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Tumor markers Flashcards

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1
Q

Tumorigenesis occurs due to

A

Growth factors and oncogenes

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2
Q

Meaning of Sensitivity of Tumor Markers

A

No false negatives

Given presence of the disease, the test predicts presence

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3
Q

Meaning of Specificity of Tumor markers

A

No false positives

Given the absence of disease, the test excludes the presence

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4
Q

Challenges of immunoassay for detection of tumor markers

A

Markers above linearity
Hook effect(resulting in false lows)
Heterophile antibodies
Lipemia, hemolysis and antibody cross reactivity cause interference

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5
Q

Examples of Enzyme Tumor markers

A
  1. Alkaline Phosphatase
  2. Creatinine Kinase
  3. Lactate DH
  4. Prostatic acid phosphatase
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6
Q

Alkaline phosphatase is an enzymatic tumor marker present in

A

Bone
Liver
Intestine

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7
Q

Creatine kinase is an enzymatic tumor marker found in

A

Prostate
Lung
Breast
Colon
Ovarian

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8
Q

Lactate dehydrogenase is an enzymatic tumor marker found in

A

Liver
Lymphomas
Leukemias

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9
Q

Prostatic acid phosphatase is an enzymatic tumor marker found in

A

Prostate

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10
Q

Which enzyme is seen in Primary or Secondary liver cancer

A

ALP

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11
Q

Which enzyme level may be helpful in evaluating metastatic cancer with bone or liver involvement

A

ALP

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12
Q

Which regan isoenzyme elevates in ovarian, lung, GI cancers and Hodgkin’s disease

A

Placental ALP

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13
Q

Increased PAP activity may be seen in

A

Osteogenic sarcoma, Multiple myeloma and Bone metastasis of other cancers.
Osteoporosis
Hyperparathyroidism

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14
Q

The clinical use of PAP has been replaced by

A

PSA

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15
Q

PSA exists in 2 forms in blood circulation

A

Complexed PSA (majority)
Free PSA

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16
Q

PSA is more specific than PAP for detecting early cancer T/F

A

T

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17
Q

PSA testing itself is effective in detecting early prostate cancer T/F

A

F. It is not effective

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18
Q

Other prostatic diseases, urinary bladder catheterization and digital rectal exam may lead to a/an increased/decreased PSA level in serum

A

Increased

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19
Q

The ration between free and total PSA is a reliable marker for detection of prostatic cancer from BPH

A

F. It is unreliable

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20
Q

The use of PSA should be together with ………….. and followed by …………. for an accurate diagnosis of cancer

