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Biochemistry > Tumour Biomarkers > Flashcards

Tumour Biomarkers Flashcards

1
Q

4 uses of tumour markers

A

Monitoring treatment and detecting recurrence of disease
Diagnosis together with biopsy and imaging
Screening or relatives
Prognosis

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2
Q

What makes a good biomarker for cancer screening?

A

Diagnostic
Sensitive
Specific

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3
Q

Predictive value

A

A measure of how well a test can predict disease

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4
Q

What is a suitable test to use in screening men for prostate cancer?

A

PSA prostate specific antigen

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5
Q

3 types of biochemical markers

A

Protein
Metabolites
Circulating tumour DNA

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6
Q

Tumour markers are not ____________ for cancer cells

A

Specific

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7
Q

Tumour marker for colorectal cancer

A

CEA

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8
Q

Tumour marker for ovarian cancer

A

CA-125

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9
Q

Tumour marker for medullary thyroid cancer

A

Calcitonin

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10
Q

CEA in screening

A

Not useful in screening since only 30% of colorectal cancer patients at time of diagnosis have elevated levels of CEA

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11
Q

Non-CRC conditions where CEA is elevated

A

Breast, lung, haematological cancers

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12
Q

CA-125

A

Glycoprotein attached to cell surface of fallopian tube
Increased in serum when a tumour has increased vasculature
Postoperative CA-125 levels correlate with residual tumour volume
Increased in pregnancy

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13
Q

When should CA-125 be measured?

A

When patients have persistent symptoms

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14
Q

Neuro endocrine tumours

A

Occur in tissue derived from stem cells
APUD cells
Generally slow growing

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15
Q

APUD cell

A

Amine - for high amine content
Precursor Uptake of (amine) precursors
D ecarboxylase - for high content of the enzyme mini decarboxylase (for conversion of precursors to amines)

Have ability to produce neurotransmitters, hormones or paracrine regulators

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16
Q

What organ contains neural type cells that can secrete bio active amines or peptide hormones?

A

Adrenal medulla

17
Q

What organ contains epithelial type cells that can secrete bio active amines or peptide hormones?

A

Islets of langerhans

18
Q

Symptoms of insulinomas

A

Headaches
Confusion
Trembling

19
Q

Symptoms of gastrinomas

A

Bleeding in stomach
Black tar-like stools
Diarrhoea

20
Q

Symptoms of stomatostinomas

A

Smelly stools
Weight loss
Anaemia

21
Q

Symptoms of glucagonomas

A

Anaemia
Weight loss
Diabetes

22
Q

Symptoms of VIPomas

A

Diarrhoea
Weakness
Sickness

23
Q

What are the two distinct categories of GEP-NETs?

A

Carcinoid - secrete serotonin
Pancreatic endocrine - secrete peptide hormones

24
Q

Name a non GEP-NET

A

Phaeochromocytoma

25
Q

Phaeochromocytoma

A

A rare catecholamine-secreting tumour derived from chromaffin cells
May be life threatening

26
Q

Medullary cancer of thyroid

A

Cancer of parafollicular cells which produce calcitonin
Characterised by elevated level of calcitonin (also raised in chronic renal failure)

27
Q

MEN

A

Multiple Endocrine Neoplasia
Autosomal dominant inheritance
Tumours involving two or more endocrine glands

28
Q

Type 1 MEN

A

Werners’s syndrome
Parathyroid
Pituitary

29
Q

Type 2 MEN

A

Sipple’s syndrome
Medullary cancer of thyroid
Phaeochromocytoma

30
Q

Diagnosis of NET

A

Clinical presentation
Peptide screen CgA
Urinary 5HIAA & 5HT
CAT MRIPET
Octreotide scitigraphy MIBG
Biopsy

31
Q

General NET markers

A

Chromogranin A

32
Q

Specific marker of NET

A

E.g. gastric if a gastrinoma
E.g. measure urinary plasma catecholamines for phaeochromocytoma

33
Q

5-HIAA

A

Serotonin metabolite
Biochemical test for carcinoid (NET)

34
Q

Biochemical test for Phaeochromocytoma

A

24hour secretion of catecholamines

35
Q

What is clonidine?

A

Alpha-adrenergic receptor agonist. Gaslights brain into thinking catecholamine levels are higher than they really are
Clonidine causes the brain to reduce its signals to the adrenal medulla => lowering catecholamine release => lowers plasma levels = negative feedback

Doesn’t happen if there is a tumour secreting catecholamines

Biochemistry (19 decks)

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