Tumor Markers

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Tumor markers ( tumor markers , TM) are laboratory-proven signs from which tumor growth depends ( oncogenes , anti -oncogenes ) or by which cancer manifests itself (tumor antigens , products of tumor cells or reactive products of non-tumor cells).

  • in the narrower (clinical) sense of the word, substances detectable in blood , urine or tissue, which have a higher value in cancer
  • used to refine the diagnosis , monitor the course of therapy and detect disease relapse early
  • they can also be elevated due to non-neoplastic causes
  • they are not used as a comprehensive screening examination, only PSA is used to screen patients at risk for prostate cancer
  • they can be produced directly by tumor cells or by non-tumor cells in response to the presence of a tumor
  • if performed in a suitable selection and at reasonable time intervals, TM examination can be a good assistant to the attending physician - determining the response to treatment, disease progression and patient prognosis
  • tumor markers can be divided according to the place of production, specificity, chemical structure and biological character

Tumor-specific tumor markers[edit | edit source]

  • is related to the presence of certain tumor tissue
  • since there is considerable overlap in TM production in different tumor tissues, specificity is low
  • suitable for monitoring cancer remission 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, it is related to a certain tissue in which a pathological event may take place (e.g. tumor growth)
  • often increased from non-cancerous causes (e.g. PSA in men - prostate; hCG and AFP - embryonic or liver tissue )

Humorous[edit | edit source]

Abbreviation Name Production physiologically Standard Raised at A 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 inflammations
AFP α-fetoprotein yolk sac and fetal liver <10 μg/L cirrhosis , active hepatitis , nonseminomas, germinal tumors ( teratoma ), hepatocellular carcinoma , hepatoblastoma pregnancy
CA 15-3 Carcinoma antigen 15-3 breast cancer , GIT tumors, glandular epithelial tumors hepatopathy, cholangitis , lung disease, renal disorders, pregnancy ↑ Breast cancer – sensitivity 75%, specificity 90%, some GIT tumors
MCA antigen of mucinous carcinomas breast cancer rise earlier than CA 15-3, use for confirmation when CA 15-3 is elevated
CA 19-9 carbohydrate antigen pancreatic cancer , stomach cancer , colorectal cancer , breast cancer obstructive jaundice
CA 72-4 carbohydrate antigen stomach cancer , esophagus cancer , lung cancer , ovarian cancer
CA 125 carbohydrate antigen ovarian cancer benign affections of the ovaries and endometrium, hepatopathy, pancreatitis, pregnancy, menstruation follow-up of ovarian cancer treatment, screening in women with ovarian cancer in the family history
SCC squamous cell carcinoma antigen squamous cell carcinomas
TPA/S tissue polypeptide antigen cell proliferation various cancers ( bladder cancer , ca head and neck cancer) a mixture of about 20 cytokeratins, increases in proportion to the growing tumor
CYFRA 21-1 fragments of cytokeratin 19 non-small cell lung cancer
PSA prostate specific antigen into the fluid of the seminal vesicles for liquefaction of the ejaculate by prostate cells <2.5 μg/l < 50 years

<5 μg/l 50–60 years 8.5< μg/l > 60 years

prostate cancer ejaculation, per rectal examination before sampling, BHP values ​​above 10 μg/l – 50% risk ca, about 20% ca prostate has a PSA in the norm
LD lactate dehydrogenase liver, myocardium, skeletal muscles, erythrocytes 4.10 µcat/l testicular tumors, leukemia , RCC, Hodgkin's lymphoma
ALP alkaline phosphatase sarcoma, prostate cancer obstruction of the bile ducts
ACP acid phosphatase skeletal metastases, prostate cancer
GGT γ-glutamyltransferase metastatic liver involvement alcoholics, bile duct obstruction
NSE neuron specific enolase neuroblastoma , retinoblastoma , malignant melanoma , SCLC hemolysis in CNS tumors it is better to determine in the cerebrospinal fluid
TK thymidine kinase leukemia , lymphomas , non-small cell lung cancer pathway of replacement DNA synthesis
hCG human chorionic gonadotropin placenta trophoblast tumors, choriocarcinoma (100% sensitivity), testicular and ovarian germinal tumors pregnancy screening of people at risk, examination of the β-subunit
PRL prolactin during pregnancy and after childbirth prolactinoma, MEN I slightly during physical exertion, mental stress
CT calcitonin medullary carcinoma of the thyroid gland
Thyroglobulin thyroglobulin follicular carcinoma of the thyroid gland
Ferritin ferritin multiple myeloma , AML , Hodgkin's lymphoma
β2 microglobulin β2 microglobulin CLL , multiple myeloma, lymphomas
Paraprotein paraprotein multiple myeloma Bence-Jones protein
VMA vanillin mandelic acid catecholamine degradation product functional adrenal tumors determination in urine, or determination of metanephrines (plasma, urine)
HIAA 5-hydroxyindoleacetic acid degradation product of serotonin functional carcinoids determination in urine

Cell markers[edit | edit source]

Abbreviation Name Production physiologically Standard Raised at A false positive Note
HER2/neu breast cancer target for monoclonal antibodies (Herceptin), increased expression = worse prognosis

Genetic markers[edit | edit source]

Abbreviation Name Production physiologically Standard Raised at A 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

Links[edit | edit source]

References[edit | edit source]

  1. ↑ Tumor Markers - National Cancer Institute. [online].
  2. ↑ KALOUSOVA, Marta. Tumor Markers - Tumor markers. [online].
  3. ↑ SCHNEIDERKA PETR. Chapters in Clinical Biochemistry . 2., add. and rework Prague: Karolinum, 2004, 365 p.
  4. ↑ PETRUŽELKA LUBOŠ and KONOPÁSEK BOHUSLAV. Clinical Oncology . 1st ed. Prague: Karolinum, 2003, 274 p.
  5. ↑ PRUSH RICHARD. Indicative range of biochemical and hematological examination values ​​according to age groups . 1st ed. Prague: Institute of Clinical Biochemistry and Pathobiochemistry of the 2nd Faculty of Medicine, Charles University, 1999, 41 p.
  6. ↑ VALÍK, D, T ZIMA and O TOPOLČAN, et al. Recommendations of the Czech Society of Clinical Biochemistry (ČSKB ČLS JEP), the Czech Oncological Society (ČOS ČLS JEP) and the Czech Society of Nuclear Medicine (ČSNM ČLS JEP) for the use of tumor markers in clinical practice. [online].
Tumor markers
oncofetal antigens CEA • AFP • CA 15–3
enzymes PSA • NSE • thymidine kinase • LD
hormones hCG • PRL • PTH • ADH
plasma proteins ferritin • β2M • paraprotein
other HIAA • VMK
Cellular ER • PR • HER2/neu
Genetic ATM • BRCA • p53 • Rb1
Portal: Pathobiochemistry

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