Flashcards in Tumor Markers Deck (58)
what is a tumor?
abnormal growth of cells (benign or malignant)
what are environmental contributors of tumors?
tobacco (1a or 2a)
dietary (charred meat)
excessive sun exposure
HPV, HIV, Hepatitis B
what are the major factors that affect cancer?
location of origin
stage at diagnosis
what is a tumor marker?
blood or urine test that is used to diagnose a malignancy, monitor recurrence, monitor treatment or screening
-glycoprotein produced by fetal liver
when is the AFP elevated?
HCC (hepatocellular carcinoma)
gastric cancer and others
what is the diagnostic level of AFP if the pt is at a high risk for HCC?
serum levels of >500 mcg/L
what are the normal levels of AFP?
HCC is normally seen in what type of pt?
cirrhosis, chronic liver disease, hepatitis
what are the symptoms of HCC?
vague abdominal pain
unexplained weight loss
feel a mass
early satiety (full to easy)
ascites (fluid leaking out of the liver)
hypercalcemia of malignancy
common in cancer patients
germ cell tumors
-one of the most curable solid neoplasms
most common type of testicular cancer
less common type of testicular cancer
what is the current 5 yr survival rate of testicular cancer
-mostly they present as stage 1
-use of platinum based combination chemotherapy
-highly sensitive tumor markers to detect residual tumor
when is LDH used?
as a tumor marker for melanoma, lymphoma, leukemia, testicular cancer
which tumor markers should be elevated in nonseminoma germ cell tumors
AFP and or beta hCG
non-seminomal germ cell tumor
when would you use AFP?
monitoring response to treatment or as a screening tool for high risk patients
when would you use beta hCG
follow treatment because the tumor will produce it
what does LDH stand for?
why would LDH increase
increased cell turnover in malignancies, which is why the LDH will rise
bad dog, five year survival rate depends on stage of disease at the time of diagnosis
what are considered the "major" features
change in size
change in color
change in shape
what are considered the "minor" features
bleeding or crusting
which tumor marker do you use with melanoma?
what tests will you do with melanoma?
chest xray for baseline (melanoma loves to met to the lungs)
what are the main four classes of lymphoma
ALL, CLL, AML, CML
lymphoblastic or myeloblastic
when are most blood cancers detected?
stage III or stage IV
what is the prognosis with acute leukemias?
rapidly fatal if untreated
what is the prognosis for chronic leukemias
may survive for years with modest treatment
classifications of lymphomas
Hodgkin or non
B-cells or T-cells
carcinoembrionic antigen (0-3 ng/mL)
what is CEA?
oncofetal protein that is elevated in the serum of pts with a variety of cancers including CRC (colorectal cancer)
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
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)
tumor marker related to the pancreatic hepatobiliary (very sensitive and specific)
used to diagnose
-gall bladder cancer
what is the best mode of action for pancreatic cancer?
surgical resection is the only potential curative treatment
what are the tumor markers for breast cancer?
invasive breast cancer
in situ breast cancer
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
ovarian cancer tumor marker
-early stage 50% show elevation
-late stage 80% show elevation
when are most ovarian cancers discovered?
CA 125 can also be elevated in
other issues that have to do with the gut
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
normal range of PSA
PSA range can change according to
age (prostate size increases with age)
what can influence prognosis?
ethnicity (AAM may have more aggressive, diagnosed later, asian men have few and WM have lower "normal" range of PSA)
what are markers for carcinoid tumor?
Chromagranin A (byproducts that the tumor produces)
where are carcinoid tumors most common
what type of test is 5HIAA
constellation of symptoms that may continue even after resection
what is the normal value for SPEP?
used to specifically look for an abnormal protein (monoclonal protein)
-used to diagnose multiple myeloma (cancer of the bone marrow)