Tumor Markers Flashcards
What is a tumor marker❓
Could include hormones, antigens, enzymes etc that are produced directly by a tumor or as an effect of a tumor on health tissue
An ideal tumor marker…
Released directly in bloodstream
Detectable at small concentrations
Tumor specific
Absent in healthy individuals
Detectable in body fluids
The concentration of a tumor marker increases with its progression
True or false
True
Highest levels are seen in metastasis
The most common method for the detection of tumor markers is❓
What are the challenges associated with this❓
1.
Immunoassays
- Markers are often above linearity
Hook effect
Heterophile antibodies
Lipemia, hemolysis and antibody cross reactivity
⬆️Alkaline phosphatase is increased in what cancers❓
Primary or secondary liver cancers
It may be helpful in evaluating metastasis with bone or liver involvement
ALP is also seen in the Intestine
Creative kinase is an enzymatic tumor marker for what cancers❓
Breast Ovarian Lung Colon Prostate
Lactate dehydrogenase is an enzymatic tumor marker for what cancers❓
Liver
Lymphomas
Leukemias
Prostatic acid phosphatase is an enzymatic tumor marker for what cancers❓
Prostate cancer
Placental ALP, Regan isoenzyme is seen in what cancers❓
Lung
GI cancers
Ovarian ca
Hodgkin’s disease
⬆️prostatic acid phosphatase may be observed in what conditions❓
Prostate cancer (used in staging and monitoring tx)
Osteogenic sarcoma
Multiple myeloma
Bony metastasis
Osteoporosis
Hyperthyroidism
PAP has been replaced by PSA test.
- True or false❓
- Why❓
- What could falsely elevate PSA levels in serum ❓
True
More specific for screening and detection of early cancer
Urinary bladder cateterization
Digital recital examination
How would you differentiate between prostatic cancer and benign prostatic hyperplasia❓
The ratio between free and total PSA levels is a reliable market for differentiation
What tests would you run in order to correctly diagnose prostatic cancer❓
PSA test
DRE
Transrectal ultrasonography
The treatment of prostatic cancer should include❓
Radical prostatectomy
Radiation therapy
Antiandrogen therapy
If PSA levels are still high after 2/3weeks of treating a prostatic cancer, should it be assumed that a residual tumor is present❓
Yes
Androgen deprivation therapy may have a direct effect on the PSA level that is independent of the antitumor effect
True or false
True
Calcitonin is a hormonal tumor marker associated with which cancers❓
•Medullary thyroid cancer
Also seen in: Lung Breast Kidney Liver
And in non malignant states like: Pulmonary diseases Pancreatitis Paget’s disease Hyperthyroidism Pregnancy Myeloproliferative disorders
Human chorionic gonadotropin is elevated in what tumors❓
Trophoblastic tumors
Chriocarcinoma
Germ cell tumors of ovary and testis
Oncofetal antigens are normal in fetal development then re-expressed in tumor growth
True or false❓
List some examples
True
CEA (Carcino-embryonic antigen)
Alpha-feta protein
CEA is caused clinically to diagnose❓
It can also be elevated in what conditions❓
1. Lung Breast GI Colorectal ca
2. In smokers Cirrhosis Rectal polips Ulcerative colitis Benign breast disease
Should CEA be used for screening❓
No
It’s useful in staging and monitoring tumors
Alpha fetoprotein is synthesized by fetal liver and re-expressed in certain types of tumors
True or false❓
Diagnostic significance❓
True; functions as transport protein and regulates oncotic pressure
Hepatocellular carcinoma
Germ cell tumors of ovary and testis
Is AFP useful in screening of cancers❓
What is the reference range ❓
Yes
> 1000 is diagnostic of cancer except in pregnancy
AFP is a prognostic indicator of survival
True or false
True
<10microgram/L in healthy adults
Elevated AFP is associated with shorter survival time
True or false
True
Which hormonal tumor markers are used in classifying and staging germ cell tumors❓
AFP
hCG
What are carbohydrate tumor markers❓
Give examples
HMW mucins/Blood Group Antigens on tumor cell surface or secreted by tumor cells
CA 15-3
CA 19-9
CA 125
What is CA 15-3 used for❓
A marker for breast carcinoma
🚫diagnosis
✅monitoring treatment
May also be found in patients with: Lung Pancreatic Colorectal Liver Ovarian ca
CA 125 is a nonspecific marker for❓
It may also be elevated in what cases❓
- Ovarian
Endometrial ca
2. Lung Breast Colorectal Pancreatic ca
Cirrhosis Hepatitis Endometriosis Pericarditis Early pregnancy
Which tumor marker can be used in differentiating a benign ovarian mass form a malignant ovarian mass❓
CA 125
The use of CA 125 as a detection for reoccurrence is ____ accurate❓
75%
CA 19-9 is a marker and monitor for❓
It may also be elevated in what cases❓
1.
Colorectal
Pancreatic ca
2. Hepatocellular Hepatobiliary Gastric Breast ca
Pancreatitis
Benign GI diseases
Beta-microglobulin is a protein marker for❓
It may also be elevated in what cases❓
- Multiple myeloma
Hodgkin lymphoma - Chronic inflammation
Viral hepatitis
Ferritin is a protein marker for❓
Hodgkin lymphoma Leukemia Liver Lung Breast ca
Thyroglobulin is a protein marker for❓
Differentiated thyroid cancer
Monoclonal immunoglobulin is a protein marker for❓
Multiple myeloma
Bence-Jones protein is a free monoclonal immunoglobulin light chain in the urine, it is reliable marker for❓
Multiple myeloma
It has been observed that patients with +ve estrogen and progesterone receptor markers tend to respond to breast cancer treatment
What % of breast cancer patients have estrogen receptors❓
Do patients with +ve receptor levels survive longer❓
60%,
Yes, 2/3rd of px with estrogen + respond to hormonal therapy
5% with estrogen -ve respond
