TUMOR MARKERS Flashcards
(127 cards)
1
Q
Tumor Marker types
[6]
A
enzymes
proteins
hormones
oncofetal antigens
metabolites
receptors
2
Q
ENZYMES
—Located [inside/outside] the cells; Each organ has specific enzymes
— [Specific/Nonspecific] that can be cancer indicator.
— A variety of enzymes are → # [INC/DEC] nonspecifically in tumors.
- tend to correlate with _______, making them clinically useful for monitoring the success of therapy.
A
inside
nonspecific
INC
tumor burden
3
Q
Tumor markers of ENZYMES
[4]
A
PSA+ACP
LD
ALP
Neuron-specific enolase
4
Q
an enzyme that is more definitive indicator of cancer
A
PSA + ACP
5
Q
Methods for tumor markers:
PSA+ACP
LD
ALP
Neuron-specific enolase
A
IA
EA
EA
RIA/HCC
6
Q
Clinical utility for tumor markers:
PSA+ACP
Neuron-specific enolase
A
Screening: Prostate CA
Therapy: monitoring/recurrence
Prognosticator indicator
Monitoring: progression for neuroendocrine tumors
7
Q
ENZYMES associated with certain malignant diseases [6]
A
Lysozyme
LDH
Sialytransferase
Fucosyltransferase
Thymidine kinase
TdT
8
Q
Malignant disease associated with Lysozyme
A
Colon cancer
Monocytic/Myelomonocytic Leukemia
9
Q
Malignant disease associated with LDH
A
Leukemia
Lymphoma
Breast& Lung cancer
Germ cell tumor
Metastatic colon
10
Q
Malignant disease associated with Sialytransferase
A
Nonspecific
11
Q
Malignant disease associated with Fucosyltransferase
A
Multiple Malignant tumor
12
Q
Malignant disease associated with Thymidine Kinase
A
Hodgkin’s lymphoma
Lung’s small cell carcinoma
13
Q
Malignant disease associated with Terminal dioxyribonucleotidase transferase
A
Immature lymphocytes
14
Q
Isoenzymes associated with malignant diseases
A
CK-BB
Type 2 Macro-CK
Mitochondrial CK-1IgA complex
Placental like ALP
Liver ALP
Bone ALP
LD1, LD4, LD5
15
Q
Malignant disease associated with CK-BB
A
ADENOMA CARCINOMA OF
prostate
stomach
lungs
16
Q
Malignant disease associated with Type 2 macro-ck
A
Metastatic liver cancer
17
Q
Malignant disease associated with Mitochondrial CK-IgA complex
A
[Prognosticator indicator] advance tumor
18
Q
Malignant disease associated with Regan
A
Germ cell tumors
Ovarian cancers
19
Q
Malignant disease associated with Liver ALP
A
Liver metastasis
Seminoma
Ovaraian cancer
20
Q
Malignant disease associated with Bone ALP
A
Bone metastasis
Osteoma
21
Q
LD1, LD4, LD5
A
Advance stage cancer
Testicular germ cell tumor
22
Q
— Carcinoembryonic proteins produced during fetal dev’t
— [X] indicate cancer BUT as a person grows → these proteins diminishes → & when it is redetected → used as indicator of cancer.
A
Serum proteins
23
Q
Under normal conditions expression of all protein is subjected to?
A
genetic regulation
24
Q
Tumor markers of serum protein [3]
A
Serum M-protien
Serum free light chain
B2-microglobulin
25
Tumor marker of serum protein associated with hematologic malignancies
B2-microglobulin
26
Methods for tumor markers:
Serum M-protein
Serum free light chain
B2-microglobulin
SPE/IFE
IA
IA
27
Clinical utility of serum m-protein & serum free light chain
Dx of plasma cell dyscrasia TM
28
Clinical utility of B2 microglobulin
[Prognostic marker] Lymphoproliferative diseases
29
— by endocrine organs just like enzymes
— Usually made up of ______.
Widely used as a SPECIFIC MARKERS OF SECRETING TUMORS.
