Tumor markers Flashcards
(221 cards)
1
Q
Produces benign/malignant cell in response to malignancy
A
TUMOR MARKERS
2
Q
Aid in Dx & characterization of diseases/cancer
A
TUMOR MARKERS
3
Q
Potential use for Tx of cancer
A
TUMOR MARKERS
4
Q
Most common non-cancerous tumor found in the uterus
A
Fibroids
5
Q
Most common fibroid
A
Myoma
6
Q
Most common benign neoplasm
A
Lipoma
7
Q
Fat accumulation, common in girls
A
Lipoma
8
Q
second leading cause of mortality
A
CANCER
9
Q
uncontrolled growth of cells that often forms a solid mass or tumor (neoplasm) and spreads to other areas of the body
A
CANCER
10
Q
metastasizes especially if not treated early on
A
CANCER
11
Q
not yet metastasized, mistakenly Dx as malignant especially if large, they can enlarge but not metastasize
A
Benign
12
Q
has now metastasized
A
Malignant
13
Q
poor prognosis, high mortality rate
A
Tumor
14
Q
tumor formation
A
Tumor Regenesis
15
Q
spread of tumor
A
Metastasis
16
Q
MMPs
A
matrix-metalloproteinase
17
Q
degrades extracellular membrane of blood vessels, allows entry of cancer cells)
A
MMPs
18
Q
Stage 1 Cancer staging and Progression
A
localized primary tumor
19
Q
Stage 2 Cancer staging and progression
A
invasion of primary tumor through epithelium and into blood vessels
20
Q
Stage 3 Cancer staging and progression
A
migration of tumor into regional lymph node
21
Q
Stage 4 Cancer staging and progression
A
Metastasis and invasion of tumor to distant tissues
22
Q
Factors affecting cancer severity:
A
- Tumor size
- Histology: what cells are found in the tumor
- Regional lymph node involvement (if affected: malignant neoplasm)
- Metastasis
23
Q
TUMOR MARKER that Monitors chemotherapy
A
serum proteins (β2-macroglobulin)
24
Q
TUMOR MARKER for AFP and CEA
A
oncofetal antigens
25
oncofetal antigen usually involved in fetal devt / women’s pregnancy
AFP
26
oncofetal antigen for one of the earlier tumor markers
CEA
27
TUMOR MARKER Increased in malignancy
hormones (calcitonin, β-hCG)
28
TUMOR MARKER increased in breast cancer
Her-2
29
TYPES OF TUMOR MARKERS:
serum proteins (β2-macroglobulin)
oncofetal antigens (AFP, CEA)
hormones (calcitonin, β-hCG)
carbohydrate epitopes/cancer antigens (CA-125)
receptors (estrogen receptors, Her-2/neu)
enzymes (ALP)
30
Transports metal ions in fetal blood circulation
AFP
31
Produced by GIT in fetal development
CEA
32
Tumor marker present in Screening
PSA
33
Tumor marker in Diagnosis
Metanephrines
HVA/VMA
PTH
PROLACTIN
CHROMOGRANIN A
CORTISOL
ACTH
34
Tumor marker in Prognosis
B2-macroglobulins
CA 125
CEA
LD
HER2/neu
ER
PR
35
Tumor markers present in Monitoring treatment
CA 125
CA 19-9
CEA
AFP
PSA
hCG
SPE
36
Tumor markers present in Detection of recurrence
CA 15-3
CA 125
CEA
PSA
AFP
hCG
37
prostate cancer tumor marker
PSA
38
METHOD for Prostate cancer
IA
39
Prostate cancer screening; therapy monitoring and recurrence
PSA
40
tumor marker for Hematologic malignancies
Lactate Dehydrogenase (LDH)
β2-microglobulin
41
method for LDH
EA
42
Prognostic indicator; elevated nonspecifically in numerous cancer
Lactate Dehydrogenase (LDH)
43
tumor marker for Metastatic carcinoma of bone, hepatocellular carcinoma, osteosarcoma, lymphoma, leukemia
Alkaline Phosphatase (ALP)
44
method used for Metastatic carcinoma of bone, hepatocellular carcinoma, osteosarcoma, lymphoma, leukemia
EA
45
Determination of liver and bone involvement; nonspecific elevation in many bonerelated and liver cancers
Alkaline Phosphatase (ALP)
46
tumor marker for Neuroendocrine tumors
Neuron specific enolase
47
method used for Neuroendocrine tumors
RIA, IHC
48
Prognostic indicator and monitoring disease progression for neuroendocrine tumors
Neuron specific enolase
49
specimen used for enzyme tumor markers
serum
50
specimen for protein tumor markers
serum
51
TUMOR MARKER for Plasma cell dyscariasis
Serum M protein
Serum-free light chains
52
METHOD for Serum M protein
SPE/IFE
53
