Tumor markers

From WikiLectures

Tumor markers (tumor markers, TM) are laboratory detectable marks from which the tumor growth unwound (Proto-oncogenes, oncogenes, anti-oncogenes) or a malignancy which manifests itself (tumor antigens, umor cells or products of the reactive products of non-tumor cells).[1][2]

  • 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
  • use to refine diagnosis, monitor the course of therapy and detect early relapse
  • they can also be elevated by non-tumor causes
  • are not used as nationwide screening, only the PSA is used for screening of patients at risk for Ca prostate
  • they can be produced directly by tumor cells or non-tumor cells in response to the presence of a tumor
  • if the TM examination is performed at the appropriate choice and at reasonable intervals, it can be a good helper 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 tumor 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:

Tissue-specific tumor markers[edit | edit source]

  • rather related to a certain tissue in which a pathological event may take place (eg tumor growth)
  • often increased from non-tumor causes (eg PSA in men - prostate; hCG a AFP – germinal liver tissue)[5][6]

Humoral[edit | edit source]

Abbreviation Name Physiologically produced Standard Increased at False positivity Note
CEA carcinoembryonic antigen epithelial cells during fetal development <3 μg/l ca colorectal, breast carcinoma, lung cancer, ovarian cancer, liver metastases, Cirrhosis, GIT inflammation
AFP α-fetoprotein yolk sac and fetal liver <10 μg/l cirhosis, active hepatitis, nonseminomas, Germinal tumors (teratoma), hepatocellular carcinoma, hepatolastoma pregnancy
CA 15-3 Carcinoma antigen 15-3 breast carcinoma, GIT tumors, glandular epithelial tumors hepatopathy, cholangitis, lung disease, renal disorders, pregnancy breast carcinoma – sensitivity 75%, specificity 90%, some GIT tumors
MCA mucinous carcinoma antigen breast carcinoma rise earlier than CA 15-3, use for confirmation at elevated CA 15-3
CA 19-9 carbohydrate antigen Pancreatic Cancer, stomach cancer, ca colorectal, breast carcinoma obstructive jaundice
CA 72-4 carbohydrate antigen stomach cancer, esophageal 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 ovarian ca in family history
SCC squamous cell carcinoma antigen squamous cell carcinomas
TPA/S tissue polypeptide antigen cell proliferation various cancers (cancer of the bladder, head and neck) 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 ejaculate by prostate cells <2,5 μg/l < 50 let
<5 μg/l 50–60 let
8,5< μg/l > 60 let
Ca prostate ejaculation, per rectum examination before collection, BPH values ​​above 10 μg/l – 50% ca risk, about20 % ca prostate has PSA in the norm
LD lactate dehydrogenase liver, myocardium, skeletal muscles, erythrocytes 4,10 µkat/l testicular tumors, leukemia, RCC, Hodgkin's lymphoma
ALP alkaline phosphatase sarcoma, Prostatic Carcinoma bile duct obstruction
ACP acid phosphatase skeletal metastases, Prostatic Carcinoma
GGT γ-glutamyltransferase metastatic liver disease alcoholics, bile duct obstruction
NSE neuron specifická enoláza neuroblastoma, retinoblastoma, malignant melanoma, SCLC hemolysis in CNS tumors better determined in cerebrospinal fluid
TK thymidine kinase leukemia, lymphoma, non-small cell lung ca. DNA replacement synthesis route
hCG human chorionic gonadotropin placenta trophoblast tumors, choriokarcinoma (100% sensitivity), germinal tumors of the 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 microglobulin β2 microglobulin CLL, multiple myeloma, lymphomas
Paraprotein paraprotein multiple myeloma Bence-Jones protein
VMA vanillic acid catecholamine degradation product functional tumors of the adrenal glands determination in urine, or determination of metanephrines (plasma, urinary)
HIAA 5-hydroxyindoleacetic acid serotonin degradation product functional karcinoids determination in urine

Cell markers[edit | edit source]

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

References[edit | edit source]

References[edit | edit source]

  1. Tumor Markers - National Cancer Institute. [online].
  2. KALOUSOVÁ, Marta. Tumor Markers – Nádorové markery. [online].
  3. SCHNEIDERKA PETR. Kapitoly z klinické biochemie. 2., dopl. a přeprac. vyd. Praha: Karolinum, 2004, 365 s.
  4. PETRUŽELKA LUBOŠ a KONOPÁSEK BOHUSLAV. Klinická onkologie. 1. vyd. Praha: Karolinum, 2003, 274 s.
  5. PRŮŠA RICHARD. Orientační rozmezí hodnot biochemických a hematologických vyšetření podle věkových skupin. 1. vyd. Praha: Ústav klinické biochemie a patobiochemie 2. lékařské fakulty UK, 1999, 41 s.
  6. VALÍK, D, T ZIMA a O TOPOLČAN, et al. Doporučení České společnosti klinické biochemie (ČSKB ČLS JEP), České onkologické společnosti (ČOS ČLS JEP) a České společnosti nukleární medicíny (ČSNM ČLS JEP) k využití nádorových markerů v klinické praxi. [online].

Kategorie:Patobiochemie Kategorie:Vnitřní lékařství Kategorie:Chirurgie Kategorie:Onkologie Kategorie:Klinická biochemie