TUMOR MARKERS Flashcards by Kristtialyn A.

Used to diagnose cancer and categorize types of cancers

Tumor Markers

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What tumor markers determine?

Tumor burden

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What are the Ideal Tumor Markers?

Specificity
Lead time
Sensitivity
Short half-life
Cost effective

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It is highly specific to a given tumor and present in patients with malignancies

Specificity

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Should not be seen on healthy individuals; only in _______ if ever present.

Specificity; trace amounts

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Produce measurable amounts even in small quantities

Lead Time

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Low false positive rates

Sensitivity

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Indicates precise progression or regression of tumors

Short half-life

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Inexpensive and acceptable to the target population

Cost effective

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2 Classification of Tumor Markers

According to Location
According to Chemical Structure

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What are included in According to Location?

a. Circulating tumor markers
b. Tumor tissue markers

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What are included in According to Chemical Structure?

a. Enzymes
b. Hormones
c. Oncofetal antigens
d. Tumor-associated antigen
e. Special serum proteins
f. Miscellaneous markers

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Where Circulating tumor markers can be found?

Blood
Urine
Stool
other body fluids

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Tumor tissue markers can found in:

Actual Tumors

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Circulating Tumor Markers can be used to:

Estimate prognosis
Detect residual disease
Assess treatment response
Monitor resistance to treatment

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Tumor tissue markers can be used to:

Diagnose, stage, and or classify cancer
Estimate prognosis
Select an appropriate treatment

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What are the Enzymes that are included in Chemical Structure of Tumor Markers?

Acid Phosphatase (ACP)
Alkaline Phosphatase (ALP)
Lactate Dehydrogenase (LDH)
Terminal Deoxyribonucleotidyl transferase (TdT)
Neuron-specific enolase

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> 3ng/mL: prostatic cancer (advanced phase)

Acid Phosphatase (ACP)

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Metastases to bone
Liver and osteogenic sarcoma

Alkaline Phosphatase (ALP)

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Lactate Dehydrogenase

Cervix
Colon
Leukmia
Liver
Lymphoma

C2L3

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Increases concentration in RBC

LD1 & LD2

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Increase LDH

Increase RBC destruction in leukemic states

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Leukemia

Terminal Deoxyribonucleotidyl transferase (TdT)

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Neuron-specific enolase

Brain Tumor
Neuroblastoma
Small cell tumor of lungs

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What are the Hormones in Chemical structure?

Adrenocorticotropic Hormone Calcitonin Catecholamines Human chorionic gonadotropin (Beta-HCG) Thyroid kinase

Human Chorionic gonadotropin (Beta-HCG)

Choriocarcinoma Germ cell tumor (ovary and testes) Pregnant Trophoblastic tumors (CGPT)

Catecholamines

Ganglioneuroma Neuroblastoma Pheochromocytoma Produced by Adrenal gland

Calcitonin

Medullary thyroid tumor

Adrenocorticotropic hormone

adrenals Cell carcinoma of lung

Thyroid kinase evaluate disease spread in patients with:

Brain tumor breast cancer Leukemia Lymphoma Small cell lung tumor (B2L2S)

What are Oncofetal Antigens?

Alpha-fetoprotein (AFP) Carcinoembryonic antigen (CEA)

>1200ng/mL: confirm the diagnosis of primary liver (hepatocellular) cancer

Alpha-fetoprotein(AFP)

Alpha-fetoprotein: (percentage) specific: non-seminoma germ tumor

60%

Cancers in Alpha-fetoprotein

Pancreas Lungs Ovary Testes Gastric (PlotG)

It is Colorectal Cancer

Carcinoembryonic antigen (CEA)

Carcinoembryonic Antigen

Breast Lungs Metastases

What are the tumor associated antigen?

Carcinomic Antigen •CA 15-3 •CA 125 •CA 19-9 •Prostate specific antigen (PSA)

CA 15-3 >30U/mL:______

Breast Cancer

CA 125 >35U/mL:______

Breast cancer Benign/malignant gynecological disease Cervical cancer Endometrial cancer

CA 15-3 Others: ______

Cervical GI Ovarian Lung Prostatic CGOLP

CA 125 Others:

Lung cancer Peritoneal malignant mesothelioma Prostatic cancer

CA 19-9 is more specific in?

Pancreatic and Liver cancer

CA 19-9

•Gastrointestinal tumors •Colorectal, Gastric, and Ovarian Cancer

Prostate Specific Antigen is specific for?

Prostatic Cancer

What are the Special Serum Proteins?

Beta-2-Microglobulin Bombesin Ferritin S-100 Protein Thyroglobulin (B2FST)

Hodgkin’s Lymphoma

Ferritin

Follicular Thyroid carcinoma

Thyroglobulin

Iron binding capacity

Ferritin

Acute Leukemia

Ferritin

Lungs Liver Prostatic Cancer

Chronic Lymphoid Leukemia & Lymphomas

Beta-2-Microglobulin

Breast Colorectal cancer Lung Pancreatic

Bombesin

Gastric cancer Neuroblastoma Pancreatic cancer small cell carcinoma of lungs

Prognostic factor of S-100 Protein

Malignant melanoma

S-100 Protein

Astrocytoma Glioblastoma Meningioma Neurinoma

What are the Miscellaneous Markers?

Polyamines Nucleosides Tissue polypeptide antigen (TPA)

Elevated in URINE in cases of rapid generation of cells of certain tissue

Polyamines

Spermine Spermidine Putrescine

Nucleosides are component of?

RNA

Nucleosides

Dimethyl guanosine Pseudoridine

Enters the circulation in large amounts in cases of enhanced cellular proliferation=malignant processes

Nucleosides

Non-specific marker of enhanced cellular proliferation

Tissue Polypeptide antigen

Immunologic detection relies on:

Monoclonal antibodies

Specific antibodies are incubated with tissue sections

Immunohistochemistry & Immunofluorescence

It detects the presence/abscence of antigen

Immunohistochemistry & Immunofluorescence

Colorimetric or fluorescent secondary antibodies

Immunohistochemistry & Immunofluorescence

It is the most commonly used method to measure tumor markers

Immunoassays

Example of Immunoassays

Radioimmunoassay (RIA) & Enzyme-linked immunosorbent assay (ELISA)

Automate testing & rapid analysis

Immunoassays

What are the methods of detection of tumor markers?

I. IMMUNOLOGIC DETECTION II. HIGH-PERFORMANCE LIQUID CHROMATOGRAPHY III. ENZYME ASSAY IV. FLOW CYTOMETRY V. CYTOGENETIC ANALYSIS VI. GENETIC ANALYSIS VII. PROTEOMICS

It is commonly used to detect small molecules

High-perfomance liquid chromatography

It detect catecholamine metalobites in plasma and urine

High-performance liquid chromatography

Requires more experience and skill than automated immunoassays

High-performance liquid chromatography

Enzyme Assays

ALP & LDH

ALP:

Bone liver leukemia sarcoma

LDH:

Liver Lymphomas Leukemia others

Analyze the presence and percentage to antibody tagged cells

Flow Cytometry

What are the Cytogenetic Analysis?

a. Fluorescent in-situ hybridization b. Spectral karyotyping c. Comparative genomic hybridization

What are the Genetic analysis?

a.Sequencing (automated) b. Reverse transcription c. Gel electrophoresis d. DNA micro-array analysis

Surface enhanced laser desorption/ionization

Proteomics

TUMOR MARKERS Flashcards

(80 cards)