Diagnosis, therapeutic monitoring of plasma cell malignancies
Serum M protein
Serum-free light chains
54
method for Serum-free light chains
IA
55
tumor marker for Hematologic malignancies
β2-microglobulin
LDH
56
method for β2-microglobulin
IA
57
Prognostic marker for lymphoproliferative disorders
β2-microglobulin
58
specimen for endocrine tumor markers
serum
59
TUMOR TYPE for Prostate specific Antigen (PSA)
Prostate cancer
60
TUMOR TYPE for Lactate Dehydrogenase (LDH)
Hematologic malilgnancies
61
TUMOR TYPE for Alkaline Phosphatase (ALP)
Metastatic carcinoma of bone,
hepatocellular carcinoma,
osteosarcoma,
lymphoma,
leukemia
62
TUMOR TYPE for Neuron specific enolase
Neuroendocrine tumors
63
TUMOR TYPE for Serum M protein
Plasma cell dyscariasis
64
TUMOR TYPE for Serum-free light chains
Plasma cell dyscariasis
65
TUMOR TYPE for β2-microglobulin
Hematologic malignancies
66
TUMOR MARKER for
Pituitary adenoma,
ectopic ACTH-producing tumor
ACTH
67
METHOD for ACTH
IA
68
Diagnosis of ectopic ACTH producing tumor
ACTH
69
tumor type for ACTH
Pituitary adenoma,
ectopic ACTH-producing tumor
70
TUMOR MARKER for Posterior pituitary tumors
ADH
71
METHOD for ADH
IA
72
Diagnosis of SIADH
ADH
73
tumor type for ADH
Posterior pituitary tumors
74
TUMOR MARKER for Insulin-secreting tumors
C-peptide
75
method for c peptide
ELISA, IA
76
Diagnosis of insulinoma
C-peptide
77
tumor type for c peptide
Insulin-secreting tumors
78
TUMOR MARKER for MTC and neuroendocrine tumors
Calcitonin
79
method for calcitonin
IA
80
Screening family members (with history of MTC & neuroendocrine turmors), response to therapy, monitoring occurrence of MTC
Calcitonin
81
tumor type for calcitonin
MTC and neuroendocrine tumors
82
tumor marker of Pheochromocytoma,
neuroblastoma, carcinoid tumors, small cell lung cancers
Chromogranin A
83
method for Chromogranin A
ELISA, RIA
84
tumor markers for Adrenal tumors
Cortisol
85
method for Cortisol
IA
86
Diagnosis of Cushing’s syndrome,
adrenal adenoma
Cortisol
87
tumor type of Cortisol
Adrenal tumors
88
tumor marker for Neuroendocrine tumor aside from neuron-specific enolase
Gastrin
89
method for gastrin
IA
90
Zollinger-Ellison syndrome,
gastrinoma
Gastrin
91
tumor type for Gastrin
Neuroendocrine tumor
92
tumor markers for Pituitary adenoma, ectopic GH-secreting tumors
GH
93
method for GH
IA
94
Diagnosis and post-monitoring of acromegaly
GH
95
tumor type for GH
Pituitary adenoma, ectopic GH-secreting tumors
96
tumor type for PTH
Parathyroid adenoma
97
method for PTH
IA
98
Diagnosis and postsurgical monitoring of parathyroid adenoma
PTH
99
tumor type for PTH
Parathyroid adenoma
100
tumor marker for Pituitary adenoma
PRL
101
tumor type for PRL
Pituitary adenoma
102
method for PRL
IA
103
Diagnosis and postsurgical monitoring of prolactinoma
PRL
104
endocrine tumor markers that requires 24 hr urine specimen
HVA
5-HIAA
Metanephrines(fractionated –metanephrine, normetanephrine)
VMA
105
TUMOR MARKER for Neuroblastoma, pheochromocytoma, paraganglioma
HVA
106
METHOD for HVA
HPLC
107
Diagnosis of neuroblastoma
HVA
VMA
108
tumor type for HVA
Neuroblastoma,
pheochromocytoma,
paraganglioma
109
TUMOR MARKER for Carcinoid tumors
5-HIAA
110
tumor type for 5-HIAA
Carcinoid tumors
111
method for 5-HIAA
HPLC
112
Diagnosis of carcinoid tumors
5-HIAA
113
tumor marker for Pheochromocytoma, paraganglioma, neuroblastoma
Metanephrines(fractionated –metanephrine, normetanephrine)
VMA
114
tumor type for Metanephrines(fractionated –metanephrine, normetanephrine)
Pheochromocytoma, paraganglioma, neuroblastoma
115
method for Metanephrines(fractionated –metanephrine, normetanephrine)
HPLC
116
Screening and diagnosis of pheochromocytoma
Metanephrines(fractionated –metanephrine, normetanephrine)
117
method for VMA
HPLC
118
TUMOR MARKER for Gastrointestinal cancer and adenocarcinoma
CA 19-9
119
tumor type of CA 19-9
Gastrointestinal cancer and adenocarcinoma
120
method for CA 19-9
IA
121
