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Cancer > Tumour markers cancer > Flashcards

Tumour markers cancer Flashcards

1
Q
A
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2
Q

What are the minimal requirements for a tumour marker to be used in cacner

A

Reliable, quick, cheap assay
High sensitivity >50% and specificity >95%
High predicitve calue of postiie and negative results

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3
Q

What is hCG

A

Glycoprotein physiologically made by syncitiotrophoblast of placenta - pregnancy

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4
Q

What cancers does hCG have 100% sensitivity for

A

Testicular
Placental choriocarcinomas and hydatiform moles

Is 50% sensitive to Non semanous germ cell, 7-14% for seminonmous germ cell tumours

Extermely accurate as to whether cancer has been treated

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5
Q

What is AFP

A

Synthesised by foetal yolk sac, liver and intestine
Albumin liek carrier protein

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6
Q

When is AFP elevated

A

Moderately - pancreatic, biliary, gastric, bronchial cancers
Non malignant hepatic disease

Increased = hepatocellular carcinoma and GCT of testses, ovary and midline structures incl mediastinum and pineal gland that contain yolk sac tissue

Can increase as result of chemo

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7
Q

What cancers is PLAP increased in

A

Isoenzyme of ALP
Elevated in seminoma nad ovarian dysgerminoma
Slight increase in smokers

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8
Q

What is CA19-9 and where is it mader

A

Epithelium of foetal stomach, intestine and pancreas
Can be elevated in mucinous tumour of ovary

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9
Q

What is CA19-9 used to monitor and what is it most accurate for

A

Monitor response to treatment in gastric and pancreatic cancer
Not usfeul in screening pancreatic cancer
Not good for how bulky tumour is, >10,000 = metastatic disease

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10
Q

What tumour marker rises in cholestasis

A

CA19-9 - exclusively exreted by bile

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11
Q

What is inhibin used for

A

Secreted by granulosa cells incl sertolic ells and inhibits pituitary FSH
Useful marker for granulosa cell tumours in ovary - over oestradiol

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12
Q

When is CEA raised

A

GI tract carcinomas
Severe benign liver disease
Inflammatory lesions esp GI
Infection
Trauma
Infarction
Collagen disease
Renal impairment
Smoking

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13
Q

What can be used to determine response to treatment in widespread metastatic tumours

A

CEA

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14
Q

What is CA15-3 useful for

A

Determining severity of disease eg staging of breast cacner

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15
Q

What can CA15-3 detect before other tests can

A

Leve during follow up can detect relapse 2-9 months before clinical signs and symptoms develop

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16
Q

When is CA-125 useful in ovarian cancer and less useufl

A

90% + IN STAGE ii/iv, 50% earlier - only helpful to diagnose late stage ovarian disease

positive 80% of time in ovarian cacner, much less in intra abdominal tumours

17
Q

CA125 what most useful for

A

Prognostic factor
Monitor response to chemo and detection of relaspe
RMI index for pelvic mass

18
Q

What indicates a good response to treatment in CA125

A

> 7 fold fall in CA125

19
Q

What RMI requires referral to oncology

A

> 200
<200 surgery by gynaecologist then refer to onc

20
Q

What is SCC ass antigen

A

Glycoprotein used for monitoring SC cervical cancer - 70-85% sensitive and head and neck SC - 60^
Also NSCLC (not routine use)
More for treatment response and relapse

21
Q

What is PSA

A

Serine protease produced by prostate epithelium to liquefy fel surrounding spermatazoa -> fully mobile

22
Q

What is an elevated PSA

A

> 4

23
Q

what is used in screening for medullary carcinoma of thyroid

A

Calcitonin and calcitonin gene related peptide

24
Q

What hormones can be used to detect neuroblastoma

A

Catecholamine metabolites
Vanillylmandelic acid
homovanillic acid

25
Q

What does LDH measure

A

Buk of tumour
Does this as measures necrosis (intracellular enxyme) - ass with rapid growing tumours

26
Q

What crisis can LDH be useful in predicting the risk of

A

Identifies patients at risk of tumour lysis syndrome

27
Q

What tumour marker used in myeloma and NHL

A

Beta 2 microglobulin

28
Q

What tumour marker used in myeloma

A

Monoclonal paraproteins

29
Q

What tumour marker is used for papillary and follicular thyroid cacner

A

thyrodglobulin

29
Q

What cancers does neurone-sepcific enolase monitor

A

Neuroblastoma, SCLC

30
Q

How often are tumour markers checked

A

With each cyle of chemo to check resposne
After treatment:
3 monthly for 2 yeras
6 monthly for 3 years
Non after 5 years

Cancer (22 decks)

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