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24 Cards in this Set
- Front
- Back
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What are two uses of tumor markers? |
1. detection 2. detecting recurrence or metastasis 3. monitoring response to therapy 4. aid in choice of therapy |
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What are prognostic markers? |
Generally used to describe molecular markers that predict disease-free survival, disease specific survival, and overall survival |
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What are predictive markers? |
Used in the context of predicting response to certain therapies |
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Using multiple tumor markers for diagnosis increases what? |
Sensitivity and Specificity |
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Types of Tumor Markers
-Serum Proteins or Molecules do what? |
They are indicative of host injury and response. Not specific for malignancy, but show inflammation (acute or chronic) |
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Types of Tumor Markers
-Ectopic Hormones as Tumor Markers
What are some characteristics of these?
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Secreted by tumor cells into circulation Fxnally identical to the native hormone Produce clinical syndromes (paraneoplastic) Assayed in serum |
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What are some examples of Ectopic Hormones that are used as tumor markers?
What does this hormone cause? |
TQ
PTH (parathyroid hormone)
-Can cause hypercalcemia in lung cancer (lytic bone metastasis can too) |
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Types of Tumor Markers
-Hormone Receptors Where are these found and where are they assayed? |
Found on the cell membrane or in the cytoplasm
Assayed in tissue, not in serum |
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What are two common hormone receptors used as tumor markers? |
Estrogen and Progesterone |
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What are Oncofetal Antigens? |
Produced by fetal cells during development but not normally produced by adult cells
Also produced by tumor cells by “de- differentiation” |
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How are Oncofetal antigens used as tumor markers? |
Used primarily to detect recurrence and metastasis, to follow the response to therapy, and to assess prognosis |
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What are two examples of Oncofetal antigens? |
1. carcinoembryonic antigens 2. alpha- fetoprotein |
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What is CEA or Carcinoembryonic Antigen? |
Glycoprotein produced by mucin-secreting glandular epithelium in the fetus |
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CEA is elevated in 60-90% of what kind of carcinoma? |
Colorectal Carcinoma |
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Levels of CEA rise in disease when? |
With recurrent and metastatic disease
Levels fall with decreased tumor burden |
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What are some benign condition associated with CEA? |
-Cigarette smokers -Inflammatory bowel disease -Alcoholic cirrhosis -Hepatitis |
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What is the Oncofetal antigen Alpha-fetoprotein and what is it synthesized by? |
A glycoprotein that is a predominate component of serum proteins in early embryonic life
Synthesized by fetal yolk sac, fetal liver, fetal gastrointestinal tract, and in minute amounts by the adult liver |
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AFP or Alpha-fetoprotein is elevated in 60-75% of what kind of carcinoma? |
Hepatocellular Carcinoma |
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What type of benign conditions can cause elevation of AFP? |
– Cirrhosis – Massive liver necrosis – Normal pregnancy |
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What are two examples of clinically useful Enzymes as tumor markers? |
-Alkaline phosphatase -Acid phosphatase |
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What use does Alkaline phosphatase have as a tumor marker? |
Detects osteoblastic lesions from the bone (like osteosarcoma). Is derived from the tumor itself |
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What are some benign conditions that could cause elevated levels of ALP or Alkaline Phosphatase? |
– Pregnancy (normal) – Hepatitis – Fractures |
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What use does Acid phosphatase (ACP) have as a tumor marker? |
Detects prostatic carcinoma and osteolytic metastasis (bone) |
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What are some benign conditions that can cause elevated levels of ACP or Acid phosphatase? |
-benign prostatic hyperplasia -mechanical trauma to prostate |