Monitoring pancreatic cancer
CA 19-9
122
method of CA 19-9
IA
123
tumor marker for Metastatic breast cancer
CA 15-3
124
method for CA 15-3
IA
125
tumor marker for Metastatic breast carcinoma
CA 27-29
126
tumor type for CA 27-29
Metastatic breast carcinoma
127
methods for CA 27-29
Metastatic breast carcinoma
128
method for CA 27-29
IA
129
tumor marker for Ovarian cancer
CA 125
130
tumor type for CA 125
Ovarian cancer
131
method for CA 125
IA
132
specimen for Carbohydrate and Cancer Antigen Tumor Markers
Serum
133
tumor marker for breast cancer
Estrogen receptor
Progesterone receptor
134
tumor marker for Hormonal therapy indicator
Estrogen receptor
Progesterone receptor
135
tumor type for Estrogen receptor
Breast cancer
136
tumor type for Progesterone receptor
Breast cancer
137
method for Estrogen receptor
IHC
138
method for Progesterone receptor
IHC
139
tumor marker for Breast, ovarian, gastrointestinal tumors
Her-2/neu
140
tumor type for Her-2/neu
Breast, ovarian, gastrointestinal tumors
141
methods for Her-2/neu
IHC, FISH, ELISA
142
tumor marker for Head, neck, ovarian, cervical cancers
Epidermal growth factor receptor
143
tumor type for Epidermal growth factor receptor
Head, neck, ovarian, cervical cancers
144
method for Epidermal growth factor receptor
IHC
145
Receptor Tumor Markers
Estrogen receptor
Progesterone receptor
Her-2/neu
Epidermal growth factor receptor
146
Receptor Tumor Markers SPECIMEN
Biopsy
147
most commonly used method to measure tumor markers
IMMUNOASSAY
148
span of analyte concentrations over which a linear relationship exists between the analyte and signal
Linear range
149
Considerable factors in IMMUNOASSAY
• Linearity
• Antigen Excess (Hook Effect)
• Heterophile Antibodies
150
excessively high tumor marker concentration can result in falsely low measurements
Hook effect (antigen excess)
151
excessively high tumor marker concentration can result in falsely low measurements in Hook effect (antigen excess)
why??
Because all Ag has bound to all available Ab in the test
152
Hook effect (antigen excess)
Resolution:
Dilute sample
153
Human anti-mouse Antibodies (HAMAs)
Heterophile Antibodies
154
red plasma
Hemolysis
155
fatty plasma
Lipemia
156
yellowish plasma
Icterus
157
commonly used for detection of small molecules (e.g. endocrine antibodies)
High Performance Liquid Chromatography
158
used to detect catecholamine metabolites in plasma and urine
High Performance Liquid Chromatography
159
common malignant tumor (occurring in children under 15 years old)
Neuroblastoma
160
Neuroblastoma diagnosis:
↑ epinephrine, norepinephrine, and dopamine
161
rare tumor associated with hypertension
Pheochromocytoma
162
Pheochromocytoma diagnosis:
↑ metanephrines(w/ urine vanillylmandelic acid and free catecholamines)
163
serotonin-secreting tumors
Carcinoid Tumor
164
arise from small intestine, appendix, or rectum
Carcinoid Tumor
165
Carcinoid Tumor diagnosis:
5-HIAA
166
pronounced flushing, bronchial constriction, cardiac valve lesions, diarrhea
carcinoid syndrome
167
utilizes tissues; biopsy
Immunohistochemistry and Immunofluorescence
168
utilizes colorimetric & fluorescent secondary Antibodies
Immunohistochemistry and Immunofluorescence
169
provides info on how to treat a certain type of cancer• apply reagents directly to histo slides
Immunohistochemistry and Immunofluorescence
170
Frequently ordered tumor markers:
a-fetoprotein
CA 125
CEA
PSA
hCG
171
abundant serum protein normally synthesized by the fetal liver that is re-expressed in certain types of tumors
α-Fetoprotein (AFP)
172
hepatocellular carcinoma (HCC) and germ cell tumors
carcinoembryonic protein
173
re-expressed AFP during malignancy
carcinoembryonic protein
174
• Peaks at 30 weeks gestation
• Upper normal limit: 15ng/mL per AFP
• May also increase in pregnancy, liver disease and testicular cancer
• should not increase in healthy adults otherwise malignancy is present.
