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4. Tumor markers


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What are 6 classes of tumor markers?
1. Enzymes
2. Glycoproteins
3. Hormones
4. Hormone receptors
5. Oncofetal proteins
6. Cell markers
What are the 8 most commonly encountered cancers?
1. Lung cancer
2. Prostate cancer
3. Breast cancer
4. Colorectal cancer
5. Ovarian cancer
6. Cervical cancer
7. Testicular cancer
8. Liver cancer
What tumor markers assoc. w/: -benign prostatic hyperplasia?
-prostate cancer?
Prostate: PSA 3+, BRCA-1 1+
What tumor markers assoc. w/:
Breast cancer?
BRCA-1 and 2
Estrogen/Progest receptors
CA 15-3
CEA, CA 19-9, CA-125
What tumor markers assoc. w/:
Stomach cancer?
CA 19-9
What tumor markers assoc. w/:
Colorectal, Lung, and Ovarian
All have: BCRA-1, CA 15-3, CEA, CA 19-9, and CA-125.

-Lung does not have BCRA-1
-Pancreas has BCRA-2 inst of 1
-Colorectal has 3+ CEA
-Ovarian has 3+ CA125
-Pancreas has 3+ CA 19-9
What tumor markers assoc. w/:
Testicular cancer?
-Beta-hCG --> 3+
-AFP/AFP-L3 --> 3+
What tumor markers assoc. w/:
Liver cancer?
-CEA --> 1+
-AFP/AFP-L3 --> 1+
What are 3 screensfor prostate cancer?
1. Digital rectal exam DRE
2. Prostatic acid phosph. PAP
3. Prostate specific antigen PSA
What is PSA?
a kallikrein enzyme in serum, urine, and semen.
How does PSA exist in the body, and what is the dominant form foundin in prostate cancer?
Complexed as PSA-ACT or PSA-MAC.

Dominant: PSA-ACT
What is the normal PSA ref range?
< 4 ng/ml
How is the need for biopsy determined?
-If the PSA is >10 and DRE pos, always biopsy.
-If PSA is 4-9.9 and DRE pos, biopsy.
-If PSA is 4-9.9 and DRE neg, Usually biopsy.
-If PSA is 4 and DRE is neg, Watchful waiting.
What are the options for colorectal cancer screening?
-Occult blood
-Carcinoembryonic antigen (CEA)
-CA 19-9
What is CEA, and what is it used for?
Carcinoembryonic Antigen
-Only for MONITORING colon cancer, NOT for diagnosis.
-only in 50% of colon ca.
what are 3 methodologies for tumor marker assays?
1. Histologic
2. Molecular
3. Immunogenic

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