Hormones/Metabolites
30
When there is an increase in the presence of tumor in the hormone-producing organs what happens? [2]
Tumor compresses the tissues/organs
Overproduction of hormones
31
Tumor markers of hormones/metabolites [13]
HVA & VMA
Metanephrines
Catecholamines
5'HIAA & Serotonin
Calcitonin
PTH
GH
PRL
ACTH
Cortisol
ADH
Chromogranina
C-peptide
32
Tumor types/Clinical utility of HVA/VMA
Pheochromocytoma
Paraganglioma
Neuroblastoma
33
TM types of:
Metanephrines
Catecholamines
Severe aplastic anemia
Pheochromocytoma
Severe aplastic anemia
Pheochromocytoma
Paranganglioma
Neuroblastoma
34
TM types of 5-HIAA & serotonin
Carcinoid tumors
35
TM types of Calcitonin
Medullary thyroid cancer
Neuroendocrine tumors
36
TM types of PTH
Pituitary adenoma
37
TM types of GH
Pituitary adenoma
Ectopic GH- tumor surgical secreting
38
Method of PRL
IA
39
TM types of ACTH
Pituitary adenoma
Ectopic ACTH- producing tumor
40
TM types of Cortisol
Adrenal tumor
41
TM types of ADH
Posterior pituitary tumor
42
TM types of Chromagranina
Pheochromocytoma
Neuroblastoma
Carcinoid tumors
Small cell lung CA
43
Clinical utility of C-peptide
insulinoma affecting b-cells islet of langerhans = glucanoma. [glucagon]
44
Methods of:
HVA/VMA
Metanephrines
Catecholamines
5-HIAA & Serotonin
HPLC
HPLC
HPLC
LC-MS
MS
HPLC
45
Methods of:
Calcitonin
PTH
GH
PRL
ACTH
Cortisol
ADH
IA
46
Methods of:
Chromogranina
C-peptide
ELISA
RIA
47
ANTIGEN
_________– one of the 1st tumor markers discovered
- [+] fetal development; [-] as person grows
- When it is redected= ________.
[2] – expressed transiently during normal development and are then turned on again in the formation of tumors. _
___________were directly identified from human tumor extracts / cell lines. These are directed toward specific [2] and are best used for monitoring treatment of tumor that secrete these ______.
Oncofetal Ag
malignancy
CEA & AFP
Monoclonal defined Ag
CA
specific carbohydrates
epitopes
48
TUmor markers of Antigen
[4]
CA-19-9
CA 15-3
CA 27-29
CA 125
49
CA 19-9 tumor type + clinical utility
GI cancer
Adenocarcinoma
Pancreatic CA
50
CA 15-3 & CA 27-29 tumor type
Breast cancer
Metastatic carcinoma
51
CA-125 tumor type
Ovarian cancer
52
— used to classify tumors for therapy = Good TM
Prototypic examples of such a marker are [2]
Receptors
Estrogen
Progesterone receptor
53
UNDER RECEPTORS
Solid tumor biopsies [+] these markers → _________ is more likely to be effective.
_________ this receptor → will respond to chemotherapy
Tamoxifen chemoterapy
Breast cancer
54
Tumor markers of RECEPTORS
[4]
Estrogen receptor
Progesterone receptor
He-2/Neu
Epidermal GF receptor
55
Method used for all Antigen Tumor Markers
IA
56
Methods for Tumor markers:
Estrogen receptor
Progesterone receptor
He-2/Neu
Epidermal GF receptor
IHC
IHC
IHC, FISH, ELISA
IHC
57
— One of the oncofetal protein which decreases in adult levels [age: _______]
— Synthesized by the fetal ____.
Alpha-fetoprotein
7-10 months
liver
58
AFP is involved in regulating _______in the fetus.
when AFP is redetected during malignancy, it is classified as a _________ protein.
oncotic pressure
carcinoembryonic protein
59
AFP is increased in what conditions? [3]
Hepatocellular carcinoma/HCC
Germ cell tumors
Neural tube defects [Spina bifida]
60
AFP is decreased in what conditions? [3]
Down syndrome
61
Experts recommend AFP to be used in high risk developing _____ patients; patients with ________virus induced ________.
HCC
Hepa B/C
liver cirrhosis
62
AFP
[#] kD glycoprotein related to albumin
Upper normal limit: [#] ng/mL.
70
15
63
AFP
--Completely [specific/ not specific] with a sensitivity levels of: [2]
Not specific
40%-65%
80%-95%.
64
Major use of AFP is the classification and monitoring therapy of ________.
