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Tumor Markers Flashcards

(58 cards)

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1
Q

what is a tumor?

A

abnormal growth of cells (benign or malignant)

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2
Q

what are environmental contributors of tumors?

A 
tobacco (1a or 2a)
benzene
excess EtOH
dietary (charred meat)
poisonous mushrooms
excessive sun exposure
genetics
obesity
radiation
HPV, HIV, Hepatitis B
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3
Q

what are the major factors that affect cancer?

A

location of origin
cell type
stage at diagnosis
resection

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4
Q

what is a tumor marker?

A

blood or urine test that is used to diagnose a malignancy, monitor recurrence, monitor treatment or screening

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5
Q

AFP

A

alpha-feta protein

-glycoprotein produced by fetal liver

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6
Q

when is the AFP elevated?

A

pregnancy
HCC (hepatocellular carcinoma)
gonadal cancers
gastric cancer and others

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7
Q

what is the diagnostic level of AFP if the pt is at a high risk for HCC?

A

serum levels of >500 mcg/L

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8
Q

what are the normal levels of AFP?

A

0-8 ng/mL

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9
Q

HCC is normally seen in what type of pt?

A

cirrhosis, chronic liver disease, hepatitis

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10
Q

what are the symptoms of HCC?

A 
vague abdominal pain
unexplained weight loss
elevated LFT
feel a mass
early satiety (full to easy)
obstructive jaundice
hepatomegaly
ascites (fluid leaking out of the liver)
paraneoplastic syndrome
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11
Q

hypercalcemia of malignancy

A

common in cancer patients

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12
Q

testicular cancers

A

germ cell tumors

-one of the most curable solid neoplasms

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13
Q

seminoma

A

most common type of testicular cancer

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14
Q

nonseminoma

A

less common type of testicular cancer

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15
Q

what is the current 5 yr survival rate of testicular cancer

A

> 95%

  • mostly they present as stage 1
  • use of platinum based combination chemotherapy
  • highly sensitive tumor markers to detect residual tumor
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16
Q

when is LDH used?

A

as a tumor marker for melanoma, lymphoma, leukemia, testicular cancer

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17
Q

which tumor markers should be elevated in nonseminoma germ cell tumors

A

AFP and or beta hCG

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18
Q

NSGCT

A

non-seminomal germ cell tumor

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19
Q

when would you use AFP?

A

monitoring response to treatment or as a screening tool for high risk patients

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20
Q

when would you use beta hCG

A

follow treatment because the tumor will produce it

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21
Q

what does LDH stand for?

A

lactate dehydrogenase

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22
Q

why would LDH increase

A

increased cell turnover in malignancies, which is why the LDH will rise

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23
Q

melanoma

A

bad dog, five year survival rate depends on stage of disease at the time of diagnosis

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24
Q

what are considered the “major” features

Study These Flashcards
A

change in size
change in color
change in shape

25
what are considered the "minor" features
inflammation bleeding or crusting sensory change lesion diameter
26
which tumor marker do you use with melanoma?
LDH
27
what tests will you do with melanoma?
CBC serum LDH chest xray for baseline (melanoma loves to met to the lungs) CMP
28
what are the main four classes of lymphoma
ALL, CLL, AML, CML | lymphoblastic or myeloblastic
29
when are most blood cancers detected?
stage III or stage IV
30
what is the prognosis with acute leukemias?
AML, ALL | rapidly fatal if untreated
31
what is the prognosis for chronic leukemias
CML, CLL | may survive for years with modest treatment
32
NHL
non-Hodgkin lymphoma
33
classifications of lymphomas
Hodgkin or non | B-cells or T-cells
34
CEA
carcinoembrionic antigen (0-3 ng/mL)
35
what is CEA?
oncofetal protein that is elevated in the serum of pts with a variety of cancers including CRC (colorectal cancer)
36
why is CEA not a good screening marker?
it can be elevated in a lot of other things as well, smoker, UC, gastritis, peptic ulcer, diverticulitis
37
why would you use CEA?
established colon cancer - CEA should return to baseline after complete resection (tumor would be present if it doesn't) - make sure they are not on chemo (can irritate GI and cause CEA to be falsely high)
38
CA 19-9
``` tumor marker related to the pancreatic hepatobiliary (very sensitive and specific) used to diagnose pancreatic cancer cholangiocarcinoma -bile duct -gall bladder cancer ```
39
what is the best mode of action for pancreatic cancer?
surgical resection is the only potential curative treatment
40
what are the tumor markers for breast cancer?
CA 15-3 | CA 27-29
41
invasive breast cancer
not sure
42
in situ breast cancer
not sure
43
when would you use CA 15-3 and CA 27-29
follow pts with previous occurrence of br CA - more useful in metastatic disease rather than screening - if it goes up, I am wanting to follow it
44
CA 125
ovarian cancer tumor marker - early stage 50% show elevation - late stage 80% show elevation
45
when are most ovarian cancers discovered?
stage III
46
CA 125 can also be elevated in
other issues that have to do with the gut
47
PSA (prostate specific antigen)
**may be used for screening*** glycoprotein expressed by both normal and neoplastic prostate tissue -consistently expressed in nearly all prostate cancers
48
normal range of PSA
<4 ng/mL
49
PSA range can change according to
age (prostate size increases with age)
50
what can influence prognosis?
ethnicity (AAM may have more aggressive, diagnosed later, asian men have few and WM have lower "normal" range of PSA)
51
what are markers for carcinoid tumor?
5HIAA Seratonin Chromagranin A (byproducts that the tumor produces)
52
where are carcinoid tumors most common
GI, lung
53
what type of test is 5HIAA
urine
54
carcinoid tumor
tumor itself
55
carcinoid syndrome
constellation of symptoms that may continue even after resection
56
what is the normal value for SPEP?
not observed
57
SPEP
used to specifically look for an abnormal protein (monoclonal protein) -used to diagnose multiple myeloma (cancer of the bone marrow)
58
multiple myeloma
body makes abnormal plasma cells that go out into the blood

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