Tumour Markers

Question 1

Alk Phos - primary cancers

Answer 1

seminoma (placental ALP)

Paget disease of the bone

Question 2

Alk Phos - metastases

Answer 2

liver

bone

Question 3

Alk Phos - special consideration

Answer 3

must exclude hepatic origin by checking LFTs and gGT

Question 4

alpha-fetoprotein

Answer 4

HCC & hepatoblastoma
yolk sac tumour
mixed germ cell tumour

Question 5

what does a low alpha-fetoprotein suggest?

Answer 5

Down’s syndrome

Question 6

when is alpha-fetoprotein physiologically elevated?

Answer 6

pregnancy - made by foetus

Question 7

beta-HCG (3)

Answer 7

H - hydatidiform mole
C - choriocarcinoma
(together Gestational trophoblastic disease)

testicular CA
mixed germ cell tumour

Question 8

breast CA

Answer 8

CA15-3/CA27-29

Question 9

pancreatic adenocarcinoma

Answer 9

CA19-9

Question 10

ovarian CA

Answer 10

CA 125

Question 11

medullary thyroid carcinoma

Answer 11

calcitonin

Question 12

CEA

Answer 12

CRC
pancreatic CA

a few other minor ones. very non-specific

Question 13

chromogranin

Answer 13

NETs

Question 14

prostate

Answer 14

PSA

Question 15

route of spread for sarcoma?

Answer 15

haematogenous

Question 16

route of spread for most carcinoma?

Answer 16

lymphatics

Question 17

which carcinoma spread differently to all the others?

Answer 17

Four Carcinoma Route Haematogenously
F- follicular thyroid
C - choriocarcinoma
R - renal cell
H - hepatocellular