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Flashcards in Tumor Markers Deck (42)
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1

Tumor Marker Makeup

Proteins produced in response to cancer growth or from cancerous tissue

Can be specific or seen in multiple cancer types

2

Tumor Risk Factors

Genetic mutations

IVDMIA

3

IVDMIA

(in vitro Diagnostic Multivariate Index Assay)

Tests available to detect mutations and offer “risk index”

4

Apoptosis

Programmed cell death, self-destruction

5

Angiogenesis

New blood vessel formation, typically embedded within a tumor, allows tumor cells entry into circulation

6

Benign

Tumor at the primary site, small risk

7

Cancer

Abnormal cell growth, proliferation and/or differentiation

8

Hyperplasia

Multiplication of cells within an organ or tissue, may be controlled by stimuli as a normal response

9

Malignant

Tumor aggressive progress, infiltration, high risk

10

Metastasis

Uncontrolled proliferation involving numerous tumor cells and host cells interactions. Penetration into adjacent tissue of primary site, circulatory system, and spread to distant organs.

11

Neoplasia

Normal cells under cancerous proliferation due to hyperplasia, which is unregulated.

12

Tumor Marker Utilization

  • Screening
  • Diagnosis
  • Staging
  • Determine prognosis
  • Guidance of Treatment
  • Monitor Treatment
  • Determine recurrence

13

Tumor Marker Utilization: Screening

Useful for patients with a strong family history of a particular cancer. Example: PSA prostate cancer

14

Tumor Marker Utilization: Diagnosis

In patients with specific clinical symptoms, tumor markers can help identify the source of the cancer and differentiate from other conditions

Examples: CA-125, BRCA1 and BRCA 2

15

Tumor Marker Utilization: Staging

If a patient does have cancer, tumor marker elevations can be used to help determine how far the cancer has spread into other tissues and organs.

16

Tumor Marker Utilization: Determine prognosis

Some tumor markers can be used to help doctors determine how aggressive a cancer is likely to be.

17

Guidance of Treatment

Some tumor markers can provide information about what treatments their patients may have the best response.

Breast cancer patients who are Her2/neu positive are more likely to respond to Herceptin treatment).

18

Monitor Treatment

Tumor markers can be used to monitor the effectiveness of treatment, especially in advanced cancers. If the marker level drops, the treatment is working; if it stays elevated, adjustments are needed.

Colorectal cancer and CEA testing: information must be used with care; not every colorectal cancer patient will have elevated levels of CEA.

19

Determine recurrence

To monitor for cancer recurrence - If a tumor marker is elevated before treatment, low after treatment, and then begins to rise over time, then it is likely that the cancer is returning. (If it remains elevated after surgery, then chances are that not all of the cancer was removed)

20

Tumor Grades

Well differentiated

Poorly differentiated

Anaplastic (without body)

21

Tumor Marker Classifications

Enzymes

Hormones

Oncofetal Infections

Tumor antigens

Genetic Markers

22

Enzymes

Catalytic activity vs mass measurements, detected with Immunoassays

23

Hormones

Immunoassay detection

24

Oncofetal Infections

AFP, CEA, PSA

25

Tumor antigens

CA125, CA15-3, CA19-9

26

Genetic Markers

Oncogene and tumor suppressor mutations

27

Prostate Specific Antigen, level indications

  • Enzyme with protease activity in Prostate tissue
  • Exists in serum as bound (complexed with another protease inhibitor) or free, higher free PSA ratio in normal, healthy patients
  • Total PSA: 2.6-4ng/mL indicates early development
  • 4-10mg/mL is diagnostic gray zone
  • >10ng/mL have a 50% chance of having cancer

28

hCG (Human Chorionic Gonadotropin)

  • Synthesized by trophoblast calls in placenta (used for pregnancy detection), made of 2 Alpha and Beta units
  • Beta is specific to hCG
  • Increased levels assoc. with Trophoblastic tumors, choriocarcinoma, testicular tumors, ovarian tumors
  • Immunoassay uses ß-hCG

29

Oncofetal Proteins

Normally produced in fetal tissues, then decline after birth

A rise later in life (60yrs) can indicate cancer formation

30

AFP (Alpha feto protein)

  • Marks Liver and Germ cell carcinoma, can also appear in viral hepatitis and chronic active hepatitis 
  • Serum levels correlate to Liver tumor size
  • During pregnancy increased levels indiacte spina bifida, neural tube defects, and fetal distress; lowered levels indicate Down's Syndrome
  • Normal adult levels should be lower than 20ng/mL
  • Found via enzyme immunoassay