Tumour markers Flashcards
What are these findings non specific markers for ?
- Hyponatraemia
- Lactate dehydrogenase
- Alkaline phosphatase
- Total protein
- Ferritin
- Hyponatraemia- SIADH secondary to small cell lung cancer
- Lactate dehydrogenase- haematological malignancy
- Alkaline phosphatase- bone cancer and bone mets
- Total protein- multiple myeloma
- Ferritin- Renal cell carcinoma, myeloid leukaemia and hepatocellular cancer
What are the two oncofoetal antigens
- Alpha feto protein- present in hepatocellular carcinoma and ovarian and testicular tumours
- Carcinoembryonic antigen- colorectal carcinoma
What are these various hormones tumour markers for?
B- human chorionic gonadotrophin (HCG)
Metanephrines
Calcitonin
Insulin growth like factor
Beta HCG- choriocarcinoma, testicular tumours , trophoblastic tumours
Metanephrines (adrenaline or noradrenaline)- pheochromocytoma
Calcitonin- thyroid (medullary) carcinoma
Insulin growth like factor- pituitary
What are the two main enzymes that are used as tumour markers
- Prostate specific antigen- prostate cancer but increases in other prostatic conditions
- Neurone specific enclave- small cell lung tumour and neuroendocrine tumours
What important antigens are used as tumour markers
- Squamous cell carcinoma antigen - present in squamous cell carcinomas of lung, uterus, cervix, head and neck
- Immunoglobulins- present in multiple myeloma
What are the tumour markers for multiple myeloma
- Heavy light chain para protein bands
- Bence jones protein
- Free light chains
- Beta 2 microglobulin (looks at tumour mass)
What are the tumour markers for CA125
-CA 125 and inhibin , HGC, AFP and CEA
How is faecal occult blood used as a tumour marker
- Colorectal cancer 2 yearly screening 60-74
- Positive result will need more tests
- FIT test is better as it takes into account haemoglobin readings more specifically to human blood
What is PSA ?
- Prostate specific antigen
- Will be increased in benign prostatic hypertrophy so has age specific reference ranges
- Not specific for malignancy- can lead to over detection
Discuss the uses of CA125
- Tested alongside pelvic ultrasound in woman with Abdominal distension, early saiety, loss of appetite, urinary frequency, Abdominal pain, unexplained weight loss and change in bowels
- Can increase in pancreatitis, hypothyroidism, pelvic inflam disease, ascites , heart failure and pleural effusion
- Also increases in tumours of uterus, cervix , breast and GI tract
Discuss the uses of AFP and HCG
- Detect germ cell tumours
- AFP- useful in hepatocellular cancer in high risk patients- Hep B&C with liver ultrasound
- AFP and HCG will be present for a non-seminoma germ cell tumour
- HCG and LDH will be present for seminoma
- AFP will also increase in cirrhosis, hepatitis and pregnancy
- HCG increases in pregnancy and marajiuana
Discuss the use of CEA as a tumour marker
- Surveillance in patients who have undergone curative colorectal cancer surgery for early detection of recurrence
- High in smokers and other tumours, high in IBD, pancreatitis, liver disease
Discuss the uses of CA-19-9 as a tumour marker
- Used for pancreatic cancer but this cancer has poor survival and limited treatment
- Elevated in colorectal, lung, liver and ovarian cancer too
- Elevated in pneumonia, hepatobiliary disease and renal failure