A

Digital Rectal Exam
Transrectal Ultrasonography

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21
Q

Serum level of PSA correlates with

A

Clinical stage
Grade
Metastasis

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22
Q

The greatest clinical use of PSA is

A

Monitoring of treatment

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23
Q

Treatment of Prostatic tumors and cancers include

A

Radical prostatectomy
Radiation therapy
Antiandrogen therapy

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24
Q

PSA levels should fall below the detection limit after treatment for how long

A

2-3 weeks

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25
Androgen Deprivation Therapy may have DIRECT effect on the PSA level that is independent of the anti tumor effect T/F
T
26
Examples of Endocrine Tumor markers
1. Beta-human Chorionic Gonadotropin 2. Calcitonin 3. Adrenocorticotropin Hormone
27
Elevated Calcitonin levels is usually associated with
Medullary Thyroid Cancer
28
Calcitonin reduces/increases CALCIUM concentration
reduces
29
Calcitonin levels are low in patients with cancer of lung, breast, kidney, liver T/F
F. They are high
30
Calcitonin levels are high/low in Hyperparathyroidism
High
31
Calcitonin levels are high in Paget’s disease and pancreatitis T/F
T
32
Calcitonin levels are low in pregnancy T/F
F. They are high Also high in myeloproliferative disorders
33
hCH consists of how many subunits
2. Alpha and Beta
34
hCG is elevated in what conditions
Trophoblastic tumors Choriocarcinoma Germ cell tumors of ovary and testis
35
Oncofetal antigens become detectable in tumor function T/F
T
36
Oncofetal antigens are elevated in fetal development T/F
T. They are normal in fetal development
37
Examples of oncofetal antigens
Carcino-embryonic antigen Alpha-fetoprotein
38
CEA can be used to detect what cancers
Colorectal, Lung, Breast, ovarian and GI cancers
39
CEA levels are elevated in smokers T/F
T
40
CEA levels are elevated in which benign conditions
Cirrhosis Rectal Polips Ulcerative colitis Benign breast disease
41
CEA testing should be used for screening, staging and monitoring therapy. T/F
F. Should not be used for screening. Some tumors don’t produce CEA
42
AFP is synthesized by
Fetal liver
43
AFP is Used to diagnose which types of tumors
Hepatocellular carcinoma Germ cell tumors(testes, ovaries)
44
AFP is useful for screening, determining prognosis and monitoring therapy of liver cancers T/F
T
45
AFP levels greater than what level are indicative of cancer except pregnancy
1000 ug/L
46
AFP is a prognostic indicator of survival T/F
T
47
What’s the measure of serum AFP levels in healthy adults
10 ug/L
48
AFP and hCG combined are useful in
Classifying and staging cell tumors
49
Which markers are antigens on tumor cell surfaces or secreted by tumor cells
Carbonhydrate markers
50
What antibodies have been developed against carbonhydrate markers?
Monoclonal antibodies
51
Most reliable carbonhydrate markers
CA 15-3 CA 125 CA 19-9
52
Which carbonhydrate marker is a marker for Breast Carcinoma
CA 15-3
53
CA 15-3 is not useful for diagnosis. T/F
T
54
Which carbonhydrate marker is non-specific and a marker for ovarian and endometrial cancers
CA 125
55
CA 125 is a non specific marker for
Ovarian and endometrial cancers
56
Uses of CA 125 concerning cancers
1. Detecting residual diseases or recurrence after initial therapy (75% accurate) 2. Differentiating benign from malignant disease in patients with ovarian masses
57
CA 19-9 is a marker for
Colorectal and Pancreatic carcinoma
58
Elevated levels of CA 19-9 are also seen in Hepatobiliary, Gastric, Hepatocellular and Breast cancer. T/F
T Also in pancreatitis and benign GI diseases
59
High CA 19-9 is indicative of recurrence after radiography T/F
F. It is indicative of recurrence before radiography
60
Examples of the Most reliable protein markers
B2-Microglobulin Ferritin Thyroglobulin Immunoglobulin
61
B2-Microglobulin is a marker for
Multiple myeloma Hodgkin lymphoma
62
What protein marker increases in chronic inflammation and viral hepatitis
B2-Microglobulin
63
Ferritin is a marker for
Hodgkin Lymphoma Leukemia Liver, Lung and breast cancer
64
Thyroglobulin is a useful marker for detection of
Differentiated Thyroid Cancer
65
Monoclonal immunoglobulin is used as a marker for
Multiple myeloma
66
Monoclonal paraproteins appear as …………….. in the ……………. area of the Serum Protein Electrophoresis
Sharp Bands Globulin area
67
Bence-Jones protein is a free monoclonal immunoglobulin light chain in the urine and is a reliable marker for
Multiple Myeloma
68
Estrogen and Progesterone receptors are used in breast cancer as indicators for
Hormonal Therapy
69
Patients with negative estrogen and progesterone receptors tend to respond to hormonal treatment T/F
F. Patients with positive receptors respond to hormonal treatment
70
Hormone receptors serve as prognostic factors in breast cancer T/F
T
71
Patients with *positive/negative* receptor levels tend to survive longer
Positive
72
Of patients with breast cancer, what percentage have tumors with estrogen receptor
60%
73
What percentage of patients with estrogen receptor positive tumors respond to hormonal therapy
Two-thirds
74
What percentage of patients with estrogen receptor negative tumors respond to hormonal therapy
5%
75
Progesterone receptor synthesis is independent/dependent on estrogen action
Dependent
76
Measurement of progesterone receptors confirms that all the steps of estrogen action are intact T/F
T

Clinical Pathology (5 decks)

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