Tumour Markers

Question 1

Predominantly raised in liver cancers, testicular or ovarian germ cell tumours.
May also be raised in other cancers e.g. gastrointestinal.
Or in non-malignant conditions e.g. chronic hepatitis, cirrhosis.

Answer 1

Alpha Fetoprotein (AFP)

Question 2

Secreted during pregnancy.
Can also be produced by cancers originating in the placenta (gestational trophoblastic disease), and germ cell tumours of the ovary or testes.
May be secreted by some GI malignancies

Answer 2

Human Chorionic Gonadotropin (hCG)
(particularly b-hCG)

Question 3

May be raised in ovarian cancer.
Other gynae conditions e.g. menstruation, pregnancy, benign ovarian cysts and endometriosis may also raise it.

Answer 3

Cancer Antigen 125 (CA 125)

Question 4

May be raised in breast cancer and other malignancies e.g. lung, bowel, pancreatic and ovarian.
Some non-malignant conditions like cirrhosis can also elevate

Answer 4

Cancer Antigen 15-3 (CA 15-3)

Question 5

May be raised in GI cancers, particularly pancreatic.
Also in some mucinous ovarian cancers

Answer 5

Cancer Antigen 19-9 (CA 19-9)

Question 6

May be raised in bowel cancer and other malignancies e.g. breast, lung, gastric, pancreatic, ovarian.
Non-malignant conditions e.g. IBD, cirrhosis may also elevate, as well as smoking.

Answer 6

Carcinoembryonic Antigen (CEA)

Question 7

May be raised in lymphoma and germ cell tumours.
Also in conditions when there is cellular damage e.g. hepatitis, kidney disease

Answer 7

Lactate Dehydrogenase (LDH)

Question 8

CA 125 can be elevated by conditions involving or inflaming the peritoneum, pericardium or pleura. Give 7 examples of these:

Answer 8

• Endometriosis
• Pelvic inflammatory disease
• Ascites
• Recent abdominal surgery
• Pleuritis
• Pericarditis
• CHF with pleural effusion

Question 9

Most non-seminomatous tumours are associated with elevated levels of one or more of serum AFP, beta-hCG and LDH. Which of these is not a useful marker in seminomas?

Answer 9

Alpha Fetoprotein