in non-cancer patients
  • Used for therapy monitoring
  • Immunoassayed using mono/poly/both assay
32
Q

Carbohydrate Tumor Markers

A

Antigens on tumor cell surface or secreted by the cell

Usually more specific when compared to hormone/enzyme markers

  • CA 125:
 ovarian, endometrial
  • CA 15-3, CA 549: breast, ovarian
  • CA 19-9: 
pancreas
  • CA 19-5:
 GI, pancreas
  • CA 72-4: Ovarian, breast, GI, colon
  • CA 50: Pancreas, GI, colon
33
Q

Protein Tumor Markers

A
  • Bence-Jones proteins
  • C-peptide
  • Ferritin
  • Immunoglobulins
  • Beta2 Microglobulin
34
Q

C-peptide

A

Insulinoma

35
Q

Ferritin

A

Liver, lung, breast

36
Q

Immunoglobulins

A

Multiple myeloma

37
Q

Beta2 Microglobulin

A

Multiple myeloma, lymphocytic leukemia

38
Q

Oncogenes

A

Normal genes (code for things like growth factor signals) related to tumor virus genes

Their activation is associated with cancer

Test for number of copies of genes, Southern blotting, PCR, FISH, Northern blotting, western blotting, ELISA, and immunohistochemistry)

39
Q

HER-2/neu

A

Transmembrane glycoprotein in epidermal growth factor family

Low levels present in breast duct epithelium

Over-expressed in ¼ breast cancers

Levels predict response to Adriamycin-based chemo., and select patients for anti-HER2/neu Ab, predicts poor response to tamoxifin therapy

40
Q

CA 15-3

A
  • Mucin glycoprotein antigen
  • Marker for breast cancer recurrance in previously treated patients
  • increased levels may also be found in Hepatitis, tuberculosis, and SLE
41
Q

CA 125

A
  • Mucin glycoprotein antigen
  • Marker for ovarian cancer, used to monitor treatment progress
42
Q

CA 19-9

A
  • Glycolipid blood group antigen derived from Lewis Blood Group
  • Marker for pancreatic, colorectal, lung and gastric carcinomas
  • Monitors patients progress

Clinical Chemistry (38 decks)

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