AFP
175
For diagnosis, staging, prognosis and treatment monitoring of HCC
AFP
176
hepatoma
Hepatocellular carcinoma (HCC)
177
tumor originating in the liver due to chronic illnesses (e.g. hepatitis and cirrhosis)
Hepatocellular carcinoma (HCC)
178
Testicular Cancer classification:
seminomatous
nonseminomatous
179
Testicular Cancer Stage I
10-20% ↑ AFP
180
Testicular Cancer Stage II
50-80% ↑ AFP
181
Testicular Cancer Stage III
90-100% ↑ AFP
182
a germ cell tumor with no increase in hCG and increase in AFP
yolk sac tumor (endodermal sinus tumor)
183
germ cell tumor with no increase in AFP and increased in hCG
Choriocarcinoma
184
germ cell tumor with increased AFP and +/- hCG
embryonal carcinoma
185
germ cell tumor with no increase in AFP and hCG
teratoma
186
germ cell tumor with no elevation in AFP in pure tumors and +/- hCG
seminoma
187
Cancer Antigen 125 (CA 125) Normal value:
35 units per mL
188
Hepatocellular carcinoma (HCC)
↑ AFP (_____ng/mL);
↑ AFP (500ng/mL);
189
useful in detecting ovarian tumors at an early stage
Cancer Antigen 125 (CA 125)
190
✓ 3% newly diagnosed malignancies
✓ Top 5 cause of cancer related death
Cancer Antigen 125 (CA 125)
191
expressed in the human ovarian carcinoma
Cancer Antigen 125 (CA 125)
192
↑ endometriosis, first trimester of pregnancy, menstruation
Cancer Antigen 125 (CA 125)
193
Cancer Antigen 125 (CA 125)
Stage I
50% ↑ CA 125
194
Cancer Antigen 125 (CA 125)
Stage II
90% ↑ CA 125
195
Cancer Antigen 125 (CA 125) Stage III and IV
>90% ↑ CA 125
196
• Not entirely common
• improved specificity than CA-125
• less frequently elevated in non-malignant conditions (endometriosis)Methodology (CA-125)
Human epididymis protein 4 (HE4)
197
• most widely used tumor marker for colorectal cancer
• diagnosis, prognosis and therapy monitoring
• frequently elevated in lung, breast, and gastrointestinal cancer
• non-specific; not used for screening
Carcinoembryonic Antigen (CEA)
198
↑ heavy smokers, some patients following radiation• treatment and chemotherapy, liver damage (due to prolonged clearance)
Carcinoembryonic Antigen (CEA)
199
Carcinoembryonic Antigen (CEA) upper normal range:
2.5 to 5 ng/mL
200
TNM Staging
• T -tumor size and involvement or invasion of nearby tissue
• N -regional lymph nodes involvement
• M -metastasis; extent of tumor spreading from one tissue to another
201
elevated in trophoblastic tumors –choriocarcinoma and germ cell tumors of the ovary and testes
Human Chorionic Gonadotropic (hCG)
202
prognostic indicator of ovarian cancer
Human Chorionic Gonadotropic (hCG)
203
considered a serological marker for ovarian cancer
CA 125
204
Human Chorionic Gonadotropic (hCG) positive for males
testicular cancer
205
• useful marker for detection of gestational trophoblastic diseases (GTDs)
Human Chorionic Gonadotropic (hCG)
206
GTDs > ________ mIU/mL
GTDs > 100,000 mIU/mL
207
not FDA approved as a tumor marker
hCG
208
GTDs should be accompanied by:
1. Careful clinical history assessment
2. Ultrasound
3. histology
209
regulates seminal fluid viscosity; dissolves cervical mucus cap to allow entry of sperm
Prostate-Specific Antigen (PSA)
210
low circulating levels in healthy men
Prostate-Specific Antigen (PSA)
211
Prostate-Specific Antigen (PSA) 2 forms:
free and complexed
212
may increase in benign prostatic hyperplasia (BPH) (normal in older men, associated with aging)
Prostate-Specific Antigen (PSA)
213
complex with certain protein particularlya-1 antichemotrypsin & a-2 macroglobulin
Complexed PSA
214
condition which men has enlarged prostate gland but not cancerous
BPH
215
Prostate-Specific Antigen (PSA) normal value:
<4 ng/mL
216
Prostate-Specific Antigen (PSA) screening should include
digital rectal examination (DRE)
217
<1 ng/mL prevalence in patient in %
6-10
218
1-4 ng/mL prevalence in patients in %
17-25
219
4-10 ng/mL prevalence in patients in %
20-30
220
>20 ng/mL prevalence in patients in %
>80
221
A good tumor marker should:
• Be highly sensitive
• Be highly specific
• Be 100% accurate in differentiating between healthy individuals and cancer patient
• Be able to differentiate malignant and benign neoplasm
• Predict early stage and early recurrence
• Be used as screening
• Be easily assayed and monitor treatment
