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Clinical Biomed yr2 > tumour markers > Flashcards

tumour markers Flashcards

1
Q

what are tumour markers

A

macromolecules forming part of a malignant cells
measured in blood, urine or tissue samples
used to diagnos cancers

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2
Q

3 main types of tumour markers

A

structural
secreted/enzymes
non-specific markers of cell turnover/DNA

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3
Q

examples of tumour markers

A 
proteins
glycoproteins
ocofoeatal antigens
receptors
hormones
enzymes
oncogenes
tumour supressor genes
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4
Q

what is the ideal tumour marker

A

100% organ specific and only detectable in malignancy

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5
Q

factors that affect tumour markers

A
  • most normal tissues may produce the fator too
  • cell proliferation affects amount of the marker
    -amount of blood the tumour is getting
  • natural excretion of tumour
  • variabiluty in assays
    tumour markers are COMPLEX
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6
Q

clinical use of tumour markers

A

monitor effectiveness of therapy

detect tumour recurrence or remission

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7
Q

what is the sensitivity of a tumour marker screening

A

ability to detect the presence of the disease

% of those with the disease who get a positive result above the ut off, true positive

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8
Q

what is the specificiy of a tumour marker screening

A

ability to excluse disease

% of those who get a negative result below the cut off, true negative

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9
Q

whats the ideal outcome of tumour marker screening?

A
  • screening for cancers using tumour markers incerases the early deetection and long term survivall of treated patientes and decrease deaths
    BUT none of the current available marker are perfect or 100% effective
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10
Q

prostate specific antigen PSA

A

serine protease present in seminal fluid

increased levels in cancer

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11
Q

is PSA test sensitive?

A

yes because its present in cancer

but also present in normal but at lower levels

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12
Q

is the PSA test specific

A

depends where the testing limit is
if its lowered too much it will give false positives eause PSA is found in normal tissue too, need to balance the speficiness

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13
Q

prostate cancer screening

A

commoness cancr in men

present in lots of deaths subclinically

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14
Q

how effective has prostate screening been?

A

screening done in US and canada
more patients have been diagnosed and early treatment
BUT death rate still the same
UK havent seen it as effective so havent started screening

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15
Q

what have the Uk dont about prostate screening

A

not seen ti worth it to screen but hae made people ore aware of it and that those worried about it can recive advice

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16
Q

what are the clinical uses of PSA for prostate cancer

A

screening: limited to as risk groups
diagnosis: limited to those at risk
prognosis: limited
tumour staging: limited to none

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17
Q

what does a tumour diagnosis depend on?

A

biopsy and tissue histology

18
Q

structural tumour marker example

A

epitheliall cell surface glycoproteins

can spill over into circulation and are detected by monoconal antibodies

19
Q

CEA

A

carinoembryonic antigen

found in almost any carcinoma but commonly in bowel cancer

20
Q

why is CEA not a perfect marker?

A

its also found in elevated levels in benign diseases

- hepatitis, cirrohis, janudice, bronchitis

21
Q

screening for bowel cancer?

A

nationwide for 60-69yrolds

22
Q

what does the bowel cancer screening look for?

A

dy reagent strips
testing for haemoglobin/blood
sometimes polyps or bowel cancers bleed so screening is for faecal occult blood
pos results allow for a colonocopy for further investigations

23
Q

what is used to monitor bowe cancer

A

CEA

24
Q

how is CEA used to monitor bowel cancer

A

used to asses effectiveness of treatment and recurrentce

monitor blood levels throughout treatment allowing effective further treatment or surgery

25
Q

why is CEA NOT used for screening for bowel cancer

A

low sensitivity and not great speicficity

26
Q

CA-15-3

A

Cancer antigen 15-3 (CA 15-3) is a normal product of breast cells. Concentrations of CA 15-3 in the blood are often increased in breast cancer.
especilly found in cancers with distant metastases

27
Q

breast cancer marker

A

no tumour marker for this has been sucessul for screening

genetic screening is useful through

28
Q

what genes can be screeened for breast cancer?

A

BRAC1 and BRAC2

29
Q

treatments of breast cancers

A

anti-oestrogens

HER/neu and herceptin

30
Q

OSNA

A

one ste nucleic acid amplification
used while removing tumours to ensure all cancer has been removed
sample a lymh node to check for cytokeratin 19 as this is only expressed in cancer
saves second operations

31
Q

CA 125

A

cancer antigen
found in some malignancies but not all so not veyr good or specific
can be found in benign diseases too!

32
Q

ovarian cancer

A

Ca125 can be monitored once the disease is known but this cannot be used for screening

33
Q

when is ca125 screening useful?

A

ovarian cysts: in combo with ultrasounds

used for those at risk

34
Q

nice guidelines for ovarian cancer ca125 screening

A

screen with ca125 if patient has these symptoms:

  • persistent pelvic and stomach pain
  • bloating
  • diffiulty eating or feeling full fast
35
Q

CA 19-9

A

blood group glycoproteins

not present in most of the popuation who have the lewis negative blood group so not present in all

36
Q

use of CA 19-9

A

raised levels in malignant aggressive pancreative carcinomas
BUT also some bengn conditions

37
Q

Ca 19-9 in pancreatic cancer

A

can be used to monitor treatment and recurrencec with thos cancers that secrete the marker
seria measureents have a high specificicty and selectivty for determinng treatment prognosis

38
Q

breast cancer tuour marker

A

Ca 15-3`

39
Q

gastrointestinal tumour marker

A

CA-19-9 antigen

40
Q

ovarian cancer progression marker

A

CA 125

41
Q

prostate cancer progression marker

A

PSA

Clinical Biomed yr2 (22 decks)

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