Tumor Markers

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Tumor markers (TM) are laboratory detectable biomarkers that can be elevated by the presence of one or more types of cancer

  • In the narrower (clinical) sense of the word substances that can be determined in blood, urine or tissue and have a higher value in cancer
  • Used to clarify the diagnosis, monitor the course of therapy and early detection of disease relapse
  • Can be produced directly by tumor cells or non-tumor cells in response to the presence of a tumor (can also be elevated from non-tumor causes)
  • Not used for all cancer screening, only PSA (prostate-specific antigen) is used for screening of patients at risk for prostate cancer
  • If the tumor marker examination is performed at the appropriate choice and at reasonable intervals, it can be a good aid for the attending physician — determining the response to treatment, disease progression and the patient's prognosis
  • Tumor markers can be divided according to the site of production, specificity, chemical structure and biological character [3] [4]

Tumor-specific markers[edit | edit source]

  • Associated with the presence of certain tumor tissue
  • Due to the considerable overlap of TM production in different tumor tissues, the specificity is low
  • Suitable for monitoring remission of cancer and early diagnosis of disease relapse e.g. CEA (Ca GITu), CA 19–9 ( pancreatic cancer), CA 125 (ovarian cancer), etc.

Tissue-specific tumor markers[edit | edit source]

  • Rather related to a certain tissue in which a pathological process can take place (eg tumor growth)
  • Often increased from non-tumor causes (e.g. PSA in men - prostate; hCG and AFP - germinal liver tissue) [5] [6]

Humoral[edit | edit source]

Abbreviation Name Physiologically produced Standard Increased at False positive Note
CEA carcinoembryonic antigen epithelial cells during fetal development <3 μg/l colorectal cancer, breast cancer, lung cancer, ovarian cancer, liver metastases cirrhosis, GIT inflammation
AFP α-fetoprotein yolk sac and fetal liver <10 μg/l cirrhosis, active hepatitis, nonseminomas, germ cell tumors (teratoma), hepatocellular carcinoma, hepatolastoma pregnancy
CA 15-3 Carcinoma antigen 15-3 breast cancer, GIT tumors, glandular epithelial tumors hepatomegaly, cholangitis, lung disease, renal disorders, pregnancy ↑ breast cancer - sensitivity 75%, specificity 90%, some GIT tumors
MCA mucinous carcinoma antigen breast cancer rise earlier than CA 15-3, use for confirmation at elevated CA 15-3
CA 19-9 carbohydrate antigen pancreatic cancer, stomach cancer, colorectal cancer, breast cancer obstructive jaundice
CA 72-4 carbohydrate antigen gastric cancer, oesophageal cancer, lung cancer, ovarian cancer
CA 125 carbohydrate antigen ovarian cancer benign ovarian and endometrial conditions, hepatopathy, pancreatitis, pregnancy, menstruation monitoring of ovarian ca treatment, screening in women with a family history of ovarian cancer
SCC squamous cell carcinoma antigen squamous cell carcinomas
TPA/S tissue polypeptide antigen Cell proliferation various cancers (urinary bladder cancer, head and neck cancer) mixture of about 20 cytokeratins, increases in proportion to the growing tumor
CYFRA 21-1 cytokeratin fragments 19 non-small cell lung cancer
PSA prostate specific antigen into the seminal vesicle fluid to liquefy the ejaculate by prostate cells <2,5 μg/l < 50 let
<5 μg/l 50–60 let
8,5< μg/l > 60 let
prostate cancer ejaculation, per rectum examination before collection, BPH values ​​above 10 μg / l - 50% ca risk, about 20% ca prostate has PSA in the norm
LD lactate dehydrogenase liver, myocardium, skeletal muscle, erythrocytes 4,10 µkat/l testicular tumors,leukemia, RCC, Hodgkin's lymphoma
ALP alkaline phosphatase sarcomas, prostate cancer bile duct obstruction
ACP acid phosphatase skeletal metastases,prostate cancer
GGT γ- glutamyltransferase metastatic liver disease alcoholics, bile duct obstruction
NSE neuron specific enolase neuroblastoma, retinoblastoma, malignant melanoma, SCLC hemolysis in CNS tumors it is better to determine in cerebrospinal fluid
TK thymidine kinase leukemia, lymphoma, non-small cell lung cancer route of alternative DNA synthesis
hCG human chorionic gonadotropin placenta trophoblast tumors, choricarcinoma (100 % sensitivity), germinal tumors of testes and ovaries pregnancy screening of endangered persons, examination of the β-subunit
PRL prolactin during pregnancy and after childbirth prolactinoma, MEN I slightly during physical exertion, mental stress
CT calcitonin medullary thyroid carcinoma
Thyreoglobulin thyreoglobulin follicular carcinoma of the thyroid gland
Ferritin ferritin multiple myeloma, AML, Hodgkin's lymphoma
β2 mikroglobulin β2 microglobulin CLL, multiple myeloma, lymphoma
Paraprotein paraprotein multiple myeloma Bence-Jones protein
VMA vanillic acid product of catecholamine degradation functional tumors of the adrenal glands determination in urine, or determination of metanephrines (plasma, urinary)
HIAA 5-hydroxyindoleacetic acid product of serotonin degradation functional carcinoids determination in urine

Cell markers[edit | edit source]

Abbreviation Name Physiologically produced Standard Increased at False positive Note
HER2/neu breast cancer target for monoclonal antibodies (Herceptin), increased expression = worse prognosis

Genetic markers[edit | edit source]

Abbreviation Name Physiologically produced Standard Increased at False positive Note
p53 guardian of the genome cell cycle regulation Li-Fraumeni syndrome, sarcomas, breast cancer
BRCA1/2 breast cancer breast and ovarian cancer


References[edit | edit source]


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