[2 TYPES]
Testicular CA
Seminomatous testicular CA
Nonseminomatous testicular CA
65
tumor formed directly from malignant germ cells; slow growing
Seminomatous testicular CA
66
Nonseminomatous testicular CA came from ______, and it spreads [slow/fast]. Differentiation [4]
other sources.
fast
Yolk sac tumors
Embryonal carcinoma
teratoma
choricarcinoma
67
Nonseminomatous testicular CA increased in AFP
Yolk sac tumors
Embryonal carcinoma
68
Nonseminomatous testicular CA increased in HcG
Choriocarcinoma
69
AFP Staging of Nonseminomatous testicular cancer
[3]
Stage 1: 10-20%
Stage 2: 50-80%
Stage 3: 90-100%
70
2 Methods of AFP
Automated IA
In serum/amniotic fluids
71
— a murine monoclonal antibody raised against a serous ovarian carcinoma cell line.
— expressed in the ovary, in other tissues of ______ duct origin [embryonic tissue] + human ovarian carcinoma cells.
CA-125
Mullerian
72
— ONLY CLINICALLY ACCEPTED SEROLOGIC MARKER OF OVARIAN CANCER but is [X] Specific.
CA 125
73
CA 125 levels w/ ovarian cancer stage:
▪ Stage I – increases by ___%
▪ Stage II – increases by ____%
▪ Stage III and IV – increases ____%
50%
90%
>90%
74
CA 125 is FALSELY [INC]: ewandi
E1D/EWANDI
Endometriosis
1st trimester of pregnancy
During menstruation
75
Methodology for ca 125
IA with the use of OC 125 + M11 Ab
76
Upper normal limit of CA 125
35 u/ml
77
— HMW mucin glycoprotein expressed by various adenocarcinoma especially those associated with the breast
CA 15-3
78
True or False
Carcinoembryonic Ag is more specific/sensitive than Metastatic Cancer
False
79
CA 15-3 is falsely increased in what conditions?
Chronic hepatitis
Liver cirrhosis
Sarcoidosisis
TB
SLE
80
Upper normal limit of CA 15-3
25U/ml
81
— glycoprotein produced only in the epithelial cells of the acini and prostatic ducts in the prostate.
Prostatic Specific Antigen
82
PSA is a serine protease of the _______ gene family and functionally regulates _____ fluid viscosity & instrumental in dissolving the_______ [protects egg cell] → allowing sperm to enter.
kalikrein
seminal fluid viscosity
cervical mucus gap
83
2 forms of PSA IN THE BLOOD:
1. ________– unbound
2. ________ – bound w/ [2]
Free
Complexed
a1-antichymotrypsin
a2-macroglobulin
84
FALSELY increased values of PSA:
Benign Prostatic Hyperplasia
Recent ejaculation & Direct rectal exam
Irritation
Prostate infection
85
Known interferences of PSA [FALSE NEGATIVE]
[2]
Hook effect
Human anti-animal Ab/HAMAS
86
METHODOLOGY:
IA: free + complexed PSA [both, if not, which one?]
Which is used?
a1-antichymotrypsin
OR a2-macroglbulin
Standard total cutoff: _____.
both
a1-antichymotrypsin
<4ng/ml
87
— HMW mucin indicator of pancreatic cancer
— Related to ______blood group substance
EXAMPLES: [2]
ca-19-9
lewis
Lea [a+, b-], Lea [a-,b+]
88
PSA INDICATOR: GLPC
— [INC] various adenocarcinoma:
Gastric
Lung
Pancreatic
Colorectal
GALUPAC
Gastric
Lung
Pancreatic
Colorectal
89
Upper Normal Limit is 37U/mL
CA 19-9
90
— Large heterogenous glycoprotein that is part of the Ig superfamily and is involved in apoptosis, immunity, cell adhesion.
Carcinoembryonic Antigen/CEA
91
— # used tumor marker for COLORECTAL CANCER and is also # [INC] Lung, Breast, and GI tumors
CEA
92
CEA is FALSE POSITIVE in what conditions?
HLCRA/hala sira
Heavy smoking
Liver damage
Chemoterapy
Radiation treatment
93
CEA
Half-life: ____ days
Upper Normal Limit:
Definitve Malignancy:
2-8 days
2.5-5 ng/ml
>10ng/ml
94
Methodology of CEA
[Assay] + use of ________.
essential that the same assay be used for _____ monitoring.
- monitored every ______ to detect recurrence and determine therapy efficacy.
IA + monoclonal anti-CEA antibodies
serial monitoring
2-3mos
95
— Major soluble protein of the
chromaffin granules
— catecholamine storage vesicle — released from adrenal medulla w/ catecholamines
Chromogranin A
96
Chromogranin A is an INDICATOR of what conditions:
[5]
Pheochromocytoma
Neuroblastoma
Peptide producing tumor
Pancreatic tumor
Small cell lung cancer
Carcinoid tumor
97
— localized in the nuclei of mammary & uterine tissue
Estrogen/Progesterone receptor
98
— GOOD TUMOR MARKER – small tendency of reoccurrence ← due to it being present.
