Tumour markers

Question 1

What groups of tumour markers are there?

Answer 1

Hormones
Enzymes
Tumour antigens
Monoclonal antibodies

Question 2

What hormones are used as tumour markers?

Answer 2

1. Calcitonin (medullary thyroid carcinoma)
2. ACTH, ADH (small cell bronchial carcinoma)
3. hCG (germ cell tumours, teratomas, seminomas)

Question 3

What tumour antigens are used as tumour markers?

Answer 3

1. CEA (predicting relapse in post-op colorectal carcinoma)
2. AFP (hepatocellular carcinoma, teratoma, germ cell tumours)
3. PSA (prostate carcinoma)
   NB (PSA also raised in BPH, prostatitis, UTIs, vigorous exercise, recent prostate stimulation)

Question 4

What mabs are used as tumour markers?

Answer 4

1. CA-125 (ovarian)
2. CA-15-3 (breast)
3. CA-19-9 (pancreatic, gastric, cholangiocarcinoma)
   NB raised CA-125 can be caused by endometriosis, fibroids, pelvic infection, liver disease, pregnancy

Question 5

What is Gleason score used for?

Answer 5

Histological grading system for prostate cancer
-2 numbers, each a score out of 5, added together (eg 2+3 = 5)
-1 = well differentiated / close to normal
-5 = poorly differentiated / abnormal
-1st number = grade of most prevalent pattern in biopsy
-2nd number = grade of 2nd most prevalent pattern in biopsy
-6 = low risk
-7 = intermediate
-8 = high