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Boards.CP.Chemistry > Tumor Markers > Flashcards

Tumor Markers Flashcards

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1
Q

Hook Effect - A very ___ concentration of an analyte gives a falsely ___ result

A

-Very high concentration of an analyte gives a falsely LOW result

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2
Q

What is the mechanism of the Hook Effect?

-How can this be overcome

A

High concentration exceeds the binding capacity of both the binding capture antibodies and the signal bearing antibodies, preventing their association.

*If the sample is sufficiently diluted, the assay will give an appropriate result

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3
Q

What are considered indications for prostate needle biopsy?

A

-PSA >4 ng/mL
or
-Abnormal DRE

(controversial)

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4
Q

What percentage of men with elevated PSA (>4 ng/mL), have prostate cancer?

A

30-40%

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5
Q

What is true regarding PSA and race?

A

Levels are significantly higher in Blacks

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6
Q

T/F: Many men with prostate cancer have serum PSA <4.0 ng/mL.

A

True

-Poor Sensitivity

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7
Q

Fecal occult blood testing:

-Guaiac blood testing mechanism

A

Hemoglobin has endogenous peroxidase activity that is capable of oxidizing guaiac in the presence of hydrogen peroxide to a blue colored product.

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8
Q

Fecal occult blood testing - Guaiac blood testing:

  • False-Positives
  • False-Negatives
A

False Positives:

  • NSAID use
  • Consumption of heme (Meat)
  • Consumption of peroxidase (turnips,horseradish)
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9
Q 
Carcinoembryonic Antigen (CEA):
-High preoperative CEA
A

Worse overall outcome

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10
Q

CEA may be elevated in what cancers? (8)

A
  • GI
  • Gastric
  • Breast
  • Pancreatic
  • Lung
  • Medullary Thyroid
  • Cervical Adenoca
  • Urothelial
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11
Q

What neoplasms are associated with elevated (cancer antigen) CA-125?

A

Nonmucinous Epithelial Ovarian neoplasms

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12
Q

CA27.29 (aka BR27.29) and CA15-3:

  • protein product of what gene?
  • Elevated in what?
A
  • MUC1 gene

- Advanced stage breast cancer (both elevated in 60-70%)

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13
Q

What is the marker for pancreatic adenocarcinoma; elevated in 80% at presentation?

A

CA19-9

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14
Q

Who does not produce CA19-9?

A

Lewis negative patients

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15
Q

Where is alpha-fetoprotein (AFP) normally synthesized? (3)

A
  • Yolk sac
  • Fetal Liver
  • Fetal GI tract
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16
Q

What NONneoplastic conditions are associated with an elevated AFP? (3)

A
  • Pregnancy (normal)
  • Cirrhosis
  • Hepatitis
17
Q

What neoplastic conditions are associated with an elevated AFP? (2)

A
  • Yolk Sac tumors

- Hepatocellular Carcinomas (Most)

18
Q

What conditions are associated with an elevated Human Chorionic Gonadotropin (HCG)? (4)

A
  • Preganancy
  • Gestational Trophoblastic Disease
  • Choriocarcinoma
  • Dysgerminoma/Seminoma (15%)
19
Q

What tumor marker is elevated whenever there is increased cell death?

A

beta2-microglobulin

20
Q

B2-microglobulin is an independent prognostic factor in what?

A

Multiple Myeloma

21
Q

Alkaline Phosphatase:

  • Indication of what?
  • Elevated in what conditions
  • Sensitive test for what?
A
  • Osteoblastic activity
  • Osteogenic Sarcoma or Bone Mets
  • Sensitive test for Hepatic Metastases
22
Q

What do carcinoids produce (generally)?

-Metabolite that is excreted into urine

A

Serotonin (5-HT)

-5-Hydroxyindoleacetic acid (5-HIAA)

23
Q

GI Carcinoids produce?

  • Foregut (3)
  • Midigut (1)
  • Hindgut (1)
A

Foregut

  • Histamine
  • Catecholamines
  • 5-Hydroxytryptamine (5-HTP)

Midigut
-Serotonin (5-HT)

Hindgut
-Nonsecretory

24
Q

Markers for Medullary Thyroid Carcinoma (2).

A
  • Calcitonin

- CEA

25
Q

Norepinephrine metabolism.

A

Norepinephrine - Normetanephrine - Vanillylmandelic acid (VMA)

26
Q

Epinephrine metabolism.

A

Epinephrine - Metanephrine - Vanillylmandelic acid (VMA)

27
Q

What is elevated in most cases of Neuroblastoma? (2)

A

Urine:

  • Vanillylmandelic acid (VMA)
  • Homovanillic acid (HVA)
28
Q

Homovanillic acid (HVA) is the final metabolic product of what?

A

DOPA and dopamine

29
Q

What are the nonspecific markers for Neuroblastoma that are used to follow disease activity? (3)

A
  • Neuron Specific Enolase (NSE)
  • Lactic Dehydrogenase (LDH)
  • Ferritin
30
Q

What is the Urine marker test for Urothelial Carcinoma?

  • Test name
  • Protein detected
  • How is it released
A
  • NMP22 (Nuclear Matrix Protein 22)
  • NuMA (Nuclear Mitotic Apparatus)
  • Released from nuclei of tumor cells when they die
31
Q

What does the Bladder Tumor Antigen (BTA) test detect?

A

Complement factor H/related proteins
-CFH/CFH-rp

*in URINE

Boards.CP.Chemistry (17 decks)

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