Estrogen/Progesterone receptor [ER/PgR]
99
— Used to identify PX MOST LIKELY TO BENEFIT FROM ENDOCRINE THERAPY
— Px whom primary tumor is rich to this → after ________ → experience longer disease-free interval.
ER/PgR
mastectomy
100
Human Chorionic Gonadotrophin
— [#] kD glycoprotein consisting of [2] subunits.
— dimeric hormone normally secreted by _______ in the placenta to maintain the ________ during pregnancy.
45
alpha
beta
trophoblasts
corpus luteum
101
__________IT IS UNIQUE:
— Degraded into multiple fragments:
HCG
Free beta subunit
Hyperglycosylated form
Intact molecules
Nicked hCG
102
HCG [INC]
— _____ hCG: in malignancies — ______ hCG: nonseminomatous tumors
beta
free-beta
103
HCG INDICATOR + ELEVATED:
Trophoblastic tumor
Choriocarcinoma
Germ cell cancer [ovary,testes]
Gestational Trophoblastic disease
104
Gestational Trophoblastic disease of HCG is comprised of? [4]
choriocarcinoma
hydatid form mole
placental site
persisent/invasive gestational trophoblastic neoplasia
105
METHODOLOGY of HCG
_________ capture & tracer
Ab targeted toward epitopes in the [2] hCG.
________: most useful because they detect both intact hormone and free b-hCG
Monoclonal
beta subunits
intact hCG
Total beta HCG assays
106
APPLICATION & PATHOPHYSIOLOGY of HCG
Nonseminomatous testicular cancer → ________ [INC] in [#]% - [#]% of patients
In combination with _____ + _______ → diagnose subtypes of testicular cancer
free-beta HCG
60%
70%
AFP
Biopsies
107
Detected by Pregnancy Kits
HCG
108
— acidic metabolites of catecholamines
HMV & VMA
109
— Excreted in larger than normal amount in px w/ tumor originating from _______ [embryonic tissue]
HMV & VMA
neural crest
110
SQUAMOUS CELL CARCINOMA ANTIGEN (SCCA)
||INDICATIVE OF:
Squamous cell carcinoma:
[7 organs/body parts]
head
neck
esophagus
lung
renal failure
advanced cervical CA
anal canal
111
________ is increased in hematologic malignancies:
[4]
Lipid associated sialic acid in plasma
Leukemia
Lymphoma
Hodgkin's lymphoma
Melanoma
112
— gamma subunit of an enolase isoenzyme in the glycolytic pathway
Neuron-specific enolase
113
NSE is an INDICATOR
of:
[2]
Neuroendocrine tumor Neuroblastoma [children]
114
NSE is increased in tumors originating from the neuroendocrine cell system:
[2 conditions]
insulinomas
glucanomas
115
NSE values is highest in these 2 conditions:
Small cell lung cancer/Oat cell cancer [LOS]
116
— low molecular weight protein
— part of constant L-chain of MHC locus Ag that is expressed on the surface of # nucleated cell.
— secreted by all nucleated cells
B2-microglobulin
117
What is the specific marker of B2 microglobulin?
high cell turnover [hich cell proliferation]
118
It is increased in solid tumor and inflammatory disorders like RA, SLE, Sjogren’s, and Chron’s disease
B2-microglobulin
119
B2 microglobulin is stable in serum or plasma?
In urine: ____pH [degrades slowly/rapidly]
Normal value:
serum
<6. 0
rapidly
0.9 – 2.5 mg/L
120
enumerate angiogenic factors
VEGF
alpha/beta FGF [acidic/basic fibroblast]
TGF alpha
121
Molecular dx for susceptibility
BRCA1/2
Adenomatous polyposis colin gene
122
when cell cycle is mutated what happens?
INC
genetic instability
cellular evolution
malignancy progression
123
EC stimuli [signal transduction]
Antigens
hormones
cytokines
C-erbB2
TGF B2
EGF
Nerve GF
124
apoptosis markers [3]
Bcl2
Fas ligand
P53
125
EGP/Oncogenes/ k-ras
Tumor suppresor/Cell Cycle regulators [3]
BRCA 1
Cyclins
P53
126
Adhesion molecules
selectins
integrins
Ig family
127
Loss of cell adhesion proteins
B-catenin
E-cadherin
