Tumor Markers
From WikiLectures
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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