Tumour Markers

Question 1

What does lactate dehydrogenase indicate?

Answer 1

Non specific marker for haematological malignancy

Question 2

What does raised ALP indicate?

Answer 2

Non specific marker for bone cancer/mets

Question 3

What does raised total protein indicate?

Answer 3

Non specific marker for myeloma, or Waldenstrom’s macroglobulinaemia

Question 4

What does raised Ferritin indicate?

Answer 4

Non specific marker for renal cell carcinoma, myeloid leukaemia, HCC

Question 5

AFP as a marker? (oncofetal antigen)

Answer 5

HCC screening

Ovarian/testes cancer

Question 6

CEA as a marker? (oncofetal antigen)

Answer 6

Colorectal carcinoma

Also:
Lung, stomach, ovarian, pancreas, breast

Question 7

bHCG as a marker? (4) (hormone)

Answer 7

Pregnacny
Choriocarcinoma
Non-seminomas
Trophoblastic tumours

Question 8

Metanephrines as a marker?

Answer 8

Phaechromocytoma

Question 9

Calcitonin as a marker?

Answer 9

Medullary carcinoma (thyroid)

Question 10

IGF-1 as a marker?

Answer 10

Pituitary malignancy

Question 11

CA 19-9 as a marker? (glycoprotein)

Answer 11

Pancreatic

Question 12

CA 125 as a marker? (glycoprotein)

Answer 12

Ovarian

Also:
Breast
Pancreas

Question 13

PSA as a marker? (enzyme)

Answer 13

Prostate malignancy (non specific)

Question 14

Neurone specific enolase as a marker? (enzyme) (2)

Answer 14

SCLC
Neuroendocrine tumours (gastrinoma(

Question 15

Squamous cell carcinoma antigen (SCC-A) as a marker?

Answer 15

SCC of lung, uterus, cervix, head and neck

Question 16

Igs as a marker?

Answer 16

Raised in myeloma

Question 17

Markers for multiple myeloma?

Answer 17

Bence Jones protein
Free light chains
B2 micoglobulin is used to measure the mass of tumour in followup

Question 18

Markers for neuroendocrine tumours? (recognise)

Answer 18

Serotonin, 5 hydroxy tryptamine
Catecholemines
Chromogranin A

Question 19

Screening programme for colorectal cancer?

Answer 19

FIT testing every 2 years for 60-74 yr olds

Question 20

Disadvantage of CA125 in ovarian screening?

Answer 20

Normal in 30% of women with stage 5 ovarian cancer

Raised in many other conditions

But may be useful with pelvic USS in women over 50 with symptoms

Gives a lead time of 4 months for detection of cancer recurrence which is useful

Question 21

Markers useful for non seminomas

Answer 21

AFP with HCG

Question 22

Markers useful for seminoma tumours

Answer 22

HCG with LDH

Question 23

Which non malignant conditions raise AFP?

Answer 23

Cirrhosis, hepatitis, telangiectasia, pregnanct

Question 24

Which marker is used to test for recurrence in colorectal cancer?

Answer 24

CEA

Can also be raised in smoking, other tumours, or IBD, pancreatitis and liver disease

Question 25

Which benign conditions can raise CA 19-9?

Answer 25

Pneumonia, hepatobiliary disease, renal failure