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Flashcards in Tumor Markers Deck (58):
1

what is a tumor?

abnormal growth of cells (benign or malignant)

2

what are environmental contributors of tumors?

tobacco (1a or 2a)
benzene
excess EtOH
dietary (charred meat)
poisonous mushrooms
excessive sun exposure
genetics
obesity
radiation
HPV, HIV, Hepatitis B

3

what are the major factors that affect cancer?

location of origin
cell type
stage at diagnosis
resection

4

what is a tumor marker?

blood or urine test that is used to diagnose a malignancy, monitor recurrence, monitor treatment or screening

5

AFP

alpha-feta protein
-glycoprotein produced by fetal liver

6

when is the AFP elevated?

pregnancy
HCC (hepatocellular carcinoma)
gonadal cancers
gastric cancer and others

7

what is the diagnostic level of AFP if the pt is at a high risk for HCC?

serum levels of >500 mcg/L

8

what are the normal levels of AFP?

0-8 ng/mL

9

HCC is normally seen in what type of pt?

cirrhosis, chronic liver disease, hepatitis

10

what are the symptoms of HCC?

vague abdominal pain
unexplained weight loss
elevated LFT
feel a mass
early satiety (full to easy)
obstructive jaundice
hepatomegaly
ascites (fluid leaking out of the liver)
paraneoplastic syndrome

11

hypercalcemia of malignancy

common in cancer patients

12

testicular cancers

germ cell tumors
-one of the most curable solid neoplasms

13

seminoma

most common type of testicular cancer

14

nonseminoma

less common type of testicular cancer

15

what is the current 5 yr survival rate of testicular cancer

>95%
-mostly they present as stage 1
-use of platinum based combination chemotherapy
-highly sensitive tumor markers to detect residual tumor

16

when is LDH used?

as a tumor marker for melanoma, lymphoma, leukemia, testicular cancer

17

which tumor markers should be elevated in nonseminoma germ cell tumors

AFP and or beta hCG

18

NSGCT

non-seminomal germ cell tumor

19

when would you use AFP?

monitoring response to treatment or as a screening tool for high risk patients

20

when would you use beta hCG

follow treatment because the tumor will produce it

21

what does LDH stand for?

lactate dehydrogenase

22

why would LDH increase

increased cell turnover in malignancies, which is why the LDH will rise

23

melanoma

bad dog, five year survival rate depends on stage of disease at the time of diagnosis

24

what are considered the "major" features

change in size
change in color
change in shape

25

what are considered the "minor" features

inflammation
bleeding or crusting
sensory change
lesion diameter

26

which tumor marker do you use with melanoma?

LDH

27

what tests will you do with melanoma?

CBC
serum LDH
chest xray for baseline (melanoma loves to met to the lungs)
CMP

28

what are the main four classes of lymphoma

ALL, CLL, AML, CML
lymphoblastic or myeloblastic

29

when are most blood cancers detected?

stage III or stage IV

30

what is the prognosis with acute leukemias?

AML, ALL
rapidly fatal if untreated

31

what is the prognosis for chronic leukemias

CML, CLL
may survive for years with modest treatment

32

NHL

non-Hodgkin lymphoma

33

classifications of lymphomas

Hodgkin or non
B-cells or T-cells

34

CEA

carcinoembrionic antigen (0-3 ng/mL)

35

what is CEA?

oncofetal protein that is elevated in the serum of pts with a variety of cancers including CRC (colorectal cancer)

36

why is CEA not a good screening marker?

it can be elevated in a lot of other things as well, smoker, UC, gastritis, peptic ulcer, diverticulitis

37

why would you use CEA?

established colon cancer
-CEA should return to baseline after complete resection (tumor would be present if it doesn't)
-make sure they are not on chemo (can irritate GI and cause CEA to be falsely high)

38

CA 19-9

tumor marker related to the pancreatic hepatobiliary (very sensitive and specific)
used to diagnose
pancreatic cancer
cholangiocarcinoma
-bile duct
-gall bladder cancer

39

what is the best mode of action for pancreatic cancer?

surgical resection is the only potential curative treatment

40

what are the tumor markers for breast cancer?

CA 15-3
CA 27-29

41

invasive breast cancer

not sure

42

in situ breast cancer

not sure

43

when would you use CA 15-3 and CA 27-29

follow pts with previous occurrence of br CA
-more useful in metastatic disease rather than screening
-if it goes up, I am wanting to follow it

44

CA 125

ovarian cancer tumor marker
-early stage 50% show elevation
-late stage 80% show elevation

45

when are most ovarian cancers discovered?

stage III

46

CA 125 can also be elevated in

other issues that have to do with the gut

47

PSA (prostate specific antigen)

**may be used for screening***
glycoprotein expressed by both normal and neoplastic prostate tissue
-consistently expressed in nearly all prostate cancers

48

normal range of PSA

<4 ng/mL

49

PSA range can change according to

age (prostate size increases with age)

50

what can influence prognosis?

ethnicity (AAM may have more aggressive, diagnosed later, asian men have few and WM have lower "normal" range of PSA)

51

what are markers for carcinoid tumor?

5HIAA
Seratonin
Chromagranin A (byproducts that the tumor produces)

52

where are carcinoid tumors most common

GI, lung

53

what type of test is 5HIAA

urine

54

carcinoid tumor

tumor itself

55

carcinoid syndrome

constellation of symptoms that may continue even after resection

56

what is the normal value for SPEP?

not observed

57

SPEP

used to specifically look for an abnormal protein (monoclonal protein)
-used to diagnose multiple myeloma (cancer of the bone marrow)

58

multiple myeloma

body makes abnormal plasma cells that go out into the blood

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