Tumor Markers Flashcards
This term means swelling
Tumor
Defined as new growth
Neoplasm
This type of neoplasm is autonomous, slow-growing; may be locally invasive but does not spread to distant organs
Benign
This type of neoplasm is autonomous, rapidly-growing; locally invasive and spreads (metastasizes) to distant organs
Malignant
This term means independent of the usual control mechanisms
Autonomous
This is a malignant neoplasm
Cancer
In benign endocrine tumors, the mass of tumor in the body can be estimated by measuring the concentration of what?
Normal cell product in the blood
The mass of most ____ tumors must be assessed by measuring the concentration of molecules known to be increased in patients w/ a specific malignancy
Malignant
This neoplasm has some characteristics of the tissue of origin
Differentiated neoplasm
This neoplasm has few characteristics of the tissue of origin
Poorly-differentiated neoplasm
This neoplasm has no characteristics of the tissue of origin, morphologically or functionally
Anaplastic (w/o form) neoplasm
This syndrome has symptoms of a cancer patient that are not a result of local neoplastic growth/spread and are not a result of metastases to distant sites
Paraneoplastic syndrome
Three most common paraneoplastic syndromes
- Cushing’s Syndrome
- Hypercalcemia
- SIADH
Cushing’s Syndrome
- Causal substance
ACTH or ACTH-like substances produced by cancer cells
Cushing’s Syndrome
- Underlying cancers
- Pancreas
- Lung
Cushing’s Syndrome
- Typical lab results
- Excess cortisol release
- Abnormal FBG
- Glucose intolerance
- ↑ serum cortisol concentration
Hypercalcemia
- Causal substance
Parathyroid hormone-related protein
Hypercalcemia
- Underlying cancers
- Lung
- Breast
- Ovary
Hypercalcemia
- Typical lab results
↑ PTH or PTH-related protein detected
SIADH
- Causal substance
ADH
SIADH
- Underlying cancers
- Brain
- Lung
SIADH
- Typical lab tests ordered
Sodium and osmolality, measured in both serum and urine
This is a substance produced by a tumor, or by the host in response to a tumor, that is used to differentiate a tumor from normal tissue or to determine the presence of a tumor based on measurements in the blood or secretions
Tumor marker
Four current uses of tumor markers
- Monitor the treatment and progression of cancer
- To determine the success of initial treatment (surgery)
- Detect the presence of cancer
- Monitor the effectiveness of continuing treatment
Four enzymes that are used as tumor markers
- ALP
- LD
- NSE
- PSA
This tumor marker is seen in primary or secondary liver cancer; greatest elevation seen in patients with prostate cancer with bone metastases
Alkaline phosphatase (ALP)
This tumor marker can detect non-Hodgkin’s lymphoma, acute leukemia, and testicular cancer
Lactate dehydrogenase (LD)
This tumor marker is found in neuronal tissue and detects neuroblastomas, carcinoid tumors, and pheochromocytoma
Neuron-Specific Enolase (NSE)
This tumor marker is primarily used to screen, stage, and monior treatment and recurrence of prostate cancer
Prostate-specific Ag (PSA)
Seven hormones that are used as tumor markers
- ACTH
- Calcitonin
- Gastrin
- hCG
- Catecholamines (nor/epinephrine, dopamine)
- Serotonin
- 5-HIAA
This tumor marker detects pituitary tumors or ectopic ACTH producing tumors
Adrenocorticotrophic hormone (ACTH)
This tumor marker is used to detect familial medullary carcinoma of the thyroid (autosomal dominant)
Calcitonin
This tumor marker is used to detect gastrinomas, which cause Zollinger-Ellison syndrome
Gastrin
This marker is elevated in trophoblastic diseases (associated with the uterine endometrial lining) and germ cell tumors; can go along with AFP to identify testicular tumors
Human Chorionic Gonadotropin (hCG)
These two catecholamines are increased in pheochromocytomas (tumors in adrenal medulla)
Epinephrine and norepinephrine
This catecholamine is increased in neuroblastomas
Dopamine
This tumor marker arises from carcinoid tumors of the GI tract and pancreas
- Serotonin
- 5-HIAA
In cancer patients, production of these antigens demonstrates that certain genes are reactivated during malignant cellular transformation
Oncofetal Ags
Two oncofetal Ags that are used as tumor markers
- Alpha fetoprotein (AFP)
- Carcinoembryonic Ag (CEA)
This is found in hepatocellular and germ cell (non-seminoma) carcinoma
LIVER CANCER
Alpha fetoprotein (AFP)
This marker is useful for colorectal carcinoma (70%) COLON CANCER
Carcinoembryonic Ag (CEA)
Four CHO Ags that are used as tumor markers
- CA 15-3
- CA 27.29
- CA 549
- CA 125
This marker is elevated in 69% of cases of breast cancer; not used to diagnost but most useful in followup of treated breast cancer
CA 15-3
This marker is used for the detection of recurrent breast cancer in patients with stage II or stage III disease
CA 27.29
This marker is usedful in detecting active breast cancer, but not early breast cancer
CA 549
This is used as a marker for ovarian cancer, useful in differentiating benign from malignant disease in patients with palpable ovarian masses
CA 125
This is useful in the detection of pancreatic and colorectal cancer
Blood Group Ag: CA 19-9
Three proteins that are used as tumor markers
- Igs
- S-100
- Thyroglobulin and Abs
Used as a marker for multiple myeloma for over 100 years
Igs
Histological marker for melanoma and melanoma metastases
S-100
Used to diagnose differentiated thyroid cancer
Thyroglobulin and Abs
Used as indicators for therapy in breast cancer
Estrogen and progesterone receptors
Genetic oncogenes that are used as tumor markers
- ras
- c-myc
- Her-2/neu
- bcl-2
- BCR-ABL
Neuroblastoma and AML and 95% of pancreatic cancers
ras
If activated, there is an association with B- and T-cell lymphoma
c-myc
Amplification is found in breast tumors and used for prognosis
Her-2/neu
Expressed in lymphomas, myeloma, and chronic leukemias
bcl-2
Useful in the diagnosis and in the directing of treatment in CML
BCR-ABL
Tumor-suppressor genes that are used as tumor markers
- Retinoblastoma gene
- p53 gene
- APC
- BRCA1 and BRCA2
Loss of banding on this gene leads to a rare pediactric tumor called retinoblastoma
Retinoblastoma
Deletions in this gene may bead to colon carcinoma
p53
Loss leads to colorectal cancer with or without many polyps
APC
Reasonably certain prediction that the woman will develop breat (85% of patients) or ovarian cancer (45%) by the age of 85
BRCA1 and